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Advanced Haematology > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Are most haemopoietic malignancies acquired or inherited?

A

acquired

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2
Q

Are most haemopoietic malignancies systemic or localised?

A

systemic

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3
Q

Are most haemopoietic malignancies genetic in origin or outside acquired?

A

genetic in origin

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4
Q

Do leucocyte neoplasms originate in a single leukaemic cell or multiple cells?

A

single - clonal - cells travel in bloodstream, lymph system

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5
Q

Are most treatments for leucocyte neoplasms localised or systemic

A

systemic

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6
Q

List some examples of reasons for the direct cause of malignancy. DNA damage caused by…..

A
  • Environmental toxins
  • Radiation
  • Chemotherapy
  • Organic solvents
  • Viruses
  • Epstein-Barr (Burkitt lymphoma)
  • Human T-cell lymphotropic virus type 1 (HTLV-1)
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7
Q

What are the 2 classification schemes?

A

French-American-British (FAB)

World Health Organisation (WHO)

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8
Q

What is the FAB scheme based largely on?

A

Morphology, histology

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9
Q

What does the WHO add to the FAB scheme?

A
  • Adds or replaces morphology based classification with
  • Cytogenetics (chromosome analysis)
  • Molecular level changes (gene / protein level changes)
  • Focus on elements that control proliferation, maturation, apoptosis
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10
Q

What are the first two genetic lesions discovered were in leucocyte malignancies?

A
  • Philadelphia chromosome – Chronic Myeloid Leukaemia - t(9;22)
  • Burkitt lymphoma - t(8;14)
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11
Q

What is the translocation that characterises leukaemic cells in Chronic Myeloid Leukaemia (CML)

A

Philadelphia chromosome

Also seen in ALL, AML

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12
Q

In the Philadelphia chromosome there is reciprocal translocation between chromosome _______ and chromosome ______

A

22,9

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13
Q

Tumour suppressor genes code for ________ that resist malignant __________

A

proteins, transformation

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14
Q

Defective or missing p53 gene results in

A

mutations in daughter cells

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15
Q

What are 4 things that gene disruptions may affect?

A
  • Normal differentiation
  • Transcription
  • Cell signalling
  • Apoptosis
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16
Q

Lymphomas and lymphocytic leukaemias are _________ lesions of the _______ system

A

neoplastic, lymphoid

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17
Q

Diagnosis of lymphomas is based on a combination what 4 things?

A
  • Morphology
  • Immunophenotype
  • Molecular genetic characteristics
  • Clinical findings
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18
Q

Internal components of a lymph node include

A 
• Cortex
• Paracortex
• Medullary cords
• Sinuses
Capsule, Follicles, Lymphatics
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19
Q

How can antigenic stimulation result in lymph node enlargement?

A

B cells have been coded to recognise a certain antigen and proliferate. They produce antibodies against that particular antigen and fight the virus or infection.

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20
Q

35 sub types of Lymphomas they are generally divided into two main types which are:

A
  • Hodgkin lymphoma

* Non-Hodgkin lymphoma

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21
Q

What is the strongest risk factor for lymphomas?

A

Altered immune function:
• Immunocompromised
• Autoimmune disease
• Some bacterial and viral infections

22
Q

35 sub types of Lymphomas they are generally divided into two main types which are:

A
  • Hodgkin lymphoma

* Non-Hodgkin lymphoma

23
Q

What is the most common form of haematological malignancy in Australia?

A

Lymphoma

24
Q

What is an example of mature B-cell lymphoma?

A

Burkitt lymphoma

25
Q

Is Burkitt lymphoma a Hodgkin lymphoma or a Non-Hodgkin lymphoma?

A

Non-Hodgkin lymphoma

26
Q

What is the most common cutaneous T-cell lymphoma?

A

Mycosis fungoides

27
Q

Mycosis fungoides is found in the ______ and ______ and may spread to regional lymph nodes.

A

epidermis, dermis

28
Q

Sezary syndrome is a variant of mycosis fungoides with _________ ________ _______.

A

circulating tumour cells

29
Q

Cerebriform nuclei are commonly found in patients with ……

A

Mycosis fungoides/Sezary syndrome

30
Q

What is an example of mature T-Cell lymphoma?

A

Mycosis fungoides / Sezary syndrome

• Cutaneous lesions

31
Q

Is Mycosis fungoides/Sezary syndrome an example of a Hodgkin lymphoma or a Non-Hodgkin lymphoma?

A

Non-Hodgkin lymphoma

32
Q

What are the two broad categories of Hodgkin lymphoma

A
  • Nodular lymphocyte-predominant Hodgkin lymphoma

* Classical Hodgkin lymphoma

33
Q

Large ‘Popcorn’ cells • Abundant cytoplasm

• Multilobulated nuclei (popcorn) is a description of the peripheral blood of a patient with

A

Nodular lymphocyte-predominant Hodgkin lymphoma

34
Q

Is Nodular lymphocyte-predominant Hodgkin lymphoma a B-Cell or T-Cell neoplasm?

A

B-Cell

35
Q 
Which lymphoma is this description:
 Heterogenous group of neoplasms
• Derived from germinal centre of lymph node
• Four subtypes
 Diagnostic cell in all subtypes
• “Reed-Sternberg cell”
A

Classical Hodgkin lymphoma

36
Q

Describe a “Reed-Sternberg cell”

A
  • Large lymphoid cell
  • Bi-lobed nucleus or two nuclei
  • Abundant eosinophilic cytoplasm
37
Q 
Which Leukaemia is this describing?
Morphology (peripheral blood):
• Small lymphoid cells
• Coarse chromatin
• Inconspicuous nucleoli
• Scant cytoplasm
• Smudge / smear cells common
A

Chronic Lymphocytic Leukaemia (CLL)

38
Q

Chronic Lymphocytic Leukaemia (CLL) and Small Lymphocytic Lymphoma (SLL) are derived from what type of cell?

A

B-Cell

39
Q

In Chronic Lymphocytic Leukaemia (CLL) andSmall Lymphocytic Lymphoma (SLL) there is an accumulation of small lymphoid cells in: (3)

A
  • Peripheral blood
  • Bone marrow
  • Lymphoid organs
40
Q

This is a description of what type of leukaemia?
• Indolent lymphoproliferative disorder of the elderly
• Median age at diagnosis is 65
• Median survival 10 years
• Emerging targeted therapies offer hope of increased
survival
• Patient outcome predicted by:
• Extent of lymphoid organ involvement
• Cytogenetic abnormalities
• Degree of cytopaenias

A

Chronic Lymphocytic Leukaemia (CLL)

41
Q

This is a description of what type of leukaemia?
• Rare mature lymphoid leukaemia
• Derived from B- or T-cells
• Involve peripheral blood, bone marrow and spleen
• Lymph node involvement more common in T-cell
• Distinct from CLL

A

Prolymphocytic leukaemia (PLL)

42
Q 
This is a description of what type of leukaemia?
• Small B lymphocytes
• Thought to derive from memory B-cell
• Abundant cytoplasm
• Fine hairy cytoplasmic projections
• Cells mainly in bone marrow, spleen
• Some in peripheral blood
• Lymph node involvement is rare
A

Hairy cell leukaemia

43
Q

What does Pancytopaenia mean?

A

Low counts for all three types of blood cells: red blood cells, white blood cells, and platelets

44
Q

What does Cytopenia mean?

A

Occurs when one or more of your blood cell types is lower than it should be

45
Q

What is DIC?

A

Disseminated intravascular coagulation (DIC) is a rare but serious condition that causes abnormal blood clotting throughout the body’s blood vessels.

46
Q

List the main types of therapy used for leucocyte neoplasms: (5)

A
  • Chemotherapy
  • Radiation therapy
  • Supportive therapy
  • Targeted therapy
  • Stem cell transplantation
47
Q

List 3 types of supportive therapy for leucocyte neoplasms.

A
  • Erythropoietin
  • Granulocyte colony stimulating factor (G-CSF) (look up when these would be used?)
  • Granulocyte macrophage colony stimulating factor (GM-CSF)
48
Q

This is a description of what type of therapy?
Aim to leave normal cells untouched
E.g.
• Philadelphia chromosome discovered in 1960
• In 2000 an agent that targets the product of the t(9;22)
translocation was developed
• Tyrosine kinase inhibitor, e.g. Imatinib

A

Targeted therapy

49
Q

Are most haemopoietic malignancies acquired or inherited?

A

acquired

50
Q

What is the difference between Small Lymphocytic Lymphoma (SLL)
and Chronic Lymphocytic Leukaemia (CLL)

A

Diagnosis based on principal site of involvement
• CLL: Peripheral blood and bone marrow
• SLL : Lymph nodes, other lymphoid organs

51
Q

What is the term for a blood film where both small and large RBC’s are present?

A

Dimorphic

Advanced Haematology (13 decks)

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