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Week 2 Flashcards

1
Q

What is the life span of neutrophils?

A

7-8 hrs

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2
Q

What is the precursor cell for platelets?

A

Megakaryocytes

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3
Q

Embryologicaly where do haemopoietic stem cells come from?

A

Mesoderm

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4
Q

What is the lifespan of platelets?

A

7-10 days

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5
Q

What are the primary lymphoid tissues?

A

Bone marrow

Thymus

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6
Q

What are the secondary lymphoid tissues?

A

Lymph nodes

Spleen

tonsils

Bone marrow

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7
Q

What happens in malignant haemopoiesis?

A

Increased numbers of abnormal and dysfunctional cells with loss of normal actiivity

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8
Q

Whithin a lymph node where is the lymph filtered?

A

Within the parenchyma

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9
Q

What is the structure of the spleen?

A

Red pulp - blood filtering

White pulp - periarteiolar lympoid sheath - Lymph

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10
Q

What is the triad for hypersplenism?

A

Splenomegaly

Fall in cellular components of blood

Correction of cytopenia by splenectomy

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11
Q

What is pancytopenia?

A

A deficiency of blood cells of all lineages

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12
Q

What are the two cause of pancytopenia?

A

Reduced production

or

increased destruction

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13
Q

What are the reduced production causes of pancytopenia?

A

Bone marrow failure

Inherited

Acquired primary

or

Acquired secondary

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14
Q

give examples of acquired primary bone marrow failure?

A

Idiopathic aplastic anaemia

Myelodysplastic syndromes

Acute leukaemia

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15
Q

What is the aname for the aneamia where there is autoimmune atack against haempopoietic stem cells?

A

Idiopathic aplastic anaemia

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16
Q

What happens in aplastic anaemia?

A

Auto-reactive T cells attack haemopoiectic stem cells

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17
Q

What is found in myelodysplastic syndrome?

A

Dysplasia

Hypercellular marrow

increased apoptosis of progenitor mature cells

(ineffective haemopoiesis)

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18
Q

What are the common causes of secondary bone marrow failure?

A

B12/folate dificiency

Drug induced - chloramphenicol, alcohol

HIV

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19
Q

What are some causes of hypersplenism?

A

Splenic congestion

Rheumatoid Arthritis

Splenic lymphoma

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20
Q

Draw the summary slide for Pancytopenia

A
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21
Q

How can you break down the symptoms of pancytopenia?

A

Anaemia

Neutropenia

Thrombocytopenia

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22
Q

What are the aneamic consequences of pancytopenia?

A

Fatigue

SoB

Cardiovascular compromise

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23
Q

What are the neutropenic symptoms of pancytopenia?

A

Increased infections

More severe and for longer

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24
Q

What are the thrombocytopeniaic consequences of pancytopaenia?

A

Bleeding

Purpura

Petechiae

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25
What does hypocellular marrow in pancytopenia suggest?
Aplastic anaemia
26
What will the marrow show in B12/folate deficiency pancytopenia?
Hypercellular
27
What happens in acute myeloid leukaemia?
Proliferation of abnormal progenitors with block in differentiation/maturation
28
What happens in chronic myeloid leukaemia?
Proliferation of abnormal progenitors with no differentiation/maturation block
29
What is the concept of "clones" in relation to malignant haemopoiesis?
Clones are cells derived from one parent cell Normal haemopoiesis = polyclonal Malignant haemopoiesis = monoclonal
30
What does myeloid mean and what does lymphoid mean?
Myeloid = erythrocytes, plaelets, macrophages Lymphoid = immune cells, T cells and B cells, lymphy stuff
31
What is acute leukaemia?
Rapidly progressive clonal malignancy of the marrow/blood with maturation defects.
32
What defines actue leaukaemia?
Excess of "blasts" in either blood or bone marrow of \>20%
33
What are the two types of acute leaukaemia?
Acute myeloid leukaemia Acute lymphoblastic leaukaemia
34
What is acute lymphoblastic leaukaemia?
Malignant disease of lymphoblasts
35
Who gets acute lymphoblastic leukaemia?
Children its the most common childhood cancer
36
who gets acute myeloid leukaemia
Oldies
37
What does a blood film in acute leakaemia look like?
Blast cells with high nuclear:cytolasmic ratio
38
Where do you find Auer rods and what do they mean?
Auer rods are found in acute myeloid leukaemia
39
How do you treat acute leakaemia?
Months to years of Curative mutliagent chemotherapy
40
What takes longer to cure ? Acute lymphoblastic leakaemia ALL or Acute Myeloid Leaukaemia
AML - months ALL - years
41
What are the cure rates for ALL and AML?
Acute Lymphoblastic leakaemia Child - 85% Adult - 30% Acute Myeloid Leakaemia \<60yrs = 50% \>60yrs = 10%
42
What are the different mechanisimsins of action in low does chemo/RT vs High dose chemo/RT ?
Low dose - apoptosis High dose- Chemo
43
What killing method is better for lymphoma and acute leaukaemia?
Low power chemo cells are ready for apoptosis
44
What are the side effects of radiotherapy/chemotherapy ?
Hair loss, Nausea, Vomiting, Neutropenic infection Tiredness long term, heart and lung dmg
45
What should be given to all imunnosupressed cancer patients
Prophylactic antifungal drugs intraconazole Posaconazole
46
What supportive therapys should haem cancer patients get?
Promped treatment of infections broad spectrum antibiotics red cell and platelet transfusions growth factors antifungals
47
What are the targeted cancer therapies ?
Monoclonal antibodies Biological agents Molecularly targeted treatmens
48
What on earth are monoclonal antiodies?
Cancer treatment which only affects the cel which possesses the target protein. avoids side effects
49
How are monoclonal antibodies usually used?
Normally in combination with chemothraphy
50
When would you have raised lymphocytes?
Increased in viral diseases like glandular fever
51
When would neutrophils be raised?
Increased in bacterial infections and inflamatory disorders
52
in what conditions would you find increased Monocytes?
In chronic bacterial infections Protozoan infections Hodgkin's disease
53
When would you find increased basophils?
Hypothyroidisim Ulcerative collitis Chickenpox
54
What are malignant lymphomas?
Cancers of normal lymphoid stuctures
55
What kinds of malignant lymphomas are there?
Hodgkins disease Non-hodgkin's Low grade or Non-hodgkin's high grade
56
How do maliganant lymphomas present?
painless lymphadenopathy Splenomegaly or hepatomegaly Night sweats, weight loss, fevers aneamia
57
How do you diagnose malignant lymphoma?
Excision biopsy
58
Where would you find Reed-Sternberg cells?
In Hodgkin's disease
59
What is the prognosis for Hodgkin's disease?
70% cure rate
60
What are the causes of hyposplenisim?
COngenital Surgical Trauma Infaction - sickle cell drugs coeliac disease
61
What infections are you worried about in peolpe with hyposplenisim?
Streptococcus pnemonia Haemophilus influenzae
62
What should all patients with hyposplenisim recieve ?
Pneumococcul immunisation Haemophilus influenzae type B vaccine if long term consider prophylaxic penicillin
63
What is Hypersplenisim?
Ehanced cellular filtration functions, pathological pooling and increased plasma volume with modest shortening of blood cell life span
64
What are myeloproliferative disorders?
Colonal malignant disorders characterised by overgrowth of one or more haematopoietic lineages
65
What precursor cell has gone haywire in chronic myeloid leaukaemia?
Granulocyte precursor
66
what type of hodgkin's lymphoma has the best prognosis?
Classical Lymphocye predominant
67
What does myeloproliferative mean?
Myelo = bone marrow lineages Prolfierative = To grow or multiply
68
What are myeloproliferative malignancies?
Clonal haemopoietic stem cell disorders
69
What are the two sub types of myeloproliferative disorders?
BCR-ABL 1 positive BCR-ABL 1 Negative
70
What type of myeloproliferative disorder is BCR- ABL1 positive?
Chronic Myeloid Leukaemia
71
What myeloproliferative disorders are BCR-ABL 1 negative?
Idiopathic myelofibosis Polycythaemia Rubra Vera Essential Thrombocythaemia
72
What clinical signs would sugest a myeloproliferative disorder?
Raised granulocyte, red cell, platelet, eosinophil and basophil counts Splenomegaly Thrombosis
73
What happens in chronic myeloid Leukaemia?
Proliferation of myeloid cells, in particular granulocytes and their precursors
74
How does chronic Myeloid Leukaemia progress?
Chronic phase for 3-5 years then accelerated phase when blasts begin to make their way in to the blood abit more then Blast crisis when it all goes cray cray
75
What weird symtpoms do people with chronic myeloid leukaemia get?
Priaprisim (prolonged erection) gout
76
How could you differentiate chronic myeloid leukaemia from a normal reactive polycythemia?
In reactive polycthemia the eosinophils and basophils must be raised. Also there must be an indentifiable cause
77
What gene defect is the hallmark of chonic myeloid leukaemia?
The philidelphia chromosome BCR-ABL 1 gene
78
How does the philidephia chromosome come about?
Translocation
79
What does the BCR-ABL 1 gene?
Makes tyrosine kinase abnormal phosphorylation chronic myeloid leaukaemia
80
What is Polycthaemia rubra vera?
Type of myloid proliferative malignancy where there is increased red cells
81
What conditions must you also consider in someone with raised red blood cells?
Secondary polycythaemia ( chronic hypoxia, eryhtropoietin-secreting tumout) Pseudopolycythaemia ( dehydration)
82
What weird symptom do people with polcycthaemia rubra vera get?
Ithcy skin when it is wet
83
What mutation is super key for diagnosing Polycythaemia rubra vera?
JAK2 mutation
84
How can you diagnosie polycythaemia rubra vera?
JAK2 mutation
85
How do you treat polycythaemia rubra vera?
Venesect to haematocrit \<0.45 Aspirin Cytotoxic oral chemotherapy - Hydroxycarbamide
86
What is Essential Thrombocythaemia?
A myeloproliferative dissorder where there is uncontrolled overproduction of platelets
87
How do you treat essential thrombocythaemia?
Anti-platelet agents - Aspirin Cytroreductive therapy to control prolifeation Hydroxycarbamide Anagrelide Interferon alpha
88
What is myelofribrosis?
Fibrosis of the bone marrow
89
In what condition do you find tear-drop shaped red blood cells?
In peripheral blood
90
What are the causes of a leucoerythroblastic blood film?
Reactive (sepsis) Marrow infiltration Myelofibrosis
91

Haematology (4 decks)

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