Goljan Hematology Lymph

Front 1

what part of the LN are the B cells in

Back 1

germinal follicles

Front 2

what part of the LN are the T cells in

Back 2

paracortex

Front 3

when do you see generalized painless lymphadenopathy

Back 3

seen in systemic disease

ex: SLE, infectionus mono

Front 4

when do you see localized painless lymphadenopathy

Back 4

malignancy- nodes draining primary cancer sides (breast-> axillary nodes)

Hodgkins Lymphoma (usually 1 cervical and 1 mediastinal)

Front 5

painless generalized lymphadenopaty

Back 5

malignacy, systemic: Metastasis of leukemia (think CLL) or follicular B cell Lymphoma (indolent in nature)

Front 6

malignancy involving cervical LN

Back 6

Hodgkins, Metastatic head tumors (larynx, thyroid, nasopharynx)

Front 7

L sided supra-clavicular LN malignancies

Back 7

(virchow's nodes)
metastatic abdominal cancers

Front 8

R sided supra-clavicular LN malignancies

Back 8

metastatic lung and esphageal cancers, Hodgkins

Front 9

Axillary LN malignancies

Back 9

Breas cancer

Front 10

Hilar LN Maligancies

Back 10

metastatic lung cancer

Front 11

Mediastinal LN malignancies

Back 11

metastatic lung cancer, Hodgkins, T cell lymphoblastic lymphoma

Front 12

para aortic LN malignancies

Back 12

metastatic testicular cancer, Burkitt's Lymphoma

Front 13

Inguinal Malignancies

Back 13

Metastatic vulvar and penis cancers

Front 14

cell type of NH Lymphoma

Back 14

85% B-cell origin- derive from germinal follicle.

Front 15

Lymphoma associated with EBV

Back 15

Burkitt's Lymphoma (Aggressive)

Front 16

what is the translocation in follicular lymphoma?

Back 16

t(14:18)- results in overexpresion of BCL2 (an anti-apoptotic gene)

Front 17

nodal involvement in nodular sclerosing Hodgkin's Lymphoma

Back 17

anterior mediastinal + cervical or supraclavicular

Front 18

neoplastic cell of Hodgkin's Lymphoma and cellular markers

Back 18

CD15 and CD30 are present on Reed Sternberg cells

Front 19

diagnosis of Hodgkins Lymphoma

Back 19

RS cells with a background of reactive cells (eosinophills, plasma cells, histiocytes)

Front 20

differences in distribution of NH Lymphoma and Hodgkins

Back 20

Hodgkins has localized LN involvement while NHL has generalized LN involvement

Front 21

clinical "B" signs of hodgkins dz and other clinical sign

Back 21

fever, weight loss >10%, night sweats

non B sign: puritis

Front 22

type of anemia in Hodgkins Lymphoma

Back 22

Normocytic anemia

Front 23

typical staging for Hodgkins Lymphoma

Back 23

I or II: usually stays above diaphragm
I- one site (mediastinal or cervical)
II- 2 sites

Front 24

malignant complications in treatment of Hodgkin's Lymphoma

Back 24

radiation may lead to AML or NHL

Front 25

CD1+ cells that contain Birbeck granules

Back 25

Histiocytes

Front 26

in what type of Lymph malignancy is skin involvement common?

Back 26

Malignant Histiocytosis (histiocytosis X)

Front 27

signs of mast cell disease

Back 27

puritis, swelling, hyperpigmentation

Front 28

define Bence Jones protein

Back 28

Ig light chains in urine

Front 29

what age is multiple myeloma seen in?

Back 29

elderly- rarely seen under 40

Front 30

what protein spike is seen in Multiple Myeloma

Back 30

M-spike
Usually IgG kappa followed by IgA

Front 31

bone marrow findings in multiple myeloma

Back 31

plasma cells > 10 % of cells

Front 32

bone findings in multiple myeloma

Back 32

lytic lesions (punched out), pathologic fractures, hypercalcemia

Front 33

multiple myeloma "crab"

Back 33

hyperCalcemia
Renal failure
Anemia
Bone destruction/pain

Front 34

2 ways kidneys are damaged in multiple myeloma

Back 34

acutely from hypercalcemia
tubular epithelium is damaged by BJ proteins

Front 35

smear findings in multiple myeloma

Back 35

rouleauz formations

Front 36

most common cause of death in multiple myeloma

Back 36

recurrent infections

Front 37

MUGS

Back 37

asymptmatic IgG M spike
plasma cells in bone marrow < 3%
no BJ proteins or CRAB symptoms

Front 38

epidemiology of Waldenstrom's macroglobulinemia

Back 38

elderly, male-dominant disease

Front 39

Waldenstrom's Triad

Back 39

result of hyperviscocity from increased IgM
1. Bleeding (platlet ag defects)
2. Visual changes (retinal hem)
3. Neurologic changes (stroke)

Front 40

what cell cause Waldenstrom's macroglob?

Back 40

neoplastic lymphoplasmocytoid B cells

Front 41

LN involvement in Waldenstrom's vs Multiple Myeloma

Back 41

generalized Lymphadenopathy in Wald. not present in MM

Front 42

most common monoclonal gammopathy

Back 42

MUGS

Front 43

evidence of splenic dysfunction on peripheral smear

Back 43

howell-jolly bodies (nuclear remnants)

Front 44

infection risk increases with splenectomy; why?

Back 44

concentration of IgM and C3b drops leading to
decrease in complement activation (IgM)
decreased opsonization (C3b)

Front 45

Pathogens patients susceptible to with splenectomy

Back 45

Hflu, strep, Salmonella

Front 46

most common cause of splenomegaly in developing countries?

Back 46

malaria

Front 47

BJ renal disease

Back 47

proteinaceous casts with multinucleated giant cell reaction