Ch. 6 - MDS Flashcards Preview

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Flashcards in Ch. 6 - MDS Deck (72):
1

MDS is characterized by one or more peripheral blood (blanks) and with (blank) in one or more myeloid lines

cytopenias; dysplasia

2

T/F: there is an inevitable risk of developing leukemia from MDS

false

3

what is the poster child for MDS?

older male; 70

4

In MDS, what is the state of the blood and cellular maturation?

cyotpenic with variable maturation

5

In MPD, what is the state of the blood and cellular maturation?

cythemic with distinct maturation

6

in Acute leukemia, what is the state of the blood and cellular maturation?

variable blood state with no maturation

7

What are the IPSS thresholds for Hemoglobin, ANC and platelets for MDS?

Hgb:

8

Are there blasts in the periph. blood in refractory anemia?

no

9

refractory anemia

10

GREATER THAN 15% ringed sideroblasts,

refractory anemia with ringed sideroblasts (RARS)

11

The red cell population in RARS can be described as;

dimorphic

12

(blank) bodies are seen in the peripheral blood of RARS

Pappenheimer

13

Which two types of MDS are the most stable?

RA and RARS

14

Refractory anemia with excess blasts has (blank)cytopenia

pancytopenia

15

Auer rods immediately classifies the disorder as RAEB (1/2)

2

16

1

17

5-19% blasts and/or Auer rods is RAEB (1/2)

2

18

No Auer rods,

5q- syndrome

19

Which has the best prognosis:RARARSRAEB 1RAEB 2 5q- syndrome

5q- syndrome

20

Clonal cytogenetic abnormalities are present in (blank) percent of MDS cases

50

21

Initiating stimuli for MDS invovles (blank) damage

genetic

22

benzene exposure, cigarettes, family Hx of heme neoplasms lead to de novo (blank)

MDS

23

What are the three heritble syndromes that lead to MDS?

Fanconi's AnemiaSchwachman-Diamond syndromeDiamond-Blackfan syndromeFDS: fuck dysplastic syndromes

24

Describe the general clinical appearance of someone with MDS?

Fatigue and weaknessPalorEcchymosesHemorrhageInfection

25

Anisocytosis and poikilocytosis indicate what about RBC morphology?

Aniso=different in sizePoikilo= different in shape

26

RBCS in MDS have an MCV >110fL, indicating:

macrocytosis

27

MDS presents with anemia, meaning the Hgb will be below:

10

28

Basophilic stippling, Howell-Joly bodies, membrane abnormlities, and the presence of a nucleus (when there shouldn't be one) are abnormalities found in what cell line in MDS?

RBCs

29

what shape do the macrocytes take in MDS?

oval

30

MDS presents with a cytopenia of what RBC maturation stage?

reticulocytopenia

31

Canon-ball nucleus is a finding of fucked up (blank) cells

nucleated RBCs that definitely should not be there

32

T/F: left shifted granulocytes are always present in MDS

false; sometimes only

33

Describe the granulation of neutrophils in MDS?

Agranular or hypogranular

34

Pseudo-Pelgeroid, hypersegmented, or ringed nuclei are found in (blank) cells in MDS

granulocytes

35

T/F: MDS can present with both leukopenia and neutropenia

true

36

In MDS are platelets larger or smaller than their normal size?

FUCKING GIANT

37

t/f: mds can lead to both thrombocytopenia and thrombocytosis

true

38

When we say "FUCKING GIANT" platelets, how big are talkin'?

the size of a goddamned RBC

39

MDS; myelogenous leukemia

40

T/F: In MDS, the bone marrrow can be normal, hypo, or hyper cellular

true

41

T/F: it is common to have dysplasia in all myeloid lines in MDS

true

42

The fuck is karyorrhexis and when do you see it?

destructive fragmentation of the nucleus of a dying cell whereby its chromatin is distributed irregularly throughout the cytoplasm. See that shit in dyserythropoesis

43

Describe the nuclear findings of dyserythropoesis?

Karyorrhexis, irregular staining, ringed sideroblasts, nuclear budding, nuclear fragmentation, multinucleation

44

Describe the cytoplasmic findings of dyserythropoesis?

Vacuolization, basophilic stippling, ringed sideroblasts

45

In the bone marrow during dyserythropoesis, describe the size of the erythroid precursors?

Giant, just like everything else

46

Describe the bone marrow findings of dysgranulopoesis?

Basically everything in both directions from normal:hypo/hypersegmentation of nucluesHypo or agranularAbsent secondary granules

47

T/F: megakaryocytes can be up, down, or normal in MDS

true

48

The fuck is a micromegakaryocyte and where the fuck do you find it?

in the bone marrow in MDS; its a dysplastic finding

49

Hyperchromatic nuclear staining happens in what cell lineage in MDS?

megakaryocytes

50

T/F: reticulocytopenia is found in the peripheral blood of all types of MDS

true

51

T/F: oval macrocytes are found in the peripheral blood of all types of MDS

true

52

In what two types of MDS do you see nomral WBCs and platelets with blasts less than 1% of peripheral blood?

RA and RARS

53

Describe the differences in blast percentages in both the peripheral blood and bone marrow for RAEB 1 and 2

RAEB1:peripheral: 5bone marrow: 10-19

54

RAEB (1/2) correlates with a higher risk of leukemia

RAEB 2

55

Which RAEB prognosis correlates with blast percentage?

RAEB 1

56

In what forms of MDS do you see monoctyes

RAEB 1 and 2

57

In which RAEB are ringed sideroblasts present?

RAEB 1

58

MDS may follow what two types of treatment?

chemo or radiation

59

T/F: therapy related MDS has a favorable prognosis and resolves after finishing treatment

false; UNFAVORABLE prognosis with high risk of leukemia

60

which two chromosomes are involved in MDS?

5 and 7

61

Complex karyotypes involving >(blank) csome abnormalities are associated with a worse MDS prognosis

3

62

Median survival worsens with increasing (blank) percentage and (blank) dysplasia

increasing blast percentage; trilineage dysplasia

63

What percent of MDS pts undergo transformation to leukemia?

10-40%

64

What IPSS MDS category is this?5-10% marrow blasts.variable karyotype2-3 peripheral cytopenias

0.5

65

What IPSS MDS category is this?

0

66

What IPSS MDS category is this?Abnormal csome 7 or more than 3 karytype abnormalities

1

67

What IPSS MDS category is this?11-20% marrow blasts

1.5

68

What IPSS MDS category is this?21-30% marrow blasts

2

69

What two growth factors are given to treat MDS?

GM-CSF, EPO

70

Chemo is given as Tx for a (better/worse) prognosis of MDS

worse

71

T/F: bone marrow transplant is an Tx for MDS

true

72

What type of chemo drugs do you give for MDS?

hypomethylating agents like 5-azacytidine and decitabine