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Z - M2 Heme/Onc > Heme/Onc - Week 1 Review - Part 3 > Flashcards

Heme/Onc - Week 1 Review - Part 3 Flashcards

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1
Q

Leukopenia - Definition + 2 Types

A

WBC < 5,000
Neutropenia
Lymphopenia

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2
Q

Neutropenia - 2 Major Causes + Treatment

A

Causes

1) Drug Toxicity
2) Severe Gram (-) Sepsis (All neutrophils used up)

Treatment - GM-CSF to boost granulocyte production

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3
Q

Lymphopenia - 4 Major Causes

A

1) Immunodeficiency
2) High Cortisol
3) Autoimmune (SLE)
4) Radation

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4
Q

Leukocytosis - Defition + Causes (5)

A

WBC > 10,000

1) Bacterial Infection
2) Monocytosis
3) Eosinophilia
4) Basophilia
5) Lymphocytic Leukocytosis

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5
Q

Bacterial Infection (Key Fact)

A

Neutrophil release with Left Shift (CD16+ Cells)

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6
Q

Monocytosis - Definition + Causes (2)

A

Increase in circulating monocytes

Chronic Infection + Cancer

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7
Q

Eosinophilia - Key Causes (3)

A

1) Type 1 Hypersensitivity Reaction
2) Parasitic Infectio
3) Hodgkin Lymphoma (Increased IL-5)

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8
Q

Basophlia - Key Cause (1)

A

CML - KEY KEY

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9
Q

Lymphocytic Leukocytosis - Key Causes (3)

A

1) Viral Infeciton

2) Bordetella Pertussis

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10
Q

Boards Ages for Leukemias (Goljan)

A

1) 0-14 - ALL
2) 15-39 - AML
3) 40-59 - AML or CML
4) >60 - CLL

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11
Q

Acute Leukemia - Types (2) + Definition + Acute Presentation (4)

A

AML (Myeloid - CD33+/MPO+) + ALL (Lymphoid - TdT+)

Blast > 20% on Marrow Biopsy - Large on Histology with “Hole Punch” Nucleus

Acute Presentation - Based on Bone Marrow being crowded out and under production

2) Reduced RBCs - Anemia/Fatigue
3) Reduced Platelets - Thrombocytopenia (Bleeding)
4) Reduced Lymphocytes (Neutropenia/Infection)

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12
Q

ALL - Key Feature + Key Population + Classes (2)

A

TdT Positive - Lymphoblasts

Children (Associated with Down’s Age > 5) + Kids 0-14

B-Cell (TdT + CD10, CD19, CD20)
T-Cell (TdT + CD2-8) - No CD10

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13
Q

B-Cell ALL - Markers + Prognosis + Translocations (2)

A

Markers - TdT + CD10, CD19, CD20

Prognosis - Great in Kids (responds to chemo)

Translocations
Kids - t(12:21) - Good Prognosis
Adults - t(9:22) - Philadelphia Bcr-Abl - Poor Prognosis (vs. Good in CML)

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14
Q

T-Cell ALL - Markers + Population

A

Markers - T-Cell (TdT + CD2-8) - No CD10

Teenagers with Thymic Masses

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15
Q

AML - Key Features + Populations + Classes (3)

A

Myeloblasts - MPO + CD33 + Auer Rods

Adults - Typically 15-39

Classes (3)
M3 - Acute Promyelocytic Leukemia
M5 - Acute Monocytic Leukemia
M7 - Acute Megakaryblastic Leukemia (LACKS MPO!)

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16
Q

Acute Promyelocytic Leukemia - Genetics + Key Information (2)

A

AML M3
t(15:17) - RAR moves from 17 to 15 - Blocks AML Maturation trigger blast accumulation

High Risk of DIC (Class is Always)
Treat with ARTA (Vitamin A)

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17
Q

Acute Monocytic Leukemia - Keys (2)

A

AML M5

Monoblast Proliferaiton - Infiltrates Gums

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18
Q

Acute Megakaryoblastic Leukemia - Keys (3)

A

AML M7
Lacks MPO
Associated with Down’s Syndrome < 5 y/o

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19
Q

Chronic Leukemias - Definition + Types (4)

A

Mature Cell Leukemia - Lymphocytic (Myeloid = Myeloproliferative Disorders)

1) CLL
2) Hairy Cell Leukemia
3) Adult T-Cell Leukemia
4) Mycosis Fungoides

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20
Q

Chronic Lymphocytic Leukemia - Definition + Key Markers/Histology

A

Neoplastic Disease of Naive B-Cells - Tons of non-functional B-Cells

Markers - CD20, CD5, CD23
Histology - Smudge Cells - Look like they were slammed against the slide of the slide)

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21
Q

Lymph Node Form of CLL

A

Small Lymphocytic Lymphoma (SLL) - Same disease with Generalized LAD

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22
Q

Complications of CLL (3)

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A

1) Hypogammaglobinulinemia (Low Ig levels from non-functional B-Cells) - Increased infections (typical cause of death)
2) Richter Transformation - Progression to DBCL - Rapidly enlarging node/spleen

23
Q

CLL Markers of Poor Prognosis (3)

Study These Flashcards
A

1) Zap70+
2) CD38 Expression
3) Deletion of 17p

24
Q

CLL Staging - 5 Stages

Study These Flashcards
A 
0 - Lymphocytosis Only
1 - Add LAD
2 - Hepatosplenomegaly 
3 - Add Anemia
4 - Add Thrombocytopenia
25
Hairy Cell Leukemia - Definition + Classic Treatment + Findings/Markers (4) + S/Sx (2)
Mature B-Cell Neoplasia Treatment - Cladribine (2-CDA) - Adenosine Deanimase Inhibitor - Anti-Metabolite Markers - TRAP+ and CD103 Findings - Dry tap from marrow fibrosis with fried egg basement membrane Histology - Hairy Processes on B-Cells S/Sx - Pancytopenia + Massive Spleenomegaly
26
Adult T-Cell Leukemia (ATLL) - Definition + Cause + Associated Lymphoma
Neoplastic Disease of CD4 T-Cells Caused by HTLV-1 Virus - Japan + Caribbean HTLV Lymphoma (High Grade T-Cell)
27
S/Sx of ATLL (5)
1) Rash 2) Generalized LAD 3) Hepatosplenomegaly 4) Lytic Bone Lesions 5) Looks a lot like Multiple Myeloma (but add rash)
28
ALK Postive T-Cell Lymphoma - Keys (2) Class Only
1) 5(2:5) NPM-ALK Fusion Protein | 2) CD30+
29
Mycosis Fongoides - Definition + S/Sx (2)
Neoplastic Proliferation of Mature CD4 T-cells Localized Skin Rash + Plaques in Nodules
30
High Grade Manifestation of Mycosis Fungoides - Definition + Decription
Sezary Syndrome Cerebriform Nuclie + Lubular Nodes of T-Cell Nuclei - Severe + High Grade
31
Plasma Cell Disorders (3)
1) Multiple Myeoloma 2) Monclonalgammopathy of Undetermined Significance (MGUS) 3) Waldenstrom Macroglobulinemia
32
Multiple Myeloma - Pathophysiology + Epidemiology + Key Mnemonic
Neoplastic disease of plasma cells in the bone marrow - Results in overproduction of several plasma cell products 1) Osteoclast Activating Factor 2) IL-6 3) Monoclonal Ig 4) Light Chain #1 Cause of Primary Bone Lesions (Metastasis still #1 overall) CRAB - hyperCalcemia + Renal Involvement + Anemia + Bone Lytic Lesions
33
Multiple Myeloma - S/Sx with Cause (6)
Osteoclast Activating Factor (RANK) 1) Bone Lytic Lesions 2) Hypercalcemia (bone destruction) Increased Ig - Monoclonal (One Type) M-Spike (Monoclonal Spike) on SPEP (With wrong Kappa/Lambda Ratio) Light Chain Primary AL Amyloidosis - Circulating Light Chain Depositis Light Chain Bence Jones Proteins - Protein in the urine that causes kidnet failure Rouleaux Formation - RBCs Stack up like coins
34
MUGS - Key Factors (2)
1) Precursor for Multiple Myeloma (1% Increase Annually) | 2) M-Spike on SPEP but no multiple myeloma symptoms
35
Waldenstrom Macroglobulinemia - Definition + Key Findings (4)
B-Cell Lymphoma with IgM Production (Big Cells) Findings 1) Generalized LAD 2) M-Spike + Increased Protein 3) Hyperviscosity - Clotting + Neurological Defects 4) Bleeding (Platelet issues)
36
BCR-Abl - Impact on Involved Disorders
1) Good Prognosis in CML | 2) Bad Prognosis in ALL
37
Key AML CD Markers (2) - Class Specific
CD13 + CD33
38
Lymphadenopathy Differential
Painful - Acute Infection | Non-Painful - Chronic Inflammation + Metastatic Carcinoma + Lymphoma
39
Cause of Inflammatory Follicular Hyperplasia (3 Regions)
Follicular (Cortex) - B-Cell - Rheumatoid + HIV Paracortex (Below) - T-Cell - Viral (EBV) Medulla - Sinus Histiocytes - Metastatic Drainage
40
Classes of Lymphoma (2) + Subclasses (6)
Hodgkins (40%) Non-Hodgkins (60%) ``` NHL Subclasses Small B-Cell - Zone Based 1) Follicular 2) Mantle 3) Marginal ``` 4) Intermediate B-Cell (Burkitt's) 5) Large - Diffuse Large B-Cell 6) T-Cell
41
Follicular B-Cell NHL - Genetics + Markers + S/Sx (3)
Genetics - t(18:14) - Bcl Over-expression Markers - CD20+ S/Sx 1) Loss of Lymph Node Architecture (paracortex invasion) 2) No Tingable Body Macrophages in Germinal Center (with macrophages = reactive follicular hyperplasia = infection) 3) Monoclonality - Ratio of Kappa/Lambda Off (Normal 3:1 -- Lymphoma = 20:1 or 1:3)
42
Follicular B-Cell NHL - First Line Therapy
Rituximab (Anti CD20 Mab)
43
Mantle Cell NHL - Genetics + Markers + Grade
Genetics - t(11:14) - Cyclin D1 Overexpression - Pushes cells from G1 to S Marker - CD20+ High Grade with painless LAD - Later Adult
44
Marginal Zone Lymphoma - Causes + MArker + Associated Disease
Causes - High Inflammation - Hashimoto's + Sjogren Syndrome + H. Pylori Marker - CD20+ Associated with GI MALToma of the mucosal mantle zone - H. Pylori
45
Burkitt Lymphmona - Genetics + Forms + Marker + Histology
Genetics - t(8:14) c-myc - EBV Association African Form = Jaw Sporadic Form = Abdominal Marker = Ki67+ (CLASS) Histology - Stary Sky = B-Cells with Tingible Body Macrophages Associated with Nasopharyngeal Carcinoma in Asian Men
46
Diffuse Large B-Cell Lymphoma (DLBCL) - Genetics + Marker + Keys (3)
Genetics - t(3:14) - Bcl6 Marker - CD20+ Keys 1) Arises from CLL and Follicular Lymphoma 2) Clinically very aggressive 3) Most common NH lymphoma
47
Hodgkin's Lymphoma - Markers + Types (5) + Classic Histology
Markers - CD15+ / CD30+ / CD20 (-) Types 1) Nodular Sclerosing 2) Mixed Cellularity 3) Lymphocyte Rich 4) Lymphocyte Depleted 5) Lyphocyte Predominant (Pop-Corn) Reed Sternberg Cells - Owl Eyes - Attract reactive lymphocytes which form the bulk of the tumor (can cause fibrosis)
48
Nodular Sclerosis HL - Classic Presentation + Classic Histology
Presentation - Young Female with Cervical or Mediastinal Mass Histology - Nodules separated by bands of fibrosis/sclerosis
49
Keys for HL Classes (Not Nodular Sclerosis)
1) Lymphocyte Rich - Best Prodnosis 2) Mixed Cellularity - IL-5 + Eosinophlia 3) Lymphocyte Depleted - Worst Prognosis + HIV + Elderly (EBV Association too) 4) Nodular Lymphocyte Predominance - Altered Popcorn RS Cells - No CD15/30 - Isolated Cervical LAD - Good Prognosis
50
Ann Arbor Lymphoma Stages (4 + 2)
1) - One Lymph Node Above Diaphragm 2) - Multiple Lymph Nodes Above the Diaphragm 3) - Multiple Nodes Above + Below Diaphragm 4) - Metastasis ``` A = Absence of Symptoms B = Presence of Symptoms (Fever/Night Sweats/Anemia) ```
51
Low Grade B-Cell Lymphomas (3)
Follicular + Marginal + MALT
52
High Grade B-Cell Lymphoma (3)
DLBCL + Burkitt + Mantle More Aggressive
53
Primary Effusion Lymphoma - Key Facts (2)
1) Pleural Space/Pericardium (Body Cavity Lymphoma) | 2) Linked to Viruses - HHV8 + HIV + EBV

Z - M2 Heme/Onc (10 decks)

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