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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
Q

What is the low mortality rate consider a LOW grade NHL, with 10y and MC form of NHL?

A

Follicular Lynphoma

26
Q

Which type of lymphona is assoc with Elevated IgM?

A

Lymphoplasmacytoid lymphoma

27
Q

What type of NHL are below:

  1. Diffuse large B cell lymphoma (31%)
  2. Burkitt’s lymphoma
  3. Lymphoblastic lymphoma
A

High grade non-Hodgkin’s lymphoma

28
Q

What does RCHOP tx?

A

NHL- Rituxan, Cytoxan, Adriamycin, Vincristine, and Prednisone
Outpatient or Hospital

29
Q

What country has higher cure recepie for NHL?

A

OF COURSE FRANCE

30
Q

When is Radiation therapy needed for NHL DLBCL?

A

IF limited stage- RCHOP followed by radiation. IF ADV w/ CTPET += radiation to abnormal area

31
Q

What would be the work up on Pt w/ Left arm swelling pain, fatigue, SOB w/ exertion for 2 wks?

A

Left upper extremity DVT and CXR. PET/CT for mass staging. Referral if mass. Order Biopsy of bone marrow

32
Q

This condition can be seen in any age(bimodal), fatigue, swelling in upper extremity, SOB, young adults, with HIGH rates in MEDIASTINAL?

A

Hodgkins Dz-Curable

33
Q

Is PET/CT scan always necessary for DX of Hodgkin Lymphoma?

A

NO! unclear

Smear show nodule lymph nodes

34
Q

If chemo and radiation are late treated in Hodgkins Lymphoma, then what are the risk?

A

secondary lung cancer, myelodysplasia, cardiac disease.

35
Q

What will a Pt c/o that are signs of multiple myeloma?

A

C/o back pain, confusion, chronic fatigue, oliguria, constipation.

36
Q

What are lab work up for signs of ARF and multiple myeloma?

A 
Oliguria, 
SrCr HIGH 3
CMP- Ca HIGH-13
24hr urine HIGH proteins
 Anemia LOW Hgb 7
37
Q

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?

A

Multiple Myeloma- Bence proteins -M proteins made in bone marrow.

38
Q

What is the result of treatment with multiple myeloma?

A

Chempotherapy: velcade, cytoxan, decadron 1. Return to normal activtiy w/ chemotherapy 2. Maintenacne therapy- treat ARF, anemia, hypercalcemia 3. Stem cell transplant needed

39
Q

What is characteristic about multiple myeloma imaging?

A

Lytic Lesions- punched out, destroyed tissue
Vertebra- DEC bone
density, vertebral collapse and pathological fractures

40
Q

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%

A

Muliple Myeloma-

41
Q

Bone marrow disorder characterized by clonal proliferation of one or more hematopoietic components in the bone marrow.

A

Myeloprolifertive do; 1. Polycythemia Vera

2. Essential thrombocynthemia myelofibrosis

42
Q

Myeloprolifertive present in the following manner?

A
  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
Q

What are significant findings on CT?

A

Splenic infact with thrombus in spleen and portal vien

44
Q

Tx for Myeloprolifertive do (bone marrow)?

A
  1. Anticoagulation 2. Phlebotomy goal Hct<45 (blood letting)
45
Q

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?

A

**Polychythemia vera(many- cell- heme RBC- blood)

46
Q

What are CP in the clinic of Polycythemia vera?

A

HA, pruritus ( jaundice and liver) facial plethora, splenomegaly, HTN, Gout, EPO low

47
Q

Which gene is assoc with polycythemia and essential thrombocythemia and myeloproliferatie do?

A

JAK 2 mutation

48
Q

What is risk with polycythemia vera?

A

survive 10-16y. Progresses to myelofibrosis 30%, leukemia 5%

49
Q

What the hallmark of Essential Thrombocynthemia?

A
  1. Hct normal (45-50%) w/ INC platelet count. 2. Thrombosis and hemorrhages 3. Bone marrow biopsy- INC megakaryocytes/erythormelegia
50
Q

Will all Pt have splenomegaly in Essential Thrombocynthemia?

A

NO! up to 40% will

51
Q

What is the treatment for High Risk Pt >60yo or >1000k platelets, or prior clinical mainfestations? LOW Risk Pt?

A

HIGH risk TX- hyroxyurea and aspirin LOW risk TX-Aspirin

SUMMED2 (38 decks)

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