Leukaemia Haematology Flashcards

1
Q

When does acute lymphoid leukaemia commonly present?

A

In childhood

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2
Q

What is the primary presenting problem of acute leukaemia?

A
  • sore legs

- not wanting to walk/play

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3
Q

What are the clinical signs of acute leukaemia?

A
  • anaemia
  • bruising
  • lymphadenopathy
  • organomegaly
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4
Q

What is used to investigate a possible case of leukaemia?

A
  • FBC
  • Differential count
  • Blood film
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5
Q

What are the two main branches of haematopoietic progenitor cells?

A

Lymphoid and Myeloid

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6
Q

What do lymphoid progenitor cells give rise to?

A
  • T and B lymphocytes

- NK cells

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7
Q

What do myeloid progenitor cells give rise to?

A
  • RBCs
  • Megakaryotes
  • Eosinophils
  • Basophils
  • Monocytes
  • Neutrophils
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8
Q

What mediates haematopoiesis?

A

Cytokines: small proteins that are important for cell signalling

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9
Q

Name four types of cytokines.

A
  • Interferon
  • Tumour necrosis factors
  • Growth factors
  • Interleukin
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10
Q

Describe haematopoietic malignancies.

A
  • clonal diseases

- single cell in bone marrow or lymphoid tissue undergoes a genetic alteration

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11
Q

Define acute leukaemia.

A
  • uncontrolled proliferation of leukaemic cells (at least 20% blasts)
  • at early stage of haematopoietic differentiation
  • with arrest of differentiation/maturation
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12
Q

What is chronic leukaemia?

A
  • proliferation of mature/differentiated haematopoietic cells
  • proliferation at slow rate
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13
Q

What signs can leukaemia cause?

A
  • hepatosplenomegaly
  • lymphadenopathy
  • gym hypertrophy
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14
Q

What is hyperleukocytosis?

A
  • increased viscosity of the blood due to an increase in WBCs
  • medical emergency
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15
Q

Briefly discuss two complications of hyperleukocytosis.

A
  • pulmonary leukostasis: present with dyspnoea and cough
  • cerebral leukostasis: loss of consciousness, confusion, cerebral nerve palsies, vision loss, cerebral infarcts, bleeding
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16
Q

What can cause hyperviscosity? (5)

A
  • decreased volume: dehydration
  • increased protein: paraprotein
  • increased RBCs: polycythaemia
  • increased WBCs: leukaemia
  • increased platelets: thrombocythaemia
17
Q

How can leukaemia be diagnostically classified?

A
  • morphology and staining
  • immunophenotyping: looking for antigens and specific cell contents
  • cytogenetics: looking for translocations, etc.
  • molecular genetics: looking for fusion proteins, etc.
18
Q

What is the aim of treatment in leukaemia?

A
  • destroy clonal cells

- protect residual stem cell compartment for normal haematopoiesis

19
Q

How is leukaemia managed?

A

Supportive care

  • Transfusions
  • Treat infections
  • Prevent and manage metabolic complications (liver, kidney, electrolytes)
  • Psychological care
20
Q

How is neutropenic fever identified?

A
  • potentially life-threatening complication of chemotherapy
  • temp > 38
  • WBC < 0.5
  • no pus formation
21
Q

How is neutropenic fever managed?

A
  • take cultures
  • broad-spectrum antibiotics within an hour
  • no rectal examinations or suppositories to avoid infection