Malignant Heme Disorders Flashcards

1
Q

patient presents with painless lymph node swelling, fever, night sweats, weight loss, pruritis. the lymphadenopathy arose in a single lymph node that spread, commonly starting in the cervical and supraclavicular regions. Dx?

A

hodgkin lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what 2 diagnostics help to diagnose hodgkin lymphoma?

A

PET/CT chest, abdomen, pelvis
lymph node open biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what finding in lymph node open biopsy indicates hodgkin lymphoma?

A

reed-sternberg cells (large, abnormal lymphocytes with more than 1 nucleus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

patient presents with painless swollen anterior cervical lymph nodes, they have fever, night sweats, weight loss, abdominal pain/fullness and obstruction, and enlarged facial bones/thyroid/tonsils. Dx?

A

non-hodgkin lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what diagnostic is required to diagnose non-hodgkin lymphoma?

A

lymph node biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what finding in lymph node biopsy indicates non-hodgkin lymphoma?

A

malignant lymphoid cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the mainstay treatment for non-hodgkin lymphoma?

A

chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

malignant proliferation of plasma cells originating in the bone marrow, producing excessive amounts of abnormal immunoglobins/light chains.

A

multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what class of immunoglobulin is most commonly associated with multiple myeloma?

A

IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

in which patients does multiple myeloma occur in?

A

older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

patient presents with bone pain in the hips/spine/ribs, history of osteolytic bones lesions/pathologic fractures, has S&S of anemia, and mucosal bleeding, visual changes, and infections. Dx?

A

multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what mnemonic helps us diagnose multiple myeloma?

A

CRAB

Calcium elevation
Renal Insufficiency
Anemia (normochromic/normocytic + rouleaux formations)
Bone disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what will urinalysis show to indicate multiple myeloma?

A

bence jones proteins (M or light chain proteins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

stacking of RBCs due to abnormal albumin : globulin ratio.
what is it associated with?

A

rouleaux formation

multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the diagnostic required to diagnose multiple myeloma?

A

bone marrow biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the treatment for multiple myeloma? (4)

A

induction therapy (choose 1):
lenalidomide / bortezomib

dexamethasone

chemotherapy
aggressive hydration
bisphosphonates

17
Q

what is the most common childhood malignancy that is a malignant proliferation of immune lymphoid stem cells in the bone marrow?

A

acute lymphoblastic leukemia (ALL)

18
Q

in which patients does acute lymphoblastic leukemia occur? (2)

A

4-5 yo
> 50 yo

19
Q

patient presents with history of being ill for days/weeks, petechiae, purpura, anemia findings, bone pain/arthralgias, headache, stiff neck, lymphadenopathy, cranial nerve palsies, and frequent infections. Dx?

A

acute lymphoblastic leukemia

20
Q

CBC reveals anemia, normal to slightly increased leukemic blast cells, and bone marrow biopsy is hypercellular with over 30% of them being lymphoblasts. Dx?

A

acute lymphoblastic leukemia

21
Q

WBC with a very large nucleus

A

blast cells

22
Q

what is the treatment for acute lymphoblastic leukemia?

A

intrathecal chemotherapy / cranial irradiation
maintenance chemo for 2-3 years

23
Q

what is the treatment for acute lymphoblastic leukemia that has relapsed?

A

bone marrow transplant

24
Q

most common in adults that is caused by proliferation of mature appearing lymphocytes in peripheral blood that invade the bone marrow, spleen, or lymph nodes.

A

chronic lymphoblastic leukemia

25
patient presents with lymphadenopathy, splenomegaly, and leukemia cutis (flesh-colored-to-violaceous papules/plaques/nodules). Dx?
chronic lymphoblastic leukemia
26
CBC reveals lymphocytosis, elevated WBC > 20,000, and peripheral blood smear reveals mature-appearing lymphocytes and smudge cells.
chronic lymphocytic leukemia
27
remnants of cells that lack any identifiable cytoplasmic membrane or nuclear structure; AKA basket cells
smudge cells
28
what is the treatment for chronic lymphoblastic leukemia if we decide to treat based on clinical indicators? (3)
chemotherapy local radiation for painful lymphadenopathy +/- transplant
29
most common leukemia in adults that is caused by proliferation of abnormal myeloid cells that do not mature and affects WBCs, RBCs, and platelets.
acute myeloid leukemia
30
patient presents with history of feeling ill for days, anemia findings, recurrent infections, bone pain, gingival hypertrophy, and leukemia cutis. Dx?
acute myeloid leukemia
31
myeloblasts are present in BM or PBS, auer rods are on peripheral smear; myeloblasts are generally positive for peroxidase and sudan black histochemical stains. Dx?
acute myeloid leukemia
32
what is the mainstay of treatment for acute myeloid leukemia? 2nd line treatment?
chemotherapy allogenic bone marrow transplant
33
caused by development of an abnormal chromosome called Philadelphia chromosome; proliferation of myeloid cells retain their capacity to differentiate/mature.
chronic myeloid leukemia
34
CBC reveals elevated WBCs, increased granulocytes in all stages of maturity, thrombocytosis, and positive Philadelphia chromosome. Dx?
chronic myeloid leukemia
35
what is the hallmark diagnostic finding for chronic myeloid leukemia?
BCR / ABL gene in peripheral blood smear or bone marrow biopsy
36
what is the mainstay of treatment for chronic myeloid leukemia? what is the only proven curative therapy?
chemotherapy allogenic bone marrow transplant