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29 Cards in this Set
- Front
- Back
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What are clinical conditions of hematologic malignancy?
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*Leukemia
*Lymphoma *Benign Lymph node disorder *Multiple Myeloma *Polycythemia |
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what are four types of leukemia?
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Acute Lymphoblastic
Acute Myelogenous Chronic Lymphoblastic Chronic Myelogenous |
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what is difference of cells that leukemia is derived from?
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lymphoblastic is from lymphoid precursors
myelogenous is from neutrophilic and monocytic precursor cells |
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what is the major key of dx acute leukemia?
how can you tell which acute leukemia it is? |
acute leukemia has predominance of BLASTS
if the blasts are lymph or myelo also lymphoblastic has unique CNS involvment and lymphadenopathy |
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what is typical age of Acute lymphoblastic?
acute myelogenous? |
lymphoblastic is kids and teens (3-7)
myelogenous is 50 |
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what are s&S of acute leukemia?
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bone pain
hepatosplenomegaly signs of anemia signs of thrombocytopenia (petech, purp, ecchy, nose bleed) |
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what are the majority of blasts in acute lymphoblastic leuk?
what are major subtypes of acute myelogenous? |
most are type B (rest are T)
myelo=8 major subtypes (M0-M7) |
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what is key dx feature of chronic leukemia?
which leukemia has the philly chromosome? |
chronic has mature differentiated B/T cells or neutrophils
Chronic Myelogenous has philly chromosome |
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what is the most common leukemia in US and estern europe?
what lab finding is consistent with this? |
Chronic Lymphocytis is most common leukemia
Periph Smear shows smudge cells (and absolute lymphocyte count >5000) |
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what are typical signs of chronic leukemia?
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weight loss, fatigue, fever, night sweats
early satiety and LUQ pain assoc with splenomegaly |
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what condition needs to be ddx's from CML?
how can you differentiate? |
leukemoid rxn needs to be distinguished
leukemoid has INCREASED lap and absent philly chromosom |
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what is tx of ALL?
what is treatment of CML? |
ALL is indcution, consolidation and maintenance
CML=Gleevac(imatinib mesylate) |
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what is prognosis of AML?
CLL? CML? |
AmL has 40-60% rate if they have a bone marrow or stem cell transplant from HLA identical sibling
CLL=prolonged survival but not curable CML has 90% 5 year follow up with gleevac and 83% overall(very promising) |
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what are two types of Lymphoma?
what is lymphoma |
Non Hodgkins and Hodgkins
malignant proliferation of lymphocytes usually presenting as painless lymphadenopathy |
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what are follicular and small lymphocytic lymphomas?
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low grade non hodkings
the rest are high grade |
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what is the major difference b/w non hodge and hodge?
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NHL is localized or generalized and has internodal LESS predictable spread
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what is presentation of follicular low grade NHL?
what is presentation of small lymphocytic? |
follicular is painless peripheral lymphadenopathy
small lymphocytic is similar to CLL |
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what is treatment of follicular low grade NHL?
what is prognosis |
tx with rituximab(rituxan) antibody therapy (traditional CHOP as well)
prognosis is not cureable yet |
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what is age of onset of High grade NHL?
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acute lymphoblastic is kids
burkitts is kids and immunocompromised Diffuse large cell is middle age and elderly |
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which type of high grade NHL is the most invasive?
what is tx? what is prognosis? |
diffuse large cell
tx is chemo for generalized and local radiation prognosis is 70% cure rate general and 85-90 local |
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what are peak ages of hodgkins lymphoma?
what are major presenting sx? |
bimodal 15-35 then >50
more common in males majority are asymptomatic but can have B symptoms (fever, night sweat, weight loss) |
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what is tx of Hodgkins?
what is prognosis? |
CHEMO and readiation
prognosis is very good (>90%) |
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what is multiple myeloma?
when does it occur? |
malignant proliferation of plasma cells
middle age and elderly |
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what is the classic triad of the multiple myeloma?
what are other impt findings? |
1. marrow plasmacytosis
2. lytic bone lesions 3. serum and/or urine PARAPROTEIN other's include: bone pain, back and chest pain, anemia and hypercalcemia |
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what causes relative polycythemia?
is there an increase in RBC mass? |
dehydration
no increase in RBC mass |
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what is absolute polycythemia?
what are causes? |
increase in RBC mass
primary cause (VERA) from excessive proliferation of RBC's *hyperviscosity and hypervolemia secondary is from increased serum erythropoietin |
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what are causes of secondary absolute polycythemia?
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hypoxia or erythropoietin
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what is classic presenation of poly vera?
what are other common s&s? |
ITCHINESS afte warm shower or bath is classic
other includes hyperviscosity and splenomegaly |
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what is a complication of poly vera?
what is treatment of poly vera? |
complication is life threatening thrombosis or hemorg of upper GI
tx with periodic phlebotomy to decrease RBC possible hydroxyurea and splenectomy |
