haem continued Flashcards by Emma Sutcliffe

what are the lymphoid cells

t cells b cells nk cells

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what cells produces platelets

megakaryocytes

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embryological origin of stem cells

mesoderm

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how does liver disease cause thrombocytopenia

thrombopoeiten regulates growth adn is produced by liver

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how do you identify lymphoid cell type

immunophenotyping

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where are b cells and t cells produced

b cells- bone
t cells - thymus

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blood film findings in hypospelnism

howell jolly bodies

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causes of hypospleinis

sick cell
graves
coeliac
SLE
amyloid

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what cells does AML come from

common myeloid proginator

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what cells does CLL - chronic lymphocytic leukaemia come from

b cells

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what cell does myeloma come from

myeloma

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what cells does acute lymphoblstic leukaemia come from

common lymphoid precusor

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what does leukaemia and lymphoma cause in terms of loss of fuction

leaukaemia - loss of haempoeisis
lymphoma - loss of immune function

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difference in AML and CML

both have proliferation of abnormal projinators
AML = block in differentiation or maturation
CML = no block in differentiation or maturation

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what mutation cause haematological cancers

driver mutations

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signs of high grade haemotological cancer on histology

large cells with high nucelus:cytoplasmic ration
prominent nucleoli and rapid prolif

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what percentage of blasts in blood/bone is indicative of acute leukaemia

> 20%

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what is the most common chidhoos cancer

Acute lymphoblastic leukaemia (CLP)

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what is involved in pancytopenia

anaemia-
thrombocytopenia
leukopenia

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differentials for non blanching petechia

meningococcal septicaemia
Leukaemia
HSP
NAI
ITP
vasculitis

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what haemotological cancer is downs syndrome assoc with

acute lymphoblastic leukaemia

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features of ALL

those assoc with marrow failure
thrombocytopenia- petechia
neutropenia- infections
anaemia - pallor, fatigue

bone pain (secondary to bone marrow infiltration)
splenomegaly
hepatomegaly
fever is present in up to 50% of new cases (representing infection or constitutional symptom)
testicular swelling

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what genetics can be seen in ALL

phildelphia chromosome 9:22 trasnlocation

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transformation of a myeloproliferative disorder causes what cancer

acute myeloid leukaemia

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what haemotological malignancy can present with DIC

acute myeloid leukaemia

auer rods

AML

blast cells indicate

an acute leukaemia

what are auer rods

abnormal granules in blast cells

what neurophil count is seen in neutropenic sepsis

<0.5

most common cause of neutropenic sepsis

coag neg gram pos STAPH EPIDERMIDIS

Treatment of neutropenic spesis

pipraciilen adn tazobactam

prophylaxis of tumour lysis syndrome adn when given

IV Allopurinol or IV rasburicase immediately prior and during first days

findings in tumour lysis syndrome

AKI high potassium, high phosphate, high uric acid low calcium

what chemo agents casue dilated cardiomyopathy

anthracyclines

what are b symptoms

night sweats fever weigth loss

utch without rash adn alcohol induced pain

hodgekins

is lymphadenopathy tender in cancer

how is CLL diagnosed

immunophenotyping

what cell does hodkins come from

b-cell

reed sternberg cells

hodgkins

what leukemia can transform to lymphoma and what is this called

CLL - richters trasnformation

smear or smudge cells

CLL

what blood test is a good marker of rpognosis in lymphoma

LDH

what are reed sternberg cells and where are they seen

hodgkins lymphoma binucelated cells - 'owl eyes". with eosinphilic inclusions

most common type of hodgkins lymphoma

nodular sclerosing

risk factors for hodgkins lymphoma

HIV EBV

staging system in lymphoma + describe

ANN ARBOUR 1- 1 lymph node 2- 2 lymph nodes on same side 3- nodes on both sides 4- spread

whats more common hodgkins or non hosgkins

non hodgkins

what cell is involved in burkitts lymphoma

b-cell high grade

genetic association of burkitts

c-myc trasnlocation (t18:4)

starry sky lymphoma

burkitts lymphoma

inherited causes of pancytopenia

fanconis anaemia

acquired causes of bone marrow failure/pancytopenia

idiopathic aplstic anaemia - autoimmune myelodysplastic syndrome acut emyeloid/lymphoblastic leukaemia

hypercellular marrow and marrow failure

myelodysplastic syndrome b12/folate deficiency hypersplenism

hypocellular marrow

aplastic anaemia

what can myelodysplastic syndrome progress to

AML

what ig is a pentamer adn what one is a dimer

pentamer - igM dimer IgA

in the body should antibodys be monoclonal or polyclonal. what is a monoclonal anitbody also called

polyclonal monoclonal- undelying b cell plasma cell disorder = paraprotein

what test is used to detect immunoglobulins

electrophoresis

what test is used to classify paraproteins

immunofixation

where would you find bence jones protein

urine

causes of paraproteinaemia

MGUS myeloma Amyloid waldstrom others eg lymphoma

what is MGUS

Monoclonal gammopathy of undetermined significance an asymptomatic paraproteinaemia that can progress to myeloma

what is rouleoux formation and when is it seen

stacks of rbc seen in myeloma

how is myeoma classified adn whats most common

based on what Ig it produced - IgG most common

what monoclonal antibodies are raised in myeloma

IgA and IgG - called bence jones in urine

symptoms of myeloma

CRABBI calicum - hypercalcaemia Renal - failure due to light chain accumulation A- anaemia (marrow failure) B- bone lytic lesion B-bleeding -thrombocytopenic -marrow failure i infection reduced norm ig

how do lytic lesions occur in myeloma

plasma cells produce IL-6 which upregs osteoclasts

what can be given to stop light chain production

steroids

what can be used to measure response in myelom atx

paraprotein levels

tx for bone pain in myeloma

OPIATES not NSAIDS

what is the paraportien level seen in MGUS

<30

apple green bifringement on congo red stain

amyloid

what is walderstorms

neoplasm producing IgM paraprotein

why does waldenstroms cause hyperviscosity

IgM pentamer thickens serum

what is th ephiladelphia chromososme

t(9:22)

types of myeloproliferative neoplasm

CML Essential thrombocythaemia polucthaemia rubra vera primary myelofibrosis

what is a myeloproliferative disorder

increase in one or more type of haemopoietic cells

what gene is involved i myeloproliferative disorders

BRC-ABL 1

what myeloproliferative disorder is BCR-ABL1 positive

CML

what is there too much f in chronic myeloid leukaemia

too many granulocytes/WCC

first line treatment of CML

imatinib

diagnostic testing for CML

genetic testign fro philadelphia chromosome

features of polcythaemia rubra vera

headache, fatigue, itch post shower hyperviscosity therefor srterial and venou thrombosis

mutation seen in polycythaemia rubra vera

JAK2

treatment of polycythaemia

venesect till haematrocrit is <0.45 aspirin hydroxycarbamine

essential thrombocytossi characteristic symptom

burning in hands

treatment of essential thromboytosis

hydroxyurae/carbamine

tear drop poikilocytes

myelofibrosis

treatment of autoimmune haemolytic anaemia

steroids

most common inherites thrombophilia

Factor V leiden

haem continued Flashcards

(91 cards)