leukemia, bleeding d/o, lymphom Flashcards by Mai Wells

elevated protein and calcicum

multiple myeloma

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leukemia in children. and age of occurence

acute lymphocytic leukemia. age between 3-7

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adult leukemia and age of occurence

Acute myelogenous leukemia. 60s

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gingival bleeding, epistaxis, and menorrhagia presenting symptom of what

acute leukemia

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cellulitis, pneumonia, peri-rectal infection are what infections

from neutropenia. seen in acute leukemia

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lymphadenopathy and hepatosplenomegaly are common in AML or ALL

ALL

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fatigue, abrupt fever, lethargy, joint pain(especially in sternum, tibia, and femur)

think acute leukemia in kids and young adults

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slow progressive onset with lethargy, anorexia, and dyspnea

think acute leukemia in adults

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hallmark is pancytopenia with circulating blasts

bone marrow bx shows what

acute leukemia

20% blasts

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auer rods, hyperuricemia, high WBC

acute leukemia

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what confirms the dx in acute leukemia

bone marrow bx

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xray of ALL

mediastinal mass

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terminal deoxynucleotidyl transferase

ALL

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philadelphia chromosome

unfavorable in ALL, also seen in CML

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tx of acute leukemia

induction chemo then consolidation chemo. give allopurinol and diuretics to prevent uric acid stones

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most prevalent leukemia

CLL

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CLL gender, age

twice as common in men. median age is 65

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what is CLL

clonal malignancy of B lymphocytes

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rai system

pronostic staging in leukemia

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CML age

young adults to middle aged adults. median age is 55

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3 phases of CML

chronic, accelerated, and acute

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fatigue, anorexia, wt loss, low fever, and excessive sweating, abdominal fullness(from splenomegaly)

CML

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rare sx: blurred vision, respiratory distress, and priaprism

CML

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which leukemia develops gradually: it runs a mild course until the blast crisis phase, which indicates accelerated disease and short survival

CML

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hallmark of CLL

isolated lymphocytosis, with a leukocytosis of greated then 20,000 cells/mL

hallmark of CML

leukocytosis, median WBC count of 150,000.

smear shows anemia and thromobocytosis

CML

smear shows increased mature small lymphocytes; and \*\*smudge cells

CLL

bone marrow is hypercellular with a left shift

chronic leukemia

BCR-ABL

CML ALL

ST1571(imatinib mesylate)

tx for CML during chronic phase

CML tx

allogenic bone marrow transplant

CLL tx

palliative

reed sternberg cells

hodgkins

staging of hodgkins

CT of neck, chest, abdomen, and pelvis. and bone marrow bx

bad lymphoma

non hodgkins

prognostic marker in non hodgkins

serum LDH

hallmark of myeloma

monoclonal spike on serum protein electrophoresis

abrupt appearance of petchiae, purpura, and hemorrhagic bullae on skin and mucous membranes

acute ITP

smear shows megathrombocytes

ITP

platelet count in acute and chronic ITP

acute: 10000 to 20000, eosinophilia, and mild lymphocytosis; chronic shows 25000-75000

what to avoid in ITP

aspirin!

tx of ITP

resolves spontaneously. do high dose prednisone in chronic one

acute ITP occurs in who and when

kids, after a URI

chronic ITP occurs in who

any age(peak at 20-50), women common. coexists with other autoimmune diseases

name 3 platelet consumption syndromes

TTP, hemolytic uremia syndrome, and DIC

severe thrombocytopenia with purpura, petechiae, pallor, abdominal pain, fever, abnormal neurologic signs, renal failure, maybe pancreatitis

TTP

severe thrombocytopenia with more renal problems

HUS

anemia, red cell fragmentation, nml leukocytes, polychromatophilia, reticulocytosis, and thrombocytopenia, Coombs test neg, ADAMTS 13 low, LDH high, indirect bilirubin increases

TTP and HUS

TTP tx

emergency large volume plasmapheresis

HUS tx

fluids and management of electrolyte imbalance important. adults treated with plasmapheresis

what is von willebrand disease

autosomal dominant congenital bleeding d/o. reduced levels of factor VIII antigen or ristocetin cofactor

sx in von willebrand d/s

bleeding in nasal, sinus, vaginal, GI mucous membranes. spontaneous hemarthrosis and soft tissue bleeds

labs in von willebrand

PT and PTT nml. vWF is low. Bleeding time prolonged

tx of von willebrand

demopressin acetate; factor VIII concentrates

x linked recessive d/o and occurs in 1/7500 male births.

hemophilia A. possible seropositive for HIV

labs in hemophilia

nml PT, bleeding time, platelets nml. aPTT prolonged. reduced factor VIII, nml vWF.

what is hemophilia B

factor IX or christmas disease. think of jews and males

neutrophils-segs think of what

bacterial infection

neutrophils-bands

acute infection!

lymphocytes

viral

direct bilirubin

conjugated in liver

indirect bilirubin

pre-liver. think hemolysis (high LDH)

what is erythropoietin

made by kidney as a signal to bone marrow to make more RBC

bleeding tests to order for intrinsic clotting disorder

aPPT

bleeding tests to order for an extrinsic clotting disorder

PT and factor VII

abnormal bleeding from mucous membranes such as mouth, nose, or vagina

VWD(platelet defects)

how do purpuric lesions occur

caused by vascular wall defects

tests to order if you are wondering if clotting is going onis

D-dimer, fibrin split products, peripheral smear showing shistocytes(helmet cells)

hemophilia tx

recombinant factor replacement

what reverses heparin

protamine

gingival bleeding, epistaxis, and menorrhagia presenting symptom of what why

thrombocytosis, think acute leukemia replacement of bone marrow with abnormal WBCs

fevers in what 3 diseases

TTP, HUS, acute leukemia

neutropenia prediposes to what kind of infections

gram neg bacteria or fungi

isolated lymphocytosis, leukocytosis \>20,000 leukocytosis of median of 150,000

CLL CML

smear shows anemia and thrombocytosis mature small lymphocytes, smudge cells

CML CLL

what virus is an important factor in Hodgkins

EPV 40-50% of cases

what lymphnodes affected with hodgkins what can affect node after ingestion

cervical, supraclavicular, mediastinal alcohol

ages of hodgkins and non hodgkins

hodgkins is 15-45, peakin 20s, again after 50; rare in kids under 5 non hodgkins is 20-40 y/o

what % has constitutional symptoms in hodgkins what about non hodgkin

33%, poor prognosis less likely with non hodgkin but occur in intermediate and high grade disease non hodgkin

bone marrow involvement in which lymphoma

non hodgkins

tx of non hodgkin

indolent, treat one or 2 involved nodes with radiation intermediate and high grade treat with chemo, immunotherapy, and stem cell transplant

rouleax fomation of RBC

stack like coins, multiple myeloma

bence jones protein

urine test, multiple myeloma

most common clotting factors vWD factor vit K required for what factors

most common clotting factors is 8 and 9 vWD factor is 8 vit K required for what factors (1,2,7,9,10)

clotting factors for vWD hemophillia A hemophillia B

vWD is factor 8 hemophillia A (factor 8) hemophillia B (factor 9)

shigella, salmonella, e coli

can cause HUS

treat what with emergent plasma exchange

TTP and HUS

tx for uremia

dialysis

common cause of menorrhagia what lab is prolonged

vWD aPTT due to low factor 8

leukemia, bleeding d/o, lymphom Flashcards

(90 cards)