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Hematology 1 > LEUKEMIA > Flashcards

LEUKEMIA Flashcards

1
Q

malignant neoplasm of the blood-forming tissues of the BM, spleen, and lymphatics

A

leukemia

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2
Q

old way of classifying leukemia

A

French-American-British classification

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3
Q

t or f. more blasts will lead to a shorter and more fatal disease

A

true

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4
Q

what is increased in shift to the left?

A

more younger forms of WBCs in the PBS

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5
Q

normal M:E ratio in adults

A

2:1 to 4:1

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6
Q

M:E ratio in leukemic patients

A

10:1

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7
Q

type of anemia that is commonly present in cases of acute leukemia

A

normocytic, normochromic

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8
Q

acute vs chronic leukemia (3 each)

A

acute

  • short duration of symptoms
  • immature cell forms in BM
  • increased total WBC ct

chronic

  • long duration of symptoms
  • mature cell forms in BM
  • low to extremely high WBC ct
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9
Q

new way of classifying leukemia

A

WHO classification

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10
Q

2 basis in classifying leukemia accdg to FAB:

A

morphology of cells in Romanowsky-stained smear

based on cytologic and histochemical characteristics

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11
Q

2 cytochemical stains used

A

myeloperoxidase

sudan black b

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12
Q

romanowsky composition (2)

A

methylene blue

eosin y/eosin b

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13
Q

romanowsky stain examples

A

wright’s, giemsa, may-grunwald

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14
Q

MPO and SBB of lymphocytic leukemias

A

MPO negative

SBB negative

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15
Q

most common form of childhood leukemia

A

acute lymphocytic leukemia (ALL)

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16
Q

ALL subtypes

A

L1, L2, L3

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17
Q

which ALL is called Burkitt-type of leukemia

A

ALL L3

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18
Q

basis of classification for ALL (6)

aic ncc

A
  • age
  • immunologic markers
  • cell size
  • nucleus and nucleolus
  • chromatin
  • cytoplasm
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19
Q

ALL that has nuclear and cytoplasmic vacuoles

A

ALL L3

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20
Q

ALL present in 70% of children

A

ALL L1

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21
Q

ALL present in 70% of adults

A

ALL L2

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22
Q

rare in children and adult

A

ALL L3

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23
Q

immunologic marker: CD24

A

ALL L3

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24
Q

immunologic marker: CD10

A

ALL L1

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25
Q

immunologic marker: TdT only

A

ALL L2

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26
Q

cell size: small blasts

A

ALL L1

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27
Q

cell size: hetero large blasts

A

ALL L2

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28
Q

cell size: homo large blasts

A

ALL L3

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29
Q

cytochemistry:

PAS positive
ORO positive

A

ALL L1 and ALL L2

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30
Q

cytochemistry:

MGP positive
ORO positive

A

ALL L3

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31
Q

most common type of leukemia in the elderly

A

chronic lymphocytic leukemia (CLL)

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32
Q

CLL characteristics: (2)

A
  • persistent lymphocytosis

- increased number of smudge and rieder cells

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33
Q

nuclear remnants of the lymphocytes; thumbprint appearance

A

smudge cells

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34
Q

lymphocytes with notched, lobulated or cloverleaf-like nucleus

A

rieder cells

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35
Q

clinical variations of CLL (3)

hlp

A
  • hairy cell leukemia
  • lymphosarcoma cell leukemia
  • prolymphocytic leukemia
36
Q

lymphocyte with little cytoplasmic projections

A

hairy cell

37
Q

stain used to detect hairy cell

A

TRAP +

tartrate resistant acid phosphatase

38
Q

MPO and SBB of non-lymphocytic leukemia (myelogenous leukemia)

A

MPO positive

SBB positive

39
Q

2 groups of myelogenous leukemia

A

acute myelogenous leukemia

chronic myelogenous leukemia

40
Q

AML types:

A

M0-M7

41
Q

AML that is negative for both MPO and SBB

A

M0

42
Q

AML origin for M0-M3

A

myelocytic

43
Q

AML M0 name

A

AML with minimal differentiation

44
Q

AML M1 name

A

AML without maturation

45
Q

AML M2 name

A

AML with maturation

46
Q

AML M3 name

A

acute promyelocytic leukemia

47
Q

AML types with auer rods (5)

A 
M1
M2
M3
M4
M6
48
Q

most common subtype of AML

A

AML M2

49
Q

AML associated with DIC and faggot cells

A

AML M3

50
Q

generalized overactivation of the coagulation and fibrinolytic system of the body (clot formation and bleeding)

A

disseminated intravascular coagulation (DIC)

51
Q

tests to detect DIC (2)

A

PF 1 + 2 (“prothrombin fragment”)

D-dimer test

52
Q

related conditions with DIC (TOMASA)

A
  • tissue trauma
  • obstetric complications
  • mucus-secreting tumors
  • acute infections (malaria, G- septicemia)
  • snake bites
  • acute promyelocytic anemia
53
Q

WBC with bundles of auer rods

A

faggot cells

54
Q

WBC with linear projections of primary granules

A

auer rods

55
Q

AML M3 subtype name and characteristics

A

AML M3V: APL, microgranular variant

butterfly/bowtie/apple core nuclei

56
Q

AML M4 origin

A

myelocytic

monocytic

57
Q

AML M4 name

A

acute myelomonocytic leukemia (AMML)

naegeli monocytic leukemia

58
Q

2nd most common subtype of AML

A

AML M4

59
Q

AML M4 subtype name and characteristics

A

AML M4E: AMML with increased marrow eosinophils

60
Q

AML M5 origin

A

monocytic

61
Q

AML M5 name

A

acute monocytic leukemia (AMoL)

schilling leukemia

62
Q

AML M5 subtypes name and characteristics (2)

A

AML M5a: AMoL, poorly differentiated

  • seen in children
  • > 80% monoblasts in BM

AML M5b: AMoL, well differentiated

  • seen in adults
  • <80% monoblasts in BM
63
Q

AML M6 origin

A

erythrocytic

myelocytic

64
Q

AML M6 name

A

acute erythroleukemia

di guglielmo’s syndrome

65
Q

type of anemia in M6

A

macrocytic and normochromic anemia

66
Q

t or f. normal erythroid cells should be positive in PAS?

A

false

67
Q

t or f. erythroid cells in AML M6 is positive in PAS

A

true

68
Q

AML M7 origin

A

megakaryocytic

69
Q

AML M7 name

A

acute megakaryocytic leukemia

70
Q

what immunocytochemistry stain is used to diagnose AML M7?

A

factor VIII stain

71
Q

AML cytochemical stains used (6)

mss nnf

A 
MPO
SBB
specific esterase
NSE butyrate
NSE acetate
factor VIII stain
72
Q

AML cytochemical reaction:

MPO SBB SE = positive

A

myelocytic origin

M1, M2, M3, M4
M6 - positive or negative

73
Q

AML cytochemical reaction:

NSE butyrate NSE acetate = positive

A

monocytic origin

M4, M5

74
Q

CML name

A

chronic myelogenous leukemia

chronic granulocytic leukemia

75
Q

CML characteristic

A

Ph1

Philadelphia chromosome

76
Q

how many percent of patients with CML have Ph1 chromosome?

A

90%

77
Q

in a normal individual, where are ABL and BCR gene found respectively?

A

ABL - long arm of chromosome 9

BCR - long arm of chromosome 22

78
Q

in patients with CML, what happens to his/her chromosome 9 and 22?

A

long arm of C9 with ABL gene translocates with BCR gene in long arm of C22 therefore producing BCR-ABL fusion gene in long arm of C22/ Philadelphia chromosome

79
Q

what gene causes CML and where it is found?

A

BCR-ABL fusion gene in the long arm of chromosome 22

80
Q

clinical syndrome resembling leukemia

A

leukemoid reaction

81
Q

test to distinguish leukemoid reaction vs CML

A

leukocyte (neutrophil) alkaline phosphatase test

LAP/NAP

82
Q

LAP/NAP test principle

A

increased LAP activity can be observed in NORMAL neutrophils

83
Q

only leukocyte that has alkaline phosphatase activity

A

neutrophil

84
Q

method used for LAP/NAP staining

A

kaplow’s method

85
Q

normal LAP score

A

20-100

86
Q

conditions with increased LAP score (4)

A

3rd trimester of pregnancy
polycythemia vera
infections
intoxication

all of these are characterized by leukemoid reaction

87
Q

conditions with decreased LAP score (4)

A

CML
PNH
sideroblastic anemia
myelodysplastic syndrome

Hematology 1 (6 decks)

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