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Haematology > Week 2 > Flashcards

Week 2 Flashcards

1
Q

Name the 4 types of leukaemia?

A

Acute lymphoblastic leukaemia
Acute myeloid leukaemia
Chronic lymphocytic anaemia
Chromic myeloid leukaemia

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2
Q

What is acute leukaemia?

A

Rapidly progressing clonal malignancy of marrow/blood

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3
Q

What % of blasts in blood is defined as acute leukaemia?

A

20% or more

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4
Q

At what ages are the two types of leukaemia most common?

A

Lymphoblastic - childhood - most common childhood cancer

Myeloid - elderly

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5
Q

What is the only definitive way to tell ALL and AML apart?

A

Immunophenotyping

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6
Q

What is the difference in treatments between ALL and AML?

A

ALL - chemotherapy can last 2-3 years

AML - Chemo more intensive - 2-4 cycles of 5-10 days

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7
Q

What device is often used to give chemotherapy?

A

Hickman line

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8
Q

What haematological complications may arise from chemotherapy?

A

Anaemia
Neutropenia - infections
Thrombocytopenia - bleeding - purpura, petechiae

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9
Q

What is the cure rate for childhood ALL?

A

85-95%

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10
Q

What sort of transplant may be curable for acute leukaemia?

A

Allogenic stem cell transplant

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11
Q

Normal and malignant haemopoiesis - polyclonal or monoclonal?

A

Normal - polyclonal

Malignant - monoclonal

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12
Q

Name 3 symptoms of lymphoma?

A 
Night sweats
Weight loss
Itch without rash
Alcohol induced pain
Fatigue 
Lymphadenopathy
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13
Q

What are the categories of lymphoma?

A

Hodgkins

Non-hodgkins - T cell or B cell (low grade B cell, high grade B cell)

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14
Q

Which lymphoma is the hardest to treat - low grade or high grade?

A

Low grade

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15
Q

Why are lymphoma lymph nodes not painful?

A

Because they enlarge slowly

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16
Q

Why do metastatic lymph nodes feel irregular?

A

Because the cancer cells grow out of the node

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17
Q

Are lymphoma nodes tender?

A

No

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18
Q

What is a blast?

A

Nucleated precursor cell

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19
Q

What is the life span of a RBC?

A

120 days

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20
Q

What is the lifespan of a neutrophil?

A

7-8 hours

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21
Q

What is the lifespan of a platelet?

A

7-10 days

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22
Q

What is a megakaryocyte?

A

Platelet precursor

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23
Q

What are immunoglobulins made of?

A

2 light and 2 heavy chains

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24
Q

Which is the most common type of myeloma?

A

IgG

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25
Q

What is the second most common type of myeloma?

A

IgA

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26
Q

Why is renal impairment seen in myeloma?

A

Light chains form casts which block the nephrons

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27
Q

Why does bone pain occur in myeloma?

A

Excessive stimulation of osteoclasts causing lytic lesions and hypercalcaemia

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28
Q

What are bence jones proteins and in what condition would you see them?

A

Light chains in the urine - myeloma

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29
Q

What type of immunoglobulin is a pentamer?

A

IgM

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30
Q

What type of immune globulin is a dimer?

A

IgA

31
Q

What type of immunoglobulin is a monomer?

A

IgD, IgE, IgG

32
Q

What type of anaemia may be seen in myeloma?

A

Normochromic normocytic anaemia

33
Q

What is the average survival for patients with myeloma?

A

5-8 years

34
Q

What drugs should you avoid in Myeloma and why?

A

NASIDS - can tip patients into renal failure

35
Q

What is a paraprotein and what happens to it in myeloma?

A

A monoclonal immunoglobulin - rises in myeloma

36
Q

What percentage of bone marrow is plasma cells in myeloma and MGUS?

A

Myeloma more than 10%

MGUS - less than 10%

37
Q

What is the risk of progression from MGUS to Myeloma?

A

1%

38
Q

What does amyloidosis stain with?

A

Congo red - birefringent

39
Q

What paraprotein is involved in waldenstroms macroglobulinaemia?

A

IgM

40
Q

What is Pancytopenia?

A

A deficiency of blood cells in all lineages

41
Q

What are the two main causes of pancytopenia?

A

Reduced production and increased destruction

42
Q

What sort of condition if fanconia anaemia?

A

Inherited bone marrow failure

43
Q

What % of patients with fanconis anaemia will have bone bone marrow failure by age 20?

A

84%

44
Q

What % of patients with fanconis anaemia will have leukaemia by age 40?

A

52%

45
Q

What are the 3 phases of chronic myeloid leukaemia?

A

Chronic
Accelerated
Blast crisis

46
Q

Name 4 lab features of CML?

A 
Normal or decreased Hb
Leucocytosis
Neutrophilia
Basophilia
Eosinophlia
Thrombocytosis
Myeloid precursors
47
Q

What chromosome is involved in CML and what is it?

A

Philadelphia chromosome

Reciprocal translocation between 9 and 22

48
Q

What gene is present in CML and what does this produces?

A

BCR-ABL - produces tyrosine kinase

49
Q

What targeted treatment is useful in CML and what does it do?

A

Imatinib - tyrosine kinase inhibitor

50
Q

What lab counts are raised in polycythaemia rub vera?

A

Hb and haematocrit, erythrocytosis

And blood viscosity

51
Q

What is a cause of pseudo polycythaemia?

A

Dehydration, diuretics, obesity

52
Q

What gene is mutated in 95% of PRV?

A

JAK2

53
Q

What is the treatment of PRV?

A

Venesect hct to less than 0.45

54
Q

What abnormality causes essential thrombocythaemia?

A

Uncontrolled productions of abnormal platlets

55
Q

Name 3 conditions that should be excluded before making a diagnosis of ET?

A

Blood loss, inflammation, malignancy, iron deficiency

56
Q

In what % of ET patients it JAK 2 present?

A

50%

57
Q

What characteristic feature is seen on blood film in myelofibrosis?

A

Tear drop Red cells

58
Q

Name a Jak2 inhibitor?

A

Ruxolitinib

59
Q

What are the 2 groups of cell cycle specific cytotoxic drugs?

A

Mitotic spindle inhibitors - M phase

Anti metabolites - S phase

60
Q

What are the 2 groups of non cell cycle specific cytotoxic drugs?

A

Alkylating agents

Cytotoxic antibiotics

61
Q

Name 2 High grade non hodgkin B cell lymphoma?

A

Diffuse large B cell

Burkitt lymphoma

62
Q

Name 3 low grade non hodgkin B cell lymphoma?

A

Small lymphocytic
Follicular
Marginal

63
Q

What % of NHL is T cell?

A

10-15%

64
Q

What are the categories of hodgkin lymphoma?

A

Nodular

Classic

65
Q

What is the characteristic histology finding in hodgkin lymphoma?

A

Reed steenburg cells

66
Q

What staging system is used for hodgkin lymphoma?

A

Cotswalds system

67
Q

What is the difference between acute and chronic leukaemia?

A

Acute - maturation defect

Chronic - maturation preserved

68
Q

What % of blasts is considered remission in acute leukaemia?

A

Less than 5 %

69
Q

What is the cure rate for adult AML?

A

Under 60 - 40-50%

Over 60 - 10% or less

70
Q

What is the name given to red lines on the skin spreading from a skin lesion?

A

Lymphangitis

71
Q

What is the arterial and venous supply to the spleen?

A

Splenic artery

Splenic vein

72
Q

What causes Howell-Jolly bodies?

A

Hyposplenism

73
Q

What is CD20?

A

B cell marker

74
Q

What is CD3?

A

T cell marker

Haematology (5 decks)

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