high yield leukemia (big ideas) Flashcards
difference between how acute vs chronic leukemias present in clinic
acute will likely be sick and symptomatic
chronic likely has mild or no symptoms
patient presentation between AML and ALL
AML typically over 60 yo
ALL is #1 leukemia in kids
patient presentation diff between CML and CLL
CLL tends to be 70+ yo
which leukemia has auer rods?
AML
which leukemia has philly chromosme?
CML
which leukemia has smudge cells on smear?
CLL
which leukemia isn’t treated if asymptomatic and common in older ppl?
CLL
which of the leukemias is also a myeloproliferative d/o?
CML
which chronic leukemia will have hepatosplenomegaly?
CML
which chronic leukemia will have lymphadenopathy
CLL
which chronic leukemia involves increased granulocytes
CML
2 general treatments for all leukemias
maintain counts w/ transfusions
tx/prevent infections
tx of both acute leukemias
chemo
BMT
tx of CML
chemo
TKI
BMT
tx of CLL
don’t treat if asymptomatic
AML vs ALL on blood smear
AML– myeloblasts & auer rods
ALL– lymphoblasts & glycogen granules
what are lytic lesions on xray indicative of?
multiple myeloma
will also have bony pain and increased plasma cells
high calcium, increased plasma cells and bony pain is indicative of?
multiple myeloma
SPEP is a confirmatory test for…
multiple myeloma
which condition will ALWAYS have Jak 2 mutation?
polycythemia vera
expected Hg, Hct levels with polycythemia vera?
both are high
WBC and platelets normal!
2nd most common heme malignancy
multiple myeloma
disease of plasma cell malignancy
multiple myeloma
4 generalized sx & 1 specific sx to multiple myeloma
fever, wt loss, night sweats
bone pain
CRAB stands for?
it is diagnostic criteria for?
calcium elevated, renal insufficiency, anemia, bony lesions
multiple myeloma
tx for multiple myeloma
stem cell transplant
triple therapy (steroid, Proteasome inhibitor, immunmodulator)
what is needed for definitive diagnosis of multiple myeloma
plasmacytosis (clonal plasma cell) >10% via marrow aspiration
term for disorders of proliferation w/ differentiation
myeloproliferative d/o
myeloproliferative d/o of too many WBC
CML
myeloproliferative d/o of too many RBCs (high Hct,Hg)
polycythemia vera
myeloproliferative d/o of too many platelets
essential thrombocythemia (ET)
myeloproliferative d/o of too many stromal tissue
myelofibrosis
how do you tx polycythemia vera (3)
1 reduce Hct w/ phlebotomy
hydroxyurea
thrombosis prevention
3 disorders that cause cause high platelets
essential thrombocytopenia
iron deficiency
inflammation
tx of essential thrombocytopenia (ET) (2)
reduce platelet count w/ hydroxyurea
thrombosis prevention
which d/o would have massive splenomegaly w/ teardrop on blood smear?
myelofibrosis
out of the myeloproliferative d/o, which have the worst prognosis?
myelofibrosis
how is myelofibrosis tx?
address blood counts w/ transfusions, hydroxyurea, etc
stem cell transplant
dimorphic cells or abnormal morphology cells on smear is indicative of what?
MDS
how is aplastic anemia different from MDS?
they both cause pancytopenia but aplastic anemia won’t have abnormal cell morphology or chromosomal abnormalities
aplastic anemia usually has a trigger
causes of secondary polycythemia
hypoxia
dehydration
sleep apnea
smoking
tumors that secrete erythropoietin
3 clinical features of ET
abnormal clotting
abnormal bleeding
erythromelalgia (burning sensation in hands)
etiology of CML vs CLL
CML– too many WBC being made; marked leukocytosis
CLL– no normal apoptosis of B lymphocytes
both are often asymptomatic
4 lab values with AML
low Hg
low Plts
high WBC
OR pancytopenia