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C. Year 3 MLA Cardiovascular Conditions/Diseases > Blood cancers > Flashcards

Blood cancers Flashcards

1
Q

Leukaemia which relates to leukocytes is a malignant (uncontrolled) proliferation of primitive haematopoetic cells in the bone marrow. Which blood cells can be affected in leukaemia?

1 - RBCs
2 - WBCs
3 - Platelets
4 - all of the above

A

4 - all of the above
- leukocytes are WBCs, but leukaemia can affect any cells

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2
Q

Leukaemia which relates to leukocytes is a malignant (uncontrolled) proliferation of primitive haematopoetic cells in the bone marrow. Which of the following occurs in the bone marrow of patients with leukaemia?

1 - bone marrow failure
2 - bone marrow fills with blast cells
3 - poor maturation of RBCs causes anaemia
4 - all of the above

A

4 - all of the above

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3
Q

When comparing leakaemia and lymphoma, which is a solid and which is a liquid tumour?

A
  • leukaemia = liquid (blood)
  • lymphoma = solid (lymph nodes)
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4
Q

When comparing leukaemia and lymphoma, which cells are generally affected?

A
  • leukaemia = myeloid and lymphoid cells (all bone marrow cells)
  • lymphoma = lymphoid cells
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5
Q

When looking at cell lines from the bone marrow we talk about haemopoietic stem cells, which are then able to differentiate into myeloid and lymphoid stem cells. Which of the following is NOT classed as a myeloid stem cell?

1 - erythrocyte
2 - thrombocyte (platelet)
3 - monocyte
4 - natural killer cell
5 - granulocyte

A

4 - natural killer cell
- these are classed as lymphoblasts

  • granulocyte = eosinophil, neutrophil, basophil
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6
Q

When looking at cell lines from the bone marrow we talk about haemopoietic stem cells, which are then able to differentiate into myeloid and lymphoid stem cells. Which of the following is NOT classed as a lymphoblast stem cell?

1 - pre-B cell
2 - thrombocyte (platelet)
3 - Pre-T cell
4 - natural killer cell

A

2 - thrombocyte (platelet)

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7
Q

What is the human T lymphotropic virus (HTLV-1)?

A
  • virus similiar to HIV
  • can cause leukaemia
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8
Q

In leukaemia there is an acute and chronic form. What are the 2 acute forms of leukaemia?

A
  • acute lymphoblastic (blast = immature cells)
  • acute myeloid
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9
Q

In leukaemia there is an acute and chronic form. What are the 2 chronic forms of leukaemia?

A
  • chronic lymphocytic
  • chronic myeloid
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10
Q

In acute lymphoblastic and acute myeloid leukaemia, are they dangerous and who do they generally affect?

A
  • very agressive and rapid spreading
  • younger patients
  • immature cells affected (blasts = immature cells) in bone marrow
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11
Q

In chronic lymphocytic and chronic myeloid leukaemia, are they dangerous and who do they generally affect?

A
  • generally gradual onset
  • affect older patients
  • mature cells affected in bone marrow
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12
Q

Which of the cells in the image below is a neutrophil?

A
  • a is a neutrophil
  • multi lobulated cell
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13
Q

Which of the cells in the image below is a eosinophil?

A
  • b is esinophil
  • stains very pink of H&E stain
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14
Q

Which of the cells in the image below is a basophil??

A
  • c is basophil
  • appears like a large platelet with no clear nucleus
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15
Q

Which of the cells in the image below is a monocyte?

A
  • d is a monocyte
  • nucleus looks like a kidney bean
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16
Q

Which of the cells in the image below is a lymphocyte?

A
  • e is a lymphocyte
  • nucleus fills most of the cell
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17
Q

Which of the cells in the image below is a blast cell?

A
  • f is a blast cell
  • irregular nuclear and cytoplasm has odd shape
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18
Q

What ages is acute lymphoblastic leukaemia most common in?

A
  • childhood
  • most common malignancy in children
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19
Q

What ages is acute myeloid leukaemia most common in?

A
  • median age is 65
  • can occur at any age
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20
Q

In bone marrow failure, common in leukaemia, what are 2 common signs that patients may present with, similar to asthma?

A
  • fatigue
  • breathlessness
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21
Q

Neutropenia is a common sign of bone marrow failure seen in leukaemia, what is neutropenia?

A
  • infections and ulcers in the mouth
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22
Q

Thrombocytopenia is a common sign of bone marrow failure seen in leukaemia, what is thrombocytopenia?

A
  • means lack of platelets
  • bleeding in gums and under skin
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23
Q

Tissue infiltration is common in leukaemia, what is tissue infiltration?

A
  • leukaemia can spread top other tissues
  • common tissues include liver, meninges, testivles, skin
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24
Q

As leukaemia causes abnormal proliferation of all blood cells from the bone marrow, what will happen to the WBC number?

A
  • rise
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25
Q

Leukostasis is common in leukaemia, what is leukostasis?

A
  • stasis = slowing
  • blood slows due to high WBCs
26
Q

Disseminated intravascular coagulation (DIC) can cause bruising and bleeding, what is DIC?

A
  • condition that causes blood clots
27
Q

What is the most usual method for diagnosing leukaemia?

A
  • bone marrow aspirate
28
Q

What other methods, other than bone marrow aspirate can be used to diagnose leukaemia?

A
  • genetic testing
  • chromosomal analysis
  • blood film/count
  • immunophenotyping
29
Q

What are the most common treatments for leukaemia?

A
  • chemotherapy
  • radiotheraphy
  • immunotherapy
  • monoclonal atnibodies
  • bone marrow transplantation
30
Q

When diagnosing a patient with leukaemia, what is the first thing you must decide before starting treatment?

A
  • if disease can be cured or pallative care
31
Q

When treating a patient with leukaemia that has anaemia, what is the most common treatment?

A
  • blood transfusion
32
Q

When treating a patient with leukaemia that has bleeding problems, what is the most common treatment?

A
  • platelet transfusions
  • provide coagulation factors
  • hormones in women to stop menstrul cycle
33
Q

Patients with leukaemia have low WBCs and are therefore at an increased risk of infections, what is the most common treatment?

A
  • antibiotics
  • personal hygiene
34
Q

Patients with leukaemia need a lot of blood samples taken and blood given. To help this leukaemia patients are given a indwelling hickman line, what is this?

A
  • blood tube fed into subclavian vein
  • near to heart
35
Q

What is induction chemotherapy?

A
  • first line of drugs given to patients to normalise bone marrow
36
Q

Following induction drug therapy, patients are given consolidation therapy, what is this?

A
  • further chemotherapy
  • leukaemia cells will not be detectable anywhere in the body if treatment is successful
37
Q

What is allogenic transplantation that is used if induction and consolidation therapy is unsuccessful?

A
  • patients are given bone stem cells from healthy donor
38
Q

Does acute lymphoblastic leukaemia or acute myeloid leukaemia have a worse prognosis?

A
  • diagnosis can be good if caught early
  • acute lymphoblastic leukaemia has better prognosis
  • poorer outcomes in older (>60 years) males
39
Q

In acute lymphoblastic anaemia what % of children are cured?

A
  • >80%
40
Q

What is the most common form of malignancy in childhood?

A
  • Acute lymphoblastic leukaemia (ALL)
41
Q

In Acute lymphoblastic leukaemia, the most common malignancy in childhood, what leukocytes cells can be affected?

A
  • B and T cells
  • immune system is severely depleted
42
Q

In acute lymphoblastic leukaemia, the most common malignancy in childhood, a cut off for the number of blasts affected is used as a diagnosis tool. What is the cut off for diagnosis of acute lymphoblastic leukaemia?

A
  • >20% of WBC are blasts
43
Q

In acute lymphoblastic leukaemia patients B cells can be affected which can cause Bone marrow failure and a Big spleen. How can remember what 2 main things can happen to a patient with B cell acute lymphoblastic leukaemia remember this?

A
  • B is for Bone marrow failure
  • B is for Big spleen
  • B cells affected
44
Q

In acute lymphoblastic leukaemia patients T cells can be affected. This is most common in Teenage boys and causes Thoracic lymphadenopathy. How can i remember this?

A
  • T is for Teenage boys
  • T is for Thoracic lymphadenopathy
  • T is for T cells
45
Q

In acute meloid leukaemia what % of blasts must be present in the bone marrow?

A
  • >20% of blasts in bone marrow
46
Q

In acute meloid leukaemia what are two common diagnostic features that can be seen on blood films in ALL patients?

A
  • auer rods (crystals in cytoplasm of blasts)
  • granules that stain for positive for Myeloperoxidase
47
Q

In acute meloid leukaemia (A.M_._L) how can you remember the 3 things to diagnose a patient, not including >20% blasts using the mnemonic A.M.L?

A
  • A = auer rods
  • M = myeloperoxidase
  • L = leukaemia in older patients
48
Q

Acute promyelocytic leukaemia (APL) is a variant of acute myeloid leukaemia (AML). What is APL?

A
  • comes from promyelocytic cell line
  • activates coagulation pathway and uses all coagulation factors
  • patients bleed severly
  • high risk of disseminated intravascular coagulation
49
Q

How can acute promyelocytic leukaemia (APL), a variant of acute myeloid leukaemia (AML) be treated?

A
  • all– trans– retinoic acid (ATRA)
  • anti-cancer treatment
50
Q

Who does chronic lymphocytic leukaemia mainly affect and is there a good prognosis?

A
  • very common in older patients (mean 70 years)
  • good median survival
51
Q

In chronic lymphocytic leukaemia, which leukocytes are more commonly affected?

A
  • B cells
  • numbers can be high
52
Q

In chronic lymphocytic leukaemia, how do patients generally present?

A
  • incidental finding
  • asymptomatic
  • lymphadenopathy
  • splenomegaly
  • infections
  • anaemia
53
Q

How can you test a patient for chronic lymphocytic leukaemia?

A
  • coombes test is +
  • genetic analysis
  • can cross over with lymphoma
54
Q

In chronic myeloid leukaemia, what patients are most affected?

A
  • older patients (mean age 50 years)
55
Q

In chronic myeloid leukaemia, what % of blast cells present in the bone marrow would classify a patient as having chronic chronic myeloid leukaemia?

A
  • <10% of blasts in bone marrow
  • if it enters >20% this is crisis and prognosis is poor
56
Q

In chronic myeloid leukaemia, the whole myeloid line can be affected, which cells are in the myeloid cell line these?

A
  • RBCs
  • Megacaryocytes
  • Monocytes
  • WBCs (granulocytes)
57
Q

In chronic myeloid leukaemia, there is a large diversity of WBCs seen on blood smears which can present with what symptoms?

A
  • fatigue
  • breathlessness
  • fever/sweats
  • weight loss
58
Q

In chronic myeloid leukaemia, what chromosome abnormality is always present?

A
  • Philadelphia chromosome (t(9;22))
  • chromosomes 9 and 22 undergo translocation
  • causes over production of tyrosine kinase signalling
  • malignant cell proliferation
59
Q

In chronic myeloid leukaemia, what drug has been shown to be effective at putting patients into remission?

A
  • imatinib
60
Q

What is hairy cell leukaemia?

A
  • form of chronic lymphocytic leukaemia
  • B cells affected and look hairy
  • very responsive to treatment 90% remission

C. Year 3 MLA Cardiovascular Conditions/Diseases (26 decks)

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