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ZERO TO FINALS > BLOOD CANCERS > Flashcards

BLOOD CANCERS Flashcards

1
Q

What is the most common leukaemia in children?

A

Acute Lymphoblastic Leukaemia

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2
Q

Which leukaemia is associated with Down Syndrome?

A

Acute Lymphoblastic Leukaemia

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3
Q

What is the most common leukaemia in adults?

A

Chronic Lymphocytic Leukaemia

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4
Q

What is the likely diagnosis if smudge/smear cells are seen on blood film?

A

Chronic Lymphocytic leukaemia

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5
Q

Which leukaemia is known to undergo Richter’s transformation into lymphoma?

A

Chronic Lymphocytic leukaemia

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6
Q

Which leukaemia is associated with warm haemolytic anaemia?

A

Chronic Lymphocytic leukaemia

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7
Q

Which leukaemia has three phases?

What are they?

A

Chronic Myeloid leukaemia has 3 phases

  1. Chronic phase (5 years usually asymptomatic, patients may be incidentally diagnosed on high white cell count)
  2. Accelerated phase (anaemia, thrombocytopenia, immunocompromised)
  3. Blast phase (severe symptoms and pancytopenia. often fatal)
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8
Q

What cytogenic change occurs that is characteristic of Chronic Myeloid leukaemia?

A

The Philadelphia chromosome

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9
Q

What haematological malignancy is most commonly associated with the Philadelphia chromosome?

A

Chronic Myeloid chromosome

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10
Q

What haematological malignancy is associated with auer rods?

A

Acute Myeloid leukaemia

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11
Q

What is the most common acute adult leukaemia?

A

Acute Myeloid leukaemia

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12
Q

What can present before Acute Myeloid leukaemia?

A

Acute Myeloid leukaemia can be the result of a transformation from a myeloproliferative disorder.

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13
Q

What are the different types of leukaemias and what age groups are they associated with ?

A

ALL CeLLmates have CoMmon AMbitions

  • <5 and >45: Acute Lymphoblastic Leukaemia
  • >55: Chronic Lymphocytic Leukaemia
  • >65: Chronic Myeloid leukaemia
  • >75: Acute Myeloid leukaemia
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14
Q

What would you expect to see on the blood film of someone with Acute Myeloid leukaemia?

A

blast cells

with auer rods

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15
Q

What age does Hodgkin’s Lymphoma generally present?

A

bimodal age distribution with peaks around 20 years and 75 years

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16
Q

What is the key presenting symptom of lymphoma?

A

Lymphadenopathy

They are non-tender and feel “rubbery”

17
Q

What would you expect to see on a lymph node biopsy of a patient with Hodgkin’s lymphoma?

A

Reed-Sternberg cell

18
Q

What staging system is used for Hodgkin’s and non-Hodgkin’s lymphoma?

Briefly discuss

A

The Ann Arbor staging system

importance on whether affected nodes are above or below the diaphragm or are both above AND below the diaphragm(Stage 3)

19
Q

What is Burkitt lymphoma and what is it associated with?

A

A non-Hodgkin’s lymphoma

associated with EBV, malaria and HIV

20
Q

What is MALT lymphoma and what is it associated with?

A

MALT lymphoma is a non-Hodgkin’s lymphoma that affects the mucosa-associated lymphoid tissue, usually around the stomach

Associated with H. pylori

21
Q

What is diffuse large B cell lymphoma and how does it normally present?

A

A non-Hodgkin’s lymphoma

often presents as a rapidly growing painless mass in patients over 65 years

22
Q

What is myeloma?

What is multiple myeloma?

A

Myeloma is a cancer of the plasma cells (a type of B lymphocyte that produces antibodies). Cancer in a specific type of plasma cell ersults in large quantities of a single type of antibody being produced.

Multiple myeloma is where myeloma affects multiple areas of the body.

23
Q

What is monoclonal gammopathy of undetermined significance? (MGUS)

A

An excess of a single type of antibody or antibody components without features of myeloma or cancer.

It’s an incidental finding and as the name suggests its significance is unclear so patients are often followed up to monitor

24
Q

What is smouldering myeloma?

A

Where there is progression of MGUS with higher levels of antibodies or antibody components.

It is premalignant and more likely to progresss to myeloma than MGUS

25
Q

What is Waldenstrom’s macroglobulinaemia?

A

A smouldering myeloma where there is excessive IgM specifically

26
Q

What are the key features of myeloma?

A

CRAB

  • C-Calcium (elevated)
  • R- Renal failure
  • A- Anaemia (normocytic, normochromic) from replacement of bone marrow
  • B- Bone lesions and bone pain
27
Q

What investigations would you do and what results would you expect if you suspected myeloma?

A

NICE Guidelines suggest suspecting myeloma esp. in anyone over 60 y/o with persistent bone pain, esp. back pain or an unexplained fracture.

  • FBC (low white blood cell count in myeloma)
  • Calcium (raised in myeloma)
  • ESR (raised in myeloma)
  • Plasma viscosity (raised in myeloma)

If any of these are positive or myeloma is still suspected do an urgent serum protein electrophoresis and a urine Bence-Jones protein test.

28
Q

After initial investigations, what other investigations do NICE recommend carrying out to investigate myeloma?

A

BLIP

  • Bence-Jones protein (request urine electrophoresis)
  • L- serum-free Light chain assay
  • I- serum Immunoglobulins
  • P- serum Protein electrophoresis

NB: you cannot exclude myeloma with one investigation

29
Q

‘Myeloma usually takes a relapsing and remitting course’

T/F

A

True

30
Q

What is a myeloproliferative disorder?

A

A condition which occurs due to uncontrolled proliferation of a single type of stem cell. They are considered a type of bone marrow cancer.

31
Q

What are the three myeloproliferative disorders to remember?

A
  1. Primary myelofibrosis
  2. Polycythaemia vera
  3. Essential thrombocythaemia
32
Q

What condition may myeloproliferative disorders progress to?

A

Acute myeloid leukaemia

33
Q

The following genetic conditions are associated with what condition?

  • JAK2
  • MPL
  • CALR

Which of these can affect Tx options?

A

Myeloproliferative disorders

JAK2 can be the target of JAK2 inhibitors such as ruxolitinib

34
Q

What would you expect to see on the FBC of someone with polycythaemia vera?

A

Raised Hb

35
Q

What would you expect to see on the FBC of someone with primary thrombocythaemia?

A

Raised platelet count

36
Q

What would you expect to see on the blood film of someone with myelofibrosis?

A

‘teardrop-shaped RBCs’

37
Q

How are patients with primary myelofibrosis managed?

A
  1. mild disease may be just monitored
  2. Allogenic stem cell transplantation (can be curative but carries risk)
  3. Chemo (help control the disease, improve symptoms and slow progression but is not curative on its own)
  4. Supportive management (of the anaemia, splenomegaly and portal hypertension)
38
Q

How are patients with polycythaemia vera managed?

A
  1. Venesection can be used to keep the Hb in the normal rnage
  2. Aspirin
  3. Chemo
39
Q

How are patients with essential thrombocythaemia managed?

A
  1. Aspirin
  2. Chemo

ZERO TO FINALS (4 decks)

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