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IHO Week 1 > Krafts IHO Week 4 > Flashcards

Krafts IHO Week 4 Flashcards

1
Q

sudden onset, adults or children, rapidly fatal without tx, composed of immature cells (blasts)

A

acute leukemia

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2
Q

slow onset, occurs only in adults, longer course, composed of mature cells

A

chronic leukemia

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3
Q

malignant proliferation of immature myeloid or lymphoid cells in the bone marrow

A

acute leukemia

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4
Q

Causes of acute leukemia

A

clonal expansion, maturation failure

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5
Q

Badness of Acute Leukemia

A

crowd out normal cells, inhibit normal cell function, infiltrate other organs

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6
Q

Onset of Acute Leukemia

A

within days

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7
Q

Symptoms of Bone Marrow Failure in A Leukemia

A

fatigue, infections, bleeding (skin petichiae, nose bleeds won’t stop, etc)

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8
Q

CBC in Acute Leukemia features

A

blasts/immature cells, leukocytosis, anemia, thrombocytopenia

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9
Q

malignant proliferation of myeloid blasts in blood marrow, 20% cutoff for dx of blasts of WBC, many subtypes, bad prognosis

A

Acute Myeloid Leukemia

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10
Q

M0-3

A

neutrophillic series (myeloblasts, promyelocytes, etc)

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11
Q

M4/5

A

involve monocytic series (monoblasts etc)

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12
Q

M6

A

erythroid series (erythroblasts)

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13
Q

M7

A

megakaryocytic series (megakaryoblasts)

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14
Q

Where do you see myeloperoxidase (MPO)

A

Neutrophil, use to see if the blasts are neutrophilic

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15
Q

What does non-specific esterase stain?

A

Monocytes

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16
Q

lots of myeloblasts, bland blasts, MPO negative, NEED MARKERS

A

AML-M0

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17
Q

lots of myeloblasts, no maturation (just blasts but some have MPO and auer rods)

A

AML-M1

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18
Q

lots of promyelocytes, faggot cells, DIC, t(15;17) in all cases

A

AML-M3 (acute promyelocyte leukemia)

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19
Q

neutrophilic leukocytosis, basophilia, philadelphia chromosome, three phases

A

chronic myeloid leukemia

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20
Q

high WBC, left shift neutrophilia, basophilia, low hemoglobin, high platelet count, low LAP

A

CML

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21
Q

s/sx: slow onset, fever, fatigue, night sweats, abdominal fullness, big spleen and big liver

A

CML

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22
Q

Accelerated Phase of CML

A

50%, unstable counts, blast crisis within 6-12 months

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23
Q

Blast Crisis of CML

A

50%, acute leukemia with high mortality

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24
Q

high RBC, thrombosis and hemorrhage, Jak-2 mutation

A

Polycythemia Vera

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25
Q

Primary Polycythemia Vera

A

intrinsic myeloid cell problem

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26
Q

Secondary Polycythemia Vera

A

dt increased EPO

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27
Q

s/sx: HA, pruritis, dizziness, thrombosis, infarction, big spleen and liver, plethora (flushing)

A

Polycythemia Vera

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28
Q

Treatment of Polycythemia Vera

A

phlebotomy, if needed myelosuppressive drugs

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29
Q

Prognosis of Polycythemia Vera

A

9-14 years, death of thrombosis or hemorrhage, leukemic transformation in some patients

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30
Q

Very high platelet count in blood, in young women, dx of exclusion, throbosis and hemorrhage

A

Essential Thrombocythemia

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31
Q

Platelets of >600,000, Hgb

A

Essential Thrombocythemia

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32
Q

s/sx: bleeding, thrombosis, purpura, bruising, pallor, tachycardia, biggish spleen

A

Essential Thrombocythemia

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33
Q

Essential Thrombocythemia Treatment

A

platelet pheresis, myelosuppressive drugs, apsirin

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34
Q

Essential Thrombocythemia Prognosis

A

5-8 years, death from thrombosis or hemorrhage, leukemic transformation in some patients

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35
Q

panmeylosis then marrow fibrosis, extramedullary hematopoiesis, teardrop red cells

A

chronic myelofibrosis

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36
Q

s/sx: LUQ fullness, weakness, fatigue, palpitations, huge speen, pallor, tachycarida

A

chronic myelofibrosis

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37
Q

Treatment of chronic myelofibrosis

A

supportive, maybe myelosuppressive drugs (early on)

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38
Q

Prognosis of chronic myelofibrosis

A

3-5 years, death from marrow failur, leukemic transformation in some patients

39
Q

monoclonal plasma cell proliferation, monoclonal gammopathy, decreased normal immunoglobulins, osteolytic lesions

A

Multiple myeloma

40
Q

M-spike (monoclonal band), (60% IgG, 20% IgA, IgD or IgE rare, never IgM), Bence-Jones in protein in urine, decreased normal Ig

A

Multiple Myeloma

41
Q

Blood-anemia and rouleaux, Marrow-plasma cells and amyloid

A

Multiple Myeloma

42
Q

Lymphoplasmacytoid lymphoma, IgM, hyperviscosity syndrome

A

Waldenstrom macroglobulinemia

43
Q

small M spike with no myeloma sx, occasionally transforms into myeloma

A

Monoclonal gammopathy of undetermined significance (MGUS)

44
Q

Signs of malignant plasma cells

A

do not differentiate into plasma cells, continue to proliferate and accumulate in marrow, produce large amounts of immunoglobulins, normal death of cells doesn’t occur, crowds out other cells-rbc precursors; suppress antibody synthesis by normal plasma cells

45
Q

s/sx: 80% present with bone pain (low back/pelvis/ribs), bruising or bleeding from decreased platelets, infx from decreased levels of normal immunoglobulins, hypercalcemia, renal failure, hyperviscosity syndrome

A

Multiple Myeloma?

46
Q

Classic Triad of Multiple Myeloma

A

anemia, bone pain, renal failure

47
Q

Dx Criteria for Multiple Myeloma

A
  1. bone marrow with >20% plasma cells OR 2. plasmacytoma w/monoclonal protein in serum >3g/dl or monoclonal protein in urine lytic lesions 3. usual clinical features of myeloma 4. exclude connective tissue ds, chronic infx, carcinoma, lymphoma and leukemia
48
Q

Treatment of Multiple Myeloma

A

dexamethasone, melphalan (alkyalating agent), cyclophosphamide (alkylating agent)

49
Q

HPSC from peripheral blood and growth factors are given after transplantation, safe in 1-2% death rate, issue with contamination of the autologous graft by meyloma cells

A

Autologous Peripheral Blood Stem Cell Transplant (PBSC)

50
Q

antiangiogenic agent (first used with advanced and refractory myeloma)

A

Thalidomide

51
Q

newer antiangiogenic agent; maintenance after transplantation signficantly prolonged progression-free and event-free survival among patients with multiple myeloma

A

Lenalidomide (multiple myeloma)

52
Q

proteasome inhibitor

A

Bortezomib (multiple myeloma)

53
Q

Prognosis of Multiple Myeloma with Conventional Therapy vs intensive therapy under age 45

A

3-4 years vs 50% ten year survival

54
Q

Cause of death with multiple myeloma

A

marrow replacement pancytopenia, renal failure, sepsis, acute leukemia, other chronic illness unrelated

55
Q

malignant proliferation of lymphocytes in blood, bone marrow; several disorders; occur only in adults; long course that is indolent but incurable

A

Chronic Lymphoproliferative Disorders

56
Q

small, mature lymphocytes (=to small lymphocytic lymphoma), B-cell, but CD5+, long inexorable course

A

Chronic Lymphocytic Leukemia

57
Q

older (>40), asymptomatic at first, later organ filtration, infection may occur due to hypogammaglobulinemia

A

Chronic Lymphocytic Leukemia

58
Q

Positive for B-cell antigens (CD20) and a T-cell antigen (CD5), but negative for TdT

A

Chronic Lymphocytic Leukemia

59
Q

Treatment of CLL

A

conservative, reduce organomegaly, infection

60
Q

Prognosis of CLL

A

counts, adenopathy, bone marrow pattern, mean survival 9 years, death usually from infection

61
Q

hairy cells, splenomegaly without lymphadenopathy, pancytopenia, TRAP +

A

Hairy Cell Leukemia

62
Q

older (>40), M:F is 5:1, big spleen but no lymphadenopathy, usually pancytopenia and always monocytopenia (always)

A

Hairy Cell Leukemia

63
Q

TRAP + ctyochemistry and immunophenotype is positive for B-cell antigens and negative for CD5

A

Hairy Cell Leukemia

64
Q

Treatment and Prognosis of Hairy Cell Leukemia

A

Chemotherapy, usually 10+ years

65
Q

Most common cause overall of lymphadenopathy

A

Benign reaction to infection

66
Q

Most common malignant cause of lymphadenopathy

A

Metastatic Carcinoma

67
Q

large, irregular follicles, mixture of cells in germinal centers, tangible body macrophages, B-cell response to some immune stimulus

A

Follicular Hyperplasia

68
Q

expanded area between follicles, mixture of cells, partial effacement, T-cell response to some immune stimulus

A

Interfollicular Hyperplasia

69
Q

malignant proliferation of lymphoid cells (blasts or mature cells) in lymph nodes, skips around, many subtypes, most are B cell

A

Non-Hodgkin Lymphoma

70
Q

Painless, firm lymphadenopathy, extranodal manifestions, ‘B’ symptoms: weight loss, night sweats, fever

A

Non-Hodgkin Lymphoma

71
Q

older patients, indolent (incurable), small mature cells, non-destructive

A

Low Grade Non Hodgkin Lymphoma

72
Q

children, sometimes, aggressive (curable?), big ugly cells, destructive

A

High Grade Non Hodgkin Lymphoma

73
Q

Name the 4 Types of Low Grade Non Hodgkin Lymphoma

A

small lymphocytic lymphoma, malt lymphoma, follicular lymphoma, mycosis fungoides

74
Q

Name the 4 Types of High Grade Non Hodgkin Lymphoma

A

large cell lymphoma, lymphoblastic lymphoma, Burkitt lymphoma

75
Q

small mature lymphocytes, same thing as CLL, B-cell lesion, but CD5+ (weird), long course; death from infection

A

Small Lymphocytic Lymphoma

76
Q

actually a bunch of lymphomas, marginal zone pattern, malt lymphoma, helicobacter pylori

A

Marginal Zone Lymphoma

77
Q

mantle zone pattern, small angulated lymphocytes, t(11;14)-cyclin D1 and IgH, more aggressive

A

Mantle Zone Lymphoma

78
Q

follicular pattern (later diffuse), small cleaved cell, mixed or large cell, Grade 1, 2, or 3, t(14;18)-IgH and bcl-2

A

Follicular Lymphoma

79
Q

Stage 1 (single node), Stage 2 (2 or more nodes on same side of diaphragm) Prognosis Follicular Lymphoma

A

90% for 5 years

80
Q

Stage 3 (lymph nodes on both side of the diaphragm) and Stage 4 (diffuse extranodal involvement)

A

40% for 5 years

81
Q

Skin lesions, blood involvement, cerebriform lymphocytes, T-cell immunophenotype

A

Mycosis Fungoides/ Sezary Syndrome

82
Q

large B cells, extranodal involvement, grows rapidly, bad prognosis

A

Diffuse Large-Cell Lymphoma

83
Q

two types: B and T, lymphoblasts in diffuse pattern, same as ALL, T-lymphoblastic lymphoma often in teenage male with mediastinal mass

A

Lymphoblastic Lymphoma

84
Q

child with fast-growing, extranodal mass, starry-sky pattern, t(8;14)=c-myc and IgH, occasionally involves blood

A

Burkitt Lymphoma

85
Q

Japan/Carribean basin, HTLV-1, skin lesions, hypercalcemia, very aggressive

A

Adulte T-cell Leukemia/Lymphoma

86
Q

Younger patients, good prognosis, contiguous spread, five subtypes, Reed-Sternberg cell

A

Hodgkin Lymphoma

87
Q

Types Classical Hodgkin Lymphoma

A

Nodular sclerosis, lymphocyte rich, mixed cellularity, lymphocyte depletion

88
Q

asymptomatic young male with cervical lymphadenopathy, good prognosis (early stage), B-cell origin, popcorn cells

A

Nodular L-P Hodgkin Lymphoma

89
Q

most common subtype, good prognosis (early stage), Lacunar cells

A

Nodular Sclerosis Hodgkin Lymphoma

90
Q

worse prognosis, usually disseminated at presentation, classic Reed-Sternberg cells, mixture of background cells

A

Mixed Cellularity Hodgkin Lymphoma

91
Q

uncommon, usually localized at presentation, popcorn cells

A

Lymphocyte-Rich Hodgkin Lymphoma

92
Q

rare, often disseminated at presentation, classic Reed-Sternberg cells, collagen or reticulin background

A

Lymphocyte Depletion Hodgkin Lymphoma

93
Q

Treatment and Prognosis of Hodgkin Lymphoma

A

surgery, chemo, radiation, prognosis depends on stage, danger: second malignancies

IHO Week 1 (16 decks)

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