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Step 1 > White Blood Cell Disorders > Flashcards

White Blood Cell Disorders Flashcards

1
Q

MCCs of lymphopenia

A

Immunodeficiency
High cortisol state (induces apoptosis)
Autoimmune destruction (ie SLE)
Whole body radiation (lymphocytes esp sensitive)

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2
Q

With neutrophilic leukocytosis, immature cells are characterized by decreased…

A

Fc Receptors = CD16

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3
Q

MCCs of eosinophilia

A

Allergic Rxn/Type1 Hypersens rxn
Parasites
Hodgkin Lymphoma (increases IL5)

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4
Q

MCC of basophilia

A

Chr. Myeloid Leukemia (CML)

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5
Q

MCCs of lymphocytic leukocytosis

A 
Viral infection
Bordetella pertussis (produces lymphocytosis-promoting factor)
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6
Q

EBV primarily infects…

A

Oropharynx => pharyngitis
Liver => hepatitis
B-Cells

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7
Q

A negative monospot test suggests…

A

CMV as possible cause of IM

or no IM

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8
Q

Why are infectious mono patients advised to avoid contact sports for one year?

A

Increased risk of splenic rupture

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9
Q

Lymphoblasts are characterized by positive nuclear staining for…

A

TdT

DNA polymerase

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10
Q

Surface markers associated with B-Acute Lymphoblastic Leukemia

A

CD10
CD19
CD20
TdT

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11
Q

t(12;21)

A

B-ALL
Children
good prognosis

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12
Q

t(9;22) ALL

A

Philidelphia+ALL
Adults
poor prognosis

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13
Q

Surface markers associated with T-Acute Lymphoblastic Leukemia/Lymphoma

A

CD2, 3, 4, 7, 8

TdT

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14
Q

Myeloblasts characterized by positive cytoplasmic stain gin for…

A

Myeloperoxidase (MPO)

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15
Q

Crystal aggregates of MPO are called…

A

Auer Rods

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16
Q

Auer Rods can initiate coagulation cascade, which can lead to…

A

DIC

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17
Q

t(15;17)

A

Acute Promyelocytic Leukemia
Translocation of Retinoic Acid Receptor (RAR); blocks maturation
tx = all-trans-retinoic acid (ATRA)

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18
Q

Leukemia associated with prior exposure to alkylating agents or radiotherapy

A

Acute Myeloid Leukemia (AML)

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19
Q

Most common leukemia overall

A

Chronic Lymphocytic Leukemia (CLL)

= proliferation of naive B-cells

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20
Q

Surface markers on naive B cells with CLL

A

CD5

CD20

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21
Q

“Smudge Cells”

A

Chronic Lymphocytic Leukemia (CLL)

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22
Q

Richter transformation

A

Transformation of small lymphoblsatic lymphoma into diffuse large B-cell lymphoma
Seen with CLL

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23
Q

Cells positive for Tartrate-Resistant Acid Phosphatase (TRAP) suggests…

A

Hairy Cell Leukemia

= proliferation of mature B-cells

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24
Q

Mechanism of 2-CDA/Cladribine treatment with Hairy Cell Leukemia

A

Adenosine Deaminase Inhibitor => adenosine toxicity in neoplastic B-cells

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25
Q

Lytic bone lesions with hypercalcemia suggest

A

Multiple Myeloma
OR
Adult T-Cell Leukemia/Lymphoma (ATLL)

26
Q

Proliferation of mature CD4+ T-cells that infiltrate skin

A

Mycosis Fungoides

27
Q

“Sezary Cells”

A

Mycosis Fungoides

cerebriform nuclei

28
Q

t(9;22)

A 
Chronic Myeloid Leukemia (CML)
= Philidelphia chromosome, BCR-ABL fusion
(-) LAP Stain
Increased granulocytes and basophils
Can transform to AML or ALL
29
Q

Mechanism of BCR-ABL fusion leading to CML

A

increases tyrosine kinase activity (oncogene) so drives overproduction of neoplastic cells

30
Q

First line treatment for CML

A

Imantinib

= blocks tyrosine kinase activity

31
Q

JAK2 Kinase Mutation

A

Polycythemia Vera
Essential Thrombocythemia
(50%) Myelofibrosis

32
Q

Myeloproliferative disorder with esp. increased RBCs

A

Polycythemia Vera
=> hyper viscosity of blood
- potential for Budd-Chiari Syndrome

33
Q

MCC of Budd-Chiari Syndrome

A

Polycythemia Vera

increased risk of venous thrombosis in hepatic vein can lead to infarct

34
Q

Second-line therapy for PV, following phlebotomy

A

Hydroxyurea

35
Q

Lymph node follicular/cortex hyperplasia is seen with…

A

R.A.

Early HIV infxn

36
Q

Lymph node paracortex hyperplasia is seen with…

A

Viral infxns

i.e. infectious mono/EBV

37
Q

Hyperplasia of sinus histiocytes is seen with…

A

lymph nodes that are draining a tissue with cancer

38
Q

Types of Small B-cell Non-Hodgkin Lymphoma

A

Follicular
Mantle Cell
Marginal Zone
Small Lymphocyte

39
Q

Type of Intermediate B-Cell Non-Hodgkin Lymphoma

A

Burkitt

40
Q

t(14;18)

A

BCL2 translocation, over-expression, inhibits apoptosis

Follicular Lymphoma

41
Q

Mechanism of Rituximab

A

Anti-CD20 antibody

42
Q

Complication of follicular lymphoma if lymph node is enlarging

A

Progression to diffuse large B-cell lymphoma

43
Q

t(11;14)

A

Cyclin D1 translocation, over-expression, promotes G1 to S phase
Mantle Cell Lymphoma

44
Q

Chronic inflammatory states associated with Marginal zone Lymphoma

A

Hashimoto Thyroiditis
Sjogren Syndrome
H. pylori Gastritis

45
Q

Marginal zone lymphoma in mucosal sites is called…

A

MALToma

46
Q

Burkitt Lymphoma is associated with what virus?

A

EBV

47
Q

t(8;14)

A

c-myc translocation, over-expression, promotes cell growth
Burkitt Lymphoma
- high mitotic index
- starry sky appearance

48
Q

Difference between African and Sporadic Burkitt Lymphoma

A

African –> involves jaw

Sporadic –> involves abdomen

49
Q

“Starry Sky”

A

Burkitt Lymphoma

50
Q

Most common form of Non-Hodgkin Lymphoma

A

Diffuse Large B-Cell Lymphoma (DLBCL)
Clinically aggressive
Arises sporadically or transformation from low-grade lymphoma

51
Q

Reed-Sternberg cells

A

(+) CD15
(+) CD30
Large B cells, multi lobed nuclei, prominent nucleoli
- Hodgkin Lymphoma

52
Q

B-Symptoms

A

Fever
Chills
Weight loss
Night sweats

53
Q

Most common subtype of Hodgkin Lymphoma

A

Nodular Sclerosis (70%)

  • large cervical or mediastinal lymph node
  • young, female adult
54
Q

Subtype of Hodgkin Lymphoma with best prognosis

A

Lymphocyte rich

55
Q

Most common PRIMARY malignancy of bone

A

Multiple Myeloma

High IL-6 stimulates plasma cell growth

56
Q

Clinical features of Multiple Myeloma

A 
Lytic bone lesions (skull and vertebrae esp.)
M-Spike for IgG or IgA
Rouleaux formations
AL Amyloidosis
Bence Jones Proteinuria
57
Q

Rouleaux Formations (stacked RBCs on smear)

A

Multiple Myeloma

58
Q

Bench Jones protein in urine (free light chain)

A

Multiple Myeloma

59
Q

M-Spike without any other symptoms suggests…

A

MGUS

= Monoclonal Gammopathy of Undetermined Significance

60
Q

B-Cell lymphoma with monoclonal IgM production

A

Waldenstrom Macroglobulinemia

61
Q

Birbeck Granules (tennis racket shape on e-M)

A

Langerhans Cell Histiocytosis
CD1a+
S100+

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