myeloproliferative disorders (lymphoid/myeloid) - haematological disease

Question 1

acute leukaemia in general terms is

Answer 1

proliferation of primitive precursor cells usually only found in bone marrow
replaces normal one marrow cells

Question 2

what can acute leukaemia lead to

Answer 2

anaemia
palor and lethargy
neutropenia leading to infections
thrombocytopenia- bleeding

Question 3

types of leukaemia

Answer 3

lympoid
- acute lymphoblastic leukaemia
Chronic lymphatic leukaemia

Myeloid
- acute myeloid leukamia
chronic myeloid leukaemia

Question 4

acute lymphoblastic leukaemia

Answer 4

malignant proliferation of lymphoblasts in bone marrow

Question 5

treatment of acute lymphoblastic leukaemia

Answer 5

• induction chemotherapy
• consolidation chemo +/- craniospinal irradiation
• maintenance chemotherapy
• bone marrow transplantation only if relapse

Question 6

acute myeloid leukaemia

Answer 6

malignant proliferation of myeloblasts in bone marrow

Question 7

treatment of acute myeloid leukaemia

Answer 7

• cyclical high dose chemotherapy (induction and consolidation with no maintenance)
• sometimes bone marrow transplantation

Question 8

what to check for orally for acute myeloid leukaemia

Answer 8

gum infiltrate in acute moncytic subtype

- pts with gum hypertrophy do blood count to check for leukamia

Question 9

chronic lympathic leukaemia and presentation

Answer 9

proliferation of mature lymphocytes
usually B cells

anaemia, infections, lymphadenopathy, splenomegaly

Question 10

chronic myeloid leukaemia phases

Answer 10

high white cell count (i.e. too many) and splenomegaly 
3 phases
-	chronic
-	accelerated
-	blast crisis

Question 11

treatment of chronic myeloid leukaemia

Answer 11

1) imatinib
- blocks abnormal BCR-ABL tyrosine kinase activity
- can result in molecular remission
2) allogenic stem cell transplantation

Question 12

myelodysplasia

Answer 12

premalignant condition of haemopoietic precursors

can move to acute myeloid leukaemia

Question 13

types of lymphoma

Answer 13

Hodgkin lymphoma

non Hodgkin lymphoma

Question 14

hodgekin lymphoma

Answer 14

painless lymphadenopathy
B symptoms - sweats, weight loss, fever
B lymphocytes multiply in abnormal way

Question 15

treatment of hodgekin lymphona

Answer 15

chemotherapy
radiotherapy
stem cell transplantation

Question 16

types of non Hodgkin lymphoma

Answer 16

indolent or low grade

aggressive or high grade

Question 17

indolent/low grade non hodgekin + treatment

Answer 17

• gradual onset
• usually advanced at presentation
• incurable
• can be asymptomatic
  Treatment
• chemotherapy
• radiotherapy
• transplantation

Question 18

aggressive or high grade non Hodgkin + treatment

Answer 18

• rapidly progressive
• usually symptomatic
• potentially curable
  Treatment
• chemo
• radio
• transplantation bone marrow

Question 19

what is a myeloproliferative disorder

Answer 19

proliferation of cells in the marrow

Question 20

myeloproliferative disorders

Answer 20

1) polycythaemia rubra vera
2) chronic myeloid leukamia
3) essential thrombocythaemia
4) myelofibrois

Question 21

what is polycythaemia rubra vera

Answer 21

red cell proliferation

primary and secondary

Question 22

what is chronic myeloid leukamia

Answer 22

white cell proliferation

Question 23

essential thrombocythaemia

Answer 23

platelet proliferation

Question 24

myelofibrosis

Answer 24

marrow stroma proliferation

Question 25

what is secondary polycythaeia due to

Answer 25

• hypoxic: high altitude, lung or cyanotic heart disease

- inappropriate erythropoietin secretion: renal tumour can stimulate production

Question 26

primary polycythaeia causes and treatment

Answer 26

• thrombosis
• pruritus, plethoric facies
• splenomegaly, hepatomegaly

Treatment
- venesection, aspirin, myelosuppression

Question 27

primary thrombocytosis

Answer 27

uncontrolled malignant proliferation of megakaryocytes

platelets more than 600+

Question 28

treatment of thrombocytosis

Answer 28

aspirin etc

Question 29

secondary thrombocytosis

Answer 29

bleeding
infection
inflammation
malignacy

Question 30

normal platelet count

Answer 30

150-400

Question 31

multiple myeloma

Answer 31

malignant proliferation of plasma cells in the bone marrow

myeloma has monoclonal immunoglobulin in blood and urine

Question 32

symptoms of mutliple myeloma

Answer 32

lytic lesons in bones
hyper calcaemia due to bone resopriton
renal failure 
anaemia 
infections

Question 33

diagnosis and treatment of mutiple myeloma

Answer 33

blood/urine test
x ray/MRI
bone marrow

Tx
- chemotherapy 
thalidomide
bortezomib
radiation
stem cell transplantation