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HemOnc > Leukemia/Lymphoma > Flashcards

Leukemia/Lymphoma Flashcards

1
Q

leukemias are classified into (2) and additionally by (2)

A
  1. Acute vs. Chronic

2. myeloid vs. lymphoid

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2
Q

Lymphomas are classified as (2)

A
  1. Hodgkin’s lymphoma

2. non-Hodgkin’s

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3
Q

Leukemias involve:

Lymphomas are:

A
  • involve the bone marrow and blood

- “solid tumors” of the immune system

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4
Q

MALT tissue

A

mucosa associated lymphoid tissue–pyers patches, cobblestoning in throat, ^ T-cells

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5
Q

Leukemias and lymphomas further classified as (2)

A
  1. T cell

2. B cell

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6
Q

leukemia can emerge from

A

any blood cell line (i.e. basophilic leukemia, monocytic leukemia, etc.)

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7
Q

(3) aspects the reflect on leukemia presentation

A
  1. number and functional ability of immune system cells
  2. Infiltration/ replacement of normal hematopoietic compliment
  3. invasion/infiltration of lymph nodes (spleen, skin, etc.)
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8
Q

in lymphoma pt will have _______ number of circulating immune cells, but these cells…

A

greater,

won’t function normally

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9
Q

For exam know, in regards to each leukemia (2)

A
  1. what population gets them

2. key presentation feature for each

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10
Q

most common leukemia in the western world

A

Chronic lymphocytic leukemia CLL (30% of all)

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11
Q

1st and 2nd most common leukemia findings

A
  1. lymphadenopathy

2. splenomegally (infiltrated spleen)

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12
Q

CLL occurs in

A

older adults 70yo, males (least aggressive type)

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13
Q

Dx for CLL

A

BM Bx

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14
Q

Often begins w/ INDOLENT lymphocytosis and PAINLESS lymphadenopathy

A

CLL Chronic lymphocytic leukema

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15
Q

CLL stages

A

Stage 0: lymphocytosis

1: lymphocytosis w/ lymphadenopathy
2: organomegaly (spleen/liver)
3: Anemia
4: Thrombocytopenia

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16
Q

Most common leukemia in childhood and adolescence

A

acute lymphocytic leukema ALL (2-5 yo, white>black, male>female)

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17
Q

ALL prognosis

A

very aggressive, but treatable leukemia

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18
Q

ALL may present similar to

A

flu, but will not clear up

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19
Q

W/ ALL CNS r/o w/

A

lumbar puncture (looking for ALL in CNS)

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20
Q

Dx of ALL

A

bone Bx (hypercellular-blast dominate picture)

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21
Q

Tx for ALL (2) steps

A
  1. Induction therapy: aggressive chemo (daunrubicin)

2. Remission induction: “maintenance therapy” (chemo/rad)

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22
Q

radiation induced leukemia w/ highest incidence in mid 40 age group

A

Chronic Myelogenous leukemia CML

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23
Q

CML course

A

indidious, indolent course–progresses through 3 phases if not treated

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24
Q

Chronic myelogenous leukemia dx by

A

Philadelphia Chromosome-ID’s and confirms Dx

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25
Q

wonder drug for those displaying the Philadelphia Chromosome

A

Imatinib (Gleevec)–

26
Q

_____% of those w/ CML are asymptomatic

A

50%

27
Q

The most common ACUTE leukemia in adults

A

Acute Myelogenous Leukemia AML (average age 65yo)

28
Q

*smeer for AML

A

Auer Rods

29
Q

AML associated w/

A

environmental factors (radiation, benzene)

30
Q

AML may demonstrate

A

Tumor Lysis syndrom due to high turn-over of cells–Dx BM bx

31
Q

Complication of chemo in the tx of pt’s w/ very high WBC count

A

Tumor Lysis syndrome

32
Q

Tumor lysis syndrome (rapid lysis of cells dumping their contents) leads to (3)

A
  1. Hyperkalemia
  2. hyperphosphatemia + hypocalcemia
  3. hyperuricemia –> renal failure
33
Q

a heterogenous group of hematologic disorders which share these characteristics

A

Myelodysplasia/Myelodysplastic Syndrome (MDS)

34
Q

histology associated w/ abnormal appearing bone marrow

A

cytopenia

35
Q

MDS pt’s share these (3) characteristics

A
  1. cytopenia
  2. ineffective blood cell production
  3. the tendency to develop leukemia
36
Q

MDS associated w/ (3)

A

past chemo, radiation, or chem exposure

37
Q

average age of MDS onset

A

68 yo (ppl who have survived chemo/rad)

38
Q

Patient presenting w/ non-tender palpable lymph nodes, oven cervical; 1/2 will have mediastinal lymphadenopathy at dx

A

Hodgkin’s lymphoma

39
Q

classic finding in Hodgkin’s lymphoma

A

STERNBERG Cells lymph node Bx (cervical)

40
Q

lymphoma associated w/ prior epstain Bar virus infxn

A

Hodgkin’s lymphoma (peaks 20 and 65 yo)

41
Q

1/3 of Hodgkin’s lymphoma pt’s present w/

A 
B symptoms:
1. fever
2. night sweats
3. weight loss
A symptoms= No symptoms
42
Q

staging method used w/ Hodgkin’s lymphoma

A

Ann Arbor stages

43
Q

Tx for Hodgkin’s lymphoma:
Stage 1:
Stages 1-4:

A

1: radiation

2-4: Chemo + radiation

44
Q

all other lymphomas outside of hodgkin’s

A

non-hodgkin’s lymphoma

45
Q

The most RAPIDLY progressive human tumor

A

Burkitt’s lymphoma (presentation of lymphadenopathy (^head and neck) or abdominal mass) associated w/ EB virus

46
Q

T cell lymphoma of the skin

A

Mycosis fungoides

47
Q

3 grades of non-hodgkin’s lymphoma

A
  1. Low: small cell type, CLL related, elderly pts
  2. Intermediate: large cells, Middle age, B cell origin
  3. High: Lymphoblastic Lymphoma–T-cell (^aggressive)
48
Q

a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance MGUS to plasma cell leukemia

A

Multiple myeloma

49
Q

monoclonal neoplasms of a B cell line

A

Plasma cell disorder

50
Q

bone marrow is replaced by malignant plasma cell from a single clone

A

multiple myeloma

51
Q

Plasma cell disorder clinical manifestations are related to (2)

A
  1. expansion of neoplastic cells in marrow

2. secretions of the cells (immunoglobulin, lymphokines)

52
Q

M protein

A

A “PARAPROTIEN”–an immunoglobulin produced by Myeloma cells—-M protein stands for monoclonal protein (not myeloma)

53
Q

Bence Jones proteins think

A

Multiple Myeloma

54
Q

Proliferation of tumor cells and activation of osteoblasts results in

A

lytic lesions (in skull, ribs, vertebrae, and long bones)

55
Q

presentation of multiple myeloma (4)

A
  1. bone pain (worse at night)
  2. bac infxn
  3. Anemia (normochromic and normocytic)
  4. Renal failure (Bence Jones Proteins an immunoglobulin)
56
Q

Dx of Multiple myeloma (4)

A
  1. plasma pt electrophoresis
  2. x-ray or MRI
  3. BM Bx
  4. Bence Jones protein in URINE
57
Q

Tx for Multiple Myeloma (3)

A
  1. Stem cell transplant
  2. Thalidomid / Lenalidomide (Revlimid)
  3. Radiation for bone pain
58
Q

Plasma cell malignancy also presenting w/ M proteins + sensorimotor peripheral neuropathies

A

Waldenstrom’s Macroglobulinemia

59
Q

MGUS

A

Monoclonal gammopathy of undetermined significance

60
Q

An ASYMPTOMATIC PREMALIGNANT disorder characterized by limited monoclonal plasma cell proliferation in the BM and ABSENT of end-organ damage

A

monoclonal gammopathy of undetermined significance MGUS

61
Q

Cryoglobulinemia (hyperviscocity of blood)

A

Waldenstrom’s Macroglobulinemia

HemOnc (7 decks)

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