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Medicine: PBL wrap-ups > Unit 2 Case 3: ALL > Flashcards

Unit 2 Case 3: ALL Flashcards

1
Q

two lineages of white blood cell development

A

myelocytic and lymphocyticq

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2
Q

myelocytic

A

begins with myeloblast
forms neutrophils, eosinophils, basophils
monocytes

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3
Q

lymphocytic

A

forms lymphocytes
T and B cells

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4
Q

2 phases of leukaemia classification

A

speed of progression
type of white blood cell affected

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5
Q

acute leukaemia

A

abnormal blood cells that are immature
unable to function normally
rapidly multiply
aggressive treatment

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6
Q

chronic leukaemia

A

too many cells or not enough cells
more mature blood cells
replicate slow and function normally for a period of time

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7
Q

lymphocytic leukaemia

A

affects lymphocytes
that form lymphoid or lymphatic tissue

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8
Q

myelogenous leukaemia

A

affects myeloid cells
which produce red and white blood cells and platelet producing cells

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9
Q

4 main types of leukaemia

A

acute lymphocytic
acute myelogenous
chronic lymphocytic
chronic myelogenous

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10
Q

most common type of leukaemia in children

A

ALL

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11
Q

most common leukaemia in adults

A

CLL

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12
Q

what are the different types of anaemia

A

aplastic
iron deficiency
sickle cell
thalessemia (leads to anaemia)
vitamin deficiency

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13
Q

aplastic anaemia

A

when body stops producing enough new blood cells
leaves you fatigued and more prone to infections and uncontrolled bleeding
rare and serious
treated with medication, blood transfusion or stem cell transplant

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14
Q

iron deficiency anaemia

A

where the blood lacks enough healthy red blood cells
insufficient iron
not enough haemoglobin
treated via iron supplementation

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15
Q

sickle cell anaemia

A

red blood cells are shaped like sickle or crescent moons
become rigid and sticky
slow or block blood flow

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16
Q

thalassemia

A

inherited blood disorder
causes your body to make less haemoglobin than usual
can cause anaemia

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17
Q

vitamin deficiency anemia

A

pernicious anaemia
lowered amounts of B-12 and folate
without B-12 body produces red blood cells that are too large and don’t correctly carry oxygen

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18
Q

symptoms for aplastic anaemia

A

fatigue
shortness of breath
rapid or irregular heart rate
pale skin
nosebleed

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19
Q

iron deficiency anaemia symptoms

A

fatigue
wekaness
pale skin
chest pain
fast heatbeat
light headed
cold hands and feet
brittle nails

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20
Q

sickle cell anaemia symptoms

A

episodes of pain
swelling of hands and feet
frequent infections
delayed puberty
vision problems

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21
Q

thalessemia symptoms

A

fatigue
weakness
pale or yellow skin
facial bone deformities
slow growth

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22
Q

vitamin deficiency anemia symptoms

A

fatigue
shortness of breath
dizziness
weight loss
numbness in hands and feet

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23
Q

what are iron supplements

A

used to treat iron deficiency anaemia
body uses iron to make haemoglobin
low level of iron is a haemoglobin count less than or equal to 130/120 in males/females

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24
Q

anatomy of the lymph node

A

covered in unit 3

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25
risk factors of ALL
radiation exposure certain chemical exposures e.g. benzene certain viral infections e.g. HTLV-1 certain genetic syndormes age race ethnicity gender identical twin with ALL
26
symptoms of ALL
pale skin tired and breathless high temperature night sweats bone and joint pain easily bruised skin purple skin rash repeated infections over short time unusual and frequent bleeding swollen lymph nodes
27
what are the two types of chromosomal translocation
reciprocal, balanced or unbalanced robertsonian
28
reciprocal
no change in the amount of genetic information part of one chromosome joins the other occurs in both chromosomes either balanced sections or unbalanced sections
29
robertsonian
two chromosomes stick together results in 35 chromosomes rather than 36
30
most common translocation in ALL
t(4:11)
31
most common translocation in pediatric ALL
12;21 (p13;q22)
32
chromosomal tests examples
PCR FISH cytogenetics immunophenotyping
33
PCR
sensitive DNA test look at individual gene changes and not the whole chromosome used after treatment to check for remaining leukaemia cells
34
FISH
detects translocation changes
35
cytogenetics
observes dividing cells
36
philadelphia chromsome
translocation resulting in shortened chromosome 22 most common change
37
bone marrow aspirate
as ALL originates in the white blood cell producing in the bone marrow allows bone marrow cells to be viewed
38
process of a full blood count
tourniquet is put around your arm, clench your fist injection site is wiped down with an alcohol wipe insertion of a needle into your arm and the blood is drawn up, collected inside a syringe or vial gauze or cotton wool is pressed against the injection site
39
normal results of a full blood count
should have highest number of platelets then RBCs then neutrophils are the most common white blood cell then lymphocytes, monocytes, eosinophils,basophils
40
abnormal blood count results
full blood count results are compared to charts which have the normal range and ratios for each type of blood cell
41
how does a FBC help to monitor chemotherapy
some cancers produce biomarkers found in the blood during chemo they will increase showing that chemo is killing the cancer and is successful
42
process of a blood smear
take a small drop of blood onto a microscope slide use another slide as a spreader align at 30-45 degree angle bring drop up and push downwards
43
what is a relapse in ALL
can come back after successful treatment can have symptoms similar to when first diagnosed such as: chills, easy bleeding, unexplained weight loss and fatigue
44
risk for relapse
initial treatment may not have removed all cancer cells cancer may have developed resistance to initial treatment cancer may have metastasised age
45
treatment for ALL relapse
can be treated with chemo more intensive than the initial treatment if at risk to not responding stem cell transplant could be offered immunotherapy for specific types
46
examples of immunotherapy drugs
blinatumomab inotuzumab imatinib
47
what are all of the phases of treatment of chemotherapy
induction consolidation interim maintenance delayed intensification maintenance
48
aim of induction
5 weeks long remove as many leukaemia cells as possible in the blood and the bone marrow prolonged hospital stay white cell bound before starting
49
what are the drugs used in induction therapy
dexamethasone vincristine asparaginase
50
dexamethasone
glucocorticoid 28 days then tapered over 7 days side effects: increased appetite, weight gain, nightmares, fluid retention, hyperglycaemia
51
vincristine
vinka alkaloid once weekly for 5 weeks disrupts microtubule skeleton side effects: peripheral neuropathy
52
asparaginase
enzyme depletes asparaginase given in week 1 and 3 side effects: skin reactions, hypersensitivity, blood clotting disorders, raised LFTs, pancreatitis
53
aim of maintenance therapy
12 weeks for 2 years in girls and 3 in boys get rid of the few remaining leukaemia cells MRD levels
54
neutrophil count required for maintenance therapy to go ahead
greater than 0.75 x 10^9 per litre
55
platelet count required for maintenance therapy to go ahead
greater than 75 x 10^9 per litre
56
what are the drugs used in maintenance therapy
mercaptopurine methotrexate
57
mercaptopurine
purine antagonist inhibit purine synthesis which interferes with DNA, RNA and protein synthesis TMPT, thiopurine methyltransferase side effects: thrombocytopenia, hepatotoxicity, myelosuppression
58
methotrexate
antimetabolite dihydrofolate reductase inhibitor, folate antagonist given once weekly side effects: mucositis
59
what stresses do parents/families face with illnesses in family/kids
1. illness-related factors, severity of child illness and type of health problem 2. demographic factors, parent age, gender, socioeconomic status, ethnicity 3.psychological factors, current parent mental health, trait anxiety, family functioning, family structure
60
what stresses do parents/families have to face will illness in family/kids
difficult to relax financial worries difficult to remain positive siblings display behaviour problems having to remain strong
61
support for leukaemia patients and their families
Leukaemia CARE to ensure everyone gets best possible diagnosis, information, advice, treatment and support
62
other charities to support leukaemia
blood cancer UK leukaemia cancer society B Positive
63
impacts of leukaemia on mental health
increased risk of anxiety and depression -social isolation -reliant on others for support -worry about relapse -infertility -appearance
64
educational impacts of leukaemia
disruption to academic progress treatments that suppress immune system leave you susceptible to other diseases, may further decrease academic progress mild cognitive impairment
65
positive impacts of leukaemia
personal growth and resilience motivation improved relationships with those close to them
66
iron deficiency anaemia blood test results
Hb may be normal early on but will worsen as anaemia worsens early on RBC's may be normocytic and normochromc but as it progresses RBC's become microcytc and hypochromic MCV decreased MCHC decreased increased variation in RBC size
67
iron deficiency anaemia blood film results
smaller and paler RBC's ansiocytosis poikilocytosis
68
full blood count results for pernicious anaemia
low Hb MCV higher
69
blood film results perncious anaemia
abnormally large and shaped RBC's sometimes occasional giant WBC's
70
aplastic anaemia full blood count
Hb low RBC and WBC low platelet count low MCV normal or slightly raised differential white blood count shows decrease in most types of cells but not lymphocytes

Medicine: PBL wrap-ups (21 decks)

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