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Paige: Heme/Onc Module! > WBC disorders > Flashcards

WBC disorders Flashcards

1
Q

Which leukemia is the most common cancer in children?

A

ALL (ages 3-7)

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2
Q

What are the features of all acute leukemias (ALL, AML)?

A

Sx of platelet problems (gingival bleeding, epistaxis, menorrhagia)

Sx of neutropenia (predisposed to infection)

Sx of anemia, thrombocytopenia, CN palsies, rash

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3
Q

What are the sx specific to younger patients (childhood to young adult) with acute leukemias?

A

fatigue, fever, lethargy, HA

bone/joint pain specific to sternum, tibia, femur

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4
Q

How do older patients present with acute leukemias?

A

Slow and progressive onset

lethargy, anorexia, dyspnea

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5
Q

With which acute leukemia do you find lymphadenopathy and hepatosplenomegaly?

A

ALL

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6
Q

What is a characteristic diagnostic finding of AML and ALL?

A

Increased WBCs; panycytopenia w/ blast cells

Bone marrow bx has blast cells

ALL: terminal deoxynucleotidyl

AML: Auer rods

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7
Q

How do you treat acute leukemias?

A

induction chemo with consolidation therapy (destroys leukemic cells)

2nd line: allogeneic bone marrow transplant

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8
Q

Which leukemia is the most prevalent?

A

CLL - malignancy of b lymphocytes

more common in males

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9
Q

What are the symptoms of CML?

A

Triphasic; gradual

Chronic: asymptomatic, may develop fatigue, anorexia, wt loss, fever, excess sweating

Accelerated: splenomegaly causes abd fullness, sx progress w/ bone pain and bruising

Acute “blast crisis”: very pronounced sx

Rarely may get blurred vision, resp distress, priapism

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10
Q

What is a pathognomonic dx of CML?

A

CBC shows leukocytosis

Also, 95% have Philadelphia chromosome mutation

Bone marrow bx shows left shift

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11
Q

How will you treat CML?

A

Allogeneic bone marrow transplant is curative!

Imatinib mesylate (Gleevec) for chronic phase

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12
Q

What is the outcome of CML?

A

80% survive

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13
Q

What are the symptoms of CLL?

A

indolent (painless)

peripheral lymphocytosis w/ invasion of bone marrow, liver, spleen, and lymph

recurrent infections, splenomegaly, lymphadenopathy

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14
Q

What is diagnostic of CLL?

A

CBC shows isolated lymphocytosis, leukocytosis

Periph smear shows smudge cells

Bone marrow bx has left shift

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15
Q

How do you treat CLL?

A

Mostly palliative care; resistant to tx

Can give chlorambucil PO or fludarabine IV

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16
Q

What is the outcome of CLL?

A

Median survival is 6 years :(

17
Q

In what population will you find Hodgkin lymphoma?

A

Ages 15-45 or over age 50

History of EBV (1/2 of cases)

18
Q

What are the symptoms of Hodgkin lymphoma?

A

painless cervical, supraclavic, and mediastinal lymphadenopathy

possible pain in node after ETOH

A sx: no constitutional sx

B sx: fever, wt loss, night sweats, pruritis, fatigue

19
Q

How are you going to dx Hodgkin lymphoma?

A
  1. r/o other reasons for lymphadenopathy
  2. lymph node bx
20
Q

What will you see in the lymph node bx for Hodgkin’s lymphoma?

A

Reed-Sternberg cells (look like owl eyes)

21
Q

How do you treat Hodgkin lymphoma?

A

Combination chemo

initial tx: radiation therapy

ABVD chemo

22
Q

Who gets Non-Hodgkin lymphoma?

A

Ages 20-40y

Risk with HIV, immudeficiency

23
Q

What are the 2 types of Non-Hodgkins lymphomas?

A

indolent (usually progress to…)

agressive

24
Q

What are the sx of non-hodgkins lymphoma?

A

isolated, painless lymphadenopathy, bone marrow may be involved

may migrate to extralymphatic sites

Burkitt lymphoma comes w/ abd fullness

less likely to have “B” sx

25
Q

How do you diagnose non-hodgkin lymphoma?

A
  1. r/o other causes of lymphadenopathy
  2. Bx lymph nodes
  3. establish staging by CXR, CT, bone marrow bx, LP
26
Q

What will you find in lymph node bx of non-hodgkin lymphoma?

A

I have no effing idea, I just know that you do it.

27
Q

How do you treat non-hodgkin lymphoma?

A

indolent: radiation therapy alone
aggressive: chemo, immunotherapy, autologous stem cell transplantation

28
Q

What exactly is multiple myeloma?

A

malignancy of plasma cells which produces abundant M protein

29
Q

What are the symptoms of multiple myeloma?

A

anemia, bone pain (back/ribs), pathologic fx, infection

rarely renal failure, spinal cord compression, hyperviscosity

30
Q

What will you find on CBC and periph smear of multiple myeloma?

A

pancytopenic with normal cell morphology

31
Q

What studies (other than CBC and smear) will you do for multiple myeloma?

A

Electrophoresis: monoclonal spike

UA: + Bence Jones protein

Radiography: “punched out” regions

32
Q

How do you treat multiple myeloma?

A

Refer to a specialist.

Combo chemo, transplant,

Biphosphonates as adjunt therapy.

Paige: Heme/Onc Module! (8 decks)

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