Hemo mehlman 5th 12-09 (1)

Question 1

ALL - population?

Answer 1

kids

Question 1

Hairy cell leukemia, what on microscopy and what positive?

Answer 1

cytoplasmic projections; acid phosphatase +

Question 2

ALL CD, TdT?

Answer 2

ALL – kids; CD10, TdT positive

Question 3

Down syndrome –> can cause ….., but …. more prevalent

Answer 3

Down syndrome –> can cause ALL and AML, but ALL more, especially in kids.

Question 4

Leukemias are usually … cell.

Answer 4

B cell

Question 5

If the USMLE wants T cell, you’ll get a positive …………

Answer 5

positive Pemberton sign with an SVC-like syndrome

Question 6

positive Pemberton sign with an SVC-like syndrome –> what cells?

Answer 6

T cell leukemias

Question 7

SVC-like syndrome, cp?

Answer 7

flushing of the face with arms above the head

Question 8

This is due to thymic lesion with compression of SVC seen in T cell variant.

Answer 8

.

Question 9

6-mercaptopurine used in Tx of….

Answer 9

ALL

Question 10

ALL Tx?

Answer 10

6-mercaptopurine

Question 11

6-mercaptopurine pure synthesis inhibitor

Answer 11

.

Question 12

when 6-mercaptopurine used for leukemia treatment, can cause….

Answer 12

can cause tumor lysis syndrome (high K+, high phosphate, low Ca, low bicarb, high uric acid).

Question 13

However, don’t give a xanthine oxidase inhibitor such as allopurinol or febuxostat to prevent tumor lysis syndrome in the specific case of a patient receiving 6-MP (or azathioprine, which is metabolized into 6-MP) bc 6-MP requires xanthine oxidase for breakdown. 6-MP is activated by HGPRT ( same enzyme deficient in Lesch-Nyhan syndrome; XR).

Answer 13

.

Question 14

If ALL, lymphocyte count will be …..

Answer 14

be super high. Normal is 4-11k. But you’ll see like 30k+.

Question 15

Pertussis (whooping cough) has super high lymphocyte count for whatever reason (instead of neutrophils). Can resemble …..

Answer 15

Can resemble ALL based on bloods. But of course you’d have presentation of whooping cough instead.

Question 16

AML you get …. on smear, which are ….

Answer 16

AML you get Auer rods on smear, which are myeloperoxidase +

Question 17

APL (type M3 AML) is t(15;17) translocation; can treat….

Answer 17

can treat with all-trans retinoic acid.

Question 18

CLL causes ….. on smear

Answer 18

CLL causes smudge cells on smear

Question 19

CLL can cause…

Answer 19

can also cause warm autoimmune hemolytic anemia

Question 20

CLL what CD positive?2

Answer 20

CD5 and CD23 positive

Question 21

CML they like myelocytes and metamyelocytes elevated; these are almost buzzwordy they’re so HY.

Answer 21

.

Question 22

Don’t forget imatinib is Tx for …..

Answer 22

CML

Question 23

imatinib cause …adverse

Answer 23

causes fluid retention (peripheral edema).

Question 24

imatinib targets …

Answer 24

Drug targets bcr-abl tyrosine kinase.