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Haematology > Week 2 > Flashcards

Week 2 Flashcards

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1
Q

Name the 4 types of leukaemia?

A

Acute lymphoblastic leukaemia
Acute myeloid leukaemia
Chronic lymphocytic anaemia
Chromic myeloid leukaemia

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2
Q

What is acute leukaemia?

A

Rapidly progressing clonal malignancy of marrow/blood

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3
Q

What % of blasts in blood is defined as acute leukaemia?

A

20% or more

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4
Q

At what ages are the two types of leukaemia most common?

A

Lymphoblastic - childhood - most common childhood cancer

Myeloid - elderly

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5
Q

What is the only definitive way to tell ALL and AML apart?

A

Immunophenotyping

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6
Q

What is the difference in treatments between ALL and AML?

A

ALL - chemotherapy can last 2-3 years

AML - Chemo more intensive - 2-4 cycles of 5-10 days

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7
Q

What device is often used to give chemotherapy?

A

Hickman line

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8
Q

What haematological complications may arise from chemotherapy?

A

Anaemia
Neutropenia - infections
Thrombocytopenia - bleeding - purpura, petechiae

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9
Q

What is the cure rate for childhood ALL?

A

85-95%

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10
Q

What sort of transplant may be curable for acute leukaemia?

A

Allogenic stem cell transplant

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11
Q

Normal and malignant haemopoiesis - polyclonal or monoclonal?

A

Normal - polyclonal

Malignant - monoclonal

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12
Q

Name 3 symptoms of lymphoma?

A 
Night sweats
Weight loss
Itch without rash
Alcohol induced pain
Fatigue 
Lymphadenopathy
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13
Q

What are the categories of lymphoma?

A

Hodgkins

Non-hodgkins - T cell or B cell (low grade B cell, high grade B cell)

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14
Q

Which lymphoma is the hardest to treat - low grade or high grade?

A

Low grade

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15
Q

Why are lymphoma lymph nodes not painful?

A

Because they enlarge slowly

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16
Q

Why do metastatic lymph nodes feel irregular?

A

Because the cancer cells grow out of the node

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17
Q

Are lymphoma nodes tender?

A

No

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18
Q

What is a blast?

A

Nucleated precursor cell

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19
Q

What is the life span of a RBC?

A

120 days

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20
Q

What is the lifespan of a neutrophil?

A

7-8 hours

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21
Q

What is the lifespan of a platelet?

A

7-10 days

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22
Q

What is a megakaryocyte?

A

Platelet precursor

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23
Q

What are immunoglobulins made of?

A

2 light and 2 heavy chains

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24
Q

Which is the most common type of myeloma?

A

IgG

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25
What is the second most common type of myeloma?
IgA
26
Why is renal impairment seen in myeloma?
Light chains form casts which block the nephrons
27
Why does bone pain occur in myeloma?
Excessive stimulation of osteoclasts causing lytic lesions and hypercalcaemia
28
What are bence jones proteins and in what condition would you see them?
Light chains in the urine - myeloma
29
What type of immunoglobulin is a pentamer?
IgM
30
What type of immune globulin is a dimer?
IgA
31
What type of immunoglobulin is a monomer?
IgD, IgE, IgG
32
What type of anaemia may be seen in myeloma?
Normochromic normocytic anaemia
33
What is the average survival for patients with myeloma?
5-8 years
34
What drugs should you avoid in Myeloma and why?
NASIDS - can tip patients into renal failure
35
What is a paraprotein and what happens to it in myeloma?
A monoclonal immunoglobulin - rises in myeloma
36
What percentage of bone marrow is plasma cells in myeloma and MGUS?
Myeloma more than 10% | MGUS - less than 10%
37
What is the risk of progression from MGUS to Myeloma?
1%
38
What does amyloidosis stain with?
Congo red - birefringent
39
What paraprotein is involved in waldenstroms macroglobulinaemia?
IgM
40
What is Pancytopenia?
A deficiency of blood cells in all lineages
41
What are the two main causes of pancytopenia?
Reduced production and increased destruction
42
What sort of condition if fanconia anaemia?
Inherited bone marrow failure
43
What % of patients with fanconis anaemia will have bone bone marrow failure by age 20?
84%
44
What % of patients with fanconis anaemia will have leukaemia by age 40?
52%
45
What are the 3 phases of chronic myeloid leukaemia?
Chronic Accelerated Blast crisis
46
Name 4 lab features of CML?
``` Normal or decreased Hb Leucocytosis Neutrophilia Basophilia Eosinophlia Thrombocytosis Myeloid precursors ```
47
What chromosome is involved in CML and what is it?
Philadelphia chromosome | Reciprocal translocation between 9 and 22
48
What gene is present in CML and what does this produces?
BCR-ABL - produces tyrosine kinase
49
What targeted treatment is useful in CML and what does it do?
Imatinib - tyrosine kinase inhibitor
50
What lab counts are raised in polycythaemia rub vera?
Hb and haematocrit, erythrocytosis | And blood viscosity
51
What is a cause of pseudo polycythaemia?
Dehydration, diuretics, obesity
52
What gene is mutated in 95% of PRV?
JAK2
53
What is the treatment of PRV?
Venesect hct to less than 0.45
54
What abnormality causes essential thrombocythaemia?
Uncontrolled productions of abnormal platlets
55
Name 3 conditions that should be excluded before making a diagnosis of ET?
Blood loss, inflammation, malignancy, iron deficiency
56
In what % of ET patients it JAK 2 present?
50%
57
What characteristic feature is seen on blood film in myelofibrosis?
Tear drop Red cells
58
Name a Jak2 inhibitor?
Ruxolitinib
59
What are the 2 groups of cell cycle specific cytotoxic drugs?
Mitotic spindle inhibitors - M phase | Anti metabolites - S phase
60
What are the 2 groups of non cell cycle specific cytotoxic drugs?
Alkylating agents | Cytotoxic antibiotics
61
Name 2 High grade non hodgkin B cell lymphoma?
Diffuse large B cell | Burkitt lymphoma
62
Name 3 low grade non hodgkin B cell lymphoma?
Small lymphocytic Follicular Marginal
63
What % of NHL is T cell?
10-15%
64
What are the categories of hodgkin lymphoma?
Nodular | Classic
65
What is the characteristic histology finding in hodgkin lymphoma?
Reed steenburg cells
66
What staging system is used for hodgkin lymphoma?
Cotswalds system
67
What is the difference between acute and chronic leukaemia?
Acute - maturation defect | Chronic - maturation preserved
68
What % of blasts is considered remission in acute leukaemia?
Less than 5 %
69
What is the cure rate for adult AML?
Under 60 - 40-50% | Over 60 - 10% or less
70
What is the name given to red lines on the skin spreading from a skin lesion?
Lymphangitis
71
What is the arterial and venous supply to the spleen?
Splenic artery | Splenic vein
72
What causes Howell-Jolly bodies?
Hyposplenism
73
What is CD20?
B cell marker
74
What is CD3?
T cell marker

Haematology (5 decks)

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