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NYCC Physiopathology > Leukemias > Flashcards

Leukemias Flashcards

1
Q

name 4 examples of WBC disorders

A

leukopenia
leukocytosis
leukemia
lymphoma

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2
Q

White blood cell disorders form solid masses (TRUE/FALSE)?

A

FALSE

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3
Q

What is leukopenia?

A

Low WBC count due to reduced production or accelerated destruction of WBCs

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4
Q

leukopenia is associated with increased ____

A

infections

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5
Q

what is the most common cause of leukopenia?

A

chemotherapeutics (all cells affected = Aplastic anemia)

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6
Q

what are the symptoms of leukopenia?

A

malaise
chill
fever

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7
Q

What is leukocytosis?

A

High WBC count of mature non-neoplastic WBCs

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8
Q

What infection presents as a leukemoid reaction which may be confused with leukemias?

A

Acute appendicitis

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9
Q

Patient presents with lower right quadrant pain, nausea, vomiting, and pinpoint tenderness. CBC count shows 38,000 WBC and 80% neutrophils. What is a likely diagnosis?

A

Acute appendicitis

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10
Q

What is polymorphonucleocytosis indicative of?

A

Bacterial infection
(increased neutrophils)

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11
Q

What is eosinophilic leukocytosis indicative of?

A

Parasitic infection
(increased eosinophils)

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12
Q

What is lymphocytosis indicative of?

A

Viral infection
(increased lymphocytes)

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13
Q

What do lymphoid progenitor cells give rise to?

A

Lymphocytes (Agranulocytes)

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14
Q

What do myeloid progenitor cells give rise to?

A

Granulocytes (Neutrophil, Basophils, Eosinophil)

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15
Q

What form of leukemia is derived from lymphoid stem cells?

A

Lymphocytic leukemia

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16
Q

What form of leukemia is derived from myeloid stem cells?

A

Myeloid (Granulocytic) leukemia

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17
Q

What is lymphadenitis?

A

Inflammation of the lymph nodes presenting with enlarged, PAINFUL lymph nodes

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18
Q

Lymphadenitis will almost always present with…

A

pain and enlargement (lymphadenopathy) of lymph nodes (cardinal signs of inflammation)

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19
Q

What is lymphadenopathy?

A

Enraged lymph nodes with NO PAIN

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20
Q

(Lymphadenitis/Lymphadenopathy) is often the more serious condition?

A

Lymphadenopathy (independent of lymphadenitis)

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21
Q

What is leukemia?

A

Neoplastic disorder of uncontrolled proliferation of hematopoietic stem cells characterized by replacement of bone marrow with malignant cells

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22
Q

Leukemia’s are always (Benign/Malignant)?

A

Malignant

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23
Q

What is lymphocytic leukemia?

A

Leukemia derived from lymphoid stem cells including B and T cells

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24
Q

Lymphocytic leukemia affects primarily __________ cells?

A

B

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25
Q

What is myelogenous leukemia?

A

Leukemia derived from myeloid stem cells including granulocytes, monocytes, and megakaryocytes

26
Q

Myelogenous leukemia affects primarily _____________________?

A

Granulocytes

27
Q

What are histological characteristics of acute leukemia?

A
  • immature neoplastic cells, larger and less differentiated
28
Q

What are histological characteristics of chronic leukemia?

A

well differentiated cells that are mature, smaller and more compact

29
Q

describe the clinical presentation of acute leukemias

A
  • abrupt, stormy onset
  • symptoms related to depression of normal marrow: fatigue, fever, bleeding, bone pain, organomegaly, CNS involvement
30
Q

describe the clinical presentation of chronic leukemias

A
  • insidious onset, rather slow, indolent clinical course
  • elevated WBC count
  • no/vague symptomology: anemia, fatigue & weakness, weight loss, organomegaly
31
Q

(Chronic/Acute) leukemia is more severe if left untreated?

A

Acute

32
Q

If a patient has bone pain the diagnosis is more likely to be (Leukemia/Lymphoma)?

A

Leukemia

33
Q

If a patient has lymphadenopathy the diagnosis is more likely to be (Leukemia/Lymphoma)?

A

Lymphoma

34
Q

If a neoplasm is of bone marrow origin it is (Leukemia/Lymphoma)?

A

Leukemia

35
Q

If a neoplasm is of nodal origin it is (Leukemia/Lymphoma)?

A

Lymphoma

36
Q

What is the most common childhood leukemia?

A

Acute lymphocytic leukemia (ALL)

37
Q

Where does acute lymphocytic leukemia (ALL) originate in the body?

A

Bone marrow

38
Q

What is myeloperoxidase?

A

Enzyme made in the peroxisomes of myeloid (Granulocytic) cells

39
Q

What is the primarily histological indicator of a patient with acute lymphocytic leukemia (ALL)?

A

transformed B-cells are Myeloperoxidase negative (enzyme not present)

40
Q

What system of the body will be quickly affected in a patient with acute lymphocytic leukemia (ALL)?

A

CNS

41
Q

Male patient; 13 years of age. Presents with chronic fatigue, recurrent infections, fever, and bone pain. Biopsy of bone marrow cells shows bizarre cells that are negative for myeloperoxidase. What is the likely diagnosis?

A

Acute lymphocytic leukemia (ALL)

42
Q

What is the most common adult acute leukemia?

A

Acute myelogenous leukemia (AML)

43
Q

Leukemia most commonly occurs in (Children/Adults)?

A

Children

44
Q

What are the primary histological indicators of a patient with acute myelogenous leukemia?

A
  • Myeloperoxidase positive (present) and Auer Rod positive (present)
  • Abnormal retinoic acid receptors
45
Q

Male patient; 35 years of age. Presents with chronic infections, fever, fatigue, and deep, constant pain in the anterior thigh. Biopsy of the bone marrow in the anterior thigh shows large, poorly differentiated granulocytes. Granulocytic cells are positive for myeloperoxidase and Auer Rods. What is a likely diagnosis?

A

Acute myelogenous leukemia

46
Q

What form of leukemia presents with abnormal retinoic acid receptors due to gene fusion?

A

Acute myelogenous leukemia

47
Q

What form of leukemia can be treated with vitamin A therapy?

A

Acute myelogenous leukemia

48
Q

how does the prognosis of ALL and AML differ?

A
  • ALL: dramatic advances in treatment, good remission rate
  • AML: difficult to treat, relapses frequent
49
Q

What is the treatment protocol for a patient with chronic lymphocytic leukemia?

A

Difficult to treat due to maturity of neoplastic cells
Blood cell graft or bone marrow transplant

50
Q

who is most affected by chronic lymphocytic leukemia?

A

older males

51
Q

Male patient; 63 years of age. Presenting with fatigue and weakness that has been evident for almost a year. Patient reports losing 30 pounds in the last 3 months without any sort of dietary or lifestyle changes. Upon palpation, extensive bruising and tenderness is noted throughout the body. Biopsy of the bone marrow shows mature B cells that are well differentiated, small, and compact. CBC shows 96,000 white blood cells and 60% lymphocytes. What is a likely diagnosis?

A

Chronic lymphocytic leukemia (CLL)

52
Q

what is the leukemic counterpart of small lymphocytic lymphoma (SLL)?

A

CLL

53
Q

what are symptoms of chronic lymphocytic leukemia?

A

asymptomatic/vague symptoms: infection, fatigue, organomegaly

54
Q

What form of leukemia presents with the Philadelphia (Ph) chromosome?

A

Chronic myelogenous leukemia (CML)

55
Q

Chronic leukemias are more commonly seen in (Child/Adult) populations?

A

Adult

56
Q

what is the Philadelphia (Ph) chromosome?

A

translocation between chromosome 9 & 22 (t(9:22)) resulting in Bcr-c-abl gene

57
Q

What is the Bcr-c-abl gene? What neoplasm is it often present in?

A

Faulty tyrosine kinase (stuck “on”) present in patients with chronic myelogenous leukemia (CML)

58
Q

What is the common name for the t(9:22) nomenclature?

A

Philadelphia chromosome

59
Q

What chromosomes undergo chromosomal translocation to make the Philadelphia chromosome?

A

Chromosomes 9 and 22

60
Q

What is the treatment for chronic myelogenous leukemia (CML)? What is the mechanism?

A

Gleevec (MAb) that shuts down the bcr-c-abl gene

61
Q

Male patient; 52 years of age presents with deep pain described as being “On the bone” in the right arm that has been nagging him for the last 4 months. The patient has a diagnose of anemia three years prior before seeing you in his office today. Recently, the patient has decided to finally seek another opinion as he has been chronically fatigued at work. The patient is sent out for a full genetic testing panel. Results show chromosomal translocation of chromosomes 9 and 22 and the presence of the bcr-c-abl gene. What is the common name of the new chromosome that this patient has formed? What is the likely diagnosis for this patient? What treatment should be recommended to this patient?

A

Philadelphia chromosome
Chronic myelogenous leukemia
Gleevec (MAb)

NYCC Physiopathology (28 decks)

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