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Cam's Cards > Wright Heme lecture > Flashcards

Wright Heme lecture Flashcards

1
Q

Name the 4 main types of leukemia.

A

Acute Myeloid leukemia
Chronic Myeloid Leukemia
Acute Lymphoblastic Leukemia
Chronic Lymphocytic Leukemia

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2
Q

What are the signs and symptoms of leukemia?

A 
Leukocytosis
Pancytopenia
Hypogammaglobulinemia
Bone pain
LAD
spelnomegaly
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3
Q

What test should be done in all patients suspected to have leukemia

A

Bone marrow biopsy

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4
Q

What is the most common leukemia in adults?

A

AML

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5
Q

What pathologic finding is diagnostic of AML

A

Auer rods on biopsy

Circulating blasts >20%

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6
Q

First line treatment for AML

A

Chemo then Stem cell transplant

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7
Q

Prognosis for AML

A

not great, only 1/3 of patients are cured

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8
Q

What is the most common childhood malignancy?

A

Acute lymphoblastic leukemia

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9
Q

Peak incidence of ALL?

A

2-5 y.o.

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10
Q

Increased incidence of ALL with what genetic disorder?

A

Down Syndrome

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11
Q

Most common cell linages effected by ALL?

A

B cell lineage( 85%), then T (15%), then NK (1%)

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12
Q

Treatment for ALL?

A

Chemo

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13
Q

Prognosis for ALL?

A

Curable, with 85% 5 year survival, but high dose chemo in kids increases risk of long term complications

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14
Q

Good prognostic indicators in ALL?

A

Hyperdiploid (>50 chromosomes per cell)
2-10 y.o.
CD10 +
low WBC count

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15
Q

Poor prognostic indicators in ALL?

A

Hypodiploid
<2 or >10 y.o.
Male gender
High WBC count (>100k)

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16
Q

What is CAR-T therapy?

A

Therapy for ALL that removes T cells and trains them to attack neoplastic B cells. It is so effective that the B cells are killed so rapidly it causes cytokine storm.

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17
Q

What leukemia is a Philadelphia chromosome seen in?

A

Chronic Myeloid Leukemia

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18
Q

Philadelphia chromosome results from fusion of 2 genes. What are they?

A

ABL on chromosome 9 and BCR on chromosome 22

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19
Q

After what age are most CML diagnoses made?

A

After age 50

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20
Q

What are the treatment options for CML?

A

Stem cell transplant - risky but curative

Oral chemotherapy - low risk, can manage disease but not cure it

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21
Q

Chronic Lymphocytic leukemia is most often diagnosed after what age?

A

after age 70

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22
Q

CLL more common in men or women?

A

Men

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23
Q

What pathology finding on cytology is suggestive of CLL?

A

Gingersnap appearance of cells

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24
Q

What are the 2 main categories of lymphoma and how do you distinguish between them?

A

Hodgkin Lymphoma - presence of reed sternberg cells on biopsy
Non-Hodgkin lymphoma - absence of reed sternberg cells on biopsy.

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25
Q

Indolent lymphomas

A

Fuck My Life, Sike
follicular
marginal zone, lymphoplasmocytic,
small lymphocytic

26
Q

Aggressive lymphomas

A 
Big Deal, Many Problems
Burrkitt
Diffuse Large B cell
Mantle Cell
Peripheral T cell
27
Q

What lymphoma has pain in lymph nodes with alcohol comsumption?

A

Hodgkin Lymphoma

28
Q

What lymphoma is amenable to surgical excision?

A

Hodgkin Lymphoma

29
Q

What is the most common lymphoma worldwide?

A

Diffuse Large B cell lymphoma

30
Q

Common presenting symptom in Diffuse Large B cell lymphoma?

A

Rapidly enlarging symptomatic mass

31
Q

Prognosis of Diffuse Large B cell lymphoma?

A

Not great, most patients present with advanced disease.

Curable in half of cases

32
Q

Second most common non hodgkin lymphoma

A

Follicular Lymphoma

33
Q

Painless peripheral adenopathy is a common symptom in what diagnosis?

A

Follicular lymphoma

34
Q

Follicular lymphoma has a good prognosis, but it can progress to what other types of lymphoma?

A

Diffuse Large B cell
or
Burkitt lymphoma

35
Q

What is a common location for a mass in Burkitt lymphoma?

A

Abdominal or retroperitoneal

36
Q

What medication should be prescribed to patients with Burkitt lymphoma before treatment and why?

A

Alopurinol
Burkitt lymphoma can cause tumor lysis syndrome, where large amounts of potassium, phosphate, and nucleic acids are released in circulation

37
Q

Nuclear staining for cyclin D1 is positive. What is the most likely diagnosis

A

Mantle Cell lymphoma

38
Q

Where does mantle cell lymphoma occur?

A

Any region of the GI tract

39
Q

A patient with chronic gastritis from H. pylori is most susceptible to what lymphoma?

A

MALT (mucosa associated lymphoid tissue) lymphoma

40
Q

MALT lymphoma is what type of lymphoma?

A

Marginal zone lymphoma

41
Q

What lymphoma is associated with an IgM monoclonal gammopathy, Raynaud phenomenon, and smudge cells?

A

Lymphoplasmacytic lymphoma

42
Q

Why is non-hodgkin lymphoma not amenable to surgical excision?

A

It involves discontinuous groups of lymph nodes

43
Q

What organ is often involved with non-hodgkin lymphoma?

A

The spleen

44
Q

Multiple myeloma is a cancer of what type of cells?

A

Plasma cells (fully matured B cells that produce antibodies)

45
Q

You should consider multiple myeloma in a patient with what lab findings?

A

Anemia and hypercalcemia

46
Q

What labs should you order in a multiple myeloma work up? What findings indicate multiple myeloma?

A

SPEP - M spike

UPEP - Bence Jones proteins

47
Q

What findings on x ray are concerning for multiple myeloma?

A

Lytic lesions

Pathologic fracture

48
Q

What are the symptoms of multiple myeloma?

A 
CRAB
Hypercalcemia
Renal Failure
Anemia
Bone (pain, lytic lesions, pathologic fx)
49
Q

Prognosis for multiple myeloma?

A

Bad. Median survival of 6 months

Non-curable but stem cell transplant can prolong life

50
Q

Signs and symptoms of immune thombocytopenic purpura

A

signs of capillary rupture

51
Q

Define chronic, persistent, and newly diagnosed ITP

A

Chronic >12 months
Persistent 3-12 months
newly diagnosed <3 months

52
Q

Deficiency in what enzyme can cause TTP?

A

ADAMTS13 protease

53
Q

What happens to vWF in TTP?

A

vWF accumulates into long chains on endothelial surfaces capable of binding large amounts of platelets.

54
Q

Triad of symptoms for TTP?

Pentad?

A

Triad: Thrombocytopenia, neurologic changes, microangipathic anemia
Pentad: the above triad plus fever and renal failure

55
Q

Hemolytic uremic syndrome is caused by what type of infections?

A

GI infections

56
Q

HUS should be treated with antibiotics? T/F

A

False - it will cause release of more toxins worsening symptoms

57
Q

What does vWF do?

A

Carrier for factor VIII

58
Q

What is the most common inherited bleeding disorder?

A

Von Willebrand disease

59
Q

In Von Willebrand disease, what happens to PTT and PT?

A

PTT increases

PT normal

60
Q

Hemophilia A is caused by a deficiency of factor ___

A

VIII

61
Q

Hemophilia B is caused by a deficiency of factor ___

A

IX

62
Q

A hypercoagulable state increases risk for _____

A

thromboembolism

Cam's Cards (103 decks)

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