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Course 1 > blood cancers > Flashcards

blood cancers Flashcards

1
Q

which cell lines are granulocytes?

A

basophil, eosinophil, neutrophil

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2
Q

what is the limit for neutrophilia?

A

> 9 ANC

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3
Q

what happens to the neutrophil proportion in the blood during an infection?

A

left shift

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4
Q

what are the neutrophil compartments in the blood?

A

marginal pool and circulating pool

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5
Q

what is the normal order of wbc differential?

A 
Neutrophil
Lymphocyte
Monocyte
Eosinophil
Band
Basophil
never let monkeys eat bad bananas
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6
Q

what is a red flag in neutrophilia?

A

blasts

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7
Q

what is the most common cause of reactive neutrophilia?

A

glucocorticoids

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8
Q

what does basophilia indicate?

A

CML

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9
Q

what mutation is responsible for CML?

A

Ph (9;22 translocation), BCR-ABL mutation

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10
Q

what does a blast crises indicate?

A

CML–>AML

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11
Q

what is the most effective Tx for CML?

A

gleevec/imatinib

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12
Q

how does gleevec work?

A

bind BCR-ABL kinase domain and stops proliferation

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13
Q

what is the limit for neutropenia?

A

<1.5 ANC

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14
Q

what is Kostmann syndrome?

A

congenital severe neutropenia with risk of AML

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15
Q

how can we identify febrile neutropenia?

A

temp>38 in pt with ANC<0.5

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16
Q

how is febrile neutropenia treated?

A

broad spec IV antibiotics and GCSF

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17
Q

what are the organisms most commonly associated with neutropenic pts?

A

staph aureus, coagulase (-) staph, gram - bacteria, fungi (candida, aspergillus)

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18
Q

what cytomarker is indicative of leukemia?

A

CD34

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19
Q

what PBS feature points to AML?

A

auer rods (crystallized granules)

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20
Q

what is leukostasis?

A

In AML, high blasts count occludes vessels and damage endothelium (ischemia/bleeds).

Cause dyspnea, hypoxia, confusion

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21
Q

what causes DIC in AML?

A

blast secretes TF

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22
Q

what are symptoms of TLS?

A

cardiac arrhythmia (K+), renal failure (uric acid)

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23
Q

what’s the difference between cell cycle specific and non specific agents?

A

specific-target divide cells only

nonspecific-toxic to all cells

24
Q

why is combined chemo preferred over single agent?

A

different spectrum of toxicity and resistance to treat cancer

25
Q

which cells are most impacted by chemo?

A

sperm/ova (rapid division), BM, hair/nails, gut mucosa

26
Q

what is a syngeneic transplant?

A

from identical twin

27
Q

what is the graft vs leukemia effect?

A

T cells protect against malignancy in transplanted organ

28
Q

which part of the body is BMT retrieved from?

A

Pelvic (rich in HPSC)

29
Q

what is SIADH and what disease does it usually present with?

A

ADH secretion–>low Na levels, common in small cell lung cancer with neuroendocrine metastasis

30
Q

what does MAH present with?

A

bone pain, kidney stones, abd pain, confusion

31
Q

what are the clinical presentations of hyperviscosity syndrome?

A

bleeds, visual disturbances, poor tissue perfusion

32
Q

where do most B cell lymphomas happen?

A

germinal centre

33
Q

how does hodgkin lymphoma present?

A

cervical adenopathy, B symptoms

34
Q

what is the difference between lymphoma and leukemia?

A

lymphoma: originate from solid organs, stay in organs
leukemia: originate in BM, cells circulate blood

35
Q

why is CLL considered both a leukemia and a lymphoma?

A

can originate from BM or LN

36
Q

what are examples of aggressive lymphomas? why are they called this?

A

T cell lymphoma, Burkitts, DLBCL

grow quickly, can be life threatening at early stage, need urgent Tx. curable

37
Q

what does Ann Arbor stage 4 indicate in lymphoma?

A

metastatic disease

38
Q

How do you stage lymphomas?

A

PET scan

39
Q

how do autologous and allogeneic SCT differ in terms of mechanism to fight lymphoma?

A

autologous: relies on chemo to Tx
allogeneic: relies on new immune system (graft vs lymphoma) to tx

40
Q

what is the Tx for CLL?

A

FLK3 inhibitor

41
Q

what is the distinction between reactive and neoplastic lymphocytosis?

A

reactive-polyclonal, mostly T cells

neoplastic-monoclonal, mostly B cells

42
Q

why must we exclude neoplasm when diagnosing mono?

A

mono has symptoms similar to B symptoms

43
Q

reactive lymphocytes are also called

A

atypical lymphocytes

44
Q

which lymphoid cell line is affected in CLL?

A

Bcells

45
Q

what is the PBS indication of CLL?

A

smudge cells

46
Q

what are the flow cytometry markers for CLL?

A

CD5, 19, 23

need 5E9 of these cells for Dx

47
Q

what is methotrexate?

A

chemo drug, cause pancytopenia

48
Q

what is MGUS?

A

type of plasma cell dyscasias, low level monoclonal gammopathy (benign). <10% plasma cells in BM

49
Q

what are the characteristics of MM?

A

> 10% BM plasma cells, >30g/l proteins in urine

hypercalcemia, renal, anemia, bone disease (CRAB)

50
Q

what causes AL amyloidosis?

A

organ deposition of abnormal insoluble protein in beta pleats

51
Q

what is MM?

A

BM cancer with monoclonal plasma cell proliferation

52
Q

what are the complications of MM?

A

skeletal destruction, marrow infiltration (anemia), RF, Ig reduction (infection)

53
Q

what PBS signs are associated with MM?

A

monoclonal plasma cells, rouleaux RBC

54
Q

how do you treat MM?

A

only if symptomatic: chemo (proteosome inhibitors), bisphosphonates for bones, pain control, hydration

55
Q

what is the evolution pathway of meyloma?

A

MGUS–>asymptomatic/smoldering myeloma–>symptomatic myeloma

Course 1 (6 decks)

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