Hematology-Leukemias

Front 1

What is the peak age for acute lymphoblastic leukemia

Back 1

peak age 3-4yr

Hint 1

p. 198

Front 2

What is the most common neoplasm in children?

Back 2

Actue lymphoblastic leukemia

Hint 2

p. 198

Front 3

What are the signs and symptoms of acute lymphoblastic leukemia

Back 3

sx: fever, fatigue
si: anemia, pallor, petechiae, infections

Hint 3

p. 198

Front 4

What labs are used to diagnose acute lymphoblastic leukemia

Back 4

Leukocytosis, blastsin pheripheral blood, decreased RBC count, decreased platelets, PAS+, CALLA+, TdT+, marrow bx shows increased blasts

Hint 4

p. 198

Front 5

What cancer are increased blasts in bone marrow characteristic of?

Back 5

acute lymphoblastic leukemia

Hint 5

p. 198

Front 6

What cell markers are diagnostic of actue lymphoblastic leukemia?

Back 6

PAS+, CALLA+, TdT+

Hint 6

p. 198

Front 7

Describe the course of therapy in acute lymphoblastic leukemia

Back 7

induction, condsolidation and maintenance (intrathecal chemotherapy during consolidation)

Hint 7

p. 198

Front 8

What are the side effects of therapy given for acute leukoblastic leukemia? (3)

Back 8

new cancers, incrased rate of sterility, growth defects

Hint 8

p. 198

Front 9

What is the diagnosis given these markers: PAS+, CALLA+, TdT+?

Back 9

acute lymphoblastic leukemia

Hint 9

p. 198

Front 10

What is the most common leukemia in adults?

Back 10

acute myelogenous leukemia

Hint 10

p. 198

Front 11

Who gets acute myelogenous leukemia

Back 11

adults

Hint 11

p. 198

Front 12

How is actue myelogenous leukemia classified?

Back 12

FAB system: M0-M7

Hint 12

p. 198

Front 13

What are the signs and symptoms of acute myelogenous leukemia? (7)

Back 13

fever, fatigue, pallor, petechiae, infections, splenomegaly, lymphadenopathy

Hint 13

p. 199

Front 14

What leukemia is myeloperoxidase+, sudan black+, auer rods, throbocytopenia, peripheral blood & marrow bx shows myeloblasts

Back 14

acute myelogenous leukemia

Hint 14

p. 199

Front 15

What are 5 characteristic lab findings of actue myelogenous leukemia?

Back 15

myeloperoxidase+
sudan black+
auer rods
throbocytopenia
peripheral blood & marrow bx shows myeloblasts

Hint 15

p. 199

Front 16

What is the course of treatment for acute myelogenous leukemia?

Back 16

induction and consolidation only

Hint 16

p. 199

Front 17

What is the difference in treatment between actue lymoblastic leukemia and acute myelogenous leukemia?

Back 17

actue lyphoblastic leukemia treatment has a maintenance phase

Hint 17

p. 199

Front 18

M1: myeloblastic shows what 3 histologic features?

Back 18

+ auer rods
+ sudan black
+ myeloperoxidase (MPO)

Hint 18

p. 198

Front 19

M2: myeloblastic with differentiation shows what 3 histologic features?

Back 19

++ auer rods
+ sudan black
+++ myeloperoxidase (MPO)

Hint 19

p. 198

Front 20

What acute myelogenous leukemia subtype has prominent splenomegaly and + chloromas (green tumors made up of blasts)?

Back 20

M2: myeloblastic with differention

Hint 20

p. 198

Front 21

M3: promyelocytic shows what 3 histologic features?

Back 21

+++ auer rods
increased granularity
+++ myeloperoxidase

Hint 21

p. 198

Front 22

What leukemia has t(15:17) and what does it affect?

Back 22

M3: Promyelocytic, affects retinoid acid receptor

Hint 22

p. 198

Front 23

DIC is common in what leukemia

Back 23

M3: promyelocytic (acute myelogenous leukemia)

Hint 23

p. 198

Front 24

What drug is used to treat t(15:17)

Back 24

ATRA - all trans retinoic acid is used to induce blast differentiation

Hint 24

p. 198

Front 25

What subtype of acute myelogenous leukemia involves eosinophils?

Back 25

M4: Myelomonocytic

Hint 25

p. 198

Front 26

What subtype of actue myelogenous leukemia involves CNS and gingiva

Back 26

M5: monocytic

Hint 26

p. 198

Front 27

What condition often precedes M6: Erythroblastic subtype of acute myelogenous leukemia?

Back 27

myelodysplasia

Hint 27

p. 198

Front 28

What is the most common age for chronic myelogenous leukemia (CML)?

Back 28

50's but can present at any age

Front 29

What are 7 symptoms of CML?

Back 29

fatigue
anorexia
abdominal discofort
early satiety
diaphoresis
arthritis
bone tenderness

Front 30

What characterizes the peripheral blood smear

Back 30

leukostatis (WBC >=10^5)

Front 31

What are 7 clinical consequences of leukostatis (WBC >=10^5)?

Back 31

dyspnea
dizziness
slurred speech
diplopia
confusion
retinal hemorrhage
pepilledema

Hint 31

p. 199

Front 32

What are 4 lab findings of CML?

Back 32

neutrophilia
thrombocytosis
Philadelphia chromosome
peripheral blood shows cells of all maturational states

Hint 32

p. 199

Front 33

What treatment used in CML? What is it's target?

Back 33

Gleevac, philadelphia chromosome product bcr-abl

Hint 33

p. 199

Front 34

What is blast crisis in CML and what is it's outcome?

Back 34

actue phase CML, leads to death in 3-4 mo, only BMT can prevent

Hint 34

p. 199

Front 35

What is pathopnomonic of CML

Back 35

Philadelphia chromosome

Hint 35

p. 199

Front 36

What does the Philadelphia chromosome cause? Wha is the translocation?

Back 36

constitutive tyrosine kinase activity, t(9:22) ->bcr-abl
promotes the cell cycle

Hint 36

p. 199

Front 37

What is the level of leukocyte alkaline phosphatase in CML vs leukemoid reaction

Back 37

CML: low
Leukemoid reaction: high

Hint 37

p. 199

Front 38

What is the age distribution of chronic lymphocytic leukemia (CLL)?

Back 38

increases with age

Hint 38

p. 200

Front 39

What cell is proliferating in CLL?

Back 39

95% are memory B-cel types (a flrom of blood borne lymphoma) expressing CD5 protein as a surface marker

Hint 39

p. 200

Front 40

What are 3 signs of CLL

Back 40

organomegaly
+/- anemia
later stages see throbocytopenia due to autoimmunity

Hint 40

p. 200

Front 41

What are 3 lab findings of CLL

Back 41

normal morphology lymphocytes of blood and marrow
monolonal antibodies (check to determine monoclonality)
autoimmune hemolysis (Coomb's +, increased indirect bilirubin, decreased haproglobin, spherocytosis)

Hint 41

p. 200

Front 42

What are 4 causes of anemia in CLL

Back 42

autoimmunity
splenomegaly
bone marrow infiltration
chemotherapy

Hint 42

p. 200

Front 43

What causes death in CLL

Back 43

infection

Hint 43

p. 200

Front 44

What is the translocation in CLL and what is the result?

Back 44

t(11:14), bcl1 next to heavy chain promoter

Hint 44

p. 200

Front 45

What is the general presentation of T cell leukemias

Back 45

erythematous rashes

Hint 45

p. 200

Front 46

What type of leukemia is hairy cell leukemia

Back 46

B cell type

Hint 46

p. 200

Front 47

What are 3 findings that characterize hair cell leukemia

Back 47

pancytopenia
erythema nodosum
hair cell morphology

Hint 47

p. 200

Front 48

What is the treatment for hair cell leukemia

Back 48

INF-alpha
splenectomy

Hint 48

p. 200

Front 49

What are the most common ages for CML, CLL, AML, ALL

Back 49

ALL: up to age 15
AML: 15-59
CML: 40-59
CLL: 60+

Hint 49

p. 200

Front 50

What is HTLV and what dows it cause?

Back 50

HTLV is human T cell leukemia virus
Causes leukemia and tropical spastic paraparesis

Hint 50

p. 200

Front 51

Where is HTLV most common

Back 51

Japan and Caribbean

Hint 51

p. 200

Front 52

How is HTLV transmitted

Back 52

Like HIV: placenta, body fluids & sex

Hint 52

p. 200