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Hematology 1 > LEUKOCYTE DISORDERS PART 2 NEOPLASTIC AND RELATED DISORDERS > Flashcards

LEUKOCYTE DISORDERS PART 2 NEOPLASTIC AND RELATED DISORDERS Flashcards

1
Q

NEOPLASTIC AND RELATED DISORDERS

A
  1. Leukemias and Leukemoid Reactions
  2. Myeloproliferative Disorders
  3. Lymphoproliferative Disorders
  4. Plasma Cell Dyscrasias and Lymphoreticular
    Malignancies Associated with Abnormal
    Immunoglobulin Synthesis
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2
Q

are generalized neoplastic proliferation or
accumulation of leukopoietic cells with or without
involvement of the peripheral blood.

A

LEUKEMIAS

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3
Q

LEUKEMIAS
are generalized _____ or
______ with or without
involvement of the peripheral blood.

A

neoplastic proliferation or
accumulation of leukopoietic cells

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4
Q

LEUKEMIAS are group of malignant disorders affecting _____, ____
and _____.

A

blood and blood forming tissue of the bone marrow
lymph system and spleen.

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5
Q

CLASSIFICATIONS OF LEUKEMIA

A

1 Chronologic (based on natural history)
2 Cytologic (based on predominant cell type)
3 Classification based on functional capacity of
release mechanism
4 Classification based on localized proliferation of cells of the same type

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6
Q

Chronologic CLASSIFICATION OF LEUKEMIA is based on?

A

natural history

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7
Q

Cytologic CLASSIFICATION OF LEUKEMIA is based on?

A

predominant cell type

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8
Q

the cells of precursor B-cell acute lymphoblastic leukemia are all

A

immature cells

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9
Q

CONDITIONS ASSOCIATED WITH CHRONOLOGIC (BASED ON NATURAL HISTORY)

A
  1. ACUTE LEUKEMIA
  2. CHRONIC LEUKEMIA
  3. SUB-ACUTE LEUKEMIA
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10
Q

The most common form of leukemia in
children. Characterized by a rapid increase in the numbers of immature blood cells
—> rapidly progressing, lasting for several days
to six months
—> very fast

A

ACUTE LEUKEMIA

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11
Q

Acute leukemia is characterized by?

A

a rapid increase in the numbers of immature blood cells

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12
Q

Acute leukemia is rapidly progressing, lasting for about?

A

several days to six months

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13
Q

—It is characterized by the excessive build up of
relatively mature, but still abnormal, white
blood cells
—mostly occurs in older people, but can
theoretically occur in any age group
—most patients will live a minimum of 1 or 2
years or more

A

CHRONIC LEUKEMIA

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14
Q

CHRONIC LEUKEMIA is characterized by the

A

excessive build up of relatively mature, but still abnormal, white blood cells

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15
Q

CHRONIC LEUKEMIA mostly occurs in

A

older people, but can theoretically occur in any age group

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16
Q

IN CHRONIC LEUKEMIA most patients will live a minimum of

A

minimum of 1 or 2 years or more

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17
Q

a type of chronologic leukemia that last from 2 to 6 months or even 12 months

A

SUB-ACUTE LEUKEMIA

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18
Q

ONSET OF ACUTE LEUKEMIA

A

Abrupt

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19
Q

ONSET OF CHRONIC LEUKEMIA

A

Insidious

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20
Q

Death of px with ACUTE LEUKEMIA

A

w/in months

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21
Q

Death of px with CHRONIC LEUKEMIA

A

w/in years

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22
Q

White cell count of ACUTE LEUKEMIA

A

Elevated / Normal / Low (LEN)

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23
Q

White cell count of CHRONIC
LEUKEMIA

A

Elevated

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24
Q

Appearance of cells in ACUTE LEUKEMIA

A

Blasts (immature)

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25
Q

Appearance of cells in CHRONIC LEUKEMIA

A

Mature

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26
Q

Neutropenia in ACUTE LEUKEMIA, present or absent?

A

Present

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27
Q

Neutropenia in CHRONIC LEUKEMIA, present or absent?

A

Absent

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28
Q

Anemia in ACUTE LEUKEMIA, present or absent?

A

Present

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29
Q

Anemia in CHRONIC LEUKEMIA, present or absent?

A

Present

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30
Q

Platelets in ACUTE LEUKEMIA

A

LOW

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31
Q

Platelets in CHRONIC LEUKEMIA

A

Normal / increased

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32
Q

Organomegaly in acute leukemia
(abnormal enlargement of organs)

A

Mild

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33
Q

Organomegaly in chronic leukemia
(abnormal enlargement of organs)

A

Severe

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34
Q

Sub classification of acute leukemia

A

Acute Non lymphocytic Leukemia (ANLL) and Acute lymphoblastic leukemia
(ALL)

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35
Q

Acute nonlymphocytic leukemia or ANLL is more commonly called _________.

A

acute myeloid leukemia (AML).

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36
Q

Sub classification of acute leukemia

A

Chronic Myeloid Leukemia (CML)
Chronic lymphocytic leukemia (CLL)

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37
Q

T/F: ANLL and ALL both have subtypes

A

TRUE

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38
Q

T/F: CML and CLL both have subtypes

A

FALSE
—> CLL has subtypes

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39
Q

LEUKEMIA BASED ON PREDOMINANT CELL TYPE (CYTOLOGIC)

A
  1. GRANULOCYTIC OR MYELOCYTIC LEUKEMIA
  2. LYMPHOCYTIC/LYMPHOID LEUKEMIA
  3. MONOCYTIC LEUKEMIA
  4. PLASMA CELL LEUKEMIA
  5. MAST CELL LEUKEMIA
  6. HISTIOCYTIC LEUKEMIA
  7. MEGAKARYOCYTIC LEUKEMIA
  8. BASOPHILIC LEUKEMIA
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40
Q

the predominant cells are all cells coming from
common myeloid progenitors

A

Granulocytic or Myelocytic Leukemia

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41
Q

Under Granulocytic or Myelocytic Leukemia, we have (MPACE)

A

a. Acute Myeloid/Myeloblastic Leukemia
b. Chronic Myeloid Leukemia
c. Promyelocytic Leukemia
d. Myelomonocytic Leukemia
e. Eosinophilic Leukemia

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42
Q

in Lymphocytic/Lymphoid Leukemia, the predominant cells are all cells coming from

A

common lymphoid progenitors

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43
Q

2 types of Lymphocytic/Lymphoid Leukemia

A

a. Acute Lymphocytic Leukemia
b. Chronic Lymphocytic

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44
Q

CLASSIFICATION BASED ON FUNCTIONAL
CAPACITY OF RELEASE MECHANISM

A
  1. LEUKEMIC LEUKEMIA
  2. SUBLEUKEMIC LEUKEMIA
  3. ALEUKEMIC LEUKEMIA
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45
Q

presence of immature or abnormal cells with
WBC count greater than 15 x 10^9 /L

A

LEUKEMIC LEUKEMIA

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46
Q

LEUKEMIC LEUKEMIA WBC count value

A

> 15 x 10^9 /L

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47
Q

with immature or abnormal cells in peripheral blood and with WBC count less
than 15 x 10^9/L

A

SUBLEUKEMIC LEUKEMIA

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48
Q

SUBLEUKEMIC LEUKEMIA WBC count is

A

less than 15 x 10^9/L

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49
Q

with no immature cells in the peripheral
blood and with WBC count less than 15 x
10^9/L

A

ALEUKEMIC LEUKEMIA

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50
Q

CLASSIFICATION BASED ON LOCALIZED
PROLIFERATION OF CELLS OF THE SAME TYPE

A
  1. CHLOROMA
  2. MYELOBLASTOMA
  3. MYELOMA
  4. LYMPHOMA
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51
Q

—a type of myeloblastic leukemia
— formation of tumors originating from periosteum, especially of skull, orbits, nasal
sinuses, ribs and vertebrae
– bone, lungs, lymph nodes

A

CHLOROMA

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52
Q

CHLOROMA is a type of myeloblastic leukemia
with formation of tumors originating from

A

periosteum, especially of skull, orbits, nasal
sinuses, ribs and vertebrae

bone, lungs, lymph nodes

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53
Q

a focal malignant tumor composed of
myeloblast or early myeloid precursors
occurring outside of the bone marrow

A

MYELOBLASTOMA

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54
Q

local tumorous proliferation of plasma
cells in the marrow

A

MYELOMA

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55
Q

~ proliferation of one of the cell types of
the lymphopoietic reticular tissue
~ it begins and involves lymph nodes
predominantly and sometimes other sites
such as the spleen and GIT

A

LYMPHOMA

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56
Q

LYMPHOMA
~ proliferation of one of the cell types of _____

A

lymphopoietic reticular tissue

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57
Q

LYMPHOMA it begins and involves_____ predominantly and sometimes other sites
such as ____ and _____.

A

lymph nodes
spleen and GIT

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58
Q

is a reactive but excessive leukocytosis
characterized by the presence of immature cells in the peripheral blood

A

LEUKEMOID REACTIONS

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59
Q

LEUKEMOID REACTION, high WBC indicates

A

– infections

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60
Q

increase in the total of leukocyte count in which
mimics ______

A

leukemia

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61
Q

LEUKEMOID REACTION increases in

A

50x10^9/L or 60x10^9/L

62
Q

causes of increase leukemoid reaction

A

CAUSES
1) Severe infections
2) Hemolytic anemias
3) Tuberculosis
4) Trichinella spiralis infestation

63
Q

group of neoplasms characterized by proliferation of myeloid tissue and elevation in one or more myeloid cell type in the peripheral blood

A

MYELOPROLIFERATIVE DISORDERS

64
Q

2 TYPES OF MYELOPROLIFERATIVE DISORDER

A
  1. ACUTE MYELOPROLIFERATIVE DISORDERS
  2. CHRONIC MYELOPROLIFERATIVE DISORDERS
65
Q

CONDITIONS ASSOCIATED WITH ACUTE MYELOPROLIFERATIVE DISORDERS

A

a. myeloblastic leukemia
b. promyelocytic leukemia
c. myelomonocytic leukemia
d. Di Guglielmo ’s syndrome

66
Q

CONDITIONS ASSOCIATED WITH CHRONIC MYELOPROLIFERATIVE DISORDERS

A

a. polycythemia vera
b. myelofibrosis with myeloid metaplasia
c. thrombocythemia
d. chronic myelogenous leukemia
e. myelodysplastic syndromes

67
Q

is a neoplastic clonal MPD that commonly
manifests with panmyelosis in the bone
marrow and increases in RBC, granulocytes,
and platelets in the peripheral blood

A

POLYCYTHEMIA VERA

68
Q

POLYCYTHEMIA VERA manifests with ____

A

panmyelosis in the bone marrow

69
Q

POLYCYTHEMIA VERA IS INCREASED IN

A

RBC
granulocytes
platelets in the peripheral blood

70
Q

a rare disease that occurs more often in men
than women

A

POLYCYTHEMIA VERA

71
Q

Major criteria polycythemia: hemoglobin is

A

> 18.5 g/dl – men, >16.5 – girls.

72
Q

Presence of ___- associated with bone
marrow disorder cause bu production of too
many blood cells

A

JAK2/ (janus kinase 2)

73
Q

JAK 2 is associated with bone
marrow disorder caused by the
production of too many blood
cells

A

True

74
Q

Minor criteria of polycythemia

A

bone marrow biopsy
—- will show the growth of prominent erythroid and granulocytic, megakaryocytic.

75
Q

Morphologic changes – hgb is inc or dec?

A

increase( Normocytic normochromic)

76
Q

MORPHOLOGIC CHANGES:

A

› Hemoglobin is increased
› RBC volume is increased
› Normocytic normochromic - morphology
› Total WBC count is increased
› Granulocytes and platelets – increased

77
Q

Granulocytes, platelets (increase or decrease?)

A

increase

78
Q

Treatment for polycythemia

A
  1. Therapeutic phlebotomy
  2. Low dose of aspirin— to prevent thrombosis
    › If the patient is high risk, we can give
    hydroxyurea
  3. High risk – hydroxyurea
  4. Older – Busulfan
79
Q

Other names of Myelofibrosis

A

Myeloid Metaplasia
Chronic Idiopathic Myelofibrosis
Osteomyelofibrosis

80
Q

MYELOFIBROSIS is classified as a MPD in which the
proliferation of an abnormal type of BM
stem cell results in _____, or the
replacement of the marrow with
collagenous connective tissue fibers

A

fibrosis

81
Q

Myelofibrosis – peripheral blood film would exhibit ____and _____
and there is also presence of _____
and some____ shape of rbc

A

mature granulocytes and normoblasts
dacryocytes and some bizzare shape of rbc

82
Q

clinical presentation of myelofibrosis; disease occurs in____y/o and also asymptomatic.

A

patient (60 yrs old) and also asymptomatic
(fatigue, weakness, shortness of breath,
weight loss, palpitations, pain in the left upper
quadrat, discomfort)

83
Q

Treatment for myelofibrosis

A

– androgen therapy
› Prednisone
› Danazol
› Splenomegaly – hydroxyurea

84
Q

has been known as primary thrombocytosis or Idiopathic thrombocytosis and also called hemorrhagic thrombocythemia

A

Thrombocythemia

85
Q

Thrombocythemia is Characterized by autonomous proliferation of the
__________. Thrombocytosis is present without a reactive cause.

A

megakaryocytic cell lines

86
Q

platelet count in THROMBOCYTHEMIA

A

Platelet - >600x10^9/L or 1000x10^9/L

87
Q

WHO CRITERIA: requires thrombocytosis with
platelet count of _____

A

450 x 109/L or greater.

88
Q

CLINICAL PRESENTATION of THROMBOCYTHEMIA:

A

› Elevated platelet count
› Enlargement of the spleen
› Bleeding occurs most frequently because
platelets are nonfunctional (occurs most
frequently from mucous membrane in the
gastrointestinal tract and upper
respiratory)

89
Q

DIAGNOSIS of thrombocythemia

A

› JAK2
› Must be differentiated from secondary or
reactive thrombocytosis and from other
MPNs (myeloproliferative neoplasm)

90
Q

TREATMENT for thrombocythemia

A

› Busulfan in older patients
› Low dose aspirin to prevent thrombosis
› - Hydroxyurea therapy

91
Q

is a MPD arising as a clonal process from a
pluripotential stem cell

A

Chronic Myelogenous Leukemia

92
Q

Chronic Myelogenous Leukemia begins with a chronic clinical phase that progresses to an accelerated phase in ____years and often terminates as an acute leukemia

A

3 to 4 years

93
Q

Chronic Myelogenous Leukemia: characteristic feature present in proliferating
hematopoietic cells is the _____.

A

Philadelphia chromosome

94
Q

has overproduction of myeloid cellulite that
results in preponderance of immature cells in the neutrophilic line

A

Chronic Myelogenous Leukemia

95
Q

Chronic Myelogenous Leukemia hdias stain that wilfferentiatees between the CML from a glutamoid reaction, that we call ____

A

lab score

96
Q

Clinical features of Chronic Myelogenous Leukemia

A
  1. Frequent infection
  2. Anemia (with bleeding)
  3. Enlargement of spleen
  4. WBC around 50-500x10^9/L
  5. PBS show basophilia, eosinophilia, and
    thrombocytosis
  6. Can mimic neutrophilic glucamoid
    reaction
97
Q

TREATMENT of Chronic Myelogenous Leukemia

A
  1. Bone marrow stem cell
    transplantation
  2. busulfan
98
Q

are group of clonal
disorder of neoplastic pluripotential stem cells
characterized by a decrease in one or more
types of peripheral blood cells due to abnormal
maturation in the bone marrow

A

Myelodysplastic syndrome

99
Q

FAB CLASSIFICATION OF MYELODYSPLASTIC
SYNDROMES

A
  1. Refractory Anemia ( RA)
    2.Refractory Anemia with Ringed sideroblasts
    (RARS)
  2. Refractory Anemia with excess Blast ( RAEB)
  3. Chronic Myelomonocytic leukemia ( CMML)
  4. Refractory Anemia with excess Blast in
    Transformation ( RAEB-t)
100
Q

(RARS)

A

Refractory Anemia with Ringed sideroblasts

101
Q

( RA)

A

Refractory Anemia

102
Q

RAEB

A

Refractory Anemia with excess Blast

103
Q

CMML

A

Chronic Myelomonocytic leukemia

104
Q

RAEB-t

A

Refractory Anemia with excess Blast in
Transformation

105
Q

FAB classification – means

A

French, American, British Classification of Myelodysplastic syndrome

106
Q

Features of PB and BM in Myelodysplastic Syndromes (% Blast PB)

A

RA - ˂ 1%
RARS - ˂ 1%
RAEB - ˂ 5%
CMML - ˂ 5%
RAEB-t - > 5%

107
Q

Features of PB and BM in Myelodysplastic Syndromes (% Blast BM)

A

RA - ˂ 5 %
RARS - ˂ 5-20%
RAEB - ˂ 5-20%
CMML - ˂ 5-20%
RAEB-t - > 20-30%

108
Q

Features of PB and BM in Myelodysplastic Syndromes (Dyserythropoiesis)

A

RA - +++
RARS - ++
RAEB = + / -
CMML = + / -
RAEB-t = + / -

109
Q

Dysgranulopoiesis

A

RA = -
RARS = -
RAEB = ++
CMML = ++
RAEB-t = + / -

110
Q

Dysmegakaryopoiesis

A

RA = -
RARS = -
RAEB = +/-
CMML = +/-
RAEB-t = + / -

111
Q

Siderocytes/ Sideroblast

A

RA = +
RARS = +
RAEB = +/-
CMML = -
RAEB-t = + / -

112
Q

Ringed sideroblast

A

RA = +/-
RARS = >15%
RAEB = +/-
CMML = -
RAEB-t = + / -

113
Q

Specimen used in of PB and BM in Myelodysplastic Syndrome is

A

1 peripheral blood and 1 bone
marrow aspiration

114
Q

represent a group of neoplastic conditions
originating from cells of the lymphoreticular
system

A

LYMPHOPROLIFERATIVE DISORDERS

115
Q

TYPES OF LYMPHOPROLIFERATIVE DISORDERS

A

1) Acute Lymphoid Leukemia
2) Chronic Lymphocytic Leukemia
3) Hairy Cell Leukemia
4) Mycosis Fungoides and Sezary’s syndrome
5) Malignant Lymphoma

116
Q

2 types of Malignant Lymphoma

A

a. Hodgkin’s Disease / Hodgkins lymphoma
b. Non-Hodgkin’s Disease

117
Q

HAIRY CELL LEUKEMIA

A

composed of small B-lymphocytes with abundant
cytoplasm and fine (hairy) cytoplasmic
projections
— Affected – b- lymphocytes
—Stain – TRAP(titrate resistant acid phosphate)

118
Q

also known as Alibert-Bazin syndrome

A

MYCOSIS FUNGOIDES

119
Q

MYCOSIS FUNGOIDES is the most common form of ____

A

cutaneous T-cell lymphoma

120
Q

—-is a lymphoreticular neoplasm
primarily involving the skin
— as the disorder evolves, neoplastic
cells infiltrate the lymph nodes and
other visceral organs

A

MYCOSIS FUNGOIDES

121
Q
  • Classical Hodgkin lymphoma
  • a malignant disorder characterized
    by painless, progressive enlargement
    of lymphoid tissue
A

HODGKIN’S DISEASE

122
Q

3 major stages of mycosis fungoides

A
  1. Initial erythematous stage - red scaly weeping
    skin changes that resemble eczema psoriasis.
  2. Plaque Stage
  3. Final Tumor stage
123
Q

lab findings in mycosis fungoides

A

o Lab Findings - large lymphocyte with cerebriform or hyperconvulated cell

124
Q

Refers to a large group of benign and malignant
lesions of the lymphoid system

A

LYMPHOPROLIFERATIVE DISORDERS

125
Q

T/F: Lymphoma is limited to the lymph nodes or
lymphoid organ

A

TRUE

126
Q

HODGKIN’S DISEASE Hallmark

A

is a large binucleated or multinucleated cell with each nucleus bearing a very large nucleolus (Reed-Sternberg Cell)

127
Q

positive for Hodgkin’s Lymphoma; Owl’s eye
appearance or popcorn cells

A

Reed-strenberg cell

128
Q

—–Nodular lymphocyte-predominant Hodgkin
lymphoma

—–Is a B cell neoplasm composed of relatively rare
neoplastic cells scattered within the nodules of
reactive lymphocytes

A

NON-HODGKIN’S DISEASE

129
Q

PLASMA CELL DYSCRATIAS AND LYMPHORETICULAR MALIGNANCIES ASSTD WITH ABNORMAL IG SYNTHESIS

A

1) MULTIPLE MYELOMA
2) WALDENSTROM’S MACROGLOBULINEMIA

130
Q

MULTIPLE MYELOMA Other names

A

 Plasmatocytoma
 Kohler’s disease

131
Q

is a neoplasmic proliferation of
morphologically abnormal plasma cells
primarily occurring in the BM either in
nodules or diffusely.

A

MULTIPLE MYELOMA

132
Q

___ is detected in serum and urine of px with multiple myeloma

A

Bence Jones Protein

133
Q

MM, ESR

A

ESR elevated / Rouleaux formation

134
Q

WALDENSTROM’S MACROGLOBULINEMIA

A

o is an uncommon condition which
behaves as a slowly progressive
lymphoma
o is proliferation of cells which produce a
monoclonal IgM paraprotein
o Dx: asymptomatic w/ low level of IgM ( 3
g/dl) organomegaly , hyperviscosity
syndrome , anemia

135
Q

is an uncommon condition which
behaves as a slowly progressive
lymphoma

A

WALDENSTROM’S MACROGLOBULINEMIA

136
Q

OTHER LEUKOCYTE DISORDERS

A

1) INFECTIOUS MONONUCLEOSIS
2) HISTIOCYTOSES/ STORAGE DISEASE
3) SYSTEMIC LUPUS ERYTHEMATOSUS

137
Q

Other name of INFECTIOUS MONONUCLEOSIS

A

 Glandular
 Fever Pfeiffer’s Disease
 Kissing Disease

138
Q

INFECTIOUS MONONUCLEOSIS is characterized by

A

fever
sore throat
lymphadenopathy
atypical lymphocytes in the bood

139
Q

T cells reacting against B lymphocytes infected
with________

A

Epstein-Barr (EB) virus

140
Q

IM is associated with high titer of ___

A

heterophile Ab reacting with sheep red cells

141
Q

represent a group of diseases with abnormal proliferation of mesenchymal cells that are closely related to phagocytic histiocytes and to fat cells

A

HISTIOCYTOSES/ STORAGE DISEASE

142
Q

it is also due to inborn errors in metabolism
genetically transmitted

A

HISTIOCYTOSES/ STORAGE DISEASE

143
Q

is a collagen disease which affects
women most commonly

A

SYSTEMIC LUPUS ERYTHEMATOSUS

144
Q

SYSTEMIC LUPUS ERYTHEMATOSUS is characterized by

A

skin rash
arthralgia,
fever,
renal,
cardiac and vascular lesions
anemia
leukopenia and
thrombocytopenia

145
Q

3 TYPES OF ANTIBODY associated in SLE

A

a. Anti-DNP
b. Anti-DNA
c. Anti-nuclear

146
Q

 If performing in the laboratory, we need
______ then illalagay sa test tube and will
be mixed para masira. Nasa neutrophil sila na
merong nakaengulf na another cells or PMN

A

glass beads

147
Q

treatment for SLE

A

 no treatment but basically more on
supportive treatment

148
Q

a disorder secondary to an infection with
the human immunodefficiency virus
(HIV).

A

AIDS – ACQUIRED IMMUNODEFICIENCY SYNDROME

149
Q

HIV- an RNA retrovirus that is cytotropic
for ____ and ____.

A

CD4 positive T cells and macrophages

150
Q

treatment for HIV

A

No treatment yet, more on retroviral and
slowing/decreasing the disease development

Hematology 1 (5 decks)

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