Heme and GI 1B Flashcards
When we have Follicular lymphoma, what is DDX between this and Follicular Hyperplasia?
What are the genetics for Follicular Lymphoma?
Follicular Hyperplasia: tingible body in GC express Bcl-2
Follicular Lymphoma: no tingible macrophages, disrupts architecture
t(14;18) BCL-2 (inhibits apoptosis)
Mantle Cell lymphoma has genetic properties?
What does the cyclin allow?
t(11;14) of cyclin D1
CD5+++++++++
G1/S phase
Marginal Zone has a unique treatment, what is it?
What is the genetic properities? What are the CD markers?
can treat with antibiotics
t(11;18) CD19, CD20
What is the DDX of toxoplasmosis assuming there is a ring enhancing lesion on MRI?
EBV infection, Primary Central Nervous System lymphoma
Adult T cell lymphoma has what CD markers?
What is the virus?
CD4 and CD 30
HTLV
Adult T cell lymphoma has lytic bone lesions, hypercalcemia, cutaneous lesions, common in Japan, what is the DDX?
Multiple Myeloma
What is the CD marker for Pautrier Microabscess?
What is Mycosis fungoides, cutaneous T cell lymphoma?
CD4 and CD 30
Skin patches and plaques, cutaneous T cell lymphoma
Look out for cerebriform nuclei
What is CD15 and CD30, Pax 5 positive?
Hodgkin Lymphoma
Hodgkin Lymphoma: Mixed Cellularity, what is the main item seen with it?
What is the main IL marker?
eosinophillia
IL-5
What Hodgkin lymphoma has the best outcome?
Nodular Sclerosis, Broad Bands of Fibrosis
ALL: what is the main marker for pre-T and pre-B cells?
TDT+
pre-B cells: CD10, CD19, CD20
Pre-T cells: CD 2 and CD 8
What is the typical translocation for ALL?
Where would ALL spread too, may need special help with chemo?
t(12;21)
CNS and Testes
In the world of Leukemias:
Down Syndrome after the age of 5?
Down Syndrome before the age of 5?
Acute Lymphoblastic Leukemia
Acute Megakaryocyte Leukemia (elevated megakaryocytes), no MPO
CLL, is positive for what three things?
What can it transform too?
CD 5, CD 20, CD 23
Richter transformation into an aggressive lymphoma (DLBCL)
What is this from?
Assuming we have a leukemia?
CLL smudge cell
THis has dead background artifact
When there is filamentous, hair-like projections?
No peripheral lymphadenopathy
But what kind of spleenomegaly?
Hairy Cell Leukemia
Red Pulp Massive Splenomegaly
Hairy Cell Leukemia stains positive for TRAP.
What will a bone marrow biopsy have?
What is the mutation?
What does it have excellent response too?
Dry tap on aspiration
BRAF 600
2-CDA
AML has a positive stain for what?
What is seen on the peripheral smear?
Myeloperoidase +
circulating myeloblasts, commonly presents with DIC
What is the AML genetic mutation?
What is the treatment?
APL t(15;17)
all-trans retinoic acid and arsenic
What is the risk factor for AML?
What is the give away on a path stain?
Radiation, chemotherapy, myeloproliferative disorders
Auer Rods, activate the coagulation cascade
What glaring physical sign does AML have?
What is the DDX?
bleeding gums
Phenytonin use
What is the big give away for CML?
What is seen in high amounts on CML?
Granulocytes in different stages
basophils, low LAP
What is CML genetic issue?
What CD marker isnt there?
What can CML become?
t(9;22) BCR-ABL
no CD 20
AML or ALL –>Blast crisis
What is the obliteration of bone marrow with fibrosis due to low fiboblast activity?
What is seen on the path smear?
Myelofibrosis
Dacrocytes, extramedullary hematopoiesis
Increases PDGF, FYI
PCV Lung disease has what signs?
PCV reactive polycthemia has what signs?
Decreased SaO2 and Elevated EPO
Increased SaO2 and Elevated EPO, nucleated RBC (immature) in smear
If I have Leukoerthyroblastic Activity: myelofibrosis in action, why will there be more immature cells than normal?
The spleen does not have a reticulin gate, spleen, RBC, and WBC are immature cells in blood
What is Langerhans Cell Histiocytosis mutation?
What is the two markers?
BRAF 600E
CD1a and S-100
Langerhans Cell Histiocytosis has a mass located where?
Yes they have lytic bone lesions
What type of thing is seen on histology?
Mastoid Bone
Birbeck Granules
Name that Heme disease:
Langerhan’s over Front and back of Scalp
Hepatospleenomegaly
Skin Rash
Malignant
Less than 2 years old
Letter-Siwe Disease
What Heme disease is this:
Calvaral Bone defects
Floating Teeth
Malignant
Skin Rash
Hand-Schuller Christian Syndrome
What heme disease is no skin involvement
Bone Fracture
Langhan’s Cells
No Skin involvement
Benign?
Eosinophillic Granuloma
What is systemic overactivation of macrophages and cytotoxic T cells, fever, pancytopenia, hepatosplenomegaly?
Bone Marrow biopsy shows a macrophage phagocytosing marrow elements, what is elevated?
Hemophagocytic lymphohistiocytosis
Elevated Serum Ferritin levels
What heme issue arises when there is an increased surface area to volume ratio?
What heme issue arises when there is a decreased surface area to volume ratio?
Target Cells
Spherocytes
When I have the intrinsic anemias, what is the test that increases H.S. fragility?
What is a hallmark lab test for H.S.?
Osmotic Fragility
MCHC
What does pyruvate kinase deficiency, increase, that causes less oxygen binding affinity for hemoglobin?
2,3 BPG
Follicular Lymphoma has a BCL-2 problem, what is different about the lymph nodes?
They exhibit waxing and waning
If we have a polyposis syndrome issue, what is th most likely inheritance pattern?
Autosomal Dominant
Adenomatous Polyps have the following flavors, apparently, who is the most likely to be neoplastic
Tubular
Villous
Tubulovillous
Tubular: lowest
Villous: worst
Tubulovillous is medium
What polyp has intussception, bleeding, but no diarrhea?
What polyp has hypokalemia, diarrhea after stopping food?
Hamartomatous Polyps
Villous
When there is pain from postprandial epigastric pain, via intestinal hypoperfusion, when does the pain resolve?
2-3 hours
What GI issue has a thumbprint sign on imaging due to mucosal edema/hemorrhage?
The patient will have hematochezia and even currant jelly sputum
Colonic Ischemia
Ileus is another name for what?
intestinal hypomotility without obstruction
What is meconium ileus associated with?
Cystic Fibrosis
When there is necrotizing enterocolitis, we will have thin, curviliinear areas of lucancy that parallel the bowel wall, what area of the gut is this located?
terminal ileum and proximal colon
What has cardiac symptoms, arthralgias, neuro symptoms, with a PAS+ stain?
Whipple Disease
Celiac Disease has what two positive HLA things?
HLA-DQ2 and HLA-DQ8
What is longitudinal lacterations, due to severe vomiting, usually alcholics and bulimics?
Mallory-Weiss Syndrome
What is a transmural, usually distal esophageal rupture due to violent retching?
Boerhaave Syndrome
Basophilic Stippling is seen where?
Ringed Sideroblasts are seen where?
Seen in Peripheral Smear
Seen in Bone Marrow
Howell-Jolly Bodies are due to asplenia, what do they contain?
Basophilic nuclear remmants found in RBC
Alpha Thalassemia has two varieties, what the general race usually?
Cis Deletion
Trans Deletion
Asian
African
What general race has Beta Thalassemia?
Mediterranean populations
