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Pathology > WBCs Disorders and Leukemias > Flashcards

WBCs Disorders and Leukemias Flashcards

1
Q

What are the two common features of leukemias?

A
  1. WBC precursors in the bone marrow

2. Increased malignant WBCs in peripheral blood

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2
Q

What are the two major classes of leukemias?

A
  1. Myeloid (granulocyteic-monocytic)

2. Lymphoid (lymphocytic)

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3
Q

Which type of leukemia are children more commonly affected by?

A

Children = acute

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4
Q

Which type of leukemia are adults more likely to have?

A

Adults = chronic

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5
Q

What virus has implicated as a cause of Burkitt Lymphoma?

A

EBV

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6
Q

Name 3 complications common to all leukemias

A
  1. Anemia
  2. Recurrent infection
  3. Uncontrolled bleeding

*Pancytopenia

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7
Q

What is the most common cause of death in leukemia?

A

overwhelming infection, ie sepsis

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8
Q

Immature B-cell leukemia with lymph node involvement

A

Acute Lymphoblastic leukemia (ALL)

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9
Q

What is the most common form of leukemia in children <5?

A

Acute lymphoblastic leukemia

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10
Q

Describe the clinical features of acute lymphoblastic leukemia

A
  • Bone pain and arthralgia
  • Pancytopenia
    • bleeding into skin and internal organs
  • Enlarged lymph nodes
  • Mild splenomegaly
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11
Q

In the FAB- French American British classifications of acute leukemias who are L1 and L2 distinguished?

A

L1 Acute Lymphoblastic is principally pediatric and has a uniform nucleus

L2 Lymphoblastic has irregular nucleus

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12
Q

What is the prognosis for Acute Lymphoblastic leukemia?

A

No treatment = dead in 3-5 months

Treatment =>90% cure

–prognosis better in children

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13
Q

What is the most common acute leukemia?

A

Acute myeloid leukemia

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14
Q

Who is most commonly affected by acute myeloid leukemia?

A

older people

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15
Q

How is acute myeloid leukemia diagnosed?

A

Bone marrow biopsy showingn >20% myyeloblasts

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16
Q

Which leukemia is associated with radiation (ex. atomic bombs), cytoxic chemotherapy, benzene exposure, cigarette smoke

A

Acute myeloid leukemia

17
Q

Which type of leukemia is associated with Auer rods?

A

Acute Myeloid Leukemia

18
Q

What are the two cytochemical markers used for diagnosis of AML?

A
  1. Myeloperoxidase

2. Nonspecific Esterase (NSE)

19
Q

Are cytoplasmic granules associated with AML or ALL?

A

AML

20
Q

Which type of infection is especially seen in AML?

A

fungal

21
Q

Clinical features of AML?

A
  • Splenomegaly
  • Lymphadenopathy
  • Testicular enlargement
  • Infiltrates into the retina and choroid
  • CNS may be involved with infiltrates
22
Q

Prognosis of AML?

A

Most die within 6 months

Chemo can induce remission, but almost all will relapse. 30% 5 year survival

23
Q

What is a key clinical feature of chronic lymphocytic leukemia

A

bilateral axillary

24
Q

Chronic lymphocytic leukemia shares many of the same features as ________

A

small cell lymphocytic lymphoma

25
Q

What should be expected in patient with histological finding of lymphocytes >15,000 in peripheral blood

A

Chronic lymphocytic leukemia

26
Q

Which condition will show show many abnormal looking lymphocytes called smudge cells on a peripheral smear?

A

Chronic lymphocytic leukemia

27
Q

Which is the most common form of myeloproliferative syndrome? (Chronic or acute)

A

Chronic

28
Q

What is the difference in cell maturity between chronic myelogenous leukemia and chronic lymphocytic leukemia?

A

Chronic myelogenous leukemia is a maligant disease with granulocytes in all stages of maturation

chronic lymphocytic leukemia is a malignant disease of adult lymphoid cells (indistinguishable from mature lymphocytes)

29
Q

What specific chromosomal abnormality is associated with 95% of patients with Chronic myelogenous leukemia?

A

Philadelphia chromosome - reciprocal translocation between chromosome 9 and 22 –>produces uncontrolled tyrosine kinase.

30
Q

How is chronic myelogenous leukemia diagnosed?

A
  1. High WBC count

2. FISH (fluorescence in-situ hybridization)

31
Q

Is there a better prognosis or worse prognosis if you are in the 95% of people who have the reciprocal translocation for chronic myelogenous leukemia?

A

better prognosis with it

32
Q

The presence of _______ in CML cells is strong evidence of its disease causing role

A

tyrosine kinase

33
Q

Which chromosome is technically the philadelphia chromosome?

A

22

34
Q

What might you suspect if a bone marrow smear and peripheral blood smear showed granulocytes in all stages of maturation and rouleux formation (ex. metamyelocytes, myelocytes)?

A

Chronic myelogenous leukemia

35
Q

What two clinical findings are a result of accelerated clotting found in Chronic Myelogenous Leukemia?

A
  1. Splenomegaly

2. Thrombosis

36
Q

After 2-3 years of chronic phase in CML, 50% of the time it will progress to an accelerated phase which usually ends in a ___________ that resembles acute leukemia

A

“blast crisis”

37
Q

Does chemotherapy work well for CML patients?

A

chemo yields unsatisfactory results and most will die in 3-5 years.

70% 3 year survival with BM + radiation + chemo

Pathology (15 decks)

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