Leukemia

Question 1

What is neutropenia

Answer 1

lack of production/degradation- lack of white cells, granulocytes, Neutropenia < 1500 cells, Agranulocytosis < 200 cells

Question 2

What is leukopenia

Answer 2

reduction in white cells, but not as specific as neutropenia, that refers to neutrophils,

Question 3

What are the acquired disorders that cause leukopenia

Answer 3

MC**1] Drug related (chemo, abx, AED), 2] Devastating infection, 3] Splenomegaly, 4] Bone marrow dz

Question 4

What is how infections can cause leukopenia

Answer 4

at different courses in illness, white count may change. May be high initially, but then immune system can’t keep up so it goes down.

Question 5

What is Felty’s syndrome

Answer 5

RA variant, splenomegaly, low WBC count in RA Patient

Question 6

List the bone marrow diseases that can cause leukopenia

Answer 6

1] Aplastic anemia (or pancytopenia), 2] Irradiation (BM depression), 3] Overgrowth of other precursors

Question 7

What is a genetic disorder that causes neutropenia?

Answer 7

Periodic/Cyclic Neutropenia-every 21-30 d, lasts approx 10d cycles: 1] Serious or recurrent bacterial/fungal infections (MC = respiratory), 2] Necrotizing oral lesions 3] Skin/mucosal ulceration like Aphthous

Question 8

What is the formation and maturation of WBCs

Answer 8

WBCs are formed and differentiate in the bone marrow and They travel to the lymphoid organs to mature and develop

Question 9

What is neoplasms arising from bone marrow

Answer 9

cause leukemias or plasma cell dyscrasias and can spread to LN

Question 10

What is neoplasms arising from lymph node

Answer 10

lymphomas-Solid, lymphoid tumors spread to the BM

Question 11

What is the most MCC of cancer in the US?

Answer 11

Skin

Question 12

What is the hallmark of Hodgkin Lymphoma

Answer 12

Reed-Sternberg cells-1] Binucleated cell, 2] Clear chromatin, 3] Owl eyes

Question 13

What is the incidence rate of Hodgkin Lymphoma

Answer 13

1] Bimodal distribution w/ peaks in 20s and >50, 2] M:F = 1:1 early, M>F late

Question 14

What is the etiology of Hodgkin lymphoma

Answer 14

Etiology unknown - suspected response to infection EBV

Question 15

What is presentation of Hodgkin Lymphoma

Answer 15

1] Single, painless enlarged lymph node (or small group), **2] Typically superior to diaphragm (cervical/mediastinal), CONTIGUOUS 3] Fever, chills, night sweats, 4] Rapid progression of abnormal lymphocytes leads to infectious disease and “anergy”

Question 16

What is the issue in Hodgkin lymphoma

Answer 16

they don’t fight infections well due to abnormal morphology & functionality

Question 17

What is NON Hodgkin Lymphoma

Answer 17

1] Heterogeneous d/t transformation of cells at any stage of B or T cell differentiation, 2] 3x more common than hodgkins, 3] Viral cause also postulated, but not sure.

Question 18

What is the presentation of NON Hodgkin Lymphoma

Answer 18

1] Presentation depends on type and stage of tumor, 2] MC presentation is painless, superficial lymphadenopathy, 3] NON CONTIGUOUS spread, 4] Frequent infections - viral common

Question 19

What is leukemia

Answer 19

Malignant neoplasms of hematopoietic stem cells that replace bone marrow with neoplastic cells

Question 20

What is the most common childhood cancer

Answer 20

Acute Leukemia, but effects more adults than kids

Question 21

What is the classification of leukemia

Answer 21

1] Lymphocytic: immature lymphocytes, 2] Myelogenous: granulocytes/monocytes

Question 22

What is myelocytic leukemia

Answer 22

1] Mutation of myeloid cell line, 2] Overproduction of abnormal monocytes or granulocytes, 3] Production of other cell types decreases

Question 23

What is lymphocytic leukemia

Answer 23

1] Mutation of lymphoid cell line, 2] Overproduction of abnormal immune cells, 3] Production of other cell types decreases

Question 24

List the environmental exposures associated with leukemia

Answer 24

1] Chemotherapy 2] Benzene 3] Radiation

Question 25

Describe the genetic link of leukemia

Answer 25

high rates among those with genetic abnormalities (10x normal rate in Down Syndrome)

Question 26

What is acute leukemia

Answer 26

Sudden onset, >30% blast cells = diagnostic

Question 27

What is the MC childhood cancer?

Answer 27

ALL- acute lymphocytic leukemia

Question 28

What is the signs and symptoms of acute leukemia

Answer 28

S/Sx related to bone marrow depression, fever, fatigue, pallor, wt loss, infection, bruising, nosebleeds, CNS in ALL than AML

Question 29

Who is affected by AML?

Answer 29

mostly adults, linear increase thru middle age

Question 30

What are signs of pan-cythemia

Answer 30

dont clot, anemic, red cells don’t work

Question 31

What is chronic leukemia

Answer 31

Well differentiated myeloid and lymphoid cells

Question 32

What is the pathogenesis of CLL

Answer 32

CLL - mostly > 50; Malignant transformation of *B cells, Cells immunologically incompetent and Pt gets lots of Infections with Autoimmune activity

Question 33

What is the pathogenesis of CML

Answer 33

CML - 30-50yo. Transformation of pluripotent stem cell, has a characteristic Philadelphia Chromosome which is Chromosome 9:Chromosome 22 translocation

Question 34

What is the characteristic of multiple myeloma?

Answer 34

Bence Jones protein. Calcium R A B.

Question 35

What is the presentation of CLL

Answer 35

1] Slow, indolent course, 2] Often asymptomatic at dx, 3] Lymphocytosis on CBC, 4] Fatigue, reduced exercise tolerance, enlarged nodes, splenomegaly, 5] Usually an incidental finding

Question 36

What is the presentation of CML

Answer 36

1] Variable chronic phase - slow onset with weakness/wt loss, 2] Short accelerated phase - spleen enlargement, constitutional signs, 3] Terminal blast crisis - evolution to acute leukemia (3 mo)= DEATH

Question 37

What is neutropenia associated with leukemia

Answer 37

Occurs rapidly because of 1d life span in blood and then Move into peripheral tissue