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SBB > WBC Dissorders > Flashcards

WBC Dissorders Flashcards

1
Q

What are oncogenes?

A 
Mutations in proto-oncogenes
-Genes that activate DNA replication
-Genes that activate cell division
-Genes that regulate commitment to differentiation and/or apoptosis
-“Gain of function” mutations
    - growth factors 
    - growth factor receptors
    - signal transduction proteins
    - transcription factors
Dominant mutations (single allele)
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2
Q

What are congenital causes of leukemia?

A

extra chromosomes
translocations
inversion
deletions

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3
Q

What are somatic causes of leukemia?

A

Radiation
Chemicals
Immunodeficiencies

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4
Q

What is acute leukemia?

A

Unregulated proliferation and accumulation of immature, malignant hematopoietic precursors
Occurs in bone marrow
Replaces normal bone marrow elements

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5
Q

What is leukemic hiatus?

A

Lots of immature cells and fully mature cells. No cells in between.

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6
Q

What is the complication of acute leukemias?

A 
Immature leukemic cells accumulate 
bone marrow
peripheral circulation
spleen
CNS
Interferes with organ function and metabolic activity
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7
Q

What is leukostasis?

A 
WBC counts exceeds 100,000/ µl
Slowing of flow through capillaries 
Lungs 
 - Hypoxia
 - Dyspnea 
Cerebrum 
 - Stroke 
 - Coma
 - Intracranial hemorrhage
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8
Q

What are metabolic problems in acute leukemia?

A

Rapid turnover of leukemic cells
Increased metabolic waste
- Uric acid, Gout, Kidney stones, Renal
failure
Hypercalcemia due to Abnormal parathyroid regulation
Cytokine activation of osteoclasts
- Localized bone reabsorption
Hyperkalemia due to lysis of fragile white blood cells and mechanical stress

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9
Q

What does the myeloperoxidase stain differniatate?

A

Myelo vs lymph

Primary granules in myelocytes stain

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10
Q

What is the non-specific esterase stain used for?

A

Stains for non-specific esterase enzyme in monocytic cells

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11
Q

What is the specific esterase used for?

A

Granulocytic blasts (AML) stain positive 1+ to 3+ Monocytic blasts (AMoL) negative

Blasts in acute myelomonocytic leukemia (AMML) stain 1+ to 2+

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12
Q

What is the Terminal Deoxynucleotidyl Transferase (TDT) used for?

A

Stains DNA polymerase found in immature lymphoid cell nuclei

Immunofluorescent assay

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13
Q

What is the M0 FAB classification?

A

Undifferentiated myeloblasts
3% of cases
MPO negative

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14
Q

What is the M1 FAB classification?

A

Myeloblast with minimal maturation
20% of cases
Minimal granulocytic cell maturation
At least 3% of blasts stain positive with MPO

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15
Q

What is the M2 FAB classification?

A

Myeloblast with maturation to or beyond the promyelocyte stage
>50% of the cells are MPO positive
Auer rods are common
t(8;21) has favorable prognosis

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16
Q

What is the M3 FAB classification?

A 
APL or APML
Abnormal promyelocytes
Heavy granulation that packs the cytoplasm
MPO strongly positive
Associated with DIC
t(15;17) is diagnostic for APL
17
Q

What is the M4 FAB classification?

A

Myelomonocytic leukemia
Granulocytic AND monocytic differentiation
>20% of all nucleated cells
MPO, NSE and specific esterase positive
Gingival hyperplasia in 10% of patients
The bone marrow and circulating blood have variable amounts of differentiated granulocytes and monocytes.

18
Q

What is the M6 FAB classification?

A 
Erythroleukemia - Rare
>50% of Marrow cells are erythroid
Bizarre megaloblastic features
Multinuclear, multilobular forms common
CD71, glycophorin A positive
19
Q

What is the M7 FAB classification?

A

Megakaryoblastic leukemia - Rare
Immature megakaryocytes
Distinguished by extensive fibrous tissue deposits (fibrosis) in the bone marrow.

20
Q

What are the surface markers on B cells?

A

CD10 (CALLA), CD19, CD20, CD22

21
Q

What are the surface markers on T cells?

A

CD2, CD3, CD5, CD7

22
Q

What are the surface markers on myeloid cells?

A

CD13, CD15, CD33

23
Q

What are the surface markers on myeloid cells?

A

CD14, CD36, CD64

24
Q

What are the surface markers on HSC?

A

CD34, CD117

25
Q

What is the surface marker for natural killer cell?

A

CD56

26
Q

What are the characteristics of L1 ALL?

A

homogenous small blast

Nucleus is regular with scant cytoplasm

27
Q

What are the characteristics of L2 ALL?

A

Hetergenous large blast
Irregular cleft and indentations in nucleou
Prominent nucleoli
Mod - abundant cytoplasma

28
Q

What are the characteristics of L2 ALL?

A

Burkett’s lymphoma
Homogenous large blast
Regular nucleous with nucleoli
Abundant cytoplasm with vacuoles

SBB (37 decks)

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