Heam 4 - leukemias etc

Question 1

acute lymphoblastic leukaemia

1) which cells
2) common in?
3) 2 features
4) how do you treat

Answer 1

1) lymphoblasts
2) children
3) cytopenia and chest mass?
4) chemo, good prognosis but relapse rate high

Question 2

chronic lymphocytic leukaemia

1) which cells?
2) whos likely to get it?
3) how do you treat

Answer 2

1) B+T lymphocytes
2) increases with age
3) only treat troublesome symptoms e.g. bone marrow failure

Question 3

things to look for in diagnosis of chronic lymphocytic leukemia

Answer 3

splenomegaly, lymphadenopathy, high lymphocyte count, marrow suppresion, smudge cells on blood film, hypogammaglobulinameia (low antibodies in the blood) , immune disturbances

Question 4

criteria for A B and C of CLL and prognosis

Answer 4

A. 10 years, lymphocytosis
B. 5 years, A+ 3 areas
C. 2 years, B+ Hb

Question 5

Acute myeloid leukaemia

1) which cells?
2) clinical features
3) treat?

Answer 5

1) myeloblasts
2) increased WBC (not always present), may fill marrow before spilling out onto blood
3) chemo

Question 6

Chronic Myeloid Leukaemia

1) which cells?
2) clinical features
3) treatment
4) due 2?

Answer 6

1) monocyte granulocyte
2) not usually bone marrow failure! increase, spenomegaly and priapism
3) imatinim (inhibs tumor cell specific enzyme)
4) philadelphia chromosome

Question 7

what is myeloproliferative disorders

Answer 7

blood cells to grow irregularly in the bone marrow

Question 8

myeloproliferative disorders 
PRV?
ET?
MF?
can result in?

Answer 8

PRV - excess RBCs
ET - excess platelets
(both can progress to MF or actute leukamia)
MF - excess bone marrow scarring due to abnormal megakaryocyte activity - bone marrow failure
- MI or stroke

Question 9

Myelodysplasia ? what can it progres to over time

Answer 9

disordered maturation of blood cells in bone marrow . any of all cell lines may be affected
- acute leukamaemia

Question 10

name one thing that makes diagnosis easy and one hard

Answer 10

easy - easy to diagnose if chromosomal abnormaility is detected or disorganisation severe
hard - hard to distinguish from reactive marrow changes (rhem arthritis)

Question 11

diff between leukaemia and lymphoma

Answer 11

leukaemia - bone marrow and blood lymphoma - lymph nodes

Question 12

non hodgekins lymphona

1) common site?
2) common age?
3) related viruses?
4) B symptoms? otehr symptom?

Answer 12

1) 30% out of lymph nodes
2) elderly
3) HIV EBV HTLV
4) weight loss, night sweats, fever. …. lymphoadeno

Question 13

hodgekins lymphoma

1) common age?
2) related viruses?
3) presents with?
5) bulk of tumor?

Answer 13

1) 20 + elderly
2) EBV
3) B symptoms and nodal spread
5) wbc reacting to tumor

Question 14

lymphoma - grades

Answer 14

low grad - slow

high grade - fast

Question 15

lymphoma - stages

Answer 15

stages defines extent. spread doesnt mean the worst as lymphocytes naturally circulate. worst stage implies worse prognosis.

Question 16

acute leukemia can lead to…

Answer 16

BONE MARROW FAILURE - anaemia, thromocytopenia (low platelets) neutropenia (infections)

Question 17

diagnosing a lymphoma?

Answer 17

BIOPSY( not bone marrow) vital. ct scan to stage tumor

Question 18

Roles of 
IgD
igM
igG
igA
igE

Answer 18

D - from newly matured B cels
M - clears pathogens from blood
G - clears pathgogens from tissue 
A - stops pathogens from bining to mucosal surfaces
E - protects against parasites

Question 19

How do you define a myeloma

Answer 19

plasma cells in the bone marrow >10%
detectible paraproten in blood/ urine
lytic lesions on skeletal survey

Question 20

what is a Skeletal survey

Answer 20

series of plain XRs

Question 21

who is myelomas common with and what are symptoms

Answer 21

old people 
anaemia 
high esr
back pain 
unexplained renal failure
unusual fractures

Question 22

What is Waldenstroms Macroglobulinaemia

Answer 22

igM paraprotein - infiltrate of lymphoblasomyctoid lymphocytes (half way from lymph - plasma)

Question 23

what can para protein cause and why is it bad

Answer 23

hyperviscosity syndrome.

blood stickier - fatigue headache confusion