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Haematology > Lymphoid and myeloid disorders > Flashcards

Lymphoid and myeloid disorders Flashcards

1
Q

Normal blood film

A 
Donuts
Biconcave disc
Lymphocytes
Neutrophils
Platelets
***
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2
Q

Acute leukaemia

A

Proliferation of primitive precursor cells usually only found in bone marrow
Proliferation without differentiation

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3
Q

What does acute leukaemia do and lead to

A

Replaces normal bone marrow cells, leads to:

  • anaemia: palor and lethargy
  • neutropenia: infections -thrombocytopenia: bleeding
  • bone pain due to marrow infiltration
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4
Q

Acute leukaemia types

A

ALL: acute lymphoblastic leukaemia
AML: acute myeloid leukaemia

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5
Q

Chronic leukaemia types

A

Chronic lymphatic leukaemia (CLL)

Chonic myeloid leukaemia (CML)

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6
Q

Blasts in acute leukamia

A

Proliferation of balst cells?

**

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7
Q

Acute lymphoblastic leukaemia

A

Malignant proliferation of lymphoblasts in bone marrow

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8
Q

Acute lymphoblastic leukaemia affects

A

Mainly children

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9
Q

Acute lymphoblastic leukaemia prognosis

A

Good: 85% cure rate
-esp girls, age 1-10, low WBC, certain morphology
Poor: adults

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10
Q

Acute lymphoblastic leukaemia treatment

A

Induction chemotherapy
Consolidation chemotherapy +/- craniospinal irradiation
Maintenance chemotherapy
Bone marrow transplantation only if relapse
goes on for 2 years

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11
Q

Acute myeloid leukaemia

A

Malignant proliferation of myeloblasts in bone marrow

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12
Q

Acute myeloid leukaemia affects

A

Mostly adults

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13
Q

Acute myeloid leukaemia prognosis

A

Poor: 15-50% 5 year survival (depends on subtype)

Most pts relapse

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14
Q

Acute myeloid leukaemia subtype for dentists

A

M5: gum infiltration in acute monocytic subtype

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15
Q

Acute myeloid leukaemia treatment

A

Cyclical high dose chemotherapy (induction and consolidation with no maintenance)
Sometimes bone marrow transplantation

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16
Q

Chronic lymphatic leukaemia

A

Proliferation of mature lymphocytes, usually B cells

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17
Q

Chronic lymphatic leukaemia affects

A

Commonest leukaemia

Affects elderly >65 years

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18
Q

Chronic lymphatic leukaemia presents with

A

Anaemia, infections, lymphadenopathy, splenomegaly
Lymphocytosis on blood film
-nucleus is much more packed than earlier one??

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19
Q

Chronic lymphatic leukaemia prognosis

A

Good

Survival >10 years is norm

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20
Q

Chronic lymphatic leukaemia treatment

A

Only advanced disease

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21
Q

Chronic myeloid leukaemia

A

Gradual onset
High white cell count & splenomegaly
Philadelphia chromosome (chromosome translocation of 22 and 15)
BCR-ABL tyrosine kinase
-BCR and ABL oncogenes next to each other

22
Q

Chronic myeloid leukaemia phases

A

3: chronic, accelerated, and blast crisis
- diagnosis in chronic form (usually about 3 years)
- acute harder to treat with chemotherapy

23
Q

Chronic myeloid leukaemia treatment

A

Imatinib (Glivec)
-blocks abnormal BCR-ABL tyrosine kinase activity
-can result in molecular remission
Allogeneic stem cell transplantation

24
Q

Myelodysplasia

A

“Premalignant” condition of haemopoietic precursors

25
Q

Myelodysplasia affects

A

Disease of the elderly

26
Q

Myelodysplasia symptoms

A

Can be asymptomatic

May present with anaemia, thrombocytopenia, panycytopenia

27
Q

Myelodysplasia types

A

Several subtypes
Variable course
Can transform to acute myeloid leukaemia

28
Q

Myelodysplasia treatment

A

Supportive care

Bone marrow transplantation in the young

29
Q

Lymphoma

A

Hodgkin lymphoma

Non Hodgkin Lymphoma

30
Q

Hodgkin lymphoma presentation

A

Painless lymphadenopathy

B symptoms: Sweats, Weight loss, Fever

31
Q

Hodgkin lymphoma affects

A

2 peaks 15-35 years and >55

32
Q

Hodgkin lymphoma prognois

A

10 year survival 90%

33
Q

Hodgkin lymphoma types

A

4 subtypes

Reed-Sternberg cell diagnostic on biopsy

34
Q

Hodgkin lymphoma treatment

A

Chemotherapy
Radiotherapy
Stem cell transplantation

35
Q

Non Hodgkin lymphoma

A

Indolent or low grade eg follicular lymphoma

Aggressive or high grade eg Diffuse large B cell lymphoma

36
Q

Aggressive or high grade eg Diffuse large B cell lymphoma

A

Rapidly progressive
Usually symptomatic
Potentially curable

37
Q

Aggressive or high grade eg Diffuse large B cell lymphoma treatment

A

Chemotherapy
Radiotherapy
Transplantation

38
Q

Indolent or low grade eg follicular lymphoma

A

Gradual onset, usually advanced at presentation
May be asymptomatic
Incurable, median survival 10years

39
Q

Indolent or low grade eg follicular lymphoma treatment

A

Chemotherapy
Radiotherapy
Transplantation

40
Q

Myeloproliferative disorders

A 
Polycythaemia Rubra Vera (PRV)
-red cell proliferation
Chronic Myeloid Leukaemia (CML)
-white cell proliferation
Essential Thrombocythaemia (ET)
-platelet proliferation
Myelofibrosis 
-marrow stroma proliferation
41
Q

Polycythaemia = erythrocytosis

A

> in circulating red cell concentration

42
Q

Secondary Polycythaemia = erythrocytosis

A

Hypoxic: High altitude, lung or cyanotic heart disease

Inappropriate erythropoietin secretion: Renal tumour

43
Q

Primary Polycythaemia = erythrocytosis

A

Polycythaemia rubra vera
Pruritus, plethoric facies
Thrombosis
Splenomegaly, hepatomegaly

44
Q

Treatment of primary polycythaemia = erythrocytosis

A

Venesction
Aspirin
Myelosuppression

45
Q

Outcome of polycythaemia = erythrocytosis

A

Myelofibrosis (15-20%), AML (2-10%)

46
Q

Secondary Thrombocytosis

A

Bleeding
Infection
Inflammation
Malignancy

47
Q

Primary: Essential Thrombocythaemia

A

Uncontrolled malignant proliferation of megakaryocytes
Platelets >600 persistently
Arterial and venous thrombosis
Bleeding with very high counts eg >1500

48
Q

Primary: Essential Thrombocythaemia treatment

A

With aspirin, hydroxycarbamide, anagrelide, interferon

49
Q

Multiple myeloma

A

Malignant proliferation of plasma cells in the bone marrow
Plasma cells are terminally differentiated B lymphocytes that produce immunoglobulin
Myeloma has monoclonal immunoglobulin in blood and urine

50
Q

Symptoms of myeloma

A 
Lytic lesions in bones including skull
-pain and pathological fractures
Hypercalcaemia due to bone resorption 
-thirst,  polyurea, confusion, constipation
Hyperviscocity due to immunoglobulin
Renal failure
Anaemia
Infections
*Plasma cells in bone marrow*
51
Q

Diagnosis of myeloma

A

Blood and urine tests
X-rays and CT/MRI
Bone marrow

52
Q

Treatment of myeloma

A

Chemotherapy
Thalidomide, Bortezomib
Radiation
Stem cell transplantation

Haematology (6 decks)

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