L5 WBC Disorders

Question 1

Hodgkin Lymphoma
Characteristics
Age

Answer 1

Reed Sternberg cells w/ inflammatory infiltrate
Fever
Young adults (20-30) and old (50-)
Single limphnode or chain of lymphnodes

Question 2

Reed Sternberg cell
Size
Nucleus
Nucleoli
Origin

Answer 2

Large cell
Mirror image nuclei
Prominent nucleoli
B lymphocyte origin

Question 3

Other diseases with Reed Sternberg cells

Answer 3

Mono

Epstein Barr

Question 4

Non Hodkin Lymphoma
Characteristics
Ages

Answer 4

Morphologically diverse
Multiple node involvment, extranodal spread, blood involvement
All ages

Question 5

Non Hodkin Lymphoma

Origin

Answer 5

85% clonal neoplasms of B lymphocytes
15% T cell origin
B cells that have been arrested at a particular stage clonally proliferate

Question 6

Hodkins spread

Answer 6

lyphnode
spleen
liver
bone marrow

Question 7

Staging for hodkin lymphoma

Answer 7

I: Tumor in one anatomical region or two contiguous anatomic regions on same side of diaphragm
II: more than two anatomic regions or two NON contiguous regions on the same side???????
III: Tumor on both sides of diaphragm, not extending beyond lymph nodes, spleen or waldeyer’s ring
IV: tumor in bone marrow, lung, etc
A:Absent systemic
B: present systemic: fever, night sweats, weight loss

Question 8

Non Hodkin lymphoma clinical features

Answer 8

Painless enlarged lymph nodes or liver and spleen spread

Question 9

Types of leukemias

Answer 9

Acute lymphocytic
Chronic lymphocytic
Acute myelogenous
Chronic myelogenous

Question 10

Acute vs chronic leukemias
Course
Peripheral blood
White cell count
Bone marrow

Answer 10

Acute:
-Rapid, fatal in months
-Mostly blasts (immature cells)
-Increased. Decreased in 30%
-More than 20% blasts
Chronic
-Indolent, years
-mature cells
-Increased
-No increase in blasts

Question 11

Acute lymphoblastic leukemia
Proliferating cell
Age group
Subtypes

Answer 11

Primitive lymphoid cell
Most frequent in under 15, peak at 4
Principal cause of childhood deaths
Early B, Pre-B, Mature B, T

Question 12

Diagnosing AML

Answer 12

Auer rods (cytoplasmic inclusion)

Question 13

Philadelphia chromosome

What does it do

Answer 13

Occurs in proliferating cells of Chronic Myelogenous Leukemia
Results in fusion of BCR-ABL gene, mimicking growth factor, driving proliferation

Question 14

Blast crisis

Answer 14

increase in immature cells in blood and bone marrow
decreased response to treatment
1/3 lymphoid
2/3 myeloid (opposite of prevalence)

Question 15

Initial therapy for blast crisis

Answer 15

Inhibitor of BCR-ABL tyrosine kinase

Question 16

Infiltration of gingiva is a feature commonly assoicated with

Answer 16

acute myelo-monocytic leukemmia

Question 17

Clinical features of leukemia

Answer 17

Abnormal cells suppress normal
Anemia
Thrombocytopenia
Infection from decreased granulocytes or non functional granulocyes
Fever from infection or metabolism from proliferating cells

Question 18

Plasma cell disorders result from

Causes

Answer 18

clonal expansion of immmunoglobulin secreting cells
Results in increased serum monoclonal protein
Renal, neurological defects