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Flashcards in Cancers Deck (68)
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1

What are CD20 and CD3 markers for respectively?

CD20 is a B cell marker

CD3 is a T cell marker

2

What disease is IgG4 related?

Castlemans disease (causes lymphadenopathy)

3

Generalised lymphadenopathy suggest a systemic inflammatory process or widespread malignancy. Which malignancies should be highest on your list of differentials?

Lymphoma

Leukaemia

4

What are the surfaces of the spleen?

Diaphragmatic surface

Visceral surfaces; L kidney, gastric fundus, tail of the pancreases and splenic flexure of the colon

5

Describe the arterial supply and venous drainage of the spleen

Supplied by the splenic artery (branch of the coeliac axis)

Drained by the splenic vein (joins the SMV to form the portal vein)

6

What are some of the possible causes of splenomegaly?

Infection

Congestion

Haematological malignancies

Haemolytic anaemia

ITP

Myeloproliferative disorders

7

What are some of the possible causes of hyposplenism?

Splenectomy

Coeliac disease

Sickle-cell disease

Sarcoidosis

8

What are Howell-Jolly bodies indicative of?

Hyposplenism

9

What is meant by pancytopenia?

A deficiency of blood cells of all lineages

10

Give an example of an inherited marrow failure syndrome which results in pancytopenia. How does this condition present?

Faconi's anaemia

Very rare
Macrocytosis, thrombocytopenia, neutropenia
Skeletal abnormalities and short stature
Café au lait spots
Hypogenitalia

11

What are some examples of causes of acquired primary bone marrow failure?

Idiopathic aplastic anaemia

Myelodysplastic syndromes

Acute leukaemia

12

What are some examples of causes of acquired secondary bone marrow failure?

Drugs

B12/ folate deficiency

HIV

Lymphoma

13

What are some of the clinical features of pancytopenia?

Anaemia (fatigue and SOB)

Neutropenia (infections)

Thrombocytopenia (bleeding)

14

What investigations should be done to establish the cause of pancytopenia?

FBC and blood film

B12 and folate

Virology

Autoantibody tests

Bone marrow examination

15

Pancytopenia can involve different marrow cellularities. In which conditions would you expect marrow to be HYPOcellular vs HYPERcellular?

HYPOcellular =
Aplastic anaemia

HYPERcellular =
myelodysplastic syndromes
B12/ folate deficiencies
Hypersplenism

16

How is pancytopenia managed?

Transfusions of red cells/ platelets/ neutrophils

Specific treatments for the underlying cause

17

Types of haematological malignancies are based on the anatomical site involved. Where do leukaemia, lymphoma and myeloma involve?

Leukaemia - blood
Lymphoma - lymph nodes
Myeloma - plasma cells in marrow

18

What type of leukaemia can affect blood AND lymph nodes?

Chronic lymphocytic leukaemia

(acute leukaemia affect blood only)

19

What are the lifespans for RBCs, neutrophils and platelets?

RBCs - 120 days

Neutrophils -7-8 hours

Platelets - 7-10 days

20

What are blasts?

Nucleated precursor cells

21

What are megakaryocytes?

Platelet precursors

22

What are haematopoietic cells?

Cells which are able to renew

23

What is the normal amount of free light chain production by normal plasma cells?

0.5g/ day

(excess can leak into the urine as bence jones protein)

24

What is meant by paraproteinaemia?

Presence of excessive amounts of myeloma protein or monoclonal gamma globulin in the blood

25

What are some of the possible causes of paraproteinaemia?

MGUS

Myeloma

Amyloidosis

Lymphoma

Chronic lymphocytic leukaemia

Plasmacytoma

26

What is myeloma?

Plasma cell malignancy

27

What is the premalignant condition that may develop into myeloma?

MGUS

28

How does myeloma present?

Hypercalcaemia; stones/ bones/ abdominal groans/ psychiatric moans/ thirst and dehydration

Bone pain and wedge compression fractures

29

How is myeloma classified?

Classified by the type of antibody produced e.g IgA/ IgE etc. There may be light chains alone which is called Bence Jones myeloma.

30

Which classification of myeloma is most associated with kidney damage?

Bence jones myeloma (free light chains)

Deposition of light chains causes cast nephropathy