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Julia PCP2 > Haematology > Flashcards

Flashcards in Haematology Deck (37):
1

What is myeloma?

Monoclonal expansion of an antibody M-protein or Bence-Jones protein

2

What is myeloma?

Monoclonal expansion of an antibody M-protein or Bence-Jones protein

3

What is the normal % of plasma cells in the bone marrow?

4

What can be detected in the urine if the clonal proliferation occurs in the light chain component of the immunoglobulin?

Bence-Jones protein

5

What is the paraprotein found in the serum or urine when a clonal immunoglobulin is present?

M-protein

6

MGUS: what are the values of serum M-protein (g/L) and marrow clonal plasma cells (%)?

Serum M-protein

7

What is the only difference between smouldering myeloma & multiple myeloma

Presence of CRAB features

8

What are the CRAB features of myeloma?

C - hypercalcaemia
R - renal insufficiency
A - anaemia
B - bone lesions (lytic)

9

What is the normal % of plasma cells in the bone marrow?

10

What can be detected in the urine if the clonal proliferation occurs in the light chain component of the immunoglobulin?

Bence-Jones protein

11

What is the paraprotein found in the serum or urine when a clonal immunoglobulin is present?

M-protein

12

MGUS: what are the values of serum M-protein (g/L) and marrow clonal plasma cells (%)?

Serum M-protein

13

What is the only difference between smouldering myeloma & multiple myeloma

Presence of CRAB features

14

What are the CRAB features of myeloma?

C - hypercalcaemia
R - renal insufficiency
A - anaemia
B - bone lesions (lytic)

15

Besides the CRAB features, what are some of the clinical consequences of myeloma?

Hyperviscosity, amyloidosis, recurrent infections

16

What are the clinical manifestations of hypercalcaemia?

Abdominal pain, renal stones, delirium, osteopenia

17

What test is diagnostic for multiple myeloma & what bodily secretions can it be performed on?

Protein electrophoresis - on serum or urine

18

What markers are used for prognostic estimations in multiple myeloma?

LDH, B-2 microglobulin, serum albumin

19

What are the treatments for multiple myeloma?

Chemotherapy (thalidomide based + alkylator + steroids), autologous transplants

+ symptom control: renal support, bone supplements, blood transfusions

20

What medications are used for symptoms relief in multiple myeloma?

-Transfusions for anaemia
-Vitamin D supplements ± bisphosphonates for fractures
-Fluids for renal insufficiency

21

What are the 3 broad lineages of lymphoma classification according to the WHO?

-Hodgkin lymphoma
-B-cell non-Hodgkin lymphoma
-T-cell non-Hodgkin lymphoma

22

In terms of aggressiveness, name 1 low, 1 intermediate and 1 high type of B cell non-Hodgkin lymphoma.

Low: follicular lymphoma
Intermediate: diffuse large B-cell non-Hodgkin lymphoma
High: Burkitt lymphoma

23

What are 4 clinical presentations of lymphoma?

-SOB & cough
-Abdominal discomfort
-Lymphadenopathy
-PUO & night sweats

24

What cells found in the lymph nodes are pathognomic of Hodgkin lymphoma?

Reed-Sternberg cells

25

Which immunohistochemical stains confirm a diagnosis of Hodgkin lymphoma?

CD15 and CD30

26

How is Hodgkin lymphoma staged?

Ann-Arbor staging: according to extent of disease - ie. one or multiple nodes involved, one or both sides of the diaphragm

27

What sort of lymphoma is diffuse large B-cell lymphoma?

An intermediately aggressive non-Hodgkin lymphoma

28

What serum markers indicate aggressive disease in diffuse large B-cell lymphoma?

Serum uric acid and LDH

29

Chemotherapy targets which receptor on B cells in diffuse large B-cell lymphoma?

CD20

30

Which clinical syndrome might be seen in tumour lysis syndrome?

Hyperuricaemia, hypercalcaemia, hyperphosphataemia, hyperkalaemia & acute renal failure

31

What prophylactic treatment can be provided for tumour lysis treatment?

Uric acid lowering agents, hydration

32

What are some risk factors for the development of leukaemia?

-Previous cytotoxic therapy
-Exposure to ionizing radiation
-Chemical exposure
-Infections, eg/ EBV
-Genetics
-Rare familial syndromes

33

What are some clinical features of acute leukaemia (name 4)?

-Petechiae
-Lethargy
-Infection
-SOB
-B symptoms - fevers, sweats, weight loss

34

What bone marrow feature is diagnostic of an acute leukaemia?

Blast cells accounting for >20% of nucleated cells in the bone marrow

35

Which feature found in bone marrow aspirates is pathognomic of acute myeloid leukaemia?

Auer rods

36

What does immunophenotyping (flow cytometry) show?

Specific surface proteins that the malignant cells possess, eg/ CD15 and CD30 in Hodgkin lymphoma

37

What is the use of cytogenetics in leukaemia?

Cytogenetics can be used diagnostically & prognostically in leukaemia. They provide information about the particular genetic abnormalities possessed by the malignant cells.