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Year 4 Longterm Conditions > Leukaemia > Flashcards

Leukaemia Flashcards

1
Q

Leukaemia

A

cancer of a particular line of stem cells in the bone marrow

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2
Q

4 types

A

AML
CML
ALL
AML

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3
Q

pancytopenia

A

low platelets
low RBC
low WBC

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4
Q

most common leukaemia in children under 5

A

ALL

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5
Q

typical features

A 
fatigue
fever
failure to thrive
pallor 
petechiae/abnormal bruising
LN
hepatosplenomegaly
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6
Q

petchiae differentials

A 
leukaemia
meningococcal septicaemia
vasculitis 
NAI
ITP
HSP
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7
Q

diagnosis

A 
FBC
blood film 
lactate dehydrogenase
bone marrow biopsy
LN biopsy 
CXR, lumbar puncture, CT/MRI/PET
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8
Q

blood film

A

abnormal cells and inclusions

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9
Q

definitive diagnosis

A

bone marrow biopsy

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10
Q

bone marrow aspirate

A

liquid sample full of cells from bone marrow

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11
Q

bone marrow trephine

A

solid core sample of bone marrow and better assessment of cells and structure

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12
Q

where is bone marrow biopsy usually taken from?

A

iliac crest

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13
Q

what happens in ALL?

A

malignant change in lymphocyte precursor cells

acute proliferation of (usually) B lymphocytes

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14
Q

why is there pancytopenia in ALL?

A

B lymphocytes take over bone marrow and replace other cells

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15
Q

what is ALL often associated with?

A

downs syndrome

ionising radiation in pregnancy

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16
Q

ALL blood film

A

blast cells

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17
Q

ALL genetic association

A

philadelphia chromosome 30% adults but only 5% children

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18
Q

who is usually affected by CLL?

A

adults over 55

19
Q

CLL symptoms

A

often asymptomatic

infections, anaemia, bleeding and weight loss

20
Q

what can CLL cause?

A

warm autoimmune haemolytic anaemia

21
Q

what can CLL transform into?

A

high grade lymphoma

richter’s transformation

22
Q

blood film CLL

A

smear or smudge cells

23
Q

3 phases of CML

A

chronic phase
accelerated phase
blast phase - crisis

24
Q

how are those with CML often diagnosed?

A

asymptomatic raised WCC

25
Q

characteristic cytogenic change CML

A

philadelphia chromosome

26
Q

philadelphia chromosome

A

chr 9 and 22 translocation

CML

27
Q

treating CML - what drug has revolutionalised treatment?

A

imatinib

BCR-ABL tyrosine kinase inhibitor

28
Q

most common acute leukaemia in adults

A

ALL

29
Q

what can ALL progress from?

A

myeloproliferative disorder
polycythaemia ruby vera
myelofibrosis

30
Q

blood film AML

A

blast cells

auer rods in cytoplasm

31
Q

how long is asymptomatic phase of CML?

A

5 years

32
Q

complications of chemotherapy

A 
failure 
stunted growth in children 
infections
infertility 
tumour lysis syndrome
neuro/cardiotoxicity
33
Q

what causes tumour lysis syndrome?

A

release of uric acid from cells destroyed by chemo

34
Q

impact of uric acid in TLS

A

crystals in interstitial tissue and tubules in kidney - AKI

35
Q

treating tumour lysis syndrome

A

allopurinol or rasburicase
potassium and phosphate monitoring
calcium monitoring

36
Q

Is CNS involvement common in ALL?

A

yes

37
Q

3 classifications of ALL

A

morphological - FAB
cytogenic - philadelphia
immunological

38
Q

ALL treatment

A

remission
consolidation
CNS prophylaxis
maintenance

39
Q

ALL cure rate children

A

70-90%

40
Q

only cure for CML

A

stem cell transplant -HLA matched

41
Q

treating CLL

A

fludarabine
rituximab
cyclophosphamide

42
Q

staging for CLL

A

binet staging

rai stage

43
Q

binet staging

A 
A = fewer 3 LN
B = >3 LN
C = anaemia and low platelets

Year 4 Longterm Conditions (32 decks)

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