hematologic neoplastic conditions Flashcards
What are the clinical features of polycythemia vera?
typically age >60, fatigue, HA, burning pain in hands/feet, pruritis, esp after hot water contact, tinnitus, blurred vision, epistaxis, splenomegaly, large retinal veins
What are the complications of polycythemia vera?
thrombus formation, leukemia (acute and chronic myelogenous leukemia), stroke
What are the radiographic findings of multiple myeloma?
punched out lytic lesions of long bones and skull.
What are the complications of multiple myeloma?
renal failure, recurrent infection, hypercalcemia, hyperviscosity (visual changes, dementia, ataxia, vertigo, retinal vein enlargement), spinal cord compression. survival 2-3 yrs post-dx
CRAB (hypercalcemia, renal insufficiency, anemia, bone lesions and back pain)
What is MGUS?
serum monoclonal antibodiy protein
What is the main difference between Waldenstroms macroglobulinemia and multiple myeloma?
IgM spike in waldenstroms rather than IgA or IgG of MM; no lytic bone lesions in waldenstroms
What are the types of Hodgkin lymphoma and what are the typical lab/biopsy/cytogenetic findings?
- Reed sternberg cells (owl eye cells) on biopsy
- nodular sclerosis is most common and good prognosis
- lymphocyte rich is rare but has best prognosis of all
- mixed cellularity
- lymphocyte depleted has worst prognosis
What is the translocation in Burkitt lymphoma?
t8;14: c-myc and Ig heavy chain translocation
What is the primary cause of adult T-cell lymphoma
HTLV-1 virus (associated with IV drug use)
acute lymphocytic leukemia: what are typical lab/biopsy/cytogenetic findings?
in 15% of adults, 9;22 philidelphia chromosome. in everyone, lots of blasts. most ALL originates in B cell precursors. in adults, philidelphia chromosome is a poor prognostic indicator
acute myelogenous leukemia: typical labs/biopsy/cytogenetic findings
blasts of myeloid origin that stain with myeloperoxidase. smear shows notched nuclei and auer rods in many subtypes.
AML: complications, tx
DIC is a common complication or presentation due to release of Auer rods. some forms (t15;17) are responsive to all trans retinoic acid
What is CLL? typical labs/ biopsy/cytogenetic findings?
proliferation of mature B cells; considered the same disease as small lymphocytic lymphoma
often have smudge cells on peripheral smear
What is the clinical course/complications of CLL?
25% are asymptomatic and it is discovered on CBC; malignant B cells may form autoantibodies. course may be indolent (>10 yrs) or aggressive w/ high mortality in first few yrs
CML: typcial labs/ biopsy/cytogenetic studies
proliferation of mature myeloid cells in middle aged adults that may be associated with radiation exposure. may be stable for many years before progressing to a blast crisis which is often fatal. Pts have BCR-ABL fusion gene (9;22 philidelphia chromosome)
