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Flashcards in Final-Malignancies Deck (39)
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1
Q

predominance of blasts

A

acute

2
Q

predominance of most mature, differentiated cells i.e. mature lymphocytes, mature neutrophils

A

chronic

3
Q

acute myeloid leukemia (AML)

  • > or = to 20% ? on BM bx or peripheral blood smear
  • 8 subtypes, tx same for all except?
  • *note: acute PROmyelocytic leukemia has diff epidemiology and best ?, increases during ? and reaches a plateau during ?; note- initially there’s a life threatening ? from ?
  • unique Sx/signs?
A
  • myeloblasts
  • M3
  • Px, 2nd decade, young adulthood, hemorrhagic complication, DIC
  • gum bleeding, epistaxis, excessive menstrual bleeding, gingival hypertrophy, skin lesions
4
Q

Auer rods?

A

AML

5
Q

acute lymphoblastic leukemia (ALL)

  • > or = 20-25% ? on BM bx or peripheral blood smear
  • signs/Sx- 50% ?, ? uniquely involved
  • DANGER of ?, Tx ALL of ALL prophy w/ ?
  • Px in children?
A
  • lymphoblasts
  • lymphadenopathy, CNS
  • leukemic meningitis
  • chemo i.e. MTX
  • better than adults
6
Q

Chronic Myeloid Leukemia (CML)

  • predominance of ?
  • in 95% of cases?
  • may have extreme ?, tenderness over lower sternum
  • labs: sig inc ? (~100,000),
A
  • mature neutrophils
  • philadelphia chromosome
  • splenomegaly
  • WBC, blasts (bc its chronic), BASOPHILIA
  • decreased or zero
  • AML, ALL
  • ImaTINIB (others from same class ‘tinib’)- NOT curative but long term control of dz
7
Q

Leukemoid Reaction

  • similar CBC findings to ? but NO ?
  • reactive process often from ?
  • LAP score is ?
A
  • CML, myelocyte bulge
  • prolonged, severe infection
  • increased
8
Q

MC leukemia in US and western europe

A

chronic lymphocytic leukemia (CLL)

9
Q

CLL

  • often ? and discovered on routine
  • 50-90% have ?, often in ?, anywhere in size from ? to ? (always alternating size)
  • ? count typically >10,000
  • ? cells
  • ? confirms Dx
  • ? phenomena in 20% pts- results in ? anemia
A
  • aSx
  • lymphadenopathy, cervical area, few mm to orange size
  • lymphocyte
  • smudge
  • flow cytometry (essential for dx)
  • AI, hemolytic; tx w/ steroids!
10
Q

reed sternberg cells

A

hodgkins lymphoma

11
Q

hodgkins lymphoma

  • 60-80% present w/ enlarged ? and/or ? lymph nodes
  • 25-30% have ? Sx
  • Tx
  • Px?
A

cervical, supraclavicular
systemic B (fever, night sweats, wt loss)
chemo i.e. ABVD, radiation
HIGH cure rate w/ localized dz

12
Q

NONhodgkins lymphoma

  • MC extranodal site? then?
  • met profile may reveal?
  • exposure to pesticides & agent orange from ?
  • history of ? sx
A

GI tract, skin
hyperca (PTRrP)
vietname war
B symptoms (fever, wt loss, sweats)

13
Q

NHL

  • low grade (slow growing, indolent)?
  • intermediate?
A
  • follicular lymphoma, small lymphocytic lymphoma, hairy cell leukemia
  • mantle cell lymphoma
  • **rest are high grade
14
Q

MC NHL in adults ? 2

A

follicular, diffuse large B-cell

15
Q

MC NHL in children? 3

A

ALL, Burkitt’s diffuse large B-cell

16
Q

follicular lymphoma

  • multiple sites above and below?
  • dz localized to ?
  • cured by?
  • med?
  • Px?
A
diaphragm
one side of diaphragm
radiation therapy
rituximab
survival for several years
17
Q

small lymphocytic lymphoma

  • small mature appearing lymphocytes that do not function normally; are ?
  • most patients present w/ ?
A

‘incompetent’

painless generalized lymphadenopathy

18
Q

diffuse large B-cell lymphoma

  • incidence?
  • behavior- highly INVASIVE
  • may present as ? rapidly enlarging in ln in neck or abdomen; may present with ? Sx
  • usually in ?
  • Tx?
A
  • MC NHL
  • symptomatic mass, B Sx
  • GI tract
  • CHOP + rituximab
19
Q

ALL- acute lymphoBLASTic lymphoma

  • MC in ?
  • w/ leukemia** less bone marrow involvement with ?
A
  • children

- blasts <20%

20
Q

burkitt’s lymphoma

  • incidence?
  • three forms?
  • prophy?
A
  • children, I/C
  • endemic in african children, non endemic in american, IC i.e. HIV
  • CNS like with ALL i.e. MTX
21
Q

adolescents may get ? in addition to diffuse large B cell lymphoma, ALL, and Burkitt’s

A

follicular lymphoma

22
Q

multiple myeloma (MM) triad

A

plasma cells, M protein, bone lesions

23
Q

? must be done to detect hence jones proteins

A

electrophoresis

24
Q

MM Dx- need all three:

A

presence of M protein
plasma cells or plasmacytoma
ONE feature of CRAB (hyperca, renal insuff, anemia, lytic bone lesion

25
Q

polycythemia
f?
m?

A

> 16.5

>18.5

26
Q

primary vs secondary polycythemia

  • primary has inc ? i.e.
  • secondary dec ? so inc ? i.e.
A
  • RBC, tumors (polycythemia vera)

- RBC erythropoietin, lung dz, hypoxic conditions

27
Q

polycythemia vera (primary)

  • inc RBC causes blood to be ? and causes ?
  • CC?
  • physical findings? 2
  • labs- ox sat?, platelets? RBC/erythro? mutation?
  • life threatening ? or ?; prevent w/ ?
A
  • viscous, bleeding
  • itchy after warm shower
  • splenomegaly, plethora (redness of face)
  • nl., thrombocytosis, inc/dec, JAK 2
  • thrombosis, GI hemorrhage; prevent thrombosis w/ periodic phlebotomy and aspirin
28
Q

secondary polycythemia

-RBC/erythro?

A

dec/inc***

29
Q

-ALL MC in ?

A

kids (3-7)

30
Q

ALL: child may ? due to bone pain

-prophy ? to prevent ?

A

limp

MTX, leukemic meningitis

31
Q

specific PE finding in AML?
culture?
life threatening comp w/?

A

gingival hyperplasia
Auer rods
acute PROmyelocytic leukemia- DIC

32
Q

basophilia only in?

A

CML

33
Q

smudge cells
main Sx?
confirm Dx w/

A

CLL
painLESS swollen cervical lymph node
flow cytometry

34
Q

reed sternberg

A

hodgkin’s lymphoma

35
Q

high risks of relapse in CNS?

A

ALL

36
Q

essential test in CLL?

A

flow cytometry

37
Q

Tx of CML

A

imatinib

38
Q

high cure rate

A

Hodgkin’s lymphoma

39
Q

tx follicular and diffuse large B cell lymphoma?

A

rituximab