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Organ Systems - UWorld Factoids > Onc > Flashcards

Onc Flashcards

1
Q

leukemoid reaction

A

acute inflammatory response to infection.

incr in WBC WITH band forms / shifts.

key: incr in ALP (unlike w/ CML)

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2
Q

hodkin lypmphoma characteristics (4)

A

1) local + contiguous spread
2) Reed-sternberg
3) 50% associated w/ EBV
4) constitutional symptoms

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3
Q

NHL characteristics (3)

A

1) multiple nodes, noncontiguous spread
2) mostly B cells
3) HIV / immunosuppresion

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4
Q

Reed-sternberg cells

A

CD14 / Cd30 –> Bcell origin

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5
Q

prognosis for hodgkin lymphoma

A
  • lymphocyte-rich form = better prognosis than low-lymphocytic response
  • nodular sclerosing form = most common
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6
Q

Non-hodgkin lymphoma (4 types) B cells

A

1) burkitt
2) diffuse large B cell
3) mantle
4) follicular

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7
Q

NHL - T cells (2 types)

A

1) adult T cell

2) mycosis / fungoides

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8
Q

burkitt associations

A

1) t (8,14) c-myc to Ig heavy chain
2) starry sky: lymphocytes with interspred macrophages
3) EBV

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9
Q

diffuse large B cell lypmhoma

A

t (14,18) (Ig heavy chain to bcl-2); same as follicular lymphoma

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10
Q

mantle cell lymphoma

A

t (11,14) translocation of cyclin D1 to heavy chain Ig.

CD5+

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11
Q

follicular lymphoma

A

t (14, 18) –> translocation of heavy-chain Ig & bcl-2

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12
Q

presentation of follicular lymphoma

A

1) indolent course

2) painless waxing/waning lymphadenopathy

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13
Q

adult-T cell lymphoma gene + presentation

A

1) HTLV-1 (associated w/ IV drug abuse)

2) lytic bone lesions + hypercalcemia (cutaneous lesions)

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14
Q

mycosis fungoides / sezary syndrome

A

1) cutaneous patches / plaques / tumors –> potential to spread into lymph / viscera
2) malignant cells seen circulating
3) indolent / CD4+

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15
Q

multiple myeloma def + mneomnic

A

monoclonal plasma cell —> large amounts of IgG / IgA
“CRAB”

hyperCalcemia
Renal insufficiency
Anemia
Bone lysis / Back pain

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16
Q

how is multiple myeolma different from Waldenstrom macroglobulinemia?

A

there are no lytic bone lesions

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17
Q

how is multiple myeloma different from monoclonal gammopathy of undetermined significance (MGUS)

A

MGUS is asymptomatic, w/ 1-2% progressing to MM each year

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18
Q

findings of multiple myeloma (5)

A

1) primary amyloidosis (AL)
2) lytic bone lesions on xray
3) M spike on serum protein electrophoresis
4) Bench Jones protein = Ig light chains in urine
5) rouleaux formation (RBCs stacked on smear)

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19
Q

myelodysplastic syndromes

A

-stem cell disorder w/ ineffective hematopoiesis –> defects in cell maturation of non-lymphoid lineages

20
Q

what are myelodysplastic syndromes associated w/

A

AML transformation

21
Q

ALL presentation

A
  • mediastinal mass
  • Down syndrome association
  • incr. lymphoblasts
22
Q

ALL on labs

A

-TdT+

CD10+

23
Q

best prognosis for ALL?

A

t(12,21)

24
Q

where might ALL spread to?

A

CNS / testes

25
Q

SLL markers + diagnostic findings

A

CD20+, CD5+

smudge cells in periphery –> autoimmune hemolytic anemia

26
Q

what are the differences b/w SLL & CLL?

A

CLL has incr. peripheral blood lymphocytosis / bone marrow involvement

27
Q

hairy cell leukemia diagnostic findings?

A

cells w/ filamentous hair-like projections

28
Q

stains for hairy cell leukemia?

A

stains TRAP (tartrate-resistant acid phosphatase positive)

29
Q

what are hairy cell leukemia findings?

A

marrow fibrosis –> dry tap on aspiration

30
Q

treatment for hairy cell leukemia?

A

cladribine (2-CDA), which is an adenosine analog, that inhibits adenosine deaminase

31
Q

AML findings

A

auer rods –> peroxidase positive, with cytoplasmic inclusions.

can have DIC

32
Q

what are AML findings on peripheral smear?

A

circulating myeloblasts

33
Q

risk factors for AML?

A

previous alkylating chemotherapy, myeloproliferative disorders, Down syndrome

34
Q

AML genetic disorder?

A

t(15,17)

35
Q

cml

A

9,22 translocation (bcr-abl)

incr. neutrophils, metamyelocytes, basophils and splenomegaly

36
Q

what can CML transform into?

A

AML / ALL –. blast crisis

37
Q

lab findings for CML

A

low leukocyte alkaline phosphatase (LAP) due to low granulocyte activity

38
Q

langerhans cell histiocytosis presentation

A

lytic bone lesion in child w/ skin rash / recurrent otitis media w/ a mastoid mass

39
Q

what is langerhans cell histiocytosis?

A

proliferative disorder of dendritic cell from a monocyte lineage

40
Q

markers for langerhans histiocytosis?

A

S-100 + CD1A. bierbeck granules = tennis rackets on EM that are characteristic

41
Q

myelofibrosis

A

fibrotic oliberation of bone marrow –> teardrop RBCs

42
Q

essential thrombocytosis

A

overproduction of platelets –> bleeding / thrombosis.

enlarged megakaryocytes found on bone marrow

43
Q

mutations in chronic myeloproliferative disorders?

A

JAK2 –> hematocrit > 55%, presenting as intense itching after shower

44
Q

what’s the difference b/w appropriate vs. inappropriate polycythemia?

A

incr in RBC mass may be appropriate in cases of hypoxia, where the body increases EPO production to incr. O2 carrying capacity (i.e.: altitude, heart / lung disease, etc.)

overall, O2 saturation dec.

45
Q

inappropriate polycythemia ex?

A
  • renal cell carcinoma
  • Wilms tumor
  • cyst
  • hematocellular carcinoma
  • hydronephrosis

Organ Systems - UWorld Factoids (8 decks)

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