leukaemia

Question 1

what is a haematological malignancy?

Answer 1

DNA mutation
stwitches off tumour suppressor gene or on an oncogene
clonal proliferation

Question 2

what are the 3 characteristics of cancer cells

Answer 2

uncontrolled proliferation
loss of apoptosis
loss of normal functions/products

Question 3

what are the 2 categories of leukemia?

Answer 3

acute and chronic

Question 4

what describes the point in a cell line or the cell line at fault?

Answer 4

lymphocytic, lymphoblastic or myeloid

Question 5

what is leukemia?

Answer 5

a group of cancers of the bone marrow which prevent normal manufacture of the blood

Question 6

what does leukaemia result in?

Answer 6

anaemia
infection - neutropenia
bleeding - thrombocytopenia

Question 7

what is the pathogenesis of leukaemia?

Answer 7

clonal proliferation
-plasma clones spread to bone and can replace proteins
replacement of marrow
increasing marginalisation of productive normal marrow
-marrow failure
-organ infiltration

Question 8

what is the clinical presentation of leukaemia

Answer 8

anaemia
neutropenia
thrombocytopenia
lymphadenopathy-neck lumps
splenomegaly/hepatomegaly-swollen abdomen
bone pain -esp. kids

Question 9

what are the symptoms of anaemia?

Answer 9

breathlessness
tiredness
easily fatigued
chest pain/angina

Question 10

what are the signs of anaemia?

Answer 10

pallor
signs of cardiac failure
nail changes

Question 11

what is the clinical presentation of neutropenia?

Answer 11

infections associated with portals of entry
reactivation of latent infections
increased severity, frequency and can rapidly lead to systemic infection

Question 12

what are the infections associated with portals of entry?

Answer 12

mouth
throat- tonsillitis, pharyngitis
chest-bronchitis, pneumonia
skin- impetigo, cellulitis
perianal- thrush, abscesses

Question 13

what are the symptoms of neutropenia?

Answer 13

recurrent infection

unusual severity of infection

Question 14

what are the signs of neutropenia?

Answer 14

unusual patterns of infection and rapid spread
will respond to tx but recur
signs of systemic involvement-fever, rigor, chills

Question 15

what are the investigations of neutropenia?

Answer 15

unusual pathogens esp. bacterial

Question 16

what are the symptoms of bleeding?

Answer 16

bruises easily or spontaneously
minor cuts fail to clot
gingival bleeding or nose bleeds
menorrhagia

Question 17

what are the signs of bleeding?

Answer 17

bruising
petechiae
BOP
bleeding/bruising following procedures

Question 18

describe acute lymphoblastic leukaemia

Answer 18

peak age 4
25 per 1,000,000
develops over days/weeks
catabolic state-fever, sweats, malaise
lymphadeopathy
tissue infiltration
>80% children cured

Question 19

describe acute myeloid leukaemia?

Answer 19

25 cases per million
common in elderly
similar presentation to ALL

Question 20

describe chronic lymphocytic leukaemia

Answer 20

B-cell clonal lymphoproliferative disease
older adults peak 70
70 per 1,000,000
2:1 M:F
mostly asymptomatic
slow progression may not require tx
occasional blast transformation-aggressive

Question 21

describe chronic myeloid leukaemia

Answer 21

increase in neutrophils & their precursors
95% have Philadelphia chromosome
15 per 1,000,000
peak 50-7- y/o
slight male prepondernce

Question 22

what is the clinical presentation of chronic myeloid leukaemia?

Answer 22

fatigue, weightloss, sweating

anaemia, bleeding, splenomegaly