Leukaemia

Question 1

Most common type in children ?

Answer 1

ALL

L=LITTLE

Question 2

Most common acute type in older people?

Answer 2

AML

M= MATURE

Question 3

why do you get bone pain?

Answer 3

bone marrow infiltration

Question 4

They usually present with bone marrow failure. What 3 things do you get?

Answer 4

anaemia, neutropaenia, thrombocytopenia

basically a pancytopaenia

Question 5

what clinical signs do they get?

Answer 5

pallor, fever, petechaie

anaemia, netropaenia, thrombocytopenia

Question 6

what type of cells are normally always seen on blood film?

Answer 6

blasts (abnormal cells)

Question 7

what is classically seen in AML?

Answer 7

auer rods

Question 8

in which acute leukaemia are there more likely to be blasts?

Answer 8

ALL

Question 9

how is the lineage of the tumour confirmed?

Answer 9

flow cytometry immunophenotyping

Question 10

what are the two lineages

Answer 10

myeloid and lymphoid

Question 11

what is the blood count like ?

Answer 11

pancytopaenia with variable white cell count

Question 12

pancytopaenia?

Answer 12

reduction of cells of all lineages

Question 13

symptoms of pancytopenia?

Answer 13

pANcyTopaenia
Anaemia (pallor, SOB)
Neutropaenia (fever)
Thrombocytopaenia (purpura, petechaie)

Question 14

Bone and joint pain, hepatosplenomegaly and organ infiltration more common in ? less common in ?

Answer 14

more in ALL

less in AML

Question 15

In terms of treatment, which one can take a few years and which one is more intense?

Answer 15

ALL a few years, AML more intense

Question 16

what is the prognosis like in ALL for kids?

Answer 16

very good, complete remission in almost all patients

Question 17

CML, what age group? (makelele)

Answer 17

adults

Question 18

CML characterised by the presence of?

Answer 18

philidephia chromosome

Question 19

what is the first line tx of CML?

Answer 19

imatinib

Question 20

CLL - who get this?

Answer 20

old >60

Question 21

in CLL, you get an accumulation of ?

Answer 21

incompetent B cells

Question 22

how do we identify normal cells?

Answer 22

immunophenotyping

Question 23

malignant haematopoesis is characterised by?

Answer 23

increased numbers of abnormal and dysfunctional cells

Question 24

CLL, what happens to B cells?

Answer 24

proliferation

Question 25

what is myeloma?

Answer 25

plasma cell malignancy in bone marrow

Question 26

why do you get bone pain in myeloma?

Answer 26

bone marrow infiltration

Question 27

acute leukaemia is defined as excess of ?

Answer 27

blasts (>20% )

Question 28

presentation of ALL?

Answer 28

ANT | anaemia, infections, bleeding

Question 29

which leukaemia do you get gum infiltration ?

Answer 29

AML

Question 30

investigations for leukaemia?

Answer 30

blood count and film coag screen bone marrow aspirate

Question 31

cells in AML and ALL are very similar, what is needed for definitive diagnosis?

Answer 31

immunophenotyping

Question 32

why is the diagnosis of AML and ALL important?

Answer 32

they have different treatment

Question 33

bone marrow suppression causes neutropenia. what sort of infections are patients prone to?

Answer 33

gram negative

Question 34

what antibiotic is staph aureus treated with?

Answer 34

flucloxaclillin

Question 35

which haemophilia is also known as chritmas tree disease? how is it treated?

Answer 35

haemophilia B shortage of factor 9 treated with factor 9 precipitate

Question 36

what is pancytopaenia?

Answer 36

all cells down. deficiency of cells from all lineages

Question 37

platelets are produced from ?

Answer 37

megakaryocytes

Question 38

which syndrome has propensity for evolution to AML?

Answer 38

myodysplastic syndrome

Question 39

what is the white cell count like in acute leuk?

Answer 39

variable

Question 40

why does acute leukaemia cause pancyto?

Answer 40

proliferation of abnormal cells prevents normal haematopoetic stem cell development

Question 41

why does hypersplenism cause pan?

Answer 41

increased splenic pool

Question 42

causes of hypersplenism?

Answer 42

``` portal hypertension (cirrhosis) rheumatoid arthritis (feltys) splenic lymphoma ```

Question 43

bloods in pancytopaenia?

Answer 43

pANcyTopaenia Anaemia Neeutropaenia Thrombocytopania

Question 44

symptoms in pancytopaena?

Answer 44

SOB, pallor, infections, bruising and petechaie

Question 45

treatment of idiopathic aplastic anaemia?

Answer 45

immunosuppressoin

Question 46

which virus can cause bone marrow suppression?

Answer 46

HIV

Question 47

antibodies are made of which kind of chains?

Answer 47

2 heavy chains and 2 light chains

Question 48

myeloma is a malignancy of?

Answer 48

plasma cells in the marrow

Question 49

where are B cells produced?

Answer 49

bone marrow

Question 50

description of plasma cell nucleus?

Answer 50

clock face nucleus

Question 51

where are plasma cells found?

Answer 51

lymph and plasma

Question 52

what are plasma cells laden with? what do they pump out?

Answer 52

antibodies

Question 53

which proteins are a marker of underlying monoclonal b cell disorder>

Answer 53

paraproteins

Question 54

how do you detect immunoglobulins?

Answer 54

serum electrophoresis

Question 55

which protein detected on urine electrophoresis?

Answer 55

bence jones protein

Question 56

free light chain production by normal plasma cells is 0.5g/day excess can leak into the urine as?

Answer 56

bence jones protein

Question 57

direct tumour effects of myeloma?

Answer 57

bone lesions increased calcium bone pain marrow failure

Question 58

calcium in myeolma?

Answer 58

hypercalcamia

Question 59

what lesions can you get in the spine?

Answer 59

oestolytic lesions

Question 60

what do you use to monitor response to treatment

Answer 60

paraproteins

Question 61

which type of cells are seen in CLL blood film?

Answer 61

smudge cells

Question 62

why does hypercalcaemia in multiple myeloma result in pathological fractures and osteoporosis?

Answer 62

calcium out of bones

Question 63

important differential for poorly patient with herediatary spherocytosis?

Answer 63

splenic rupture

Question 64

in hereditary spherocytosis, what shape are the RBCs?

Answer 64

ball shaped

Question 65

where are spherocytes destroyed?

Answer 65

spleen. red blood cell survival is reduced

Question 66

which is more common, von willebrands or haemophilia?

Answer 66

von Willebrands