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WBC Disorders Flashcards

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1
Q

Common markers for Myeloblasts

A

1) MPO

2) CD45+

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2
Q

Cell marker for NK Cells

A

1) CD56

2) CD16 (Fc receptor)

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3
Q

Immature Lymphoblast will stain positive for what cell marker?

A

TdT+ (DNA Polymerase)

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4
Q

Describe ANC

A

Amount of Neutrophils and Bands * WBC count

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5
Q

ANC <500 is sus. to

A

Opportunistic Infections

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6
Q

General Overall causes of Neutropenia

A

1) Decreased Production

2) Increased Destruction

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7
Q

Causes of Lymphopenia

A

1) Autoimmune
2) immunodeficiency
3) Radiation/Chemo
4) Increased Corticosteroids

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8
Q

Mechanisms of Leukocytosis

A

1) Increased marrow production
2) increased release from marrow stores
3) Decreased Margination
4) Decreased Extravasation

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9
Q

Causes of Increased marrow production leading to leukocytosis

A

1) Chronic Inflammation –> Growth Factor Dependent
2) Paraneoplastic: Hodgkin Lymphoma –> Growth Factor Dependent
3) Myeloproliferative Neoplasms: Chronic Myeloid Leukemia (Growth Factor INDEPENDENT)

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10
Q

Cause of decrease margination leading to leukocytosis

A

Exercise and Catecholamines

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11
Q

Most common cause of cancer in children

A

Acute Lymphoblastic Leukemia/Lymphoma

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12
Q

Characteristics of Presentation of ALL

A

1) Fever - Decreased Neutrophils
2) Bleeding - Thrombocytopenia
3) Fatigue - Anemia
4) Pain - Marrow Hypercellularity
5) Dry Tap

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13
Q

List the Acute Leukemias

A

1) Acute Lymphoblastic Leukemia/Lymphoma

2) Acute Myeloid Leukemia

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14
Q

General Morphology of cells in Acute Leukemias

A

Large Immature Cells with poked out nuclei

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15
Q

Pathogenesis of Acute Leukemias

A

1) Gene Mutation
- Self-renewed capacity
- Maturation arrest

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16
Q

What is t(12:21)

A

Acute B-cell Leukemia/Lymphoma

-Good prognosis

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17
Q

What determines a bad prognosis in Acute Lymphoblastic Leukemia

A

1) Less than age 2
2) Adolescence/Adulthood
3) High WBC (>100K)

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18
Q

Hallmark Feature of Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia on a blood smear

A

1) Small mature lymphocytes w/ Smudge Cells

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19
Q

Pathogenesis of CLL

A

1) De Novo Mutations

- Can lead to Diffuse Large B Cell Lymphoma via Richter Transformation

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20
Q

What mutations cause CLL to transform into DLBCL also known as a Richter Transformation

A

1) MYC

2) TP53

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21
Q

When thinking about the diagnosis of CLL what would you use?
What would you be looking for with what restriction?

A

1) Flow Cytometry

2) CD5+, CD19, and KAPPA Restricted

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22
Q

Patient Presentation of Follicular B Cell lymphoma

A

1) Generalized Painless Lymphadenopathy

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23
Q

A Patient has been diagnosed with Follicular B Cell Lymphoma a year ago. They come back into clinic for a check up and you notice that their generalized lymph adenopathy under the chin has gotten larger in size but is still painless. You are nervous the cells have undergone what transformation.

A

Richter Transformation into Diffuse Large B cell lymphoma

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24
Q

Translocation for Follicular Lymphoma

A

t(14:18) = IgH/BCL-2

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25
Presentation of Chronic Lymphoblastic Leukemia/Small Lymphocytic Lymphoma
1) Increased mature lymphocytes (increased WBC) - CD5+ and CD20+ 2) Generalized Lymphadenopathy
26
Complications associated with Chronic Lymphoblastic Leukemia/Small Lymphocytic Lymphoma
1) Hypogammaglobinemia | 2) Autoimmune Hemolytic Anemia
27
List the different links with Diffuse Large B Cell Lymphoma and list the lymphoma they cause
1) EBV: Immunodeficiency-related LCL | 2) HHV-8: Primary Effusion Lymphoma
28
What somatic mutation presents in Diffuse Large B Cell Lymphoma
BCL-6 --> overexpression
29
Diagnosis of Diffuse Large B Cell Lymphoma
1) Enlarging LN or Spleen
30
Translocation of Burkitt Lymphoma
t(8:14) IgH/MYC
31
Types of Burkitt Lymphoma
1) African - Jaw (Children) - EBV 2) Sporadic - Mediastinal 3) HIV- related
32
Size of the cells in Burkitt Lymphoma
1) Intermediate
33
What is a helpful marker but not a definitive diagnosis for Burkitt Lymphoma
Ki-67 marker - associated w/ rapid cell proliferation
34
Most common malignancy between 15-19 is...
Hodgkin Lymphoma
35
Morphology of cells in Anaplastic Large-Cell Lymphoma
1) Donut Cells or Horseshoe cells
36
Pathogenesis of Marginal Cell Lymphoma
1) H. Pylori - Gastric MALToma 2) Hashimoto Thyroiditis - MZL of Thyroid 3) Chronic Sialadenitis - Salivary Gland MZL
37
Hair Cell Leukemia is common in ____
Adult Males
38
Presentation of Hair Cell Leukemia
1) Massive Splenomegaly | 2) Dry Tap on Bone
39
Why does Hairy Cell Leukemia present with Massive Splenomegaly
1) Accumulation of Hairy Cells in Red Pulp | 2) Marrow Fibrosis
40
Describe the morphology of the cells in Hairy Cell Leukemia
1) B Cells w/ Fried egg appearance | 2) Tartrate-Resistant Acid Phosphatase (TRAP)
41
What is Hairy Cell Leukemia + for?
Tartrate-Resistant Acid Phosphatase
42
ALK tyrosine kinase constitutive active due to
Gene rearrangement
43
Presentation of Adult T Cell Leukemia
1) Skin Involvement: Exfoliation and popular lesions/ necrotizing nodules 2) Lytic Bone Lesions and Hypercalcemia
44
Morphology of Cells for Adult T Cell Leukemia
Cloverleaf Cells
45
What Leukemia is associated with HTLV-1
Adult T Cell Leukemia
46
Extranodal NK/T cell Lymphoma virus association
EBV
47
Clinical Presentation for Multiple Myeloma
1) Hypercalcemia 2) Renal Failure/Dysfunction 3) Anemia 4) Bone Lesions/Back Pain
48
What are Bence Jones Proteins
Protein in Urine via Light Chains in Multiple Myeloma
49
SPEP for Multiple Myeloma will present with
Either IgG or IgA
50
List the Classical Hodgkin Lymphomas
1) Nodular Sclerosis 2) Mixed Cellularity 3) Lymphocyte Rich 4) Lymphocyte Depleted
51
Hallmark cell of Hodgkin Cell Lymphoma
Reed Sternberg
52
Reed Sternberg Cells will stain positive for ....
1) CD15 2) CD30 3) Pax-5
53
B Symptoms are associated with what cancer
Hodgkin Lymphoma
54
What are the B Symptoms
1) Fever 2) Night Sweats 3) Unexplained Weight Loss
55
How do you diagnose Hodgkin Lymphoma
Staining
56
What type of cells are present in Nodular Lymphocyte Predominant Lymphoma
Popcorn Cells
57
Cell markers in Nodular Lymphocyte Predominant Lymphoma that is not characteristic of other Hodgkin Lymphomas
ONLY CD20+ | - NOT CD30 and CD15
58
Patients with AML will present with ...
Pancytopenia: 1) Fever 2) Fatigue 3) Bleeding/Bruising
59
What is t(8:21)
Translocation that causes AML in young patients | -Good prognosis
60
What is t(15:17)
Acute Promyelocytic Leukemia
61
___ will be present in cells in pts who have Acute Promyelocytic Leukemia
1) t(15:17) | 2) Auer Rods
62
Fusion of what genes are present in AML that is caused by t(8:21)
RUNx1/Runx1T1
63
Patients who have multiple myeloma are at risk for a Thromboembolic Disorders because ....
Hyperviscosity
64
How do you treat Acute Promyelocytic Leukemia?
All Trans RA
65
Myeloproliferative Neoplasms are associated with mutated ____
Kinases
66
Describe the HCT of a pt that has CML
Increased Buffy Coat
67
List the Clnical Manifestations of CML
Splenomegaly - extramedullary hematopoiesis | Marked Leukocytosis
68
List the Myeloproliferative Neoplasms
1) Polycythemia Vera 2) Essential Thrombocythemia 3) Primary Myelofibrosis 4) CML
69
_____ MPS presents with massive splenomegaly due to depletion of marrow elements. You treat with Ruxolitinib
Myelofibrosis
70
What do you use to treat primary myelofibrosis
Ruxolitinib
71
Polycythemia Vera, Essential Thrombocythemia, and Primary Myelofibrosis all have a mutated
JAK2 Kinase
72
Chromosome Translocations of Philadelphia Chromosome
t(9:22); BCR-ABL
73
List the Langerhan Cell Histiocytosis cell morphology
1) Grooved nuclei of Langerhans Cells 2) Berback Granules 3) Stains S100 and CD1
74
List the Langerhans Cell Histiocytosis
1) Multifocal Multisystem Langerhans Cell Histiocytosis (Letterer-Siwe Disease) 2) Unisystem Langerhans Cell Histiocytosis (Eosinophilic Granuloma) 3) Pulmonary Langerhans Cell Histiocytosis

SBL (8 decks)

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