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clin med final > Leukemia > Flashcards

Leukemia Flashcards

1
Q

what cells are derived from the Myeloblast

A
  • erythrocyte
  • Thrombocyte
  • Monocyte
  • Neutrophil
  • Basophil
  • Eosinophil
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2
Q

What can cause elevated neutrophils

A

bacterial infections

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3
Q

What can cause elevated immature neutrophils (bands)

A
  • acute bacterial infections
  • sepsis
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4
Q

What can cause elevated lymphcytes

A

viral infections

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5
Q

What can cause the presence of atypical lymphcytes

A

epstein-barr virus

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6
Q

What is the most common acute leukemia in adults

A

acute Myelogenous leukemia

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7
Q

what lab values would lead you to suspect acute Myelogenous leukemia

A
  • peripheral blood is always abnormal
  • accumulation of leukemic blasts
  • reduced production of normal cells
    • neutrophils
    • erythrocytes
    • platelets
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8
Q

what are two important causes of acute Myelogenous leukemia

A
  • chemical exposure
  • Myelodysplastic syndrome (MDS): malignant hematologic disease
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9
Q

AML signs and symptoms arrives from which three cells being affected

A
  • RBC-> anemia
  • Neutropenia
  • thrombocytopenia
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10
Q

AML prognosis

A
  • favorable if younger than 60 yo
  • unfavorable if older than 60 yo or evolved from MDS
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11
Q

what is expected on peripheral smear in acute Myelogenous leukemia

A

Auer rods

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12
Q

what needs to be found in bone marrow biopsy for diagnosis of AML

A

Blasts > or = 20% of sample

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13
Q

What is Myelodysplastic syndrome

A
  • ineffective hematopoiesis
  • see cytopenias
  • more common in those > 60 y.o.
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14
Q

What is tumor lysis syndrome

A
  • emergeny!-> associated with high mortality
  • initiation of cytotoxic therapy or can occur spontaneously
  • massive tumor cell lysis: release of cellular contents
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15
Q

tumor lysis syndrome is manifested by what 4 symptoms

A
  • Hyperkalemia
  • Hyperphosphatemia
  • Hypocalcemia
  • Hypouricemia
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16
Q

treatment of tumor lysis syndrome

A
  • prevention
  • fluids
  • frequent monitoring of
    • K
    • phosphorus
    • uric acid
    • calcium
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17
Q

risk factor for chronic myeloid leukemia

A

ionizing radiation

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18
Q

90% of chronic myeloid leukemia is due to what genetic abnormality

A
  • philadelphia chromosome
  • translocation of chromosomes 9 and 22
19
Q

what are B symptoms

A
  • fever
  • drenching night swights
  • weight loss
20
Q

presentation

  • fatigue
  • malaise
  • abdominal fullness
  • splenomegaly
  • B symptoms
A

chronic myeloid leukemia

21
Q

chronic myeloid leukemia presents in what 3 phases

A
  1. chronic
  2. accelerated
  3. blast
22
Q

chronic phase of chronic myeloid leukemia

A
  • 80% patient diagnosed in this phase
  • asymptomatic
  • WBC > 100,000
  • <10% blood or bone marrow cells are blasts
  • typically lasts 5-6 yrs
23
Q

accelerated phase of chronic myeloid leukemia

A
  • 10-19% blood or BM cells are blasts
  • symptomatic
    • anemia
    • fatigue
    • malaise
    • flu-like symptoms
24
Q

blast crisis stage of chronic myeloid leukemia

A
  • 20% or more of blood or bone marrow cells are blasts
  • symptomatic
    • splenomegally
    • fatigue
    • fever
25
Q

how is chronic myeloid leukemia diagnosed

A
  • bone marrow biopsy
  • identification of Philadelphia chromosome
26
Q

treatment of chronic myeloid leukemia

A
  • tyrosine kinase inhibitors
    • gleevac=imatinib
27
Q

complications of chronic myeloid leukemia

A
  • hyperleukocytosis
    • wbc > 100,000/mcl
    • emergency!
    • decreased tissue perfusion
    • may require leukapheresis
  • hyperviscosity syndrome
28
Q

what is the most common cancer in children and teens

A

acute lymphocytic leukemia

29
Q

In acute lymphocytic leukemia, is cure rate more favorable in children or adults

A

children

30
Q

acute lymphocytic leukemia laboratory findings

A
  • blasts in peripheral blood
  • cytopenia
    • neutropenia
    • anemia
    • thrombocytopenia
  • elevated LDH
31
Q

what is expected to be found in peripheral smear of acute lymphocytic leukemia patients

A

lymphoblasts

32
Q

how is acute lymphocytic leukemia diagnosed

A
  • peripheral smear
  • bone marrow biopsy
33
Q

precursor B-cell acute lymphocytic leukemia has what prognosis

A
  • 70-80% cases of childhoos ALL
  • favorable!
    • 90% enter remission
34
Q

T cell acute lymphocytic leukemia

A
  • older age, male predominance
  • hyperleukocytosis at dx
  • tend to have more problems than B-cell ALL
35
Q

what is Mature B-cell acute lymphocytic leukemia? Prognosis?

A
  • Burkitt cell leukemia/lyphoma
  • favorable prognosis
36
Q

acute lymphocytic leukemia treatment

A
  • induction chemotherapy
  • monoclonal antibodies
37
Q

what is the most prevalent leukemia in adults in western countries

A

chronic lymphocytic leukemia

38
Q

what malignancy has the highest inheritability

A

chronic lymphocytic leukemia

39
Q

what is chronic lymphocytic leukemia

A
  • accumulation of incompetent lymphocytes in blood, bone marrow, and lymph nodes
40
Q

chronic lymphocytic leukemia clinical features

A
  • bone marrow failure
    • anemia
    • thrombocytopenia
    • neutropenia
  • organomegaly in advanced disease
    • lymphadenopathy
    • splenomegaly
    • hepatomegaly
41
Q

presentation

  • anemia
  • B symptoms
  • atypical infections
  • death due to
    • infection
    • bleeding
    • cachexia
A

chronic lymphocytic leukemia

42
Q

how is chronic lymphocytic leukemia diagnosed

A
  • bone marrow biopsy
  • lymph node biopsy
43
Q

treatment of chronic lymphocytic leukemia

A
  • Rituximab and other monoclonal antibodies

clin med final (9 decks)

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