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Blood and Cancer > test 2 deck > Flashcards

test 2 deck Flashcards

1
Q

What defines a leukemia?

A

Leukemia is applied to neoplasms that typically involve the bone marrow and peripheral blood

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2
Q

What is the difference between a chronic and acute leukemia?

A

Chronic leukemia will be composed primarily of mature cells (< 20% blasts in marrow)

Acute will primarily be composed of blast cells (> 20% blasts in marrow)

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3
Q

What visual feature can differentiate a blast from a more mature cell?

A

Blast cells contain nucleoli in their nuclei

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4
Q

What is the only definitive visual feature that can differentiate between AML and ALL? Can this be used all the time?

A

AML contains Auer rods

(Auer rods are crystalized myeloperoxidase enymes)

No! Auer rods are only found in the promyelocytic subtype.

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5
Q

What defines a lymphoma?

A

Lymphoma is used to describe lymphoid tumors that present as masses within lymph nodes and other soft tissues

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6
Q

Draw the hematopoiesis lineage (Pathoma version)

A
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7
Q

Where in the hematopoiesis lineage are Acute Myeloid Leukemias?

A
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8
Q

What are the general clinical symptoms of AML?

A

Bone infiltration of blasts results in:

anemia

neutropenia

thrombocytopenia

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9
Q

What are the 3 subtypes of Acute Myeloid Leukemia (AML)?

A

Acute promyelocytic leukemia

Acute monocytic leukemia

Acute magakaryoblastic leukemia

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10
Q

Name the genetic mutation, lab finding, common complication, and treatment for Acute Promyelotic Leukemia.

A

Genetic mutation: t(15;17) PML-RAR-alpha

Common lab finding: Auer rods (crystalized myeloperoxidase)

Common complication: DIC (ruptered cells release Auer rods)

Treatment: ATRA (Vitamin D); forces cells to mature

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11
Q

Name the common complication for Acute Monocytic Leukemia.

A

gum infiltration

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12
Q

Where in the hematopoietic lineage are myeloproliferative disorders?

A
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13
Q

What are the 4 myeloproliferative disorders (important to us?)

A

Polycythemia vera

CML

Essential thrombosis

Myelofibrosis

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14
Q

Name the genetic mutation, lab finding, PE finding, common complication, and treatment for Acute Promyelotic Leukemia.

A

Genetic: t(9;22) philadelphia translocation BCR-ABL

Lab finding: pancytosis (basophilia is common) and decrease alkaline phosphatase

PE finding: splenomegaly

complication: Blast crisis (either AML or ALL)

Treatment: Imatinib

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15
Q

Name the genetic mutation, lab finding, common complication, and treatment for Polycythemia vera

A

Genetic: JAK2 mutation

Lab finding: pancytosis, especially in RBCs

Common complication: erythromelalgia, pruritus after shower, and headache

Treatment: phelbotomy and ASA to prevent thrombosis

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16
Q

Where in the hematopoietic lineage are ALLs?

A
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17
Q

What are the 2 types of ALLs we need to know? How common are they?

A

B-ALL (very common)

T-ALL (not common)

18
Q

Name the genetic mutation, lab finding, and common complication for B-ALL.

A

Genetic: t(12;21) good progrnosis; t(9;22) bad prognosis

lab findings: Express CD10 (calla), CD19, CD20; tDt +

Common complications: brain and testes mets

19
Q

Name the lab findings and common PE finding for B-ALL.

A

lab finding: CD2-CD8

mediastinal mass (thymus)

20
Q

Where in the hematopoietic lineage are chronic leukemias?

A
21
Q

What are the 4 types of chronic leukemias?

A

CLL

Hairy cell

Adult T-Cell Leukemia/Lymphoma

Mycosis Fungoides

22
Q

Name the cell type (B or T), genetic mutation, lab finding, and common complication for CLL.

A

Cell type: B cell

Genetic: Del 17q (TP53) - bad prognosis; Del 13q - good prognosis

Lab findings: Cells co-express CD5 (T cells) and CD20 (B cells)

Common complication: can cause LAD, which then becomes small lymphocytic lymphoma; autoimmune hemolytic anemia (warm and cold)

23
Q
A
24
Q

Is lymphadenopathy common in lymphomas?

A

yes

25
Q

What is a virchow’s node?

A

supraclavicular LAD (virchow’s node) usually indicates malignancy

26
Q

What are B symptoms?

A

Fever, night sweats, weight loss

27
Q

What are the two types of lymphomas (big categories)

A

Hodgkin lymphoma

Non-Hodgkin lymphoma

28
Q

Are B cells or T cells more common in NHL?

A

B cells (~85%)

T cells & NK cells (~15%)

29
Q

What are the 5 types of NHLs? (Only the B cells)

A

Follicular lymphoma

Mantle cell lymphoma

Marginal cell lymphoma

Burkitt lymphoma

Diffuse large B cell lymphoma

30
Q

Name the genetic mutation, lab findings, clinical course (fast/slow growing), and PE finding for follicular lymphoma.

A

genetic: t(14;18) Bcl2-IgH (Bcl2 inhibits apoptosis)

lab findings: mutliple follicles even in the medula; Cleft nucleus

Clinical course: indolent

PE finding: LAD

31
Q

Name the genetic mutation, lab finding, and PE finding for Mantle cell lymphoma.

A

genetic: t(11;14) cyclinD-IgH (cyclinD pushes G1/S cycle)

Lab finding: CD5+, CD20+

PE finding: LAD

32
Q

Name the genetic mutation, lab finding, subtypes, and common association for Burkitt lymphoma.

A

Genetic: t(8;14) c-myc-IgH

Lab findings: starry sky apprearance (sheets of lymphocytes and stars are macrophages); cytoplasmic vacuoles

subtypes: Sporatic (abdomen) and Endemic (jaw)

Common association: EBV

33
Q

Name the genetic mutation and lab finding for Diffuse Large B Cell Lymphoma.

A

genetic: unknown

lab findings: large atypical cells

34
Q

Where in the hematopoietic lineage are plasma cell malignancies?

A
35
Q

What is the plasma cell malignancies we need to know?

A

Monoclonal gammapathy of undetermined significance (MGUS)

multiple myeloma

36
Q

What is MGUS (basic)?

A

MGUS is basically MM without the CRAAB symptoms

37
Q

What is multiple myeloma?

A

Malignant proliferation of plasma cells in bone marrow

38
Q

What are the clinical manifestations of MM? (CRAAB)

A
  • HyperCalcemia
  • Renal involvement
    • Bence-Jones protein in urine (free light chains)
    • Renal failure is free light chains deposit into the tubules
  • Anemia
  • Amyloidosis
  • Bone lytic lesions/Back pain
39
Q

What would indicate MGUS or MM on SPEP?

A

M spike

40
Q

in MM, how do RBCs arrange themselves?

A

Rouleaux formation

Blood and Cancer (10 decks)

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