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Z - M2 Heme/Onc > Heme/Onc - Week 1 Review - Part 3 > Flashcards

Heme/Onc - Week 1 Review - Part 3 Flashcards

1
Q

Leukopenia - Definition + 2 Types

A

WBC < 5,000
Neutropenia
Lymphopenia

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2
Q

Neutropenia - 2 Major Causes + Treatment

A

Causes

1) Drug Toxicity
2) Severe Gram (-) Sepsis (All neutrophils used up)

Treatment - GM-CSF to boost granulocyte production

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3
Q

Lymphopenia - 4 Major Causes

A

1) Immunodeficiency
2) High Cortisol
3) Autoimmune (SLE)
4) Radation

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4
Q

Leukocytosis - Defition + Causes (5)

A

WBC > 10,000

1) Bacterial Infection
2) Monocytosis
3) Eosinophilia
4) Basophilia
5) Lymphocytic Leukocytosis

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5
Q

Bacterial Infection (Key Fact)

A

Neutrophil release with Left Shift (CD16+ Cells)

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6
Q

Monocytosis - Definition + Causes (2)

A

Increase in circulating monocytes

Chronic Infection + Cancer

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7
Q

Eosinophilia - Key Causes (3)

A

1) Type 1 Hypersensitivity Reaction
2) Parasitic Infectio
3) Hodgkin Lymphoma (Increased IL-5)

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8
Q

Basophlia - Key Cause (1)

A

CML - KEY KEY

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9
Q

Lymphocytic Leukocytosis - Key Causes (3)

A

1) Viral Infeciton

2) Bordetella Pertussis

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10
Q

Boards Ages for Leukemias (Goljan)

A

1) 0-14 - ALL
2) 15-39 - AML
3) 40-59 - AML or CML
4) >60 - CLL

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11
Q

Acute Leukemia - Types (2) + Definition + Acute Presentation (4)

A

AML (Myeloid - CD33+/MPO+) + ALL (Lymphoid - TdT+)

Blast > 20% on Marrow Biopsy - Large on Histology with “Hole Punch” Nucleus

Acute Presentation - Based on Bone Marrow being crowded out and under production

2) Reduced RBCs - Anemia/Fatigue
3) Reduced Platelets - Thrombocytopenia (Bleeding)
4) Reduced Lymphocytes (Neutropenia/Infection)

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12
Q

ALL - Key Feature + Key Population + Classes (2)

A

TdT Positive - Lymphoblasts

Children (Associated with Down’s Age > 5) + Kids 0-14

B-Cell (TdT + CD10, CD19, CD20)
T-Cell (TdT + CD2-8) - No CD10

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13
Q

B-Cell ALL - Markers + Prognosis + Translocations (2)

A

Markers - TdT + CD10, CD19, CD20

Prognosis - Great in Kids (responds to chemo)

Translocations
Kids - t(12:21) - Good Prognosis
Adults - t(9:22) - Philadelphia Bcr-Abl - Poor Prognosis (vs. Good in CML)

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14
Q

T-Cell ALL - Markers + Population

A

Markers - T-Cell (TdT + CD2-8) - No CD10

Teenagers with Thymic Masses

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15
Q

AML - Key Features + Populations + Classes (3)

A

Myeloblasts - MPO + CD33 + Auer Rods

Adults - Typically 15-39

Classes (3)
M3 - Acute Promyelocytic Leukemia
M5 - Acute Monocytic Leukemia
M7 - Acute Megakaryblastic Leukemia (LACKS MPO!)

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16
Q

Acute Promyelocytic Leukemia - Genetics + Key Information (2)

A

AML M3
t(15:17) - RAR moves from 17 to 15 - Blocks AML Maturation trigger blast accumulation

High Risk of DIC (Class is Always)
Treat with ARTA (Vitamin A)

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17
Q

Acute Monocytic Leukemia - Keys (2)

A

AML M5

Monoblast Proliferaiton - Infiltrates Gums

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18
Q

Acute Megakaryoblastic Leukemia - Keys (3)

A

AML M7
Lacks MPO
Associated with Down’s Syndrome < 5 y/o

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19
Q

Chronic Leukemias - Definition + Types (4)

A

Mature Cell Leukemia - Lymphocytic (Myeloid = Myeloproliferative Disorders)

1) CLL
2) Hairy Cell Leukemia
3) Adult T-Cell Leukemia
4) Mycosis Fungoides

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20
Q

Chronic Lymphocytic Leukemia - Definition + Key Markers/Histology

A

Neoplastic Disease of Naive B-Cells - Tons of non-functional B-Cells

Markers - CD20, CD5, CD23
Histology - Smudge Cells - Look like they were slammed against the slide of the slide)

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21
Q

Lymph Node Form of CLL

A

Small Lymphocytic Lymphoma (SLL) - Same disease with Generalized LAD

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22
Q

Complications of CLL (3)

A

1) Hypogammaglobinulinemia (Low Ig levels from non-functional B-Cells) - Increased infections (typical cause of death)
2) Richter Transformation - Progression to DBCL - Rapidly enlarging node/spleen

23
Q

CLL Markers of Poor Prognosis (3)

A

1) Zap70+
2) CD38 Expression
3) Deletion of 17p

24
Q

CLL Staging - 5 Stages

A 
0 - Lymphocytosis Only
1 - Add LAD
2 - Hepatosplenomegaly 
3 - Add Anemia
4 - Add Thrombocytopenia
25
Q

Hairy Cell Leukemia - Definition + Classic Treatment + Findings/Markers (4) + S/Sx (2)

A

Mature B-Cell Neoplasia

Treatment - Cladribine (2-CDA) - Adenosine Deanimase Inhibitor - Anti-Metabolite

Markers - TRAP+ and CD103
Findings - Dry tap from marrow fibrosis with fried egg basement membrane
Histology - Hairy Processes on B-Cells

S/Sx - Pancytopenia + Massive Spleenomegaly

26
Q

Adult T-Cell Leukemia (ATLL) - Definition + Cause + Associated Lymphoma

A

Neoplastic Disease of CD4 T-Cells

Caused by HTLV-1 Virus - Japan + Caribbean

HTLV Lymphoma (High Grade T-Cell)

27
Q

S/Sx of ATLL (5)

A

1) Rash
2) Generalized LAD
3) Hepatosplenomegaly
4) Lytic Bone Lesions
5) Looks a lot like Multiple Myeloma (but add rash)

28
Q

ALK Postive T-Cell Lymphoma - Keys (2)

Class Only

A

1) 5(2:5) NPM-ALK Fusion Protein

2) CD30+

29
Q

Mycosis Fongoides - Definition + S/Sx (2)

A

Neoplastic Proliferation of Mature CD4 T-cells

Localized Skin Rash + Plaques in Nodules

30
Q

High Grade Manifestation of Mycosis Fungoides - Definition + Decription

A

Sezary Syndrome

Cerebriform Nuclie + Lubular Nodes of T-Cell Nuclei - Severe + High Grade

31
Q

Plasma Cell Disorders (3)

A

1) Multiple Myeoloma
2) Monclonalgammopathy of Undetermined Significance (MGUS)
3) Waldenstrom Macroglobulinemia

32
Q

Multiple Myeloma - Pathophysiology + Epidemiology + Key Mnemonic

A

1 Cause of Primary Bone Lesions (Metastasis still #1 overall)

Neoplastic disease of plasma cells in the bone marrow - Results in overproduction of several plasma cell products

1) Osteoclast Activating Factor
2) IL-6
3) Monoclonal Ig
4) Light Chain

CRAB - hyperCalcemia + Renal Involvement + Anemia + Bone Lytic Lesions

33
Q

Multiple Myeloma - S/Sx with Cause (6)

A

Osteoclast Activating Factor (RANK)

1) Bone Lytic Lesions
2) Hypercalcemia (bone destruction)

Increased Ig - Monoclonal (One Type)
M-Spike (Monoclonal Spike) on SPEP (With wrong Kappa/Lambda Ratio)

Light Chain
Primary AL Amyloidosis - Circulating Light Chain Depositis

Light Chain
Bence Jones Proteins - Protein in the urine that causes kidnet failure

Rouleaux Formation - RBCs Stack up like coins

34
Q

MUGS - Key Factors (2)

A

1) Precursor for Multiple Myeloma (1% Increase Annually)

2) M-Spike on SPEP but no multiple myeloma symptoms

35
Q

Waldenstrom Macroglobulinemia - Definition + Key Findings (4)

A

B-Cell Lymphoma with IgM Production (Big Cells)

Findings

1) Generalized LAD
2) M-Spike + Increased Protein
3) Hyperviscosity - Clotting + Neurological Defects
4) Bleeding (Platelet issues)

36
Q

BCR-Abl - Impact on Involved Disorders

A

1) Good Prognosis in CML

2) Bad Prognosis in ALL

37
Q

Key AML CD Markers (2) - Class Specific

A

CD13 + CD33

38
Q

Lymphadenopathy Differential

A

Painful - Acute Infection

Non-Painful - Chronic Inflammation + Metastatic Carcinoma + Lymphoma

39
Q

Cause of Inflammatory Follicular Hyperplasia (3 Regions)

A

Follicular (Cortex) - B-Cell - Rheumatoid + HIV
Paracortex (Below) - T-Cell - Viral (EBV)
Medulla - Sinus Histiocytes - Metastatic Drainage

40
Q

Classes of Lymphoma (2) + Subclasses (6)

A

Hodgkins (40%)
Non-Hodgkins (60%)

NHL Subclasses
Small B-Cell - Zone Based 
1) Follicular
2) Mantle
3) Marginal

4) Intermediate B-Cell (Burkitt’s)
5) Large - Diffuse Large B-Cell

6) T-Cell

41
Q

Follicular B-Cell NHL - Genetics + Markers + S/Sx (3)

A

Genetics - t(18:14) - Bcl Over-expression

Markers - CD20+

S/Sx

1) Loss of Lymph Node Architecture (paracortex invasion)
2) No Tingable Body Macrophages in Germinal Center (with macrophages = reactive follicular hyperplasia = infection)
3) Monoclonality - Ratio of Kappa/Lambda Off (Normal 3:1 – Lymphoma = 20:1 or 1:3)

42
Q

Follicular B-Cell NHL - First Line Therapy

A

Rituximab (Anti CD20 Mab)

43
Q

Mantle Cell NHL - Genetics + Markers + Grade

A

Genetics - t(11:14) - Cyclin D1 Overexpression - Pushes cells from G1 to S

Marker - CD20+

High Grade with painless LAD - Later Adult

44
Q

Marginal Zone Lymphoma - Causes + MArker + Associated Disease

A

Causes - High Inflammation - Hashimoto’s + Sjogren Syndrome + H. Pylori

Marker - CD20+

Associated with GI MALToma of the mucosal mantle zone - H. Pylori

45
Q

Burkitt Lymphmona - Genetics + Forms + Marker + Histology

A

Genetics - t(8:14) c-myc - EBV Association

African Form = Jaw
Sporadic Form = Abdominal

Marker = Ki67+ (CLASS)

Histology - Stary Sky = B-Cells with Tingible Body Macrophages

Associated with Nasopharyngeal Carcinoma in Asian Men

46
Q

Diffuse Large B-Cell Lymphoma (DLBCL) - Genetics + Marker + Keys (3)

A

Genetics - t(3:14) - Bcl6

Marker - CD20+

Keys

1) Arises from CLL and Follicular Lymphoma
2) Clinically very aggressive
3) Most common NH lymphoma

47
Q

Hodgkin’s Lymphoma - Markers + Types (5) + Classic Histology

A

Markers - CD15+ / CD30+ / CD20 (-)

Types

1) Nodular Sclerosing
2) Mixed Cellularity
3) Lymphocyte Rich
4) Lymphocyte Depleted
5) Lyphocyte Predominant (Pop-Corn)

Reed Sternberg Cells - Owl Eyes - Attract reactive lymphocytes which form the bulk of the tumor (can cause fibrosis)

48
Q

Nodular Sclerosis HL - Classic Presentation + Classic Histology

A

Presentation - Young Female with Cervical or Mediastinal Mass

Histology - Nodules separated by bands of fibrosis/sclerosis

49
Q

Keys for HL Classes (Not Nodular Sclerosis)

A

1) Lymphocyte Rich - Best Prodnosis
2) Mixed Cellularity - IL-5 + Eosinophlia
3) Lymphocyte Depleted - Worst Prognosis + HIV + Elderly (EBV Association too)
4) Nodular Lymphocyte Predominance - Altered Popcorn RS Cells - No CD15/30 - Isolated Cervical LAD - Good Prognosis

50
Q

Ann Arbor Lymphoma Stages (4 + 2)

A

1) - One Lymph Node Above Diaphragm
2) - Multiple Lymph Nodes Above the Diaphragm
3) - Multiple Nodes Above + Below Diaphragm
4) - Metastasis

A = Absence of Symptoms
B = Presence of Symptoms (Fever/Night Sweats/Anemia)
51
Q

Low Grade B-Cell Lymphomas (3)

A

Follicular + Marginal + MALT

52
Q

High Grade B-Cell Lymphoma (3)

A

DLBCL + Burkitt + Mantle

More Aggressive

53
Q

Primary Effusion Lymphoma - Key Facts (2)

A

1) Pleural Space/Pericardium (Body Cavity Lymphoma)

2) Linked to Viruses - HHV8 + HIV + EBV

Z - M2 Heme/Onc (10 decks)

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