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PLE Review > Patho-Hema > Flashcards

Patho-Hema Flashcards

(46 cards)

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1
Q

Marker for B cells

A

CD20

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2
Q

LYMPH NODE

Location of mostly B cells

Location of mostly T cells

A

Cortex
>Lymphoid follicles (primary and secondary) - B cells
>Paracortex - T cells

Media
>Sinuses

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3
Q

Location of naive B cells

Area of B cell activation

A

Mantle zone
Secondary follicle

Germinal center

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4
Q

Hematologic abnormality in Leukemia

Types of Leukemia

A

Anemia, Thrombocytopenia, Leukopenia

ALL, AML, ApML
CLL/SLL, CML

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5
Q

Differentiate acute from chronic leukemia in terms of

  1. Age
  2. Morphology of cells
  3. Clinical course
  4. Response to treatment
A

Acute
-young, primitive, aggressive, responsive

Chronic
-old, mature, indolent, resistant

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6
Q

Hypercellular marrow with lymphoblasts

Differentiate types in:
age
clinical presentation
mutation

A

B cell ALL

  • children, bone marrow failure
  • t(12;21), t(9;22)

T cell ALL

  • adolescent, thymus mass
  • NOTCH-1
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7
Q

> 20% myeloblast in BM
Aleukemic leukemia

Age
Presentation
Prognosis

A

AML

Adults
Bone marrow failure
Poor

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8
Q

Cells with Needle-like azurophilic granules

Associated with DIC

Dx:
Mutation:
Tx:

A

Acute Promyelocytic Leukemia

With faggot cells containing auer rods

Mutation in t(15;17)

Curanle with all-trans retinoic acid

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9
Q

Hepatosplenomegaly
Lymohadenopathy
Hypogammaglobulinemka

Lymph node has lymphocytes with proliferation centers

Peripheral blood smear shows SMUDGE CELLS

A

CLL >5000 lymphocytes, leakage

SLL <5000, distinct tissue mass

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10
Q

Blasts <10% in peripheral blood
WBC >100000
Thrombocytosis

Accelerated phase: unresponsive to therapy, increasing splenomegaly

Blast crisis: >20%, chloroma

Mutation?
Tx?

A

CML

t(9;22) Philadelphia gene
With tyrosinase activity

Tx: tyrosine kinase activity inhibitor (Imatinib)

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11
Q

Differentiate leukemoid reaction from leukemia

A

Leukocyte alkaline phosphatase:
Inc. in leukemoid (reactive AP)
Dec. In CML

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12
Q

Differentiate hodgkin from nonhodgkins lymphoma

A

HL- single axial nodes (cervical, mediastinal, para aortic)

NHL- multiple, peripheral

  • extranodal presentation
  • mesenteric ring and waldeyer ring involvement
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13
Q

Large, multiple nuclei or single with multiple lobes, each with owl-eye nucleolus

A

Reed-Sternberg cells in Hodgkins lymphoma

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14
Q

HL type with reactive B cells? Marker

HL types associated with EBV?

Most common HL type?

HL associated with HIV?

Tx of HL

A

Lymphocyte predominant, CD20

Lymphocyte depleted, Mixed cellularity

Nodular sclerosis

Lymphocyte depleted

Radiotherapy
Anti CD30

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15
Q

Types of NHL
B cell lymphomas
T and NK cell lymphomas

Most common form of NHL

Most common lymphoma in adults

Most common indolent lymphoma in adults

Fastest growing human tumor

A

DLBCL

DLBCL

Follicular lymphoma

Burkitt lymphoma

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16
Q

Middle age
Painless, generalized lymphadenopathy

Lymph node shows nodular or diffuse aggregate of lymphoma cells and BMA shows paratrabechular lymphoid aggregates

A

FOLLICULAR LYMPHOMA
B cell lymphoma

Indolent, incurable
May transform to DLBCL or Burkitt

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17
Q

Present in male, 60yo
Rapidly enlarging nodular mass

Diffuse pattern of growth of large cells with highly anaplastic appearance

Fatal without treatment

A

DIFFUSE LARGE B CELL LYMPHOMA
B cell lymphoma

CD45 (lymphoid), CK (epithelial), Vimentin (mesenchymal)

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18
Q

Diffuse infiltration if medium sized anaplastic lymphocytes, punctuated sith macrophages ghah phagocytose apoptotic lymphocytes

A

BURKITT LYMPHOMA
B cell lymphoma

Starry Sky pattern

Endemic: mandibular, kidney, adrenal, gonads; latent infection with EBV
Sporadic: ileoceum, peritoneal

MYC t(8;14)
Aggressive, responsive to chemo
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19
Q

Arises in tissues on chronic inflammation like Sjogren syndrome, Hashimoto thyroiditis, H. pylori gastritis

Study These Flashcards
A

MARGINAL ZONE LYMPHOMA

Memory B cell origin

20
Q

Infiltration of epidermis and upper dermis T cells with cerebriform nuclei

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A

MYCOSIS FUNGOIDES
CUTANEOUS T CELL LYMPHOMA

Sezary cells
CD4 helper t cells in skin

21
Q

65yo
With multiple lytic punched out bone lesions, fracture, renal failure

Lymphocytes, plasma cells and plasma ytoid lymphocytes with mast cell hyperplasia

PAS+ cytoplasmic and nuclear inclusions containing Ig

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A

MULTIPLE MYELOMA
Most important plasma cell neoplasm

Russell bodies
Dutcher bodies

Hypercalcemia > fracture, lytic bone lesions
Dec Ig > recurrent bacterial infections
Bence Jones Proteinuria > renal failure

22
Q

Ringed sideroblasts

Prusian blue

Iron laden mitochondria in erythroblasts

Nuclear budding abnormalities

Study These Flashcards
A

ERYTHROID

Myelodysplastic Syndrome

23
Q

Pseudo-Pelget Huet cells

-PMNs with 2 lobes

Study These Flashcards
A

GRANULOCYTIC

Myelodysplastic syndrome

24
Q

Pawn ball

-megakaryocytes

Study These Flashcards
A

MEGAKARYOCYTIC

Myelodysplastic syndrome

25
Increase in all cell lines, more erythroid lines Erythromelalgia - throbbing and burning of hands and feet due to thrombotic occlusoon Hyperuricemia Thrombosis Infarcts Dx? Tx?
POLYCYTHEMIA VERA Phlebotomy JAK2 mutation
26
Increase in megakaryocytic lines Giant platelets in peripheral blood Thrombosis Erythromelalgia Hemorrhage
ESSENTIAL THROMBOCYTOSIS | chemotherapy
27
Extensive deposition of collagen in marrow by non neoplastic fibroblasts Pronounced hepatosplenomegaly Hyperuricemia Increased WBC and platelets Dacrocytes
PRIMARY MYELOFIBROSIS Hematopoietic stem cell transplant
28
Langerhab cells | Birbeck granules
HISTIOCYTOSIS
29
Thymic hypoplasia
DiGeorge Syndrome
30
Thymic hyperplasia
Myasthenia gravis
31
Autosomal dominant Defects in spectrin, ankyrin, band 3 and band 4.2 Spherical cells without central pallir Dx? Type and Site of hemolysis Diagnostic? Tx?
HEREDITARY SPHEROCYTOSIS Intrinsic, Extravascular Osmotic fragility testing Splenectomy
32
X linked recessive Dec NADPH Heinz bodies Bite cells Dx? Type and Site of hemolysis Diagnostic? Tx?
G6PD DEFICIENCY Intrinsic, Both Newborn screening Aversion to triggers
33
Autosomal recessive 6th glu to val mutation Howell jolly bodies Dx? Type and Site of hemolysis Diagnostic? Tx?
SICKLE CELL ANEMIA intrinsic, extravascular Hgb electrophoresis Hydroxyurea
34
Alpha thalassemia No. Of genes affected: 4, 3, 2, 1 Beta thalassemia
Alpha - presents at birth - hydrops fetalis, HbH, a thalassemi trait, silent carrier Beta - 5-6mos - major: HbF, minor: HbA a2d2 Intrinsic, extravascular
35
Nocturnal hemoglobinuria Thrombosis PIGA mutations (CD55, CD59, C8) Dx? Type and Site of hemolysis Diagnostic? Tx?
PAROXYSMAL NOCTURNAL HEMOGLOBINURIA Extrinsic, Extravascular Flow cytometry Hematopoietic stem cell transplant Ecalizumab
36
Macroangiopathic hemolytic anemia: cardiac valve prosthesis Microangioathic hemolytic anemia: DIC, TTP HUS, SLE
Extrinsic, intravascular
37
``` Vit B12 deficiency Gastrectomy Ileal resection Methotrexate VitB9 deficiency ```
Megaloblastic anemia
38
Most common nutritional disorder Microcytic hypochromic Prussian blue
IDA Decreased ferritin Dec serum fe/tibc
39
Most common cause of anemia in hospitalized patients IL6 > Hepcidin > dec iron transfer > storage pool to bone marrow Decreased transferrin Inc ferritin
ACD
40
Pancytopenia Most common cause: DRUGS Hypocellular bone marrow Dry tap
APLASTIC ANEMIA
41
Suppression of erythroid elements in bone marrow Autoimmune Parvovirus B19 Absent erythroblast in bone marrow but still with platelets and granulocytes
PURE RED CELL APLASIA
42
Antibodies against gpIIb-IIIa and gbIb-IX IgG Increased megakaryocytes Congestion, follicular hyperplasia of spleen
ITP -dec PC, inc BT Acute - postviral - self limited Chronic - sle, hiv, cll - glucocorticoid - anti cd20 (Rituximab)
43
HUS triad -normal PC TTP pentad -dec PC, inc Bt
HUS 1. Microangiopathic hemolytic anemia 2. Thrombocytopenia 3. Renal failure TTP + 4. Fever 5. Neurologic manifestations
44
GpIb-IX deficiency Platelet adhesion problem GpIIb-IIIa deficiency Platelet aggregation problem
Bernard Soulier Disease dec platelet, inc BT Glanzmann thrombasthenia Inc BT
45
Most common inherited bleeding disorder Autosomal dominant Inc BT, inc PTT
Von Willebrand Dse Desmopressjn Factor VIII and vWF replacement
46
Most common hereditary syndrome associated with life threatening bleeding X linked recessive FVIII and FIX , FXI deficiency (A,B,C)
HEMOPHILIA inc PTT Factor replacement

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