LEC 15 Flashcards
what is the blood banking stain
Sudan black b
are granulocytes pos or neg when stained with specific esterase
pos
what is myeloperoxidase (MPO) and Sudan black b used for
differentiating the blast of AML from ALL
leukemic myeloblast are ___ for myeloperoxidase (MPO)
pos
what stains strongly MPO pos in leukemic blasts
auer rods
lymphoblast in ALL and lymphoid cells are MPO ___
neg
what part of the cell does Sudan black b (SBB) stain
lipids
is MPO or SBB more sensitive
SBB
SBB: granulocytes ___, monocytes ___ , and lymphoid cells ___
neg, neg to weak pos, and neg
what are esterase stains used for
distinguishing acute leukemias that are granulocytic from leukemias that originate from monocytes
naphthol AS-D chloroacetate: granulocytic cells ___ and monocytic cells ___
pos, neg to weak
esterases: leukemic myeloblast ___ and auer rods ___
pos, pos
alpha- Naphthyl acetate: monocytes ___ and lymphoid and granulocytes ____
pos, neg
what is added to alpha-naphthol acetate in a pos monocyte reaction to inhibit it
sodium fluoride
what is the use for acid phosphatase
diagnose T cell ALL and hairy cell leukemia
what stain confirms hairy cell leukemia
tartrate-resistant acid phosphatase
what does periodic acid Schiff reaction stain
glycogen in all hematopoietic cells
what does periodic acid Schiff reaction stain ID in AML and MDS (amyloid dysplastic syndrome)
erythroblast and dysplastic megakaryocytes
how many pairs of chromosomes do humans have
23
what mitogen stimulates lymphocytes
PHA
what agent is added to halt cell division in cytogenetics
colcemid
what agent is added to spread chromosomes apart in cytogenetics
KCL
during what phase of cell division are chromosomes squashed
metaphase
what stain is used for chromosomes in cytogenetics
DNA-binding dyes
what kind of patterns help ID chromosomes
banding
def? abnormal amount of chromosomes such as having an single extra chromosome or missing one
aneuploidy
def? more than 2 sets of chromosomes (all chromosomes are affected)
polyploidy
what kind of chromosome abnormality causes Klinefelter syndrome
aneuploidy
def? one chromosome is absent
monosomy
def? one chromosome extra
trisomy
monosomy and trisomy are examples of what kind of chromosome abnormality
aneuploidy
def? 2 chromosomes join long arms or exchange parts
translocation
def? segment of chromosome is reversed
inversion
def? a chromosome with identical arms
isochromosome
def? a chromosome that forms a ring due to deletion in telomeres, which cause ends to adhere
ring chromosome
what causes chronic myelogenous leukemia
Spontaneous chromosome mutation
what molecular technique amplifies a short piece of DNA multiple times
PCR
T or F: dead cells can be used in PCR
T
what enzyme do dead cells release
proteinases
what catalyzes the degradation of RNA into smaller components.
ribonuclease
is PCR qualitative or quantitative
quantitative
what kind of PCR: amplify DNA from a small amount of DNA template
PCR
what kind of PCR: uses reverse transcription to produce a DNA template from an RNA source that can then be amplified.
reverse transcription PCR
def? small number of cancer cells in the body after cancer treatment
minimal residual disease
what test is more specific for detecting minimal residual disease
molecular methods
what type of leukemia has a rapid trend
acute
what type of leukemia has an accumulation of blast
acute
what type of leukemia has a problem at the primitive level
acute
what type of leukemia has an accumulation of mature cells
chronic
can the mature cells in chronic leukemia function
no
what type of leukemia has a slow trend
chronic
what is the common childhood leukemia
acute lymphoblastic leukemia
do kids or adults have a better response to therapy in acute lymphoblastic leukemia
kids
what type of acute lymphoblastic leukemia is more common
B cell ALL
what type of acute lymphoblastic leukemia has lymphadenopathy and hepatosplenomegaly
B cell ALL
what type of acute lymphoblastic leukemia has a large mass in the mediastinum
T cell ALL
what kind of prognosis does b lymphoblastic leukemia/lymphoma with t(9;22)(q34.1;q11.2);BCR-ABL1 have
very bad!
who is likely to get lymphoblastic leukemia/lymphoma with t(9;22)(q34.1;q11.2);BCR-ABL1
adults
who is likely to get lymphoblastic leukemia/lymphoma with t(v;11q23.3);KMT2A (MLL)
very young infants
when does lymphoblastic leukemia/lymphoma with t(v;11q23.3);KMT2A (MLL) translocation occur
in utero
b lymphoblastic leukemia/lymphoma with hypodiploidy prognosis
poor in both kids and adults
what kind of ALL: small blast with thin rim of cytoplasm, blast are all the same size
Pre B ALL (L1)
what kind of ALL: irregular clefts of nucleus
T cell ALL (L2)
what kind of ALL: blast have vacuolations
burkett lymphoma- mature B cell ALL (L3)
what is the immunophenotype of early (pro/pre-pre) B-ALL
CD34, CD19, cytoplasmic CD22, and TdT
what is the immunophenotype of intermediate (common) B-ALL
CD34, CD19, CD10, cytoplasmic CD22, and TdT
what is the immunophenotype of pre b ALL (4)
CD19, cytoplasmic CD22, cytoplasmic µ, TdT (variable)
what is the immunophenotype of T ALL
CD2, CD3, CD4, CD5, CD7, CD8, and TdT
what condition is common in teen males with a mediastinal mass, elevated peripheral blast count, and meningeal involvement
T- ALL
what condition can have hand mirror forms
ALL
what is known as the eythroid marker
cCD79a
def? cell expresses a marker that it shouldn’t
aberrant expression
what test must be preformed when diagnosing acute leukemias
BM aspiration/biopsy
what will the BM of ALL look like
hypercellular
what will tell you if a cell is a myloidblast
auer rods
what kind of leukemia? accumulation of abnormal blast cells in marrow and impaired production of normal blood cells
acute myelogenous leukemia
what is the most common type of leukemia in adults
acute myelogenous leukemia
what are the symptoms of acute myelogenous leukemia
- risk of DIC
- anemia
- thrombocytopenia
what will the BM of acute myelogenous leukemia pts look like
hyper cellular with more than 20% blast
what subtype of acute myelogenous leukemia: minimally differentiated
M0
what subtype of acute myelogenous leukemia: no maturation
M0
what subtype of acute myelogenous leukemia: with maturation
M2
what subtype of acute myelogenous leukemia: acute promyelocytic leukemia
M3
what subtype of acute myelogenous leukemia: acute myelomonocytic leukemia
M4
what subtype of acute myelogenous leukemia: acute myelomonocytic leukemia with eosinophilia
M4eo
what subtype of acute myelogenous leukemia: acute monocytes leukemia, poorly diff
M5a
what subtype of acute myelogenous leukemia: acute monocytes leukemia, well differentiated
M5b
what subtype of acute myelogenous leukemia: acute erythroleukemia
M6
what subtype of acute myelogenous leukemia: acute megakaryocytic leukemia
M7
who is more likely to have acute myeloid leukemia with t(8;21) (q22;q22.1); RUNX1/RUNX1T1
kids
what leukemia has pseudo-pelter-huet cells
acute myeloid leukemia with t(8;21) (q22;q22.1); RUNX1/RUNX1T1
what AML has myeloblast, mono blast, and promyelocytes in PB and BM
acute myeloid leukemia with inv(16) (p13.1q22) or t(16;16)(p13.1;q22);CBFB-MYH11
what stages does acute promyelocytic leukemia with PML-RARA stop diff
promyelocyte stage
people with acute promyelocytic leukemia with PML-RARA are at risk of
DIC
where is the translocation in acute promyelocytic leukemia with PML-RARA
15;17
what kind of AML has an increase of mono blast and immature monocytes
acute myeloid leukemia with t(9;11) (p22;q23);KMT2A (MLL)-MLLT3
AML M0: MPO ____ and SBB ____
neg
neg
AML M1: MPO __ and SBB ___
pos
pos
who is mostly likely to get MPNs
seniors
what causes MPN
gene mutations in HSC
what do gene mutation in HSC do
increase proliferation in all cell lines
what cell is the most increased in polycythemia vera
erthrocytosis
what mutation do polycythemia vera, essential thrombocythemia, and primary myelofibrosis
JAK2 mutation
what mutation does CML have
Ph chromosome
CML: basophils are ____
increased
CML: LAP ____
decreased
what is the M:E ratio of CML
10:1
what is the treatment for CML
sleenomagaly. and clevec
what does a mutated Philadelphia chromosome and BCR/ABL fusion gene activate
protein kinase –> proliferation of cells
what is other lab finding of CML
increase in uric acid
during a CML blast crisis how do pt respond to therapy
poorly
what % of blast will be present during a blast crisis in CML
10 to 19%
what can a CML blast crisis transform into
acute lymphoid or acute myeloid leukemia
what are the 4 criteria for polycythemia vera diagnosis
- increased hb and hct
- BM hypercellularity
- ID of JAK2 mut
- low serum EPO levels
people with polycythemia vera are at risk of(3)
hemorrhage, tissue infarction, and thrombosis
PV or secondary hypoxia? red cell mass always increased
PV
PV or secondary hypoxia? EPO is decreased
PV
PV or secondary hypoxia? arterial o2 saturation is normal
PV
PV or secondary hypoxia? leukocytosis and increased plts
PV
PV or secondary hypoxia? splenomegaly
PV
PV or secondary hypoxia? red cell mass can be increased
secondary hypoxia
PV or secondary hypoxia? BM only erythroid hyperplasia
secondary hypoxia
PV or secondary hypoxia? EPO increased
secondary hypoxia
PV or secondary hypoxia? arterial o2 saturation is decreased
secondary hypoxia
what are the clinical features of PV
thrombosis and hemorrhage
what condition cause blood vessels in face to be red
PV
what is the therapy for PV
giving their own blood
what are the PBS findings of essential thrombocythemia
- neutrophilia with slight left shift
- increase in PLts
T or F: plts function properly in essential thrombocythemia
F
what are the complications of essential thrombocythemia
hemorrhage and thrombosis
what will the BM look like of essential throbocythemia
hypercellularity with marked megakaryocytic hyperplasia
disease? abnormal clone of megakaryocyteds stimulate the BM fibroblast to produce collagen
primary myelofibrosis
what do fibroblastic growth factors release
plt derived growth factors
describe the BM tap from a primary myelofibrosis pt
dry tap
what kind of hematopoiesis do primary myelofibrosis pts do
extra medullary
diagnosis:
- immature granulocytes
- nRBCs
- teardrop cells
- giant plts
primary myelofibrosis
what CBC parameter is increased in CML
WBC
what CBC parameter is increased in pv
RBC
what CBC parameter is increased in essential thrombocythemia
plt
