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23 Cards in this Set

  • Front
  • Back
major classifications of leukemia?
myeloid vs lymphoid and acute vs chronic
techniques to work up an increased WBC?
look at the blood smear, then can use cytogenetics, cytochemistry (check for certain enzymes) or immunophenotyping (fluorescing cells via Abs specefic for it). This is all done to see what type of cell we are dealing with. What type of leukemia
where are primary areas of hematopoiesis in an adult and where are most bone marrow aspiration and biopsies taken?
sternum, rib, and pelvic bones. posterior iliac crests are common sites for bone marrow aspiration
what are the acute myelogenous leukemias and how are they grouped.
M0-M7. the following are all treated with the same chemotherapeutic drugs: M0-1, M2 t(8;21), M4 (myelomonocytic), M5 (monocytic), M6 (erythro), M7 (megakaryoblastic). M3 is treated with vit A first and is acute promyelocytic leukemia
what is the intracytoplasmic inclusion body commonly found in AML and MDS?
auer rods (look like needles)
describe M0 and M1 acute myelogenous leukemias
both very hard to differentiate morphologically, need cytogenetics. M0 is 5q-, 7q-, +8, +13, and monosomy 7. note that M1 is 10 to 20% of AMLs while M0 is 2 to 3%
describe the morphology, occurence, and cytogenetics of M2
large blast cells, 30 to 45% of AMLs, -7,-5,+4,+8, del (5q), t(8;21) in 25%
describe the morphology, occurence, and cytogenetics of M3
most are hypergranular(75%) some are microgranular (25%), 5-8% of AMLs, t(15,17)
describe the morphology, occurence, and cytogenetics of M4
myelo monocitic, 15 to 25%
describe the morphology, occurence, and cytogenetics of M4Eo
monocytosis with eosinophilia. 10 to 12% of AMLs. inv (16)
describe the morphology, occurence, and cytogenetics of M5a
monoblasts, 5 to 8% of AMLs, chromosome 11q23
describe the morphology, occurence, and cytogenetics of M5b
monocytosis, promonocytes. 3 to 6% of AMLs. deletions, translocations 11q23
describe the morphology, occurence, and cytogenetics of M6
glycophorin A + erythroblasts, 5 to 6% of AMLs
describe the morphology, occurence, and cytogenetics of M7
sheds plateletes - promegakarytoblasts, 2 to 5 % AML, no specefic chrom abnormality. T(1;22),CD41 and CD61+
clinical features of AML
pallor, fatigue, and weakness from anemia. bleeding, bruising, and petechial hemmorrhages from thrombocytopenia. infections that fail to respond to appropriate therapy. bone tenderness, hepato-splenomegaly and lymphadenopathy. gum hyperplasia and extramedullary involvement (lymph nodes, skin, CNS, liver, spleen)
describe the different types of acute lymphogenous leukemias and their surface markers.
pre pre B cell: CD19, CD79a, CD22. common ALLs: CD10 (CALLA). pre B cell: cytoplasmic IgM. mature B cells: cytoplasmic or surface Ig, kappa, or lambda chains. pre T cell: CD1a,2,5,7,8, and cCD3. mature T cell: surface CD3 plus any other T cell markers.
clinical features of ALL?
abrupt onset, fatigue, pallor, weight loss, anorexia, petechiae, ecchymoses, bone pain. CNS sxs, splenomegaly, hepatomegaly, lymphadenopathy
what kind of leukemia has vacuolated blasts in the marrow?
burkitt's leukemia which is very dangerous
describe a common translocation in chronic myelogenous leukemia and the treatment.
philadelphia chromosome: t(9;22) - BCR and ABL. activates the tyr kinase. Gleevic, Imatinamib will inhibit the tyr kinase free of side effects. 50% get complete response.
clinical features of CML.
middle aged, 25% of all adult leukemias, weight loss, night sweats, anorexia, visual disturbances, bone pain, splenomegaly, hepatomegaly, anemia, bleeding disorders, gout
what are the three phases of CML?
chronic stable phase, accelerated phase, and blastic phase.
describe the clinical manifestations of CLL.
mainly in those over 50. 30% of all leukemias - most common leukemia. enlargement of superficial lymph nodes. hepatosplenomegaly. frequent infections (sinusitis). asympto vs night sweats, weight loss, fatigue.
describe the classification, Cell type, chemo drugs, and common diseases associated with CLL.
mature B cell. Rai classification (0 is lymphocytosis, 1 is nodes, 2 is organomegally, 3 is anemia, 4 is thrombocytopenia). fludarabine and rituxan. usually autoimmune diseases