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Hematology > LEUCEMII ACUTE > Flashcards

LEUCEMII ACUTE Flashcards

1
Q

LAM

A

expansiunea clonala a blastilor de linie mieloida la nivelul maduvei

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2
Q

Transformarea leucemica a cel stem

A

bloc maturatiei
inhibarea hematopoiezei normale
anomalii cromosomiale dobandite => rearanjamente genice la niv pct de ruptura => GENE DE FUZIUNE -> deregl sint fact de transcriptie ai dif) => PROTEINE LEUCEMOGENE

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3
Q

LAM - Hlg

A

anemie normocroma, normocitara, aregenerativa
leucocitoza/ hiperleucocitoza/leucopenie
trombocitopenie

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4
Q

LAM - tablou sg perif

A

netropenie
cel blastice circulante
hiatus leucemic = absenta elem intermediare intre elem mature si blasti

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5
Q

LAM - medulograma

A

maduva hipercelulara
>20% BLASTI IN MADUVA
ex morfo, citoch, imunologic si citogenetic al blastilor

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6
Q

LAM 0

A

citologic neindentificabila
exprima markeri mieloizi
rata de rasp scazuta - prognostic NEFAVORABIL

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7
Q

LAM 1

A

LAM fara diferentiere
blastii seamana cu mieloblastul N
MPO +

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8
Q

LAM 2

A

LA cu maturatie
blastii seamana cu mieloblastul N
exista ELEM INTERMEDIARE
t(8;21) -> prognostic FAVORABIL

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9
Q

LAM 3

A

LA PROMIELOCITARA
blastii seamana cu promielocite anormale cu granule si corpi Auer
elib subst procoag -> CID
pancitopenie cu putini blasti circulanti
t (15;17) - gena pt R ATRA => trat specif

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10
Q

LAM 4

A

LA MIELO-MONOCITARA
tablou clinic: splenomegalie, adenopatii, hipertrofie gingivala
monocitoza perif (>5.000)
medulograma: monocitoza >20% din pop blastica

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11
Q

LAM 5

A 
LA MONOCITARA
hiperleucocitoza
hipertrofie gingivala
lizozim seric si urinar crescut
prolif EXCLUSIV linia monocitara
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12
Q

LAM 6

A 
ERITROLEUCEMIA
hiperplazie a liniei eritrocitare cu megaloblastoza si vacuoliz cel
mieloblasti >30% din seria G
glicoforina A +
prognostic defavorabil
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13
Q

LAM 7

A 
LA MEGACARIOBLASTICA (MIELOFIBROZA ACUTA)
CD 41 + (markeri care coresp GP plachetare)
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14
Q

LAM - fact de prognostic negativ

A 
varsta >60
leucocitoza >40.000
LAM 0, 4, 5, 6, 7
anomalii citogenetice - cr 5,7, complexe
forme sec
forme tu
neobt rasp hematologic complet dupa prima cura de inducere
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15
Q

Remisiune completa

A 
disparitia simptomelor clinice
Hlg normala
disparitia blastilor din tabloul sg
blasti <5% in maduva
maturatie N a celor 3 linii
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16
Q

LAM - tratament adjuvant anemie si hemoragii

A

tranfuzii de MER si/sau masa trombocitara

17
Q

LAM - tratament adjuvant prevenirea infectiilor

A

izolare
igiena pt prev infect exogene
decontamin tubului dig pt prev infect endogene

18
Q

LAM - trat adjuvant prevenirea IR

A

hiperdiureza alkalina

trat hipouricemiant

19
Q

LAM - tratament citostatic

A

de inducere - doze standard
!CORTICOIZI - doar pentru formele cu comp monocitara
de consolidare
de intensificare

20
Q

LAM 3 - tratament

A

ATRA (acid trans retinoic) -> prognostic favorabil

21
Q

LAL

A

prolif clonala a limfoblastilor la niv mad osoase

22
Q

transformarea maligna a limfoblastului

A

anomalii cromosomiale specif = rearanjamente genice la niv genelor care codif Ig (LyB) sau R Atg (LyT) (MARKERI DE CLONALITATE) => tulb de dif => bloc intr-un anumit stadiu de diferentiere

23
Q

LAL - clinic

A

insuf med, dureri osoase
sdr meningian (blastii au tropism pt SNC) -> PUNCTIE LOMBARA sistematic
adenopatii -> sdr de vcs
hepatosplenomgalie

24
Q

LAL - Hlg

A

anemie normocroma, normocitara, aregenerativa
trombocitopenie
leucocite crescute/N/scazute

25
Q

LAL - tablou sg perif

A

blasti circulanti

fara elem intermed

26
Q

LAL - medulograma

A

mad hipercel

disp/diminuarea liniilor mieloide

27
Q

LAL - clasif FAB

A

L1 - microlimfoblastica
L2 - macrolimfoblastica
L3 - Burkitt -lieke

28
Q

LAL3 - Burkitt-like

A

cel de talie medie, B
citopl bazofila, vacuoliz citoplasmatice
prognostic rezervat

29
Q

LAL - citogenetica

A

t(8;14) - LAL3

t(9;22) - prognostic rezervat, mai frecv la adulti, trat specif

30
Q

LAL - fact de prognostic nefavorabil

A 
anomalii cromosomiale t(8;14), t(9;22)
varsta <1 si >10
sex masculin
vol tu mare
LAL3
31
Q

LAL - tratament

A

citostatic - inducere, consolidare, intensificare, intretinere
!citostatice intrarahidian
transplant alogenic de cel stem - la prima remisiune completa in caz de fact de prognostic nefavorabil
transplant autolog de cs - caz de resuta, fara donator

Hematology (12 decks)

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