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Hematology > Chapter 18, 19 > Flashcards

Chapter 18, 19 Flashcards

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0
Q

What are some general characteristics of acute leukemias?

A

You will see mostly blasts and other immature cells in the bone marrow. Normal stem cells (RBC, WBC, Plt) are displaced by malignant stem cells.

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1
Q

What usually kills leukemia patients?

A

Infections because they have such abnormal WBCs.

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2
Q

What are some general symptoms of acute leukemias?

A

Weakness from anemia
Bleeding and easy bruising from thrombocytopenia
Infections from dysfunctional WBCs

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3
Q

What is the FAB classification based on?

A

Wright stained morphology of marrow and peripheral cells.

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4
Q

Are WBC counts always high in acute leukemia patients?

A

No, sometimes they can be normal or decreased.

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5
Q

What age is M1 (Acute Myelogenous Leukemia) usually common in?

A

Children less than 18 months old or adults around 46.

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6
Q

What symptoms does M1 cause?

A

Fever, weakness, bleeding.
Splenomegaly, hepatomegaly.
Chloromas.

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7
Q

What are chloromas?

A

Green tumor like masses of myeloblasts.

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8
Q

What cells do you see in M1 leukemias?

A

Predominance of myeloblasts in the bone marrow.

Possible auer rods.

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9
Q

What types of cells do you see in M2 leukemias?

A

Blasts with possible auer rods and also the presence of other more mature granulocytes.

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10
Q

What types of cells do you see in M3 leukemias?

A

Increased numbers of promyelocytes and myeloblasts. Decreased RBC and Plt.

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11
Q

What types of cells do you see in M4 (Acute Myelmonocytic) leukemias?

A

Increased monoblasts and other immature granulocytes. Some blasts may have folded nuclei and possible auer rods.

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12
Q

What types of cells do you see in M5 (Acute Monocytic) Leukemias?

A

20-75 % monoblasts and monocytes.

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13
Q

What types of cells do you see in M6 (Erythroleukemia)?

A

Proliferation of immature graulocytes and erythrocytes. Myeloblasts and rubriblasts are seen in the marrow and peripheral blood.

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14
Q

What types of cells do you see in M7 (Megakaryocytic) Leukemias?

A

50% megakaryoblasts in marrow and thrombocytopenia in peripheral blood.

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15
Q

What is ALL?

A

Acute Lymphoblastic Leukemia which is the most common in children.

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16
Q

What cells do you in ALL?

A

Mostly blasts, lymphocytes, and smudge cells on smear.
Blasts have very high N/C ratio with NO auer rods.
Blasts in spinal fluid.

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17
Q

What symptoms does ALL cause?

A

Weakness, fever, bleeding, bone pain

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18
Q

What is a leukemia?

A

Cancer caused by unregulated production of WBCs and stem cells in the bone marrow.

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19
Q

What is a lymphoma?

A

Cancer caused by unregulated WBCs in the lymphatic system. Only lymphocytes are affected.

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20
Q

What do you see on peripheral blood smears when a person has a chronic leukemia?

A

Immature and mature WBCs

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21
Q

What is the most common chronic leukemia?

Study These Flashcards
A

CLL - chronic lymphocytic leukemia

22
Q

What do 90% of CLLs involve?

23
Q

What happens to B-lymphs in CLL?

Study These Flashcards
A

Decreased antibody synthesis by defective cells

24
What do the white counts look like in CLL?
Leukocytosis, 1/3 have WBC > 100.0
25
What is the majority of cells seen on blood smear of a CLL patient?
80-90% small, monotonous mature lymphs and high number of smudge cells
26
What is the chromosomal translocation in CLL?
8 and 14
27
What do you usually see in Prolymphocytic Leukemias?
Numerous small lymphs with nucleoli WBC counts may exceed 100.0 B-Lymphs More aggressive than CLL (48 month survival)
28
What is HCL (Hairy Cell Leukemia)?
B-cell leukemia that has large lymphs with frayed or ragged cytoplasmic edges.
29
What happens when you have hairy cell leukemia?
Pancytopenia, fibrotic marrow (dry taps)
30
What are plasma cells?
Immunologically activated B-lymphs that are actively synthesizing antibody.
31
What does a plasma cell look like?
Large in size. Large, mature, coarsely condensed, eccentric nucleus. Basophilic cytoplasm with perinuclear halo.
32
What do you see in Multiple Myeloma (Plasma Cell Leukemia)?
Increase in plasma cells in marrow and peripheral blood.
33
What leukemia causes skeletal destruction and bone pain?
Multiple myeloma (plasma cell leukemia)
34
What do WBC counts look like in Multiple myeloma patient?
Decreased to normal WBC counts. | In late disease, lymphocytosis to 50% plasma cells
35
What protein do you find in a Multiple Myeloma patients urine?
Bence-Jones
36
What does RBC morphology look like in Multiple Myeloma patient?
Increased Rouleux and ESR | Anemia
37
What is Waldenstrom's Primary Macroglobulinemia?
Plasma cell disorder with increased IgM synthesis
38
What are plasma Cryoglobulins?
Immunoglobulins that precipitate at 0 degrees Celsius and dissolve at 100 degrees Celsius.
39
What causes plasma hyperviscosity?
Excessive plasma protein
40
What cells do you see in Hodgkin's Lymphoma?
Reed-Sternberg cells in lymph node biopsy
41
What are "cleft nucleus's" usually associated with?
Lymphoma cells
42
What are clonal disorders?
Cells descended of a genetically defective precursors
43
What is a characteristic associated with Myeloproliferative Disorders?
Excessive production of morphologically normal mature cells with abnormal functions
44
What are four classifications of the Myeloproliferative Disorders?
``` Chronic Myelogenous Leukemia (CML) Polycythemia Vera (PV) Idiopathic Myelofibrosis (IM) Essential Thrombocytopenia (ET) ```
45
What is the chromosome associated with Chronic Myelogenous Leukemia (CML)?
Philadelphia Chromosome translocated at 9:22
46
What do WBC counts look like in a CML patient? RBC counts?
``` Extreme leukocytosis (greater than 100) Anemic ```
47
What types of WBCs do you see in CML?
Mixture of mature and immature granulocytes (blasts <5%)
48
What happens in Idiopathic Myelofibrosis?
Marrow fibrosis and extramedullary hematopoiesis. Blood/marrow barrier disrupted with immature cells released into blood. Hypocellular bone marrow (dry taps). Anemia.
49
What do you see in peripheral blood in a IM patient?
Increased tear drop cells, NRBCs, immature granulocytes, large platelets, and megakaryocytes in peripheral blood.
50
What happens in Polycythemia Vera?
Stem cell disorder causes erythroidhyperplasia, makes too many RBCs. Increased RBCs and RBC stem cells (also increase Plts and WBCs)
51
What happens in Essential Thrombocytopenia (ET)?
Increased dysfunctional plt counts > 1000.0 | Least common MPD
52
What are five FAB classifications of Myelodysplastic syndromes?
Refractory Anemia, Refractory Anemia with Ringed Sideroblasts, Refractory Anemia with Excess Blasts, Chronic Myelomonocytic Leukemia, and Refractory Anemia with Excess Blasts in Transformaation.

Hematology (7 decks)

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