Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Blood & Lymph > Leukemia Clinical Care 1 > Flashcards

Leukemia Clinical Care 1 Flashcards

(49 cards)

Start Studying
1
Q

Leukemias are a primary bone marrow malignancy which 2 categories _______.

A
  1. acute vs. chronic
  2. myeloid vs. lymphoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MC types of cancer

A
  1. Breast
  2. Lung

(leukemia cases a year ~ 60K)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Myeloblasts give rise to _______ which terminal cells

A

granulocytes

(all blood components come from myeloid stem cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Feather’s edge allows you to look at

A

a zone of morphology: gives you a view of different cell types

(important for dx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
A
  • A: RBC
  • B: lymphocyte (granules)
  • C & E: neutrophil (kidney beans)
  • D: Eosinophil (kidney beans w/orange granules)
  • F: monocyte (tissue MF)
  • G: plt
  • J: basophil
  • H: lymphocyte (B or T: dark nucleus w/little cytoplasm)
  • I: band cell (baby neutrophil, no segmentation yet)
  • J: basophil (dark purple granules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
A

smudge cells: fragile cells → CLL

(obtained by putting coverslip on it; CLL will also have large lymphoblasts w/little cytoplasm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MC Leukemia

A

CLL

(AML>CML>ALL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CLL affects which age group?

A

men >70 yo

(~ 9 year survival rate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CLL distinguishing sx (3)

A
  1. cytopenia: bone marrow infiltration
  2. Auto-Immune AIHA, ITP (Igs attack)
  3. anorexia

(50% asymptomatic, other sx: lymphadenopathy, hepatosplenomegaly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diagnosis of CLL, shows a lymphocytosis > _____/uL via flow cytometry.

A

5,000

(also look for CD5+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

______ is a precursor to CLL

A

MBL: monoclonal B-cell lymphocytosis (1% chance of progressing to CLL)

(CLL phenotype but ALC<5000/uL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

30% of patients with MBL have _____ (disease).

A

hepatitis C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is Small Lymphocytic Lymphoma different than CLL?

A

same; the difference is location. SLL is in the lymph nodes (>1.5cm)

(ALC<5000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lymphocytosis may be caused by other diseases. It must be categorically ______ to be considered cancer.

A

clonal

(may be viral or stress that causes the WBC to increase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Rai Staging of CLL

A
  • 0 Lymphocytosis only
  • 1: lymphadenopathy
  • 2: hepatosplenomegaly
  • 3: anemia (bone marrow involved)
  • 4: thrombocytopenia

(all have lymphocytosis. Bone marrow involved)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Binet Staging System for CLL :

A

A: <2 lymph areas enlarged

B: 3+ lymph areas + organomegaly

C: anemia or thrombocytopenia

(there is also an international workshop staging system that combines Rai and Binet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The majority of leukemia depends on their cytogenetic molecular abnormalities. Which ones are associated with poor prognosis? Good prognosis?

A

Poor:

  1. TP53 gene on 17p13.1
  2. ATM gene on 11q22.3

Good:

  1. RB1 gene on 13q14.3

(identifying these is extremely important for survival estimates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When is CLL treated (7)?

A
  1. massive lymphadenopathy
  2. massive splenomegaly
  3. constitutional: fever, weight loss, fatigue
  4. recurrent infections
  5. bone marrow failure: anemia
  6. autoimmune cytopenias
  7. rapid doubling time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Rituximab

A

anti-CD20 mAb → complement activation & phagocytosis

(type 1, the new one is Obinituzimab)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

New generation CD-20 mAb

21
Q

New generation CD-20 mAb? Why is it better than Rituximab?

Study These Flashcards
A

Obinituzumab

ADCC & direct apoptosis

22
Q

Which medications are the most effective at controlling proliferation of B cells in CLL?

Study These Flashcards
A
  1. BTK inhibitors
  2. PI3K inhibitors
23
Q

Venetoclax MOA

(treatment for CLL)

Study These Flashcards
A

BCL-2 inhibitor

(BCL-2 = anti-apoptotic protein; CA upregulates its expression)

24
Q

CLL can transform to ______ (5)

Study These Flashcards
A
  1. Richter’s: transformation to other lymphomas
  2. Prolymphocytic
  3. Hodgkin’s
  4. Acute lymphoblastic leukemia
  5. Multiple Myeloma
25
Richter Syndrome is a transformation from CLL. The main finding is diffuse large B-cell lymphoma w/ rapidly \_\_\_\_\_\_\_.
enlarging nodule in lymph node or spleen (prognosis \< 1 yr)
26
What elements of supportive care are provided to newly diagnosed CLL patients?
1. Risk stratification 2. Counseling 3. Health Screening 4. Vaccination/infection prevention
27
Hairy cell leukemia
28
Dry-tap: fibrosis (hairy cell leukemia)
29
Hairy cell leukemia ("fried egg" appearance)
30
TRAP +: acid phosphatase + cells (Hairy cell leukemia)
31
How do you identify Hairy Cell Leukemia by flow cytometry?
1. **C**D11**c** : C = the 3rd letter of the alphabet 2. CD25: 5-2 = **3** 3. CD10**3** 4. CD12**3** (mn: picture hairy cell w/3 projections)
32
Which mutation is seen in 90% of hairy cell leukemia (HCL) patients?
BRAF V600E (important to ID for medication)
33
2 types of HCL & their differences
1. classical: dry tap, BRAF V600 + 2. variant: easy marrow tap, no BRAF mutation, no response to purine analogs
34
HCL treatment options
35
What is Agent Orange?
Used in Vietnam & Korea to defoliate jungle vegetation (others were used. All predisposed Vietnam veterans to leukemia)
36
What are the presumptive diagnoses for cancers caused by Agent Orange (5)?
1. ALL 2. Chronic B-cell Leukemia 3. Hodgkin & NHL 4. Multiple Myeloma 5. Prostate, respiratory & soft tissue sarcomas
37
What are the presumptive diagnoses for dermatologic conditions caused by Agent Orange (2)?
1. Chloracne 2. Porphyria Cutanea Tarda
38
What are the presumptive diagnoses for Chronic diseases caused by Agent Orange (4)?
1. DM 2. Ischemic heart disease 3. parkinson's 4. peripheral neuropathy
39
“variety show” - multiple cells (chronic myeloid leukemia)
40
Normal bone marrow is \_\_\_\_\_\_% cells & \_\_\_\_\_% space. Erythroid:Myeloid?
* 50%/50% * 1:3
41
marrow completely replaced by cells
42
Chronic myeloid leukemia (CML) account for 15% of leukemias and mostly affects which demographic?
60 yo (M:F = 1:1)
43
BCR-ABL (philidelphia chromosome) is found in which 2 diseases?
1. CML 2. B-cell ALL
44
CML sx
1. **splenomegaly** 2. anemia, thrombocytopenia 3. increased uric acid
45
CML phases
46
Imatinib indications
CML
47
Imatinib MOA
occupies ATP binding pocket of Abl kinase → blocks signaling & proliferation
48
How is CML response to Imatinib evaluated?
% of cells in the metaphase that were Ph+
49
What is the goal of CML treatment?
Deep molecular response

Blood & Lymph (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions