Haematology II QUIZ C1-3 Flashcards by SITI AFRINA

What is the primary function of white blood cells (WBC)?

Immune response, phagocytosis, production of antibodies, cell-mediated immunity, detection of foreign substances

WBC are crucial for the body’s defense against infections and foreign invaders.

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Name the two broad classifications of white blood cells based on granule presence.

Granulocyte, Agranulocyte

Granulocytes include basophils, eosinophils, and neutrophils; agranulocytes include lymphocytes and monocytes.

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What are the normal total range values for white blood cells (WBC)?

4.0 – 11.0 x 10^9 /L

This range indicates the typical number of WBCs in a healthy adult’s blood.

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What is neutrophilia?

Neutrophils > 7.5 x 10^9/L

Neutrophilia is an increase in neutrophils, often due to infection or inflammation.

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List the causes of neutrophilia.

Bacterial infections
Inflammation and tissue necrosis
Metabolic disorders
Neoplasms
Acute hemorrhage or hemolysis
Drug effects
Rare inherited disorders

Each of these causes can lead to an elevated neutrophil count.

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What is the definition of leukocytosis?

Increase in the number of leukocytes

This condition can indicate various underlying health issues.

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What are the characteristics of reactive neutrophilia?

Increase in immature cells
‘Shift to the left’
Presence of toxic granulation
Elevated Neutrophil Alkaline Phosphatase (NAP) score

Reactive neutrophilia often occurs in response to infections or inflammation.

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What causes eosinophilia?

Allergic diseases
Parasitic diseases
Acute infections
Hypereosinophilic syndrome
Certain skin diseases
Drug sensitivity

Eosinophilia is characterized by high eosinophil levels usually related to allergic reactions or parasitic infections.

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What is the definition of lymphocytosis?

Lymphocytes > 4.0 x 10^9/L

Lymphocytosis can indicate viral infections or chronic inflammation.

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What are the causes of lymphopenia?

Bone marrow failure
Corticosteroid therapy
Immunosuppressive therapy
HIV
Neoplastic conditions

Lymphopenia indicates a reduced number of lymphocytes, affecting immune function.

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What is the definition of leukemias?

A group of disorders characterized by the accumulation of malignant white blood cells in the bone marrow and blood

Leukemias can be classified into acute and chronic types.

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Name the classifications of acute leukemias according to FAB.

Acute myeloid leukemia (AML): M0-M7
Acute lymphoblastic leukemia (ALL): L1-L3

These classifications help in diagnosing and determining treatment options for leukemia.

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What are the cytogenetic tests used for leukemia diagnosis?

Karyotyping
Fluorescence in Situ Hybridization (FISH)
Polymerase Chain Reaction (PCR)
Array Comparative Genomic Hybridization (aCGH)
Next-Generation Sequencing

These tests detect chromosomal abnormalities and mutations associated with leukemia.

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Fill in the blank: Neutrophils < 0.5 x 10^9/L are likely to have _______.

recurrent infections

Low neutrophil counts can lead to increased susceptibility to infections.

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What is the normal range for eosinophils?

0.04 – 0.44 x 10^9/L

Eosinophils play a role in allergic reactions and combating parasites.

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What are the two main types of acute leukemia?

Acute Myeloid Leukemia (AML) and Acute Lymphoid Leukemia (ALL)

AML is classified as M0-M7 and ALL as L1-L3.

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Define Acute Myeloid Leukemia (AML).

Malignant transformation of immature hematopoietic cells leading to proliferation and accumulation of clonal myeloid progenitor cells that do not differentiate normally.

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What percentage of blast cells is required to diagnose acute leukemia?

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> 20% blast cells in the blood or bone marrow.

What are the main causes of Acute Myeloid Leukemia (AML)?

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Increased rate of proliferation
Reduced apoptosis
Blockage in the cellular differentiation

List the clinical features of Acute Myeloid Leukemia (AML).

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Anaemia
Thrombocytopenia
Disseminated intravascular coagulation (DIC)
Gum hypertrophy and infiltration
Skin and CNS diseases

What laboratory investigations are used for diagnosing AML?

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Complete blood counts
Peripheral blood film examination
Bone marrow aspirate
Bone marrow trephine biopsy
Cytochemistry
Chromosomes and genetic analysis
Immunological markers

What are common cytogenetic abnormalities associated with AML?

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Mutation of FLT-3 gene
Chromosomal translocation inv(16) and t(8:21)
t(15;17) – Good prognosis

What is the prognosis for adults diagnosed with AML over the age of 65?

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Approx. 5% will be alive 5 years after diagnosis.

What is the definition of Acute Lymphoid Leukemia (ALL)?

Accumulation of lymphoblasts in the bone marrow.

What is the most common form of leukemia in children?

Acute Lymphoid Leukemia (ALL), specifically B-cell ALL.

What are the clinical features of Acute Lymphoid Leukemia (ALL)?

* Bone marrow failure * Anaemia * Neutropenia * Thrombocytopenia * Organ infiltration * Tender bones * Lymphadenopathy * Splenomegaly and hepatomegaly * Testicular swelling and erythema * Fever

List the laboratory investigations for ALL.

* Haematological investigation * Peripheral blood examination * Bone marrow hypercellularity * Biochemical tests * Cytogenetic and molecular testing

What cytogenetic abnormalities are associated with good prognosis in ALL?

* Hyperdiploid cells * t(12;21) – TEL-AML1 fusion gene

What cytogenetic abnormality is linked to poor prognosis in ALL?

t(9;22) – Philadelphia chromosome.

What are the treatment options for Acute Lymphoid Leukemia (ALL)?

* Chemotherapy * Radiotherapy * Hematopoietic stem cell transplantation

Fill in the blank: Acute Myeloid Leukemia (AML) is classified based on cytochemical stains and _______.

[immunophenotype]

True or False: ALL is more common in females than in males.

False

What is the typical age range with the highest incidence of ALL?

3-7 years old.

What is the significance of the Philadelphia chromosome in leukemia?

It generates the BCR-ABL1 fusion gene, which codes for a tyrosine kinase protein and is linked to poor prognosis.

What is chronic myeloid leukemia (CML)?

A type of leukemia involving cell lines in the myeloid lineage with gradual onset and accumulation of malignant mature white blood cells in the bone marrow and blood. ## Footnote CML is characterized by the presence of the Philadelphia chromosome.

What is the significance of the Philadelphia chromosome?

It is a translocation between chromosome 9 and 22 (t(9;22)), leading to the production of a BCR-ABL fusion gene that enhances tyrosine kinase activity. ## Footnote This chromosome is commonly associated with chronic myeloid leukemia.

What are the clinical features of chronic myeloid leukemia (CML)?

* Symptoms related to hypermetabolism * Weight loss * Lack of energy * Anorexia * Splenomegaly * Features of anemia * Bruising * Epistaxis * High leukocyte count * Abnormal platelet function * High serum uric acid ## Footnote Other symptoms may include visual disturbances and renal impairment.

What are the primary treatment options for chronic myeloid leukemia (CML)?

* Tyrosine kinase inhibitors (e.g., Imatinib) * Chemotherapy * α-interferon * Stem cell transplantation ## Footnote Tyrosine kinase inhibitors are particularly effective in the chronic phase.

What is chronic lymphoid leukemia (CLL)?

A group of disorders characterized by the accumulation of mature lymphocytes in the blood, either of B-cell or T-cell type. ## Footnote CLL often presents with chronic persistent lymphocytosis.

What are the subtypes of chronic lymphoid leukemia (CLL)?

* B-cell diseases * T-cell diseases * Chronic lymphocytic leukemia (CLL) * Large granular lymphocytic leukemia * Prolymphocytic leukemia (PLL) * Adult T-cell leukemia * Hairy cell leukemia (HCL) * Sezary syndrome * Plasma cell leukemia ## Footnote Subtypes are distinguished by morphology, immunophenotype, and cytogenetics.

What is the peak incidence age range for B-cell chronic lymphoid leukemia (CLL)?

Between 60 and 80 years, with only 15% of cases occurring before the age of 50 years. ## Footnote CLL is more common in Western countries compared to Eastern countries.

What are the clinical features of chronic lymphoid leukemia (CLL)?

* Enlargement of lymph nodes (cervical, axillary, inguinal) * Anemia * Thrombocytopenia * Splenomegaly * Hepatomegaly * Immunosuppression ## Footnote Immunosuppression may lead to hypogammaglobulinemia.

What is the laboratory finding in chronic lymphoid leukemia (CLL)?

* Lymphocytosis >5 x 10^9/L * Presence of small lymphocytes in blood film * Smudge or smear cells * B cell (CD19+) * Weak expression of IgM or IgD * Normocytic normochromic anemia * Low platelet count ## Footnote Bone marrow aspiration in CLL typically shows a dominance of lymphocytes.

True or False: Chronic leukemias are generally easier to cure compared to acute leukemias.

False ## Footnote Chronic leukemias are more difficult to cure.

What is the male-to-female ratio for chronic myeloid leukemia (CML)?

1.4:1 ## Footnote This indicates a slightly higher incidence in males.

Fill in the blank: The Philadelphia chromosome results in the production of a _______ fusion gene.

BCR-ABL ## Footnote This fusion gene codes for a protein that enhances tyrosine kinase activity.

Haematology II QUIZ C1-3 Flashcards

quiz 1 study (47 cards)