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Human Systems and Anatomy > malignant haematology > Flashcards

malignant haematology Flashcards

1
Q

what is leukemia

A

a group of blood cancers affecting a particular line of stem cells in the bone marrow, leading to an unregulated production.
the bone marrow produces a high amount of immature blast cells, leading to loss of bone marrow function.

there is acute and chronic leukaemia, coming from both myeloid or lymphoid lineage

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2
Q

describe the difference between chronic and acute leukemia

A

acute leukemia comes on very fast, with more severe symptoms and a less favourable outcome than acute.

chronic is slower and sometimes does not require any form of treatment

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3
Q

what happens as the increased numbers of blast cells are produced

A

the normal blood cells are replaced, leading to anaemia, impaired immunity, and platelet deficiency meaning there is easy bleeding

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4
Q

effects of leukemia

A

blast cells propagate, displace normal cell development.

rbc deficiency leading to anaemia
white blood cell deficiency, leading to impaired immunity
platelet deficiency leading to easy bleeding

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5
Q

what are the four leukemia subtypes

A

acute lymphoblastic, seen most often in kids under 5

acute myeloid leukemia seen in adults

chronic lymphocytic leukemia, seen in older adults

chronic myeloid leukemia, caused by Philadelphia chromosome

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6
Q

which leukemia subtype is associated with down syndrome

A

acute lymphoblastic

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7
Q

what are the non specific symptoms of leukemia

A
  • fatigue
  • fever
  • weight loss
  • easy bruising and bleeding
  • abnormal infections
  • lymphadenopathy
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8
Q

how is leukemia diagnosed

A

via blood tests, bone marrow biopsies, and scans

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9
Q

how is leukemia managed

A

led by specialist haematology oncology MDT

  • mainly chemotherapy
  • targeted therapies
  • bone marrow transplant, immunosuppression
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10
Q

what is chemotherapy

A

a cancer treatment where medicine is used to kill cancer cells, usually intravenous

this halts or slows the growth of cancer cell, which grow and divide quickly

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11
Q

what does chemotherapy do

A

kills fast growing cancer cells, and targets healthy cells that grow and divide quickly

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12
Q

which cells are affected by chemotherapy aside from the cancer cells

A

oral mucosa
gut mucosa
hair cells

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13
Q

what are the general side effects of chemotherapy

A

hair loss
nausea
infertility
diarrhoea
bone marrow suppression
immunosuppression
cardiac toxicity
oral mucositis
depression or anxiety

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14
Q

what is lymphoma

A

a cancer affected the white blood cells in the lymphatic system whereby the lymph nodes because abnormally large and painless

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15
Q

what are the two mai types of lymphoma

A

Hodgkins lymphoma
non hodgkin lymphoma

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16
Q

which type of lymphoma is the most common

A

non Hodgkin

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17
Q

what is the key presenting symptoms of lymphoma

A

lymphadenopathy, where the lymph nodes become non tender, rubbery and feel pain with alcohol

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18
Q

what are the constitutional symptoms of lymphoma

A

fever
night sweats
weight loss

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19
Q

what is cancer staging

A

determining the size and spread of a cancer

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20
Q

how is lymphoma diagnosed

A

a lymph node biopsy, identification of reed Sternberg cells in Hodgkins lymphoma

CT, MRI and PET scans

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21
Q

how is lymphoma managed

A

chemotherapy
radiotherapy
targeted therapy
stem cell transplant

22
Q

what is the targeted therapy for managing lymphoma

A

targets b cells

23
Q

what is myeloma

A

a cancer affecting the plasma cells (b cells producing antibodies)

24
Q

what happens with myeloma

A

over production of one specific protein called a paraprotein, causing organ and tissue impairment. the paraproteins are present in the urine

25
Q

what are the key features of myeloma

A

increased calcium
renal impairment
anaemia
bone lesions

26
Q

why does multiple myeloma cause renal impairment

A

the paraprotein clogs the kidneys and prevents it from filtering like it normally does

27
Q

what does multiple myeloma present as

A

unexplained fever
weight loss
fatigue
anaemia
renal impairment
bone pain
pathological fractures
rarely presents in the mouth

28
Q

what is raindrop skull

A

this is when there are myeloma deposits in the bone in the skull

29
Q

how can multiple myeloma be managed

A

there is no cure, the management instead focuses on disease control.
chemotherapy
stem cell transplant
biphosphonates

30
Q

what are biphosphonates

A

medicines that stop the bone from getting broken down. as a result, they are important for the healing of the jaw
they can cause medication related osteonecrosis of the jaw

31
Q

what are the disease features of haematological malignancies

A

easy bleeding
low immunity
anaemia
gingival swelling
presentation of myeloma in the mandible

32
Q

how does easy bleeding from haematological malignancies present in the mouth

A

petechiae
haemorrhage after extraction
spontaneous gingival bleeding

33
Q

how does low immunity associated with haematological malignancies manifest in the mouth

A

candidosis infection
herpes simplex virus

34
Q

what is petechiae

A

small bruises on the roof of the mouth

35
Q

what is leukopenia

A

lack of white blood cells leading to impaired immunity

36
Q

what is neutropenia

A

lack of neutrophils in the blood

37
Q

how does anaemia present in the mouth

A

pallor

38
Q

what is ecchymosis

A

bruises

39
Q

what causes herpetic gingivostomatitis

A

herpes simplex virus

40
Q

what are the oral side effects of chemotherapy

A

mucositis
dry mouth, leading to caries risk, taste disturbance, dysphagia
infection, fungal, viral, vulnerable
easy bleeding - thrombocytopenia

41
Q

what are the oral side effects of radiotherapy

A

dry mouth
osteoradionecrosis of jaw
fibrosis

42
Q

what is trismus

A

restriction in the range of motion of the jaw

43
Q

what is gvhd

A

graft vs host disease

44
Q

what is fibrosis

A

scarring of the muscles of mastication, meaning cannot open the mouth enough

45
Q

what causes fungal infection in the mouth and how to manage

A

reduced salivary flow and immunosuppression
managed via topical anti fungals

46
Q

what causes lichen plants and erythema multiform in the mouth and how to manage

A

drug reactions

manage by referral to secondary or tertiary care services

47
Q

what causes caries and how to manage

A

reduced salivary flow and high calorie dietary supplements

managed via high fluoride toothpaste, fluoride varnishes, and tailored oral hygiene instruction

48
Q

what causes osteonecrosis and how to manage

A

anti resorptive, anti angiogenic, and immunosuppressive effects

managed via chlorhexidine rinses and referral to secondary, tertiary care services

49
Q

what causes bleeding tendency in the mouth and how to manage

A

thrombocytopenia, managed via haematological screening prior to invasive procedures

50
Q

what causes mucositis and ulceration, how to manage it

A

leukopenia, manage via analgesics, crushed ice, benzyldamine rinses.

51
Q

what causes xerostomia and altered taste and how to manage it

A

reduced salivary flow and diffusion of tt into oral cavity. idk what tt is. manage via frequent sips of water, and oral lubricants.

Human Systems and Anatomy (57 decks)

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