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Hematology / Oncology > Leukemias & Myeloproliferative Diseases > Flashcards

Leukemias & Myeloproliferative Diseases Flashcards

1
Q

Pancytopenia

A

Low RBCs, WBCs, Platelets

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2
Q

Most childhood leukemia is what type?

A

Acute Lymphocytic Leukemia (ALL) - 80% of childhood leukemia is ALL but only 20% of adult leukemia is ALL

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3
Q

Where is the malignancy in the cell lineage in the case of ALL?

A

ALL is a malignancy of progenitor cells in the lymphoid lineage (the lineage leading to B and T Cells)

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4
Q

What causes ALL, AML?

A

Often exposure to chemo, radiation, benzene toxins, also unknown etiology. smoking in AML.

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5
Q

ALL Labs will show:

A

Pancytopenia w/ circulating blasts & increased blast B and T cells in the hyper cellular bone marrow; thymus will be enlarged.

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6
Q

Signs and symptoms of ALL, AML:

A

Rapid onset, bleeding bums/mucosa, epistaxis, infections, pallor, purpura & petechiae, ecchymosis, bone pain / tenderness

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7
Q

ALL Treatment

A

Chemo / steroids, bone marrow transplant

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8
Q

What is the cell lineage affected in acute myelogenous leukemia?

A

AML affects myeloid cell progenitors (granulocytes, WBCs, megakaryocytes, RBCs)

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9
Q

What segment of the population usually gets AML?

A

Adults over 60.

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10
Q

With labs and radiology, how do you differentiate AML from ALL?

A

ALL patients - enlarged mediastinal mass on x-ray; AML patients will have blast cells that present with AUER RODs (needle-like inclusions in the cytoplasm), cytoplasm w/granules.

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11
Q

What is the most common type of leukemia / who gets it?

A

Chronic Lymphocytic Leukemia / adults & elderly

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12
Q

What cells are affected in Chronic Lymphocytic Leukemia?

A

B Cells.

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13
Q

Labs for CLL:

A

Normal hematocrit and platelet count

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14
Q

Treatment for CLL:

A

In early stages - observe; in late stages - combination chemotherapy

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15
Q

Who gets Chronic Myeloid Leukemia?

A

Middle Aged (avg. age of onset is 55)

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16
Q

What occurs in CML?

A

Over production of myeloid progenitor cells

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17
Q

CML and CLL can both remain ___________________ for years:

A

asymptomatic and low grade

18
Q

Etiology of CML:

A

Philadelphia Chromosome (translocation)

19
Q

Symptoms of CML:

A

Night sweats, priapism, fever, blurred vision, splenomegaly, sternal tenderness from bone marrow expansion

20
Q

Labs in CML:

A

Left shifted myeloid cells, elevated WBCs

21
Q

CML can progress to:

A

AML

22
Q

Polycythemia Vera is caused by:

A

Caused by mutation in signaling protein (JAK2)

23
Q

What occurs in polycythemia vera?

A

The body overproduces all types of blood cells, particularly RBCs. This leads to thicker blood viscosity.

24
Q

Symptoms in Polycythemia Vera:

A

Tinnitus, headache, dizziness, blurred vision, epistaxis, fatigue, pruritis due to increased histamine release, clots, splenomegaly.

25
Q

EPO level in a patient with polycythemia vera.

A

Even though all cells are increased, EPO is NOT increased.

26
Q

Polycythemia Vera labs:

A

EPO - normal, Increased RBC mass, elevated WBCs and platelets, splenomegaly, elevated hematocrit, high B-12 levels.

27
Q

Polycythemia Vera Treatment:

A

Phlebotomy

28
Q

Essential Thrombocytosis cause:

A

Unknown

29
Q

Essential Thrombocytosis labs:

A

High platelet counts, high megakaryocytes, normal RBC count, most everything else = normal

30
Q

Complications of Essential Thrombocytosis:

A

Clotting

31
Q

Most common symptoms (2) of Essential Thrombocytosis:

A

Burning of hands, splenomegaly

32
Q

Myeloproliferative Disorders:

A

Polycythemia Vera & Essential Thrombocytosis

33
Q

What disease can follow either of the two Myeloproliferative Diseases?

A

Myelofibrosis

34
Q

Myelofibrosis occurs secondary to:

A

It occurs secondarily to the two myeloproliferative disorders

35
Q

What causes myelofibrosis?

A

Increased secretion of platelet derived growth factors and cytokines

36
Q

Side effects of myelofibrosis:

A

splenomegaly and hepatomegaly due to extramedullary hematopoiesis in the liver, spleen, and lymph nodes.

37
Q

Symptoms of Myelofibrosis:

A

Insidious onset - abdominal fullness, anemia & fatigue, enlarged spleen and liver, fibrosis of bone marrow, thrombocytopenia leads to bleeding, cachectic, bone pain

38
Q

Lab work of Myelofibrosis always shows:

A

Anemic Triad

39
Q

What is the anemic triad?

A

Tear drop poikilocytosis, leukoerythroblastic blood, giant abnormal platelets

40
Q

Treatment for Myelofibrosis:

A

Stem cell transplant (only curative tx), splenectomy (not curative)

41
Q

Elevated WBCs with the presence of blasts is:

A

Acute leukemia - medical emergency - call 9-11.

Hematology / Oncology (9 decks)

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