Leukemia

Question 1

define leukaemia

Answer 1

cancer of the bone marrow

Question 2

cause of leukaemia

Answer 2

immature blast cells uncontrollably proliferate, taking up space within bone marrow and then infiltrating into other tissues

fewer healthy cells can mature and be released

Question 3

Features of Acute lymphoblastic leukaemia

Answer 3

The most common leukaemia in children (often 0-4 years old)
Proliferation of immature lymphoblasts

Question 4

Presentation of Acute lymphoblastic leukaemia

Answer 4

General anaemia symptoms
Bleeding/bruising
Infections
Hepatosplenomegaly
Lymphadenopathy
CNS infiltration -> headaches, CN palsies

Question 5

how would you diagnose Acute lymphoblastic leukaemia

Answer 5

FBC -> anaemia, thrombocytopenia, neutropenia
Blood film
Bone marrow biopsy
Imaging (CXR/CT) -> lymphadenopathy

Question 6

management of ALL

Answer 6

Blood and platelet transfusions
Chemotherapy (methotrexate)
Steroids
Stem cell/bone marrow transplant
Antibiotics

Question 7

What would show on the blood film for ALL

Answer 7

Tdt

Question 8

Acute myeloid leukaemia can be the result of..?

Answer 8

transformation from a myeloproliferative disorder such as polycythaemia ruby vera or myofibrosis

Question 9

features of acute myeloid leukaemia

Answer 9

Proliferation of immature myeloblasts
Present mostly in the elderly
Only 15% 5-year survival

Question 10

presentation of Acute myeloid leukaemia

Answer 10

General anaemia symptoms
Bleeding/bruising
Infections
Hepatosplenomegaly
Gum hypertrophy

Question 11

diagnosis of acute myeloid leukaemia

Answer 11

FBC -> anaemia, thrombocytopenia
Blood film
Bone marrow biopsy -> auer rods

Question 12

what would blood film show for myeloid leukaemia ( acute )

Answer 12

myeloid peroxidase which appears as rods

Question 13

management of acute myeloid leukaemia

Answer 13

Blood & platelet transfusions
Chemotherapy
Stem cell/bone marrow transplant
Antibiotics

Question 14

features of Chronic lymphoblastic leukaemia

Answer 14

Proliferation of B lymphocytes
Mostly affects those 60+
Most common type of leukaemia in adults

Question 15

presentation of CLL

Answer 15

Often asymptomatic
Lymphadenopathy
May have night sweats and weight loss

Question 16

diagnosis of CLL

Answer 16

FBC -> anaemia, thrombocytopenia, leukocytosis
Blood film -> smudge cells
Bone marrow biopsy

Question 17

Management of cll

Answer 17

Watch and wait in early stages
Chemotherapy (rituximab)
Stem cell/bone marrow transplant

Question 18

features of chronic myeloid leukaemia

Answer 18

Proliferation of myeloid blood cells
Most common in adults over 40
The vast majority of cases are associated with the philadelphia chromosome

Question 19

presentation of cml

Answer 19

Presentation
General anaemia symptoms
Bleeding/bruising
Infections
Hepatosplenomegaly
Weight loss and night sweats
Gout

Question 20

diagnosis of CML

Answer 20

FBC -> anaemia, thrombocytopenia, leukocytosis
Bone marrow biopsy
Blood film
Genetic testing

Question 21

Management of CML

Answer 21

Chemotherapy
Stem cell/bone marrow transplant
Tyrosine kinase inhibitors (Imatinib)

Question 22

Differential diagnoses of petechiae

Answer 22

• leukaemia
• meningococcal septicaemia
  -vasculitis
  -HSP
• non-accidental injury

Question 23

most common leukaemia in children

Answer 23

acute lymphoblastic leukaemia - associated with down syndrome

Question 24

most common leukaemia in adults

Answer 24

chronic lymphotic leukaemia- associated with warm haemolytic anaemia