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Clin Med hematology > Leukemia and Lymphoma > Flashcards

Leukemia and Lymphoma Flashcards

1
Q

What is the median age at diagnosis for AML

A

68

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2
Q

How does AML present

A

Nonspecific symptoms that have been around for 3 months or less
-weight loss
-fever
-cough
-bone pain
-bruising / easy bleeding

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3
Q

What is the workup for AML

A

Variable WBC count (>20% blasts)
Low neutrophil count

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4
Q

What is the workup for AML

A

Variable WBC count (>20% blasts)
Low neutrophil count
Thrombocytopenia
*decreased reticulocyte count

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5
Q

What will be present on histology reports in AML

A

Auer rods

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6
Q

What are supportive measures for AML

A

Platelet transfusions
PRBCs
Prophylaxis with neutropenia
Prompt abx if febrile

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7
Q

What lab value is determinant of remission

A

blasts <5%

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8
Q

What are some antibiotics you could use for someone with AML who has a fever

A

Imipenem
Meropenem
Pipercillin/tazobactam

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9
Q

Which gender is more prone to developing CML

A

Males

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10
Q

What is the average age of diagnosis for someone with CML

A

65y/o
*rare under age 40

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11
Q

What is the pathophys of CML

A

Bar-abl (philadelphia chromosome) results in hyperactive Tyrosine

*Interferes with JAK/STAT pathway to produce resistance to apoptosis

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12
Q

What are some lab findings of CML

A

Leukocytosis
Thrombocytosis

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13
Q

What gives a definitive dx of CML

A

Bone marrow bx
genetic testing

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14
Q

What is the first line treatment of CML

A

Tyrosine Kinase Inhibitor

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15
Q

What is curative treatment of CML

A

Bone marrow transplant

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16
Q

What are signs that CML is progressing

A

Leukocytosis is resistant to treatment

Worsening anemia

Fever

Increased number of blasts / basophils

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17
Q

What is the most common malignancy in kids

A

ALL

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18
Q

What causes ALL

A

T or B cell mutations

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19
Q

Which cell line mutation has a worse prognosis

A

T cell mutation

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20
Q

Which children have an increased risk of developing ALL

A

Children with Down syndrome

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21
Q

What is the presentation of ALL

A

Fever
Fatigue/lethargy
Bone pain
Weight loss
Fever
Bruising / easy bleeding

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22
Q

What is the most common finding of ALL

A

Pallor
petechiae
ecchymosis

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23
Q

What laboratory findings will be found with ALL

A

Leukocytes (normal or elevated)
Most patients will have blasts
Elevated eosinophils
neutropenia
thrombocytopenia

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24
Q

How do you get a definitive diagnosis for ALL

A

Bone marrow biopsy

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25
Q

What is considered a cute in ALL

A

10 or more years in remission

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26
Q

What is CLL

A

malignancy of B lymphocytes

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27
Q

What are risk factors for CLL

A

Agent orange (vietname vets)
Hairdressers
Farmers
hx of HCV infection

28
Q

What are some symptoms with CLL

A

Fatigue
lymphadenopathy (non painful)

29
Q

What are some laboratory findings of CLL

A

Sustained lymphocytosis >20,000
CD19 & CD5 on flow cytometry
*platelet count usually normal

30
Q

What occurs in stage 1 of CLL

A

Presence of lymphadenopathy

31
Q

What stage CLL does Spleno- hepatomegaly occur in

A

Stage 2

32
Q

What occurs in stage 3 of CLL

A

Presence of anemia

33
Q

What stage of CLL does the presence of thrombocytopenia occur in

A

Stage 4

34
Q

What is the first line treatment for CLL

A

observation

35
Q

What is the first line treatment if the patient is symptomatic

A

Bruton tyrosine kinase inhibitors

36
Q

What is the median age of diagnosis for non-hodgkin lymphoma

A

76

37
Q

What do oncogenes allow for

A

Promote unchecked cell proliferation

38
Q

What does the tumor suppressor gene do

A

Stop cell proliferation

39
Q

What occurs in burrito lymphoma

A

Unchecked proliferation of B-cell proliferation

40
Q

What occurs in follicular lymphoma

A

Inhibition of Apoptosis

41
Q

How does Non-hodgkin lymphoma present

A

Lymphadenopathy (painless)
B symptoms

42
Q

What are B symptoms in Hodgkin lymphoma

A

Fever
Night sweats (drenching)
Weight loss (>10% in 6 months)

43
Q

how do you get a definitive diagnosis of non-hodgkin lymphoma

A

Lymph node biopsy

44
Q

How do you do staging with non-hodgkin lymphoma

A

PET/CT
Bone marrow bx
+/- LP

45
Q

What is the mainstay treatment of non-hodgkin lymphoma

A

Chemotherapy

46
Q

When can radiation therapy be used in non-hodgkin lymphoma

A

Stage 1 or 2 disease

47
Q

When are bone marrow transplants used in non-hodgkin lymphoma

A

Reserved for relapse that remain positive to chemotherapy

48
Q

What is the median age of diagnosis for Hodgkin lymphoma

A

39-40

49
Q

What is the average age range for Hodgkin lymphoma

A

20-34

50
Q

Which gender is at higher risk for developing Hodgkin lymphoma

A

Males

51
Q

What are the risk factors for Hodgkin lymphoma

A

Epstein Barr virus
HIV
Aids

52
Q

What is the presence of Hodgkin lymphoma

A

Similar to non-hodgkin lymphoma
-arisus from single lymph node
-contiguous spread
-hemotogenous spread

*generalized pruritic with ETOH ingestion and bathing

53
Q

What will be seen on a lymph node biopsy for Hodgkin lymphoma

A

Reed-sternberg cell on biopsy
-owl eye appearance
-Symmetric, bilobed nucleus

54
Q

What is the most common primary bone malignancy

A

Multiple myeloma

55
Q

Which ethnicity is at higher risk of developing multiple myeloma

A

African American

56
Q

What type of cell makes up multiple myeloma

A

Plasma cell tumor

57
Q

What is often the first symptom of multiple myeloma

A

Bone pain

58
Q

What will be seen on laboratory workup of multiple myeloma

A

Anemia (rouleau formation)
Hypercalcemia
Proteinuria (bence jones protein)

59
Q

What signs allow for diagnosis of multiple myeloma

A

Presence of paraproteins
Moth eaten appearance on imaging
CRAB symptoms

60
Q

What is the gold standard for multiple myeloma diagnosis

A

Biopsy
“fried egg appearance”

61
Q

What are CRAB symptoms

A

HyperCalcemia
Renal insufficiency
Anemia
Bone lesions

62
Q

How does Leukopenia generally present

A

Infections

63
Q

What are some causes of neutropenia

A

Drugs (chemo)
Infection
Nutritional
Genetic
Hematologic disease
Hypersplenism
Autoimmune diseases

64
Q

What ANC is indicative of infection risk

A

ANC< 1,000

65
Q

What are some causes of lymphopenia

A

Acute stressful illness (MI, sepsis)
Glucocorticoids
Lymphoma
Radiation
Bone marrow failure

66
Q

What are causes of monocytopenia

A

Acute stressful illness
Aplastic anemia
Leukemia
Immunosuppressants

67
Q

What are causes of eosinopenia

A

Glucocorticoids

Clin Med hematology (6 decks)

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