Heme and GI 1B Flashcards by Aaron Sircy

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)

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Mantle Cell lymphoma has genetic properties?

What does the cyclin allow?

t(11;14) of cyclin D1

CD5+++++++++

G1/S phase

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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

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What is the DDX of toxoplasmosis assuming there is a ring enhancing lesion on MRI?

EBV infection, Primary Central Nervous System lymphoma

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Adult T cell lymphoma has what CD markers?

What is the virus?

CD4 and CD 30

HTLV

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Adult T cell lymphoma has lytic bone lesions, hypercalcemia, cutaneous lesions, common in Japan, what is the DDX?

Multiple Myeloma

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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

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What is CD15 and CD30, Pax 5 positive?

Hodgkin Lymphoma

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Hodgkin Lymphoma: Mixed Cellularity, what is the main item seen with it?

What is the main IL marker?

eosinophillia

IL-5

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What Hodgkin lymphoma has the best outcome?

Nodular Sclerosis, Broad Bands of Fibrosis

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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

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What is the typical translocation for ALL?

Where would ALL spread too, may need special help with chemo?

t(12;21)

CNS and Testes

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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

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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)

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What is this from?

Assuming we have a leukemia?

CLL smudge cell

THis has dead background artifact

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When there is filamentous, hair-like projections?

No peripheral lymphadenopathy

But what kind of spleenomegaly?

Hairy Cell Leukemia

Red Pulp Massive Splenomegaly

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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

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AML has a positive stain for what?

What is seen on the peripheral smear?

Myeloperoidase +

circulating myeloblasts, commonly presents with DIC

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What is the AML genetic mutation?

What is the treatment?

APL t(15;17)

all-trans retinoic acid and arsenic

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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

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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