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Leukaemia Flashcards

1
Q

leukaemia defination ?

A
  • it is a neoplastic disorder
  • characterized by
  • uncontrolled abnormal proliferation of Haemopoirtic cells
  • progresively increasing infiltration of bOne marrow
  • which refelcts the Peripheral blood
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2
Q

L classification ?

A
  • acute myeloblastic L
  • chronic lymphoblastic L
  • MIXED phenotypic AL
  • acute myelocytic / granulocytic L
  • chronic lymphocytic L
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3
Q

ALL classification ??

A
  • small homogenous lymphoblast
  • large h l
  • heterogenous l

L1 - L2 - L3

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3
Q

AML classification ?

A
  1. minimal differentiated AML
  2. ML without maturation
  3. ML with maturation
  4. hypergranular pro-myelocytic L
  5. myelo-monocytic L
  6. monocytic L
  7. Erythro-L
  8. Megakaryo-Blastic L

FAB classification

M0 - M7

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4
Q

which Acute L in children ??

A

lymphoblastic

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4
Q

which acute L in adult ??

A

myeloblastic

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5
Q

Blast cell >30% = ??

A

AL

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5
Q

BLAST cell = 20%
> 5%
<30%

A

myelodysplastic syndrome

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6
Q

which L is less aggressive?

A

chronic L

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6
Q

DIFFICULt to cure / less respinsivee to therapeutic intervention which L ?N

A

chronic L

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7
Q

WHAT is Blast cell ??

A

early bone marrow Haemopoietic cells - found in AL

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7
Q

Slower progression which L ?

A

Chronic L

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8
Q

CBC of AML ?

A
  • Hb% -
  • PCV -
  • RBC count -
  • WBC count = high/normal with blast cell = Gross leukocytosis
  • platelet count -
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8
Q

Bone marromarrow of AML ??

A
  1. cellularity = hypercellular
  2. M/E ratio = +
  3. erythropoiesis = -
  4. granulopoiesis = immature blast cells
  5. megalaryopoiesis = -
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8
Q

PBF of AML ?

A
  • RBC = Normochromic normocytic anisocytosis poikilocytosis macrocytes - mild polychromasia
  • platelet = (-)
  • WBC = immature blast cells + Auer bodies + smear cells + gross leukocytosis with left shift + prominent cell - Myeloblast
    *
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9
Q

cytochemical stains of AML ?

A
  • sudan black B +
  • myeloperoxidase +
  • periodic acid schiff -
  • non-specific esterase +
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10
Q

immunophenotyping of AML ?

A

CD13
CD33

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11
Q

CBC & PBF of ALL ?

A

Same as AML

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12
Q

Bone marrow of ALL ?

A

same as AML

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13
Q

Cytochemical stains of ALL ?

A

Opposite to AML

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14
Q

main diagnostic criteria for acute L ?

A
  • anemia
  • thrombocytopenia
  • presence of blast cells
  • with/without leukocytosis
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15
Q

cytoplasm of myeloblast special feature ?

A

auer rods ?

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16
Q

what is auer rods ?

A

large crystalline cytoplasmic inclusion bodies found in myeloblastic cells

17
Q

what is faggots ?

A

multiple auer rods

18
Q

origin of auer rods ?

A

fusion of azurophil granules

19
Q

Myeloblast vs Lymphoblast ?

just Myeloblast porbo then ulta for L

A
  • size= larger
  • cytoplasm = more- granular
  • nucleoli = more
  • N/C ratio =not so high
  • chromatin = loose
  • auer body = +
20
Q

why anemia & thrombocytopenia in acute L ?

A

normal HSC are replaced by infiltrating neoplastic cells

21
Q

AML & ALL ??

100%

A
  1. AML = adult
  2. prominent cell = myeloblast
  3. more common
  4. auer rods = +
  5. smears cell = -
  6. cytochemical stain = all
  7. response to therapy is low
22
Q

PBF of CML ?

A
  • RBC - N-N-A-P-polychromasi - basophilic stippling
  • Platelet = chroni + late stage -
  • WBC = leukocytosis & markdly shift to left , myelocyte , metamyelocytes , E+B = ++++ Eosinoiphilia
22
Q

CBC of CML ?

A
  • Hb% -
  • RBC -
  • WBC= gross leukocytosis with left shift
  • Platelet = chronic phase + late phase -
23
Q

BM of CML ?

A
  • C= hypercellular
  • M/E = +
  • E= -
  • G= myelocyte & myeloblast
  • M = +/depressed
24
Q

chromosomal study of CML ?

A

Philadelphia c

25
Q

Lab Dx of CLL ?

A

same as CML

25
Q

biochemical examination of CML ?

A
    • = V-B12 , uric acid , LDH
    • = LAP score leukocyte alkaline phosphate
26
Q

which chromosome abnormal in Philadelphia

27
Q

M/A of Philadelphia C ?

A

Reciprocal translocation between C- 22 & 9

28
Q

transfer portion of chromosome of 22 & 9 ??/

A

C-abl = abelson cellular protooncogen of C-9 is transferred to Break point cluster region of C-22
long aarm of C-22 is transferred to short arm of c-9

29
Q

consequences of Philadelphia C ?

A

C-abl DNA are joined to DNA of C-22 = oncogene producntion = alerted structure & fucntion

30
Q

Phases of CML?

A
  1. chronic phase
  2. accelerated phase
  3. blastic phase
30
Q

cause of death in CML ?

A
  1. blastic crisis
  2. secodary infection
  3. myelofibrosis
31
Q

Blastic crsis means ??

A

transformation to acute L

32
Q

what is Chloroma ?

A

localized sub-periosteal leukaemic tumor masses

AML-CML/CGL

32
Q

Blast cells count in Blastic crisis ?

A

-. myeloblast = 70-80%
lymphopblast = 20-30%

33
Q

Blood picture of blastic crisis ?

A
  • Hb% -
  • Plateelt - =thrombocytopenia
  • Basophill = +
    • blast cells
34
Q

types of Leukaemoid reaction ?

A
  1. myeloid LR
  2. lymphatic LR
35
Q

What is Leukaemoid reaction ??

A

it is a occurance of peripheral blood picture resembling that of L in a subject who does not have L
but BM = shows normal picture ……

35
Q

MLR ?/

A
  1. acute haemolysis
  2. infection
  3. pneumonia
  4. meningitis
  5. septicemia
  6. miliary TB
36
Q

Lymphatic Leukaemoid reaction >??

A
  • CMV
  • Infectious mononucleosis
  • pertusis
  • measles
  • wouphing cough
  • miliary TB

413

37
Q

what is leuco-erythroblastic Blood picture ??

A

presence of immature myeloid + nucleated red cells in the peripheral blood

38
Q

causes of L-E blood picture ?

A
  1. secondary carcinoma of bone
  2. multiple myeloma
  3. myelofibrosis
  4. marble bone diseases
  5. Thalassemia
  6. lymphoma
  7. haemolytic anaemia
39
Q

Pancytopenia + L-E-Blood picture ?

A
  1. lymphoma
  2. myelofibrosis
  3. metasttatic carcinoma of BM
40
Q

Sub-leukaemic L ????

A
  • total WBC count in peripheral blood is not increased - few blast cells are presnet ???
  • but BM shows a picture of L
40
Q

No blast cells in PBF is called ??

A

Aleukaemic L

41
Q

what is myelodysplastic syndrome ?

A

it is a heterogenous group og L related condition characterized by various combination of A+ N+thrombocytopenia

42
Q

Hallmark of myelodysplastic syndrome ?

A

apoptosis in peripheral blood

43
Q

CBC of Myelodysplastic s ?

A

same as AML

Pathology-Medical-Prof (36 decks)

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