Malignancy

Question 1

Which antigen is used to identify stem cells?

Answer 1

CD34

Question 2

What is malignant haemopoiesis?

Answer 2

Increased numbers of abnormal and dysfunctional cells with the loss of normal activity.

Question 3

What occurs in acute leukaemia?

Answer 3

Abnormal proliferation of primitive progenitor cells with a failure of differentiation and/or maturation.

Normal cells in the bone marrow are lost, resulting in bone marrow/blood failure.

Question 4

What occurs in chronic myeloid leukaemia?

Answer 4

Abnormal proliferation of primitive progenitor cells with NO failure in differentiation/maturation.

Question 5

Is malignant haematopoiesis referred to as polyclonal or monoclonal?

Answer 5

Monoclonal

Question 6

What is leukaemia affecting primitive B cells called?

Answer 6

Acute lymphoblastic leukaemia

Question 7

What is leukaemia affecting more mature B cells called?

Answer 7

Chronic lymphoblastic leukaemia

Question 8

What cells are affected in myeloid malignancies?

Answer 8

More primitive progenitor cells

Question 9

Cancer involving the lymph node is called what?

Answer 9

Lymphoma

Question 10

Cancer involving the bone marrow and blood is called what?

Answer 10

Leukaemia

Question 11

What is myeloma?

Answer 11

Malignancy of plasma cells within the bone marrow

Question 12

What cells appear in excess in acute leukaemia?

Answer 12

Blasts

Will make up >20% of the bone marrow/blood cells.

Question 13

What are the 2 types of acute leukaemia?

Answer 13

Acute myeloid leukaemia (AML)

Acute lymphoid leukaemia (ALL)

Question 14

What individuals commonly present with ALL?

Answer 14

Children

Question 15

How does ALL present?

Answer 15

Marrow failure (may have raised WCC)
High numbers of lymphoblasts
CNS/Testicular involvement due to blasts obstructing circulation
Bone pain

Question 16

In which individuals does AML present?

Answer 16

Elderly

Question 17

What form of AML can cause DIC?

Answer 17

Acute promyelocytic leukaemia

Question 18

What factors can indicate DIC?

Answer 18

Raised D-dimers

Low fibrinogen/clotting factors

Question 19

In acute leukaemia, raised blasts within circulation are known as what?

Answer 19

Auer rods

Question 20

What tests are used to diagnose acute leukaemia?

Answer 20

Bone marrow examination

Immunophenotyping

Question 21

What test is used to distinguish between ALL and AML?

Answer 21

Immunophenotyping

This distinguishes the lineage of the cells.

Question 22

How is acute leukaemia treated?

Answer 22

Intensive chemotherapy

Question 23

What can be used to achieve long-term venous access?

Answer 23

Hickman line

Question 24

What should be carried out in those with suspected neutropenic fever?

Answer 24

Take culture and start antibiotics which cover gram negative organisms, prior to result.

Question 25

In prolonged neutropenia , despite patient given antibiotics, what is the potential causation?

Answer 25

Fungal infection

Question 26

What infection does ALL predispose to?

Answer 26

Pneumocystis pneumonia (PJP) Consider prophylactic cover.

Question 27

What is a side-effect of anthracycline chemotherapy?

Answer 27

Cardiomyopathy

Question 28

What does the absence of leukaemic cells in the bone marrow indicate?

Answer 28

Remission

Question 29

how is disease described if no response is exhibited following treatment?

Answer 29

Referred to as being refractory.