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Hematology Oncology > Blood Dyscrasias > Flashcards

Flashcards in Blood Dyscrasias Deck (46):
1

Acute lymphocytic leukemia (ALL) is the MC malignancy in?

Children under the age of 15 in the US

2

Is ALL responsive to therapy?

Yes, most responsive to therapy

3

What are some clinical features of ALL?

Bone and joint pain (invasion of periosteum)

splenomegaly, hepatomegaly, lymphadenopathy

Anterior mediastinal mass

4

Diagnostic lab findings for ALL and AML?

Variable WBC count

significant numbers of blast cells in peripheral blood

5

What complication is associated with ALL chemotherapy?

Tumor lysis syndrome

6

What is tumor lysis syndrome?

rapid cell death that releases intracellular contents

7

What does tumor lysis syndrome cause?

Hyperkalemia

Hyperphosphatemia

Hyperuricemia

Hypocalcemia

8

Acute myelogenous leukemia (AML) occurs mostly in?

Adults (80% of adult acute leukemias)

9

What risk is involved with AML?

Increased risk of bacterial infections (d/t neutropenia)

10

What unique clinical feature is seen in AML?

Skin nodules

11

What would you see in a bone marrow biopsy for diagnosing AML?

Auer Rods

12

What are Auer rods?

Granules and eosinophilic rods inside malignant cells

Present in AML, but not in ALL

Particularly noted if it is the APL phenotype

13

What is the best treatment option for AML?

Bone marrow transplantation gives the best change of remission or cure

14

Chronic lymphocytic leukemia (CLL) is most common in?

> 60 years of age

Leukemia occurring after age 50

Most common leukemia in the Western world

15

What is the cause of CLL?

B-type lymphocytes are mature, but functionally defective.

16

Is CLL considered the most or least aggressive type of leukemia?

Least aggressive

17

Clinical features of CLL?

Usually asymptomatic at the time of diagnosis

Generalized painless LAD (nontender lymph nodes)

Splenomegaly

18

Diagnostic findings for CLL?

Pancytopenia is common (anemia, thrombocytopenia, neutropenia)

Peripheral blood smear: smudge cells

19

What are smudge cells?

"fragile" leukemic cells that are broken when placed on the glass slide.

20

What are some general characteristics of chronic myelogenous leukemia (CML)?

Philadelphia chromosome (cheesesteak me likeee)

21

Treatment options for CML?

Target therapy: TKI Imatinib (Gleevec)

22

What are constitutional (B) sxs?

Fever, night sweats, anorexia, weight loss

23

What is Hodgkin lymphoma bimodal age distribution?

X1: 15-30 yrs old
X2: >50yrs of age

24

Lymph node bx lab finding for Hodgkin lymphoma?

Reed Sternberg Cells "owl eyes"

25

What is the MC clinical features of Hodgkin lymphoma?

Painless lymphadenopathy

26

What differentiates between Hodgkin lymphoma and non-Hodgkins lymphoma?

Presence of inflammatory cell infiltrates

27

How common is non-Hodgkins lymphoma compared to Hodgkins lymphoma?

Twice as common has Hodgkins lymphoma

28

Burkitt lymphoma a high-grade subtype of NHL is linked to?

African variety linked to EBV infection

29

Clinical features of NHL?

Lymphadenopathy

30

What is the definitive dx of NHL?

Lymph node bx- no Reed Sternberg Cells

31

What is multiple myeloma?

Neoplastic proliferation of a single plasma cell line that produces monoclonal immunoglobulin.

32

Age and race MC for multiple myeloma?

>50 yrs
2x more common in AA compared to caucasian pts

33

What is a general characteristic of multiple myeloma?

Bone marrow elements are replaced by malignant plasma cells

34

What are skeletal manifestations of multiple myeloma?

Bone pain d/t osteolytic lesions, fractures, and vertebral collapse

35

Anemia manifestations of multiple myeloma?

Normocytic normochromic

36

Urine test finding for myeloma nephrosis caused by multiple myeloma

Bence Jones protein in urine - large amounts of free light chains

37

What is the MCC of death in pts with multiple myeloma?

Infections: pulmonary or urinary tract

38

Clinical feature of back/spine in pt with multiple myeloma?

Cord compression

39

What is a peripheral smear finding in pts with multiple myeloma?

Rouleaux formation

40

what are CRAB manifestations of multiple myeloma?

C = Calcium issues (hypercalcemia)

R = Renal insufficiency (elevated creatinine)

A = Anemia

B = bone lesions and pain

41

What is the preferred tx of multiple myeloma?

Autologous hematopoietic cell transplant (stem cell transplant)

42

What mutations are found in polycythemia vera?

Mutations of the JAK2 tyrosine kinase

43

S/Sxs of polycythemia vera?

Hyperviscosity: HA, dizziness, weakness, pruritus, visual impairment, dyspnea

44

In order to r/o polycythemia vera?

Rule out causes of secondary polycythemia (hypoxia, CO exposure)

45

DDx of polycythemia vera?

Smoking and Hypoxemia (secondary polycythemia)

46

Tx for polycythemia vera?

Repeated phlebotomy to lower the hematocrit