Onc Flashcards

1
Q

CD34

A

hematopoietic stem cell

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2
Q

myeloblast

A

produces granulocytes

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3
Q

neutropenia seen in….

A

drug toxicity or infection (low neutrophils)

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4
Q

causes of lymphopenia

A
  • immunodeficiency (digeorge)
  • high cortisol (cushing)
  • autoimmune (SLE)
  • radiation (most sensitive cells)
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5
Q

causes of leukocytosis

A
  • bacterial infection (left shift - immature cells - less Fc receptors)
  • tissue necrosis
  • high cortisol (release of marginated pool)
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6
Q

CD16

A

marker for decreased Fc receptors in left shift

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7
Q

monocytosis

A
  • chronic inflammatory states
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8
Q

high yield increase in eosinophila

A
  • Hodgkin lymphoma (IL5)

- also allergy and parasites

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9
Q

basophilia

A

CML

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10
Q

lymphocytic leukocytosis

A
  • viral infections

- bordetella pertussis (bacterial exception) - lymphocytosis factor blocking to lymph node

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11
Q

causes of mono

A

EBV then CMV

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12
Q

findings in mono

A
  • LAD
  • splenomegaly (PALS)
  • atypical lymphocytes and high white count (look like monocytes)
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13
Q

PALS

A

t cells in spleen

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14
Q

monospot

A
  • detects IgM heterophile antibodies

- negative in CMV

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15
Q

definitive diagnosis in mono

A

EBV viral capsid antigen

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16
Q

complications of mono

A
  • splenic rupture
  • penicillin allergy
  • dormant in B cells (can cause lymphoma)
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17
Q

acute leukemia

A

increase in blasts in bone marrow

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18
Q

presentation of leukemia

A
  • anemia, thrombocytopenia, neutropenia (bone marrow is crowded out)
  • high WBC count
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19
Q

tDt

A

ALL - DNA polymerase marker

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20
Q

myeloperoxidase

A

AML (auer rod)

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21
Q

ALL associations

A
  • lymphoblast
    has tDt (DNA polymerase)
  • children and Down syndrome after 5
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22
Q

markers in B-ALL

A

CD10, CD19, CD20

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23
Q

prophylaxis in B-ALL needed in…

A

scrotum and CSF (blood brain barrier)

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24
Q

chromosomes in B-ALL

A

12: 21 = good (kids)
9: 22 = bad (adults)

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25
markers in T-ALL
CD2-CD8, no CD10
26
T-ALL
- teenager - thymic mass - call it lymphoma
27
AML
- myeloperoxidase (Auer rods)
28
APML
- retinoic acids receptor - promyelocytes - Auer rods risk for DIC - give ATRA (cause blast to mature) - 15:17
29
acute monocytic leukemia
- infiltrate gums
30
acute megakaryoblastic leukemia
- no MPO | - associated with Down syndrome (before 5)
31
AML from preexisting dysplasia
- from myelodysplastic syndrome - cytopenias - less than 20% blasts - from radiation
32
CLL
- naive B cells - CD5 (normally on T cell and CD20 - smudge cells - goes to lymph node
33
smudge cell
CLL
34
complications of CLL
- hypogammaglobulinemia (immature cells don't work) - hemolytic anemia (poor antibodies attack itself) - transformation to B cell lymphoma
35
hairy cell leukemia
- mature B cells - TRAP - splenomegaly (red pulp) - dry tap on bone marrow (cells get trapped) - lack lymphadenopathy
36
2-CDA
- ADA inhibitor | - for hairy cell leukemia
37
ATLL
- mature CD4 T cells - associated with HTLV-1 - rash - LAD and HSM - lytic bone lesions and hypercalcemia
38
lytic bone lestions
multiple myeloma | - but also ATLL with rash
39
mycosis fungoies
- mature CD4 T cells - T cells in epidermis are called pautrier microabscess - sezary syndrome when in blood
40
chronic leukemia
ONLY LYMPHOID LINES (myeloid lines are called myeloproliferative disorders) - except for CML
41
myeloproliferative disorders are named....
by predominate cell
42
complications of MDs
- hyperuricemia and gout (too much cell turnover) - marrow fibrosis - transformation to acute leukemia
43
CML
- granulocytes (BASOPHILS) - 9:22 translocation - BCR-ABL tyrosine kinase - treated with imatinib
44
accelerated phase in CML
spelnomegaly | - can progress to acute leukemia (from stem cells)
45
CML vs leukemoid reaction
- leukocyte alkaline phosphatase (positive in infection) - CML has basophils - CML has 9:22 - CML have no intention of fighting infection
46
polycythemia vera
- mostly RBCs | - driven by JAK2 kinase (think of endo man with his love for EPO and JAK kinase)
47
clinical symptoms of PV
- blurry vision and headache - venous thrombosis (Budd-Chirari - itching after bathing (morre mast cells
48
itching after bathing
PV
49
what ectopically produces EPO
renal cell carcinoma
50
essential thrombocythemia
- all cells up - JAK2 kinase mutation - can look like iron deficiency anemia - rarely progressive to fibrosis or leukemia - no risk for gout (not a lot of cell turnover)
51
myelofibrosis
- JAK2 kinase - overproduction of megakaryocytes - produce excess PDGF
52
features of myelofibrosis
- leukoerythroblastic smear (hematopoiesis in spleen, cells get out early) - splenomegaly - increased risk of infection, thrombosis and bleeding - tear drop cells
53
painless LAD causes
- chronic inflammation | - metastatic carcinoma, lymphoma
54
Lymph follicles
RA and early HIV
55
paracortex
viral infection (mono)
56
sinus histiocytes LAD
seen in lymph node draining tissue
57
follicular lymphoma
- CD20 cells - painless LAD - too many follicles - driven by 14:18 (BCL2 keeps B cells stable) - treat with rituximab
58
follicular hyperplasia vs lymphoma
- lymphoma = - disruption of architecture - lack of tingible bodies (dying cells by apoptosis cleaned up by macrophages) - expression of Bcl2 (not seen in normal nodes) - monoclonality
59
mantle cell lymphoma
- expands mantle zone (adjacent to follicle) | - 11:14 (cyclin D - promotes G1-S phase)
60
marginal zone lymphoma
- B cells expand marginal zone - chronic inflammatory states (too much activation) - hashimotos thyroiditis, sjogrens, h pylori gastritis
61
h pylori cancer
MALToma (marginal zone lymphoma)
62
burkitt lymphoma
- EBV CD20 Bcells - jaw and abdomen - driven by c-myc (promotion of growth) - 8:14 - starry sky appearance (cells turning over quickly)
63
DLBCL
diffuse large b cell lymphoma - most common NHL - transformation of follicular lymphoma
64
hodgkin lymphoma
- reed sternberg cells draw in other cells producing mass
65
reed sternberg cells
CD15 and CD30 | - produce cytokines giving B symptoms
66
nodular sclerosis HL
- neck of mediastinum - young female - broad pink bands of fibrosis - RS cell sit in lacunar cells
67
IL elevated in myeloma
IL-6
68
what does myeloma produce
1. osteoclast activating factor - punched out lesions, increased risk of fracture 2. immunoglobulin - M spike (monoclonal Ig) - usually IgG or IgA 3. light chain
69
clinical findings in MM
- increased infection (least Ab diversity) - less charge between blood cells (piling of RBCs) - AL amyloidosis (too much light chain) - proteinuria (bence jones protein)
70
MGUS
- increased serum protein with M spike | - no other findings (lytic lesions, hypercalcemia, Bence Jones)
71
Waldenstrom macroglulinemia
lymphoma with monoclonal IgM - LAD, no lytic bone lesions - increase viscosity of blood - stroke and bleeding - treat by removing IgM
72
langerhans cell histiocytosis
- proliferation of Langerhan cells - Birbeck granules - CD1a and S100
73
things with tennis rackets
langerhan cell histiocytosis and clostridium tetani
74
Letter-Siwe disease
- malignant - skin rash and cystic skeletal defects in infant - multiple organs and fatal
75
eosinophilic granuloma
- benign - pathologic fractures - no skin involvement - eosinophils
76
Hand-Schuller-Christian disease
- malignant proliferation of Langerhan cells | - rash, lytic skull defects, diabetes insipidus and exopthalmos in child