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SUMMED2 > HEME-CA > Flashcards

HEME-CA Flashcards

1
Q

What has acute onset, cell type *immature, survival FATAL if untreated, Tx w/ Aggressive Chemo?

A

Acute Leukemia-maligant WBC in bone marrow and blood.
2/2- bone marrow failulre: Anemia, neutropenia, low platelet
AML- myeloid stem cell- WBC
ALL- Lymphod cell T.B

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2
Q

What has acute gradual, cell type *mature, survival LONG, Tx w/ ObservedChemo?

A

Chronic Leukemia

2/2- liver spleen, lymph nodes, meninges brain or skin

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3
Q

What are seen on smears that DX. AML?

A

Myeloblast Auer rods- pink rod like structure in cystomplasm+ large nucleus

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4
Q

Mr. Heme has hgb <8, thrompcytopenia 15K, coagulation. LABS WBC 60K, His gums are hypertrophy, petechia over arms, with CNS neurological deficits? What is TX

A

Acute Myeloid Leukemia-MC in adults
 Supportive care w/ transfusions
 Chemotherapy
 Stem cell transplant

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5
Q

What are the odds with AML if <60yo?

A
  1. Higher remission rates and more cures
  2. Better tolerance of therapy
  3. More options for therapy if AML relapses
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6
Q

What is ideal goal to DX cancer early?

A

cytogentics, FH, Social, Health status- Help determin who and kind of therapy

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7
Q

Children at 3-7yo is MC in what type of leukemia?

A

Acute Lymphoblastic leukemia- 80% acute, 2nd rise after 40

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8
Q

What would be seen on work up for ALL?

A
  • DEC or INC WBC
  • Peripheral blast with small cytoplasm, faint nucleus
  • Elevated LDH, uric acid
  • Bone marrow blast present
  • Lumbar puncture
  • CXR enlarged mediastinal mass (thymus-T/Bcell)
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9
Q

These indicate what in ALL?
o Profound anemia (pallor, lethargy, dyspnea)
o Neutropenia (fever, malaise, infxns of mouth, throat,)
o Thrombocytopenia (bruising, bleeding gums)

A

CP Signs of ALL Bone marrow failure

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10
Q

What are signs of infiltrated organs in ALL with children?

A

o Tender bones, LAD, HSM in 20% of pts
o CNS involvement in 6%-CSF
Fever, night sweats

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11
Q

What cell is detected up to 12mo after infusions, genetically modified from Pts cells that Binds to B cell?

A

CD19-targeting CAR T cells (CTL019)

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12
Q

What is typical presenation for a Pt w/ presence of Philadelphia Chromosome?

A

Chronic Myeloid Leukemia-
1. **Wt loss, nt sweats, fatigue-hypermetabolism 2. Male 40-60y any age 3. NORMOCYTIC anemia 4. Splenomegaly 5. Incidental finding from CBC- ** WBC >50-150, H/H <10.2, **Platelet >550K-bruising, epistaxis, 6. Platelet varies. 7. Smear Diff stages of mature cells. 8. incidental finding from 2/2 abdominal pain-splenomegaly 9. Bone marrow INC cells vs stroma

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13
Q

What does the PH chromosome result in d/t Tyrosin Kinase activation?

A
  1. Stem cell disorder
  2. Characterized by myeloproliferation
  3. Well-described clinical course- Majority will have rapid sustained response w/ any drug
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14
Q

This chemo agent inhibits Tyrosine Kinase for CML tX?

A

Imatinib

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15
Q

What is necessary to biopsy to determine progression from CML and tx in 6m?

A

Bone marrow

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16
Q

What should be considered if Pt who has 60% mature lymphocytes, WBC 17k, smear show *smudge cells, HgB low, and platelet low, with adenopathy?

A

B Cell Chronic Lymphocytic Leukemia- MC

60-80yo West.

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17
Q

What is the etiology of B cell CLL?

A

Cells accumulate in blood, bone marrow, liver, spleen and lymph nodes as a result of prolonged lifespan and impaired apoptosis. Old damaged lymphocytes and Low hypogammaglobuin

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18
Q

B/c B cell CLL is rare, and benign what is TX?

A

Doen’t cause much issues. IF SX: Chemotherapy, Monoclonal, FCR

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19
Q

Pt PMH of multiple infx, anemia, and splenomegaly W/O lynphadenopathy. But blood smear shows “hair cell’ TRAP+?

A

Hairy cell Leukemia

TX- high success, rare relapse

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20
Q

Pt c/o sore throat for 4w, night sweats, fever, fatigue. Mass noted on neck exam. Biopsy reveals B Cell lymphoma? DX

A

Non- Hogkins Lymphoma

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21
Q

What is signifiant about NON-Hodgkins?

A

very active to very indolent (silent)

Affect lymph nodes regionally

22
Q

What is different about CP for NHL?

A

Lymphadenopathy Asymmetric and painless

23
Q

What lab finding are sig. with NHL?

A

Anemia, Neurtopenia w/ infx or thrompcytpneia. Elevated LDH-cell tumor prolif

24
Q

What lab work up did your big bro have recent for his DDX sarcoidosis vs NHL?

A

Biopsy of lymph node. CBC, Chem panel, LDH, uric acid, serum protein electrophoresis
Bone marrow biopsy
NEVER FNA
Staging only CT

25
What is the low mortality rate consider a LOW grade NHL, with 10y and MC form of NHL?
Follicular Lynphoma
26
Which type of lymphona is assoc with Elevated IgM?
Lymphoplasmacytoid lymphoma
27
What type of NHL are below: 7. Diffuse large B cell lymphoma (31%) 8. Burkitt’s lymphoma 9. Lymphoblastic lymphoma
High grade non-Hodgkin’s lymphoma
28
What does RCHOP tx?
NHL- Rituxan, Cytoxan, Adriamycin, Vincristine, and Prednisone Outpatient or Hospital
29
What country has higher cure recepie for NHL?
OF COURSE FRANCE
30
When is Radiation therapy needed for NHL DLBCL?
IF limited stage- RCHOP followed by radiation. IF ADV w/ CTPET += radiation to abnormal area
31
What would be the work up on Pt w/ Left arm swelling pain, fatigue, SOB w/ exertion for 2 wks?
Left upper extremity DVT and CXR. PET/CT for mass staging. Referral if mass. Order Biopsy of bone marrow
32
This condition can be seen in any age(bimodal), fatigue, swelling in upper extremity, SOB, young adults, with HIGH rates in MEDIASTINAL?
Hodgkins Dz-Curable
33
Is PET/CT scan always necessary for DX of Hodgkin Lymphoma?
NO! unclear | Smear show nodule lymph nodes
34
If chemo and radiation are late treated in Hodgkins Lymphoma, then what are the risk?
secondary lung cancer, myelodysplasia, cardiac disease.
35
What will a Pt c/o that are signs of multiple myeloma?
C/o back pain, confusion, chronic fatigue, oliguria, constipation.
36
What are lab work up for signs of ARF and multiple myeloma?
``` Oliguria, SrCr HIGH 3 CMP- Ca HIGH-13 24hr urine HIGH proteins Anemia LOW Hgb 7 ```
37
This condition is neoplastic proliferation characterized by plasma cell accumulation in the bone marrow, can of plasma cells, hence INC proteins/albumin the presence of monoclonal proteins in the serum, urine and related tissue damage?
Multiple Myeloma- Bence proteins -M proteins made in bone marrow.
38
What is the result of treatment with multiple myeloma?
Chempotherapy: velcade, cytoxan, decadron 1. Return to normal activtiy w/ chemotherapy 2. Maintenacne therapy- treat ARF, anemia, hypercalcemia 3. Stem cell transplant needed
39
What is characteristic about multiple myeloma imaging?
Lytic Lesions- punched out, destroyed tissue Vertebra- DEC bone density, vertebral collapse and pathological fractures
40
Bone pain-vertebral collapse and pathological fractures Anemia: Lethargy, pallor, dyspnea Recurrent infections from deficiency of antibody production Renal failure Hypercalcemia Abnormal bleeding, brusing tendency- platelet dysfunction CA Amyloidosis- abnormal protein from bone marrow in 5%
Muliple Myeloma-
41
Bone marrow disorder characterized by clonal proliferation of one or more hematopoietic components in the bone marrow.
Myeloprolifertive do; 1. Polycythemia Vera | 2. Essential thrombocynthemia myelofibrosis
42
Myeloprolifertive present in the following manner?
1. Young male 2. Neurofibroma w. testicular infart (dec blood supply 2/2 thrombus) 3. WBC elevated w/ neutrophllia (INC), plt 530K (aggregation massive) 4. HSM 5. EPO very low <10 6. JAK 2 positive (cytokines inflame) 7. **Hct 50 or higher 8. Gout 9. TEARDrOP RBC
43
What are significant findings on CT?
Splenic infact with thrombus in spleen and portal vien
44
Tx for Myeloprolifertive do (bone marrow)?
1. Anticoagulation 2. Phlebotomy goal Hct<45 (blood letting)
45
What is excess production of red blood cells, but in over half of patients there is also overproduction of WBC and platelets. Slow growing type of malignancy?
**Polychythemia vera(many- cell- heme RBC- blood)
46
What are CP in the clinic of Polycythemia vera?
HA, pruritus ( jaundice and liver) facial plethora, splenomegaly, HTN, Gout, EPO low
47
Which gene is assoc with polycythemia and essential thrombocythemia and myeloproliferatie do?
JAK 2 mutation
48
What is risk with polycythemia vera?
survive 10-16y. Progresses to myelofibrosis 30%, leukemia 5%
49
What the hallmark of Essential Thrombocynthemia?
1. Hct normal (45-50%) w/ INC platelet count. 2. Thrombosis and hemorrhages 3. Bone marrow biopsy- INC megakaryocytes/erythormelegia
50
Will all Pt have splenomegaly in Essential Thrombocynthemia?
NO! up to 40% will
51
What is the treatment for High Risk Pt >60yo or >1000k platelets, or prior clinical mainfestations? LOW Risk Pt?
HIGH risk TX- hyroxyurea and aspirin LOW risk TX-Aspirin

SUMMED2 (38 decks)

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