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WBC Flashcards

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1
Q

Pancytopenia + hep splenomegaly
Dd in bone marrow aspirate or biopsy

A

Hypercellular marrow with normal hematopoiesis
Dry tap fibrosis on biopsy
Infiltrative dx
Hypercellular with abno cells

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2
Q

Hypeecellular with nor hematopoiesis

A

Hypersplenism

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3
Q

Dry tap fibrosis on biopsy

A

Myelofibrosis

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4
Q

Infiltrative dx

A

Metastasis

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5
Q

Hypercellular with abn cells

A

See morphology
Immature/blast- (big cells)
Mature cells

Use flow cytometry for diff

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6
Q

Immature or blast cells
Abundant granular cytoplasm, auer rods+ spl stain- mpo sundan black

A

Myeloblast

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7
Q

Immature or blast cells
Scant cytoplasm, no auer rods. Spl stain- pas

A

Lymphoblast

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8
Q

If myeloid what inv is done

A

Cytogenetics- FISH

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9
Q

If FISH + FOR MYELOBLAST

A

Aml with cytogenetic abnormality

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10
Q

If FISH -ve for myeloblast

A

Do pcr/ sequencing

Its either mutations -AML with mutations
Or
AML morphological

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11
Q

In lymphoid what test is done

A

Flow cytometry

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12
Q

In lymphoblast flow cytometry

CD3+ TdT CD10 CD34

A

T ALL

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13
Q

In lymphoblast flow cytometry
CD19 CD20 CD10 TdT CD34

A

B ALL

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14
Q

Common marker for lymphoblasts

A

TdT CD10 CD34

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15
Q

If in flow cytometry its mature cells then we look for morphology
Scant cytoplasm na

A

Lymphoid - flow cytometry done

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16
Q

If in morphology for mature cells it has abundant cytoplasm with granules

A

Myeloid- FISH/PCR is done for subtyping

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17
Q

Pancytopenia+ no hep splenomegaly

A

Hypocellular/dry tap -aplastic
Hypercellular and dysplasia- PNH
Hemoglobinuria and thrombosis- MDS

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18
Q

In lymphadenopathy cf seen are

A

If generalised lymphadenopathy, extranodal+ , numerous neoplastic cells on biopsy

Regional ln, extranodal- , occasional neoplastic cells on biopsy

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19
Q

Lymphadenopathy + Regional ln, extranodal- , occasional neoplastic cells on biopsy

A

Hodgkins

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20
Q

Hodgkins markers

A

CD15 CD30 20 45

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21
Q

In hodgkins
If CD 20 45 +

A

Nodular lymphocyte predominant
Popcorn cells seen

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22
Q

In hodgkins
If CD15 30+

A

Reed sternberg cells seen
Classical Hodgkins

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23
Q

Lymphadenopathy + generalised lymphadenopathy, extranodal+ , numerous neoplastic cells on biopsy

A

Non hodgkins

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24
Q

In non hodgkins markers to diff if it is b or t cell

A

CD 3 19 20

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25
In NHL IF CD 3+
T nhl
26
In NHL IF CD19 CD20 +
B cell NHL
27
In B NHL well further look for
CD 5 ( PREGERMINAL)
28
In B NHL IF CD5+ we further look for
CD 23 + - B CLL SLL CD23- - check for cyclin D1
29
In B NHL IF CYCLIN D1+
Mantel cell lymphoma
30
In B NHL IF CYCLIN D1- VE
Cyclin D1- ve mantel cell lymphoma
31
Marker for cyclin D1- ve mantel cell lymphoma
Sox 11
32
In B NHL IF CD5- VE
It can be precursor germinal or post germinal
33
In B NHL IF CD5 - VE we look for
CD 10,TdT
34
TdT maker for
Precursor cell
35
CD 10 is positive for
Precursor and germinal
36
In B NHL WHICH IS- VE FOR CD5 IF CD10 AND TdT +
B ALL
37
In B NHL WHICH IS- VE FOR CD5 CD 10+ VE TdT-ve
Germinal B symptoms- fever wt loss ni8 sweats+ - high grade B symptoms absent- low grade
38
In B NHL WHICH IS- VE FOR CD5 CD10 AND TdT -ve
Post germinal- marginal zone lymphoma, MALToma
39
Low grade b cell lymphoma from germinal centre's
Follicular lymphoma - BCL 2+, low ki67 index
40
Hugh grade b cell lymphoma from germinal centre's
Burkit- ki67> 95% Diffuse large b cell lymphoma- ki67 high but<95%
41
Diagnostic criteria for ALL
Inc lymphoblast with characteristic immunophenotype
42
Diagnostic criteria for AML either of 2
Blast >_ 20% in BM Any genetic abnormality in myeloid blasts except t(9;22)
43
Diagnostic criteria for plasma cell neoplasm Multiple myeloma - both present
1. Bm monoclonal plama cells>10% 2. Presence of any of the following myeloma defining events- CRAB, BM MONOCLONAL PLASMA CELL>60%, SR INVOLVED TO UNINVOLVED LIGHT CHAIN RATIO>100, >1 FOCAL LESION ON MRI
44
Diagnostic criteria for polycythemia vera All 3 major or first 2 major and minor criteria
Major 1. Hb>16.5 / HCT>49 IN men or Hb>16 or Hct>48 in women 2. Hyper cellular bm with erythroid predominance 3. JAK 2 mutation Minor - low sr erythropoietin levels
45
Diagnostic criteria for plasma cell neoplasm MGUS all 3 present
No myeloma defining events Inc M protein but<3g/dl BM monoclonal plasma cell <10%
46
Diagnostic criteria for plasma cell neoplasm Smoldering myeloma - both present
No myeloma defining event Sr.M protein>3g/dl or urine protein >500mg/24hr or BM monoclonal plasma cell 10-60%
47
Diagnostic criteria for plasma cell neoplasm Plasma cell leukemia
Peripheral blood plasma cells>20% or >2million /cu mm
48
Tx for hodgkins lymphoma
ABVD Adriamycin Bleomycin Vinblastine Dacarbazine Radiotherapy
49
NHL TX
R CHOP Rituximab Cyclophosphamide Oncovin/vincristin Prednisone
50
Tx for B ALL
Child - LOP ( L asparginase, oncovin,prednisone) Adult- CAR ( chimeric antigen receptor) t cell therapy
51
Tx for CLL/ SLL
Asymptomatic- wait and watch Symptomatic- ibrutinib
52
Tx for plasma cell neoplasms
Asymptomatic( MUGS/ smoldering)- wait and watch Plasmacytoma- bone: radiotherapy, soft tissue: excision Multiple myeloma- BLD, BM transplant
53
Tx for hairy cell leukemia
Asymptomatic- wait and watch Symptomatic- 1st line: dabrafenib if not responding add rituximab, cladribine, pentostatin
54
Tx of AML
Cytarabine and daynorubicin
55
Tx for acute promyelocytic leukemia or AML t(15;17)
All trans retinoic acid and arsenic trioxide
56
Tx of CML
Imatinib
57
Tx of polycythemia vera
Phlebotomy Hydroxyurea if no response add ruxolitinib
58
Tx of essential thrombocytosis
Hydroxyurea, interferon alpha, anagrilide
59
Abdominal mass fever ni8 sweats starry sky app
Burkiy lymphoma M/c mutation: t(8;14) T(2;8) t(8;22) Agent: ebv
60
Cervical lymphadenopathy Owl eye app
Hodgkins lymphoma Rs cells Agent: ebv
61
Elderly recurrent inf. Anemia+ Smudge cells+ , lymphocytes+
CLL
62
Multiple grape like inclusion- mott cells 55 yrs old , backache
Multiple myeloma
63
2 yr old lytic lesions in skull Tennis racket shape. Birbeck granules
Langerhan cell histiocytosis Markers- CD 207, CD1a, S-100

Pathology (5 decks)

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