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Haematology Week 3 2018/19 > Peer tutoring for Haem cancers > Flashcards

Flashcards in Peer tutoring for Haem cancers Deck (43)
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1

What causes the difference in presentation between acute and chronic leukaemias?

Acute - total block of proliferation, so you only get progenitor cells which can't function --> pancytopaenia

Chronic - some proliferation preserved so you still get functioning cells

2

Which form of leukaemia is more commonly seen in children?

Lymphoblastic

3

Which form of leukaemia is more commonly seen in the elderly?

Myeloid

4

Which forms of leukaemia are more common in

a) elderly

b) paediatric

patients?

a) Myeloid

b) Lymphoblastic

5

What do blast cells look like on a blood film?

Large in diameter

High nuclear:cytoplasmic ratio

6

What is the most common childhood cancer?

Acute lymphoblastic leukaemia (ALL)

7

What is the presentation of pancytopaenia?

Anaemia

Recurrent infection

Abnormal bleeding

8

What is the presentation of acute lymphoblastic leukaemia?

Typically a child with acute onset anaemia, infection and abnormal bleeding

Examination reveals hepato/splenomegaly

Blood film shows lymphoblasts

FBC shows raised white cell count

9

How is the

a) anaemia

b) increased infection risk

c) abnormal bleeding

of pancytopaenia managed?

a) Blood transfusion

b) Prophylactic antibiotics

c) Platelet transfusion

10

Which combination of chemotherapy and immunosuppression is used to treat ALL?

Vincristine

Prednisolone

wipes out the immune system, start from scratch

11

What is the typical presentation of CLL?

Asymptomatic

Examination: non-tender lymphadenopathy, hepato/splenomegaly

Blood film: lymphocytosis, smear cells

12

Smear cells are a blood film finding of which malignancy?

Chronic lymphoblastic leukaemia (CLL)

13

What is a blood film finding specific to CLL?

Smear cells

14

How is CLL treated?

Chemotherapy + radiotherapy

IV Ig injections

15

What is a mnemonic for remembering the symptoms of multiple myeloma?

CRAB

Hypercalcaemia

Renal impairment

Anaemia

Bacterial infection / Back pain

16

Where do myeloma patients often feel pain?

Back pain

17

Why do patients with multiple myeloma develop hypercalcaemia?

Which organs does a raised serum calcium damage?

Bony involvement (inflammation causes osteoclast activation, raises serum calcium)

Kidneys (renal impairment, plus the paraproteins cause damage too)

18

What is a blood film finding of multiple myeloma?

Rouleaux formation

i.e a "stack of coins" appearance, with RBCs overlapping

19

What is found in the urine of patients with multiple myeloma?

Bence Jones proteins

Paraproteins secreted by the malignant plasma cells

20

Describe the CRAB presentation of multiple myeloma.

Hypercalcaemia

Renal impairment

Anaemia

Bacterial infection

21

Which demographic of patients tends to develop multiple myeloma?

What does this mean for management?

Elderly

Intensive treatment isn't likely to be in the patient's best interest

22

What is the management of multiple myeloma in patients unfit for chemotherapy?

Analgesia

Bisphosphonates

23

What is the management of multiple myeloma in younger, fitter patients?

VAD

Vincristine

Adriamycin

Dexamethasone

> Immune reset

24

Which malignancy causes acute onset pancytopaenia, typically in older patients?

Acute myeloid leukaemia (AML)

25

What is the presentation of AML?

Older patient who is anaemic, bleeding abnormally and recurrently infected

Examination reveals hepato/splenomegaly

Blood film / biopsy shows myeloblasts and Auer rods

26

What are blood film findings specific to AML?

Myeloblasts

Auer rods

27

AML typically affects older patients, who are subsequently treated with replacement and chemotherapy.

How can it be treated in young patients?

Bone marrow transplant

28

Chemotherapy can lead to which inflammatory arthropathy?

Why?

Gout

Uric acid released when cells are killed off by chemotherapy

29

CML, like the other leukaemias, causes a ___ on FBC.

pancytopaenia

30

What is the specific cause of CML?

TRANSLOCATION OF BCR-ABL GENE (9:22)

ON PHILADELPHIA CHROMOSOME