leukaemia

Question 1

what symptoms warrant V urgent FBC in young people for leukaemia

Answer 1

pallor // fatigue // unexplained fever // unexplained infections // lymph // bone pain // unexplained bruising // unexplained bleeding

Question 2

what is acute leukaemia

Answer 2

bone marrow failure –> maturation defects –> increased -blast cells // fast progression

Question 3

what is the most common childhood malignancy

Answer 3

acute lymphocytic leukaemia

Question 4

peak incidence ALL

Answer 4

2-5 (boys slightly > girls)

Question 5

what condition increases risk of ALL

Answer 5

downs

Question 6

symptoms ALL

Answer 6

anaemia: lethargy, pallor // neutropenia: frequent infections // thrombocytopenia bruising, petechia // bone pain // hepatosplenomegaly // fever // testes swelling

Question 7

types ALL

Answer 7

common (75%) // T cell // B cell

Question 8

poor prognostic factors ALL

Answer 8

age <2 // age 10+ // WBC >20 at diagnosis // T or B type // not-white // male

Question 9

who is acute myeloid leukaemia common in

Answer 9

adults (60)

Question 10

what diseases can progress to AML if not a priamry condition

Answer 10

myeloproliferative syndrome eg polycthaemia

Question 11

AML symptoms

Answer 11

anaemia // neutropenia - infections // thrombocytopenia - bleeds // splenomegaly // bone pain

Question 11

AML symptoms

Answer 11

anaemia // neutropenia - infections // thrombocytopenia - bleeds // splenomegaly // bone pain

Question 12

poor prognosis AML

Answer 12

60+ // >20% blasts after chemo // genetics

Question 13

what is acute promyelocytic leukaeia

Answer 13

subtype AML // t(15:17) // younger age 25

Question 14

presentation acute promyelocytic leukaeia

Answer 14

DIC or thrombocytopenia

Question 15

blood film acute promyelocytic leukaeia (ApML)

Answer 15

aeur rods

Question 16

initial invx + findings acute leukaemia

Answer 16

FBC + Blood film // low RBC, low platelets, low neutrophils (maybe high WCC) // ApML = auer rods

Question 17

definitive diagnosis acute leukaemia

Answer 17

bone marrow aspirate –> immunotyping

Question 18

mx acute leukaemia

Answer 18

multi-chemo agents + steroids

Question 19

what is chronic lymphocytic leukaemia

Answer 19

monoclonal proliferation mature B cells

Question 20

symptoms CLL

Answer 20

usually asmptomatic - mild bleeding, infection, lymph, anorexia, weight loss

Question 21

FBC + film CLL

Answer 21

raised lymphocyes // anaemia // thrombocytopenia // film = smudge or smear cells

Question 22

most common leukaemia in adults

Answer 22

CLL

Question 23

what type of anaemia is common in CLL

Answer 23

autiummune haemolytic anaemia (warm type)

Question 24

diagnostic invx CLL

Answer 24

bone marrow –> immunotype

Question 25

complications CLL (4)

Answer 25

anaemia // hypogammaglobulinaemia (infections) // warm autoimmune haemolytic anaemia // richters transdormation

Question 26

what is richters transformation

Answer 26

leukamie (CLL) enters lymph –> changes to high grade, fast NHL

Question 27

symptoms richter’s

Answer 27

lymph node // fever (no infection)// weight loss // night sweats // nausea// abdo pain