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52 Cards in this Set

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Name 4 types of leukemias:
1. acute lymphocytic leukemia
2. chronic lymphocytic leukemia
3. acute myelogenous leukemia
4. chronic myelogenous leukemia
leukemia:
-abnormal overproduction of a specific cell type (WBC)but they are not fuctional
-accumulation in marrow hinder normal blood cell production
-inhibits normal RBC production therefore pts are anemic
-acute or chronic
What is the survival rate in children with acute lymphocytic leukemia?
93%, poorer in adults
chronic lymphocytic leukemia:
-rarest of major leukemia groups
-initially in nodes, later bone marrow
-mainly >50 yrs (insidious onset)
-prognosis is ultimately poor
T/F - Surgery is a common treatment for leukemia.
False, surgery is not an option with this disease.
acute myelogenous leukemia:
-primarily granulocytes
-rare in adolescence, rising incidence middle age to 8th and 9th decades
chronic myelogenous leukemia:
-onset and progression insidious
-70% undergo acute transformation (not amendable to chemotherapy)
-death within months
-peak incidence is age 25-60
Etiology of leukemia:
-cause of gene damage is not known
What causes an increase in risk for leukemia?
marrow hypoplasia
thrombocytopenia:
-count of <20,000
-causes petechiae, bleeding gums, hematuria
hematuria:
blood in urine
leukopenia:
-decrease in WBC count, primarily neutrophils
acute lymphocytic leukemia:
-immature cells that are not fuctional
-predominantly in children
-most common malignancy in children
What are the 3 main categories of leukemia?
mylocytic (neutrophils), monocytic (monocytes), lymphatic (lymphocytes)
What are the risk factors of leukemia?
1. radiation
2. chemicals
3. drugs
4. genetic factors
5. viral factors
What caues an increase in risk for leukemia?
marrow hypoplasia
thrombocytopenia:
-count of <20,000
-causes petechiae, bleeding gums, hematuria
hematuria:
blood in urine
leukopenia:
-decrease in WBC count, primarily neutrophils
Symptoms of anemia:
pallor, fatigue, transfusion, SOB, malaise
malaise:
A vague feeling of bodily discomfort, as at the beginning of an illness
Treatment for leukemia:
1. combination drugs (initially used)
2. second phase - short duration of treatment (4-5 days)
What is the remission time frame for combination therapy?
75% in adults
80-90% in children
What is the remission time frame for second phase treatment?
2-3 years
Symptoms of chronic leukemia:
1. remission is never completely etablished
2. pt needs continuous tx
3. due to blood-brain barrier, intrathecal therapy is used when CNS is involved
What drug is a contraindication for leukemia?
Aspirin
blood-brain barrier:
-cell metabolism occurs and goes into bloodstream
-the byproducts also goes to our brain and our body adjusts to this
-stops chemicals from going to the brain
What are the major effects of leukemia?
1. decreased RBCs
2. decreased platelets
3. decreased mature WBCs
4. huge risk of infection
Manifestations of leukemia:
1. lymphadenopathy (enlarged lymph nodes)
2. joint swelling and pain
3. weight loss
4. hepatosplenomegaly (liver and spleen enlargement)
5. CNS involvement
What type of diet should a pt with leukemia have?
-diet high in proteins and calories
-combat weight loss and slowing of growth
alopecia:
Loss of hair, baldness
Major complications of leukemia:
1. infection
2. anemia
3. bleeding
4. pain
5. alopecia
Hodgkins Disease:
-proliferation of lymphocytes, not stem cell precursors
-metastisize with lymphatics
-painless lymph node enlargement
proliferation:
rapid growth and reproduction of similar cells
With HD, what percentage of pts have malignant lymphomas?
40%
What age group has the most cases (50%)?
age 20-40, but this disease occurs across all age levels
What is the cause of HD?
unknown
Where does HD originate?
in the node or chain of nodes
Systemic effects of HD:
possible fever, malaise, night sweats, weight loss
What determines treatment of HD?
location of the disease in the body; either above or below (inguinal) diaphragm
Diagnosis of HD entails;
1. biopsy
2. clinical picture
3. CBC, liver function tests (AP)
4. chest Xray
5. possible radioisotipe studies
6. other approp. biopsies
7. staging laparotomy (operate to det)
Treatment for HD:
radiation, chemotherapy, nutrition
Non-Hodgkins lymphoma:
-worse than hodgkins,more common, harder to treat
-most arise from lymph nodes in older adults
-extranodal involvement, unpredictable
2 Types of Malignant lymphomas:
Hodgkins and non-Hodgkins lymphoma
Hodgkins disease is a specialized form of lymphoma that has the presence of an abnormal cell called a ___.
Reed-Sternberg cell
HD vs. NHD
HD: group of cancers chara by Reed-Sternberg cells that begin as a malignancy in a single lymph node and spreads to other ones.

NHD: a group of heterogenous lymphocytic cancers that are multicentric in origin and spread to various tissues throughout the body, including bone marrow.
multiple myeloma:
-proliferation of abnormal plasma cells in bone marrow
-disseminates to lymph nodes, liver, spleen and kidneys
-age > 40
What protein in urine diagnoses multiple myeloma?
Bence-Jones protein (abnormal immunoglobulin from plasma cells)
Manifestations of multiple myeloma:
1. bone pain
2. slow onset (5-20 yrs)
3. pathological fractures
4. renal insufficiency (hypercalcemia)
5. immunoglobin abnormalities
6. Bence-Jones protein (in blood and urine)
7. x-rays
Treatment for multiple myeloma:
antineoplastic chemotherapeutic agents and supportive therapy
List 3 complications of multiple myeloma:
1. renal failure
2. need adequate fluid intake
3. infections
Name 4 lymphoproliferative disorders:
1. Leukemia
2. Hodgkin's Disease
3. Non-Hodgkins Lymphoma
4. Multiple Myeloma