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Luke 2 Flashcards

1
Q

What is the function of blood?

A
  • transportation
  • regulation
  • protection
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2
Q

What are the components of blood?

A
  • blood plasma

- formed elements (RBC, WBC, platelets)

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3
Q

What is Leukaemia?

A
  • neoplastic proliferation of immature white blood cells
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4
Q

What are the three types of WBC?

A
  • monocytes
  • lymphocytes (t-cell responsible for cell mediated immunity, b-cel associated with antibody production)
  • granulocytes
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5
Q

What are the three types of haematological malignancies?

A
  • leukaemia
  • mutliple myeloma
  • Polycythaemia Rubra Vera
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6
Q

What does leukaemia do to bone marrow?

A
  • take up space in the marrow so there is no room left for normal cells to grow
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7
Q

What are the four types of leukaemia?

A
  • ALL (acute lymphoblastic leukaemia)
  • AML (acute myeloid leukaemia)
  • CLL (chronic lymphocytic leukaemia)
  • CML (chronic myeloid leukaemia)
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8
Q

How many cases of Leukaemia are diagnosed in australia each year?

A
  • 4800 cases

- 40% of which are acute

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9
Q

What age groups does ALL affect?

A
  • most common in children

- rare in adults

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10
Q

What are groups does AML affect?

A
  • mainly affects adults

- can occur in children and adolescents

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11
Q

What age groups does CLL affect?

A
  • affects adults

- does not occur in children

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12
Q

What age does CML affect?

A
  • occur at any age

- but uncommon below 20

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13
Q

What is ALL?

A
  • bone marrow makes too many large immature lymphocytes (lymphocytes are not able to fight infection)
  • can cause infection, anaemia and easy bleeding
  • gets worse quickly
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14
Q

Where does ALL spread to?

A
  • central nervous system
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15
Q

What is the epidemiology of ALL?

A
  • male: female = 1:1

- affects children: 40% occur between 2-5yrs

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16
Q

What is the aetiology of ALL?

A
  • down’s syndrome
  • environmental agents (viruses)
  • radiation exposure
  • benzene
  • anti-cancer treatment (after Hodgkins diease and ovarian treatment)
  • smoking
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17
Q

What are the signs and symptoms of ALL?

A
  • peripheral lymphadenopathy
  • splenomegaly
  • liver palpable
  • bone marrow failure
  • bruising/bleeding due to thrombocyopenia
  • petechiae
  • fever
  • shortness of breath
  • loss of appetite or weight loss
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18
Q

What are the clinical features of ALL in child?

A
  • anaemia
  • thrombocyopenia
  • infection
  • bone pain
  • malaise
  • oral and pharyngeal ulceration
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19
Q

What are the adverse prognostic features in child ALL?

A
  • Adverse cytogenetic markers
  • CNS disease at presentation
  • Early marrow relapse
  • Testicular relapse
  • T-cell phenotype
  • Philadelphia chromosome present
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20
Q

What is the staging for ALL?

A
  • not formal staging
  • total WCC more then 20,000 poorer prognosis
  • age
  • metastases to brain or spinal cors
  • Philadelphia chromosome
  • cancer recurrence
21
Q

What is the prognosis for ALL?

A
  • child = 70%

- adult = 35%

22
Q

What characterises AML?

A
  • overproduction of immature WBC (myeloblasts)

- dividing cells fill up bone marrow preventing it from making healthy blood

23
Q

What is the epidemiology of AML?

A
  • rare (0.8% of tumours)
  • 2000 adults, 50 children per year
  • men slighly higher
  • common age is 60
  • rare under 20
24
Q

What is the aetiology of AML?

A
  • damage to one of more genes that control blood development
  • ionising radiation
  • blood disorder (myelodysplastic syndrome)
  • downs syndrome
25
What are the signs and symptoms of AML?
- anaemia - low platelet count (bruising) - low WCC (persistent infection) - feeling unwell or run donw - aching joints and bones - unusual bleeding (reduced platelets) - weight loss - bone pain
26
What is the AML staging?
- french-american-british (FAB) classification system
27
What is the AML prognosis?
- 40% of all patients cured - 50% by successful transplantation - poor prognosis if WCC > 100 x 10
28
What characterised CML?
- excess granulocytes - progress slowly in chronic phase (4-6 yrs) then rapid (3-9 months) - only cure is stem cell transplant
29
What is the epidemiology of CML?
- 249 per year diagnosed - age over 50 - slightly higher in males
30
What is the aetiology of CML?
- not really known - 90% have philadelphia chromosome - ionising radiation
31
What are the signs are symptoms are CML?
- Massive splenomegaly - Tiredness & pale skin due to anaemia - bleeding or bruising - Petechiae - Women may find their periods become very much heavier - Generalised itching - Hepatomegaly (abdominal distension) - Lymphadenopathy - Thrombocytopenia (due to bone marrow failure) - Bone pain - Fevers - Weight loss - Very high white cell count
32
What are the three phases of CML?
- chronic phase (stable) - accelerated phase - blast phase
33
What are the three stages of CML?
- relapsed chronic myeloid leukaemia - complete remission (blood and bone marrow are normal) - molecular remission (not more philadelphia chromosome)
34
What characterises CLL?
- similar to non hodgkins lymphoma - results from acquired injury to DNA of single cell in bone marrow - leukaemic cells dont impede blood production as much as ALL
35
What is the epidemiology of CLL?
- 718/year diagnosed - age over 60 - more in men - uncommon under 40
36
What is the aetiology of CLL?
- no known factors - damaged to one or more genes that control cell development - family history
37
What are the signs and symptoms or CLL?
- Peripheral lymphadenopathy - Splenomegaly - Hepatomegaly - Anaemia - Tiredness - Shortness of breath - Recurrent infections of skin, lungs, kidneys & other areas - Fever - Sweats - Weight loss
38
What is hairy cell leukaemia?
- overproduction of B lymphocyte (WBC) | - abnormal WBC build up in spleen causing splenomegaly
39
What is the aetiology of hairy cell leukaemia?
- 100 cases/year - age 40-60 - men: women = 5:1 - develops slowly - cause unknown
40
What are the signs and symptoms of hairy cell leukaemia?
- Tiredness, Weakness, lethargy - Weight loss - Infections - Breathlessness - Anaemia - Frequent infections - Enlarged spleen (abdominal discomfort)
41
What characterises mutliple myeloma?
- cancer of the plasma cell - continued synthesis and release of immunoglobulins - Neoplastic proliferation of a clone of B-lymphocytes results in large numbers of immature plasma cells that infiltrate the bone marrow
42
What is the epidemiology of multiple myeloma?
- uncommon under 50 - males: females = 2:1 - twice as frequent in African Americans as in white - first degree relative - BRCA 1 and 2
43
What is the aetiology of multiple myeloma?
- radiation exposure
44
What are the signs and symptoms of mutliple myeloma?
- acute back pain - weakness/fatigue - anorexia - reccurent bacterial infections - bone lesions tenderness - anaemia - hypercalcaemia
45
What is the clinical management of multiple myeloma?
- not curable but can relieve symptoms - chemo (oral melphalan) - palliative RT
46
What characterises Polycythaemia Rubra Vera?
- uncommon bone marrow disease | - proliferation of RBC (myeloproliferation) is not regulated by erythropoietin
47
What is the aetiology of Polycythaemia Rubra Vera?
- age 50-65
48
What are the clinical features of Polycythaemia Rubra Vera?
- Increased peripheral cell volume - Headaches/ Dizziness - Tinnitus (rinning in your ears) - Tiredness - Visual disturbances - Cyanosis (blue around the lips) - Pruritus on exposure to heat/cold - Palpable spleen (75%) - Hepatomegaly (30%) - Haemorrhage - Venous thrombo-embolism

Pete 3 (11 decks)

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