Cvt - Path Exam 2 Lymphoproliferative Disorders

Front 1

Name 4 types of leukemias:

Back 1

1. acute lymphocytic leukemia
2. chronic lymphocytic leukemia
3. acute myelogenous leukemia
4. chronic myelogenous leukemia

Front 2

leukemia:

Back 2

-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

Front 3

What is the survival rate in children with acute lymphocytic leukemia?

Back 3

93%, poorer in adults

Front 4

chronic lymphocytic leukemia:

Back 4

-rarest of major leukemia groups
-initially in nodes, later bone marrow
-mainly >50 yrs (insidious onset)
-prognosis is ultimately poor

Front 5

T/F - Surgery is a common treatment for leukemia.

Back 5

False, surgery is not an option with this disease.

Front 6

acute myelogenous leukemia:

Back 6

-primarily granulocytes
-rare in adolescence, rising incidence middle age to 8th and 9th decades

Front 7

chronic myelogenous leukemia:

Back 7

-onset and progression insidious
-70% undergo acute transformation (not amendable to chemotherapy)
-death within months
-peak incidence is age 25-60

Front 8

Etiology of leukemia:

Back 8

-cause of gene damage is not known

Front 9

What causes an increase in risk for leukemia?

Back 9

marrow hypoplasia

Front 10

thrombocytopenia:

Back 10

-count of <20,000
-causes petechiae, bleeding gums, hematuria

Front 11

hematuria:

Back 11

blood in urine

Front 12

leukopenia:

Back 12

-decrease in WBC count, primarily neutrophils

Front 13

acute lymphocytic leukemia:

Back 13

-immature cells that are not fuctional
-predominantly in children
-most common malignancy in children

Front 14

What are the 3 main categories of leukemia?

Back 14

mylocytic (neutrophils), monocytic (monocytes), lymphatic (lymphocytes)

Front 15

What are the risk factors of leukemia?

Back 15

1. radiation
2. chemicals
3. drugs
4. genetic factors
5. viral factors

Front 16

What caues an increase in risk for leukemia?

Back 16

marrow hypoplasia

Front 17

thrombocytopenia:

Back 17

-count of <20,000
-causes petechiae, bleeding gums, hematuria

Front 18

hematuria:

Back 18

blood in urine

Front 19

leukopenia:

Back 19

-decrease in WBC count, primarily neutrophils

Front 20

Symptoms of anemia:

Back 20

pallor, fatigue, transfusion, SOB, malaise

Front 21

malaise:

Back 21

A vague feeling of bodily discomfort, as at the beginning of an illness

Front 22

Treatment for leukemia:

Back 22

1. combination drugs (initially used)
2. second phase - short duration of treatment (4-5 days)

Front 23

What is the remission time frame for combination therapy?

Back 23

75% in adults
80-90% in children

Front 24

What is the remission time frame for second phase treatment?

Back 24

2-3 years

Front 25

Symptoms of chronic leukemia:

Back 25

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

Front 26

What drug is a contraindication for leukemia?

Back 26

Aspirin

Front 27

blood-brain barrier:

Back 27

-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

Front 28

What are the major effects of leukemia?

Back 28

1. decreased RBCs
2. decreased platelets
3. decreased mature WBCs
4. huge risk of infection

Front 29

Manifestations of leukemia:

Back 29

1. lymphadenopathy (enlarged lymph nodes)
2. joint swelling and pain
3. weight loss
4. hepatosplenomegaly (liver and spleen enlargement)
5. CNS involvement

Front 30

What type of diet should a pt with leukemia have?

Back 30

-diet high in proteins and calories
-combat weight loss and slowing of growth

Front 31

alopecia:

Back 31

Loss of hair, baldness

Front 32

Major complications of leukemia:

Back 32

1. infection
2. anemia
3. bleeding
4. pain
5. alopecia

Front 33

Hodgkins Disease:

Back 33

-proliferation of lymphocytes, not stem cell precursors
-metastisize with lymphatics
-painless lymph node enlargement

Front 34

proliferation:

Back 34

rapid growth and reproduction of similar cells

Front 35

With HD, what percentage of pts have malignant lymphomas?

Back 35

40%

Front 36

What age group has the most cases (50%)?

Back 36

age 20-40, but this disease occurs across all age levels

Front 37

What is the cause of HD?

Back 37

unknown

Front 38

Where does HD originate?

Back 38

in the node or chain of nodes

Front 39

Systemic effects of HD:

Back 39

possible fever, malaise, night sweats, weight loss

Front 40

What determines treatment of HD?

Back 40

location of the disease in the body; either above or below (inguinal) diaphragm

Front 41

Diagnosis of HD entails;

Back 41

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)

Front 42

Treatment for HD:

Back 42

radiation, chemotherapy, nutrition

Front 43

Non-Hodgkins lymphoma:

Back 43

-worse than hodgkins,more common, harder to treat
-most arise from lymph nodes in older adults
-extranodal involvement, unpredictable

Front 44

2 Types of Malignant lymphomas:

Back 44

Hodgkins and non-Hodgkins lymphoma

Front 45

Hodgkins disease is a specialized form of lymphoma that has the presence of an abnormal cell called a ___.

Back 45

Reed-Sternberg cell

Front 46

HD vs. NHD

Back 46

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.

Front 47

multiple myeloma:

Back 47

-proliferation of abnormal plasma cells in bone marrow
-disseminates to lymph nodes, liver, spleen and kidneys
-age > 40

Front 48

What protein in urine diagnoses multiple myeloma?

Back 48

Bence-Jones protein (abnormal immunoglobulin from plasma cells)

Front 49

Manifestations of multiple myeloma:

Back 49

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

Front 50

Treatment for multiple myeloma:

Back 50

antineoplastic chemotherapeutic agents and supportive therapy

Front 51

List 3 complications of multiple myeloma:

Back 51

1. renal failure
2. need adequate fluid intake
3. infections

Front 52

Name 4 lymphoproliferative disorders:

Back 52

1. Leukemia
2. Hodgkin's Disease
3. Non-Hodgkins Lymphoma
4. Multiple Myeloma