Blood Dyscrasias Flashcards

(46 cards)

1
Q

Acute lymphocytic leukemia (ALL) is the MC malignancy in?

A

Children under the age of 15 in the US

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2
Q

Is ALL responsive to therapy?

A

Yes, most responsive to therapy

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3
Q

What are some clinical features of ALL?

A

Bone and joint pain (invasion of periosteum)

splenomegaly, hepatomegaly, lymphadenopathy

Anterior mediastinal mass

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4
Q

Diagnostic lab findings for ALL and AML?

A

Variable WBC count

significant numbers of blast cells in peripheral blood

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5
Q

What complication is associated with ALL chemotherapy?

A

Tumor lysis syndrome

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6
Q

What is tumor lysis syndrome?

A

rapid cell death that releases intracellular contents

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7
Q

What does tumor lysis syndrome cause?

A

Hyperkalemia

Hyperphosphatemia

Hyperuricemia

Hypocalcemia

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8
Q

Acute myelogenous leukemia (AML) occurs mostly in?

A

Adults (80% of adult acute leukemias)

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9
Q

What risk is involved with AML?

A

Increased risk of bacterial infections (d/t neutropenia)

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10
Q

What unique clinical feature is seen in AML?

A

Skin nodules

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11
Q

What would you see in a bone marrow biopsy for diagnosing AML?

A

Auer Rods

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12
Q

What are Auer rods?

A

Granules and eosinophilic rods inside malignant cells

Present in AML, but not in ALL

Particularly noted if it is the APL phenotype

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13
Q

What is the best treatment option for AML?

A

Bone marrow transplantation gives the best change of remission or cure

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14
Q

Chronic lymphocytic leukemia (CLL) is most common in?

A

> 60 years of age

Leukemia occurring after age 50

Most common leukemia in the Western world

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15
Q

What is the cause of CLL?

A

B-type lymphocytes are mature, but functionally defective.

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16
Q

Is CLL considered the most or least aggressive type of leukemia?

A

Least aggressive

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17
Q

Clinical features of CLL?

A

Usually asymptomatic at the time of diagnosis

Generalized painless LAD (nontender lymph nodes)

Splenomegaly

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18
Q

Diagnostic findings for CLL?

A

Pancytopenia is common (anemia, thrombocytopenia, neutropenia)

Peripheral blood smear: smudge cells

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19
Q

What are smudge cells?

A

“fragile” leukemic cells that are broken when placed on the glass slide.

20
Q

What are some general characteristics of chronic myelogenous leukemia (CML)?

A

Philadelphia chromosome (cheesesteak me likeee)

21
Q

Treatment options for CML?

A

Target therapy: TKI Imatinib (Gleevec)

22
Q

What are constitutional (B) sxs?

A

Fever, night sweats, anorexia, weight loss

23
Q

What is Hodgkin lymphoma bimodal age distribution?

A

X1: 15-30 yrs old
X2: >50yrs of age

24
Q

Lymph node bx lab finding for Hodgkin lymphoma?

A

Reed Sternberg Cells “owl eyes”

25
What is the MC clinical features of Hodgkin lymphoma?
Painless lymphadenopathy
26
What differentiates between Hodgkin lymphoma and non-Hodgkins lymphoma?
Presence of inflammatory cell infiltrates
27
How common is non-Hodgkins lymphoma compared to Hodgkins lymphoma?
Twice as common has Hodgkins lymphoma
28
Burkitt lymphoma a high-grade subtype of NHL is linked to?
African variety linked to EBV infection
29
Clinical features of NHL?
Lymphadenopathy
30
What is the definitive dx of NHL?
Lymph node bx- no Reed Sternberg Cells
31
What is multiple myeloma?
Neoplastic proliferation of a single plasma cell line that produces monoclonal immunoglobulin.
32
Age and race MC for multiple myeloma?
>50 yrs | 2x more common in AA compared to caucasian pts
33
What is a general characteristic of multiple myeloma?
Bone marrow elements are replaced by malignant plasma cells
34
What are skeletal manifestations of multiple myeloma?
Bone pain d/t osteolytic lesions, fractures, and vertebral collapse
35
Anemia manifestations of multiple myeloma?
Normocytic normochromic
36
Urine test finding for myeloma nephrosis caused by multiple myeloma
Bence Jones protein in urine - large amounts of free light chains
37
What is the MCC of death in pts with multiple myeloma?
Infections: pulmonary or urinary tract
38
Clinical feature of back/spine in pt with multiple myeloma?
Cord compression
39
What is a peripheral smear finding in pts with multiple myeloma?
Rouleaux formation
40
what are CRAB manifestations of multiple myeloma?
C = Calcium issues (hypercalcemia) R = Renal insufficiency (elevated creatinine) A = Anemia B = bone lesions and pain
41
What is the preferred tx of multiple myeloma?
Autologous hematopoietic cell transplant (stem cell transplant)
42
What mutations are found in polycythemia vera?
Mutations of the JAK2 tyrosine kinase
43
S/Sxs of polycythemia vera?
Hyperviscosity: HA, dizziness, weakness, pruritus, visual impairment, dyspnea
44
In order to r/o polycythemia vera?
Rule out causes of secondary polycythemia (hypoxia, CO exposure)
45
DDx of polycythemia vera?
Smoking and Hypoxemia (secondary polycythemia)
46
Tx for polycythemia vera?
Repeated phlebotomy to lower the hematocrit