Pearl_09

Question 1

Pt presents with prog fatigue / easy brusing / dyspnea / hypoxia / worsening mental status –> WBC > 100k

Has the following cells on smear, below:

Dx? Dx is assoc with what t(x, x) situation?

Name of image on smear?

Tx

• treat symptomatic hyperleukocytosis with _____ and start _____ prior to chemo

Dont forget a HIGH concern for ___ in pts with this condtion!

Answer 1

Dx

• AML

assoc with t(15,17)

Name of image on smear –> Auer Rods

Tx?

• symptomatic hyperleukocytosis with leukapheresis and start ATRA prior to chemo

HIGH concern for *DIC* in pts with this AML

Question 2

Elderly patient presents with fatigue, easy bruisability, and cervical lymphadenopathy -> CBC with 60K WBC and 95% lymphocytes and this smear (see attachment 2)

Dx?

Order what DxM?

Associated with?

Answer 2

• > think CLL -> order FLOW cytometry
• > often assoc with hemolytic anemia and ITP

Question 3

Young patient presents with painless lymphadenopathy, fever, night sweats, weight loss, and pruritis:

Dx?

DxM?

If it is positive, they need what?

Tx? (and prognosis is based on ___)

Answer 3

Lymphoma

-> order excisional LN biopsy -> if positive needs CT CAP

Tx

-> multidrug chemo is treatment

(prognosis based on stage – see below). We had to know staging last year (ridiculous, I know!)

Lymphoma staging:

Stage I 1 node or group

Stage II 2 or more lymph node groups, same side of the diaphragm

Stage III Spans the diaphragm

Stage IV Disseminated disease

Subscripts for lymphoma staging

A B symptoms absent

B B symptoms present

X Bulky disease –defined as any mass >10 cms or a mass > 1/3 the diameter of the chest

E Extranodal disease

Question 4

Dx?

What do you see?

t(x, x)?

Answer 4

AML

Auer Rods

t(15,17)

Question 5

Dx?

Assoc with?

Answer 5

CLL

Assoc with hemolytic anemia and ITP

Question 6

symptomatic hyperleukocytosis

Tx with eukapheresis and start ATRA prior to chemo

This is treatment for what oncology dz?

Answer 6

AML

Question 7

associations with some onc dz:

DIC?

hemolytic anemia and ITP?

Answer 7

DIC: high concern in AML pts

hemolytic anemia: in CLL pts

Question 8

Lymphoma staging:

One node or group

Answer 8

Stage I

Question 9

Lymphoma staging:

2 or more lymph node groups, same side of diaphragm

Answer 9

Stage II

Question 10

Lymphoma staging:

Spans the diaphragm

Answer 10

Stage III

Question 11

Lymphoma staging:

Disseminated dz

Answer 11

Stage IV

Question 12

Subscripts for lymphoma staging:

• If B symptoms are absent?*
• If B symptoms are present?*
• Bulky disease* (defined as any mass >10 cms or a mass > 1/3 the diameter of the chest
• Extranodal disease?*

Answer 12

If B symptoms are absent –> A

If B symptoms are present –> B

Bulky disease (defined as any mass >10 cms or a mass > 1/3 the diameter of the chest) –> X

Extranodal disease –> E