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32 Cards in this Set

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1. Disease of_____
2.2nd peak in_____
3.Amount of lymphoblast in blood and in bone marrow
4.WBC amt
5.platelet and granulocyte ?
6.Cytochemical stain?
1.children (2 to 10 years)
2.elderly
3.> 30%
4. >100,000/mm3 but 50% have normal or low WBC
5.decreased
6. PAS (+) positive
ALL Subclassifications
1.FAB L1 (2 desc.)
2.FAB L2 (1 desc.)
3. FAB L3 (4 desc.)
1.FAB L1:small lymphoblasts, most common(71% of ALL)
2.FAB L2: large lymhoblasts (2nd most common)
3.FAB L3: leukemic conversion of Burkitt's Lymphoma; very basophilic cytoplasms; "punched-out" vacuoles, TdT (=) negative.
Chronic Lymphocytic Leukemia
1. common/uncommon type of leukemia?
2.usually occurs in _____
3.men vs women occurance
4._____of B-cell leukemias
1.most common
2.older adults (>40 years of age)
3.men more often than women
4.95% of B-cell leukemias
Myeloproliferative Disorders
1.Clonal disorder of______
2.Classifications:
(3 answers)
3.Name the Diseases included in this category
1.Hematopoeitic stem cells
2.acute:acute non-lymphocytic leukemia
subacute:myelodysplastic syndromes
chronic:myeloproliferative disorders
3.CML
Polycythemia Vera PV
Essential(primary)thrombosis ET
Agnogentic myeloid metaplasia
Characterististics of myeloproliferative disorders
Panhyperplasia of bone marrow
Extramedullary hematopoesis
Bone Marrow fibrosis
Increased Megakaryocytes-
abnormal in bone marrow
Platelet Dysfunction
Chromosomal abnormalities
Polycythemia vera
vs. Secondary Polycythemia
1.malignant inc. in red cell mass vs. due to hypoxia
2.Increased granulocytes and platelets (>400,000) vs. NORMAL granulocytes and platelets
3.Normal O2 sat vs. DECREASED O2 sat
4.Increased LAP vs. normal LAP
Relative Erythrocytosis
1.Decreased in ____
2. Normal in_____(3 answers)
3.Give 2 groups of people
1.plasma volume -elevated hematrocrit;normal rbc mass
2.O2 sat;EPO;granulocytes and platelets
3.dehydrated; asyptomatic middle-aged WM (hypertensive, obese, long history of heavy smoking)
Essential (Primary)
Thrombocytopenia
1.platelet count____
2.____________ complications
3.Blood smear constituents
1.>600,000/mm3 (often >1 million)
2.thrombotic and hemorrhagic complications
3.Large masses of plt aggregates (giant and bizaare forms, many small forms, occ megakaryocyte fragment
Hematological features of Essential Thrombocytopenia
-increased megakaryopoesis in bone marrow
-leukoerythroblastosis
-platelet count >600,000/mm3
-spontaneous plt aggregation
-giant and bizaare forms of platelets
-occasional megakaryocyte fragments
Myelodysplastic Syndromes
1.ranging from______
2.previously called
3.clonal abnormality of____
4.chromosomal abnormality on which one?
5.specific immunological marker?
1.mild anemia to acute leukemia
2.preleukemias
3.pluripotent stem cells
4.most common found 5q
5.none found
Myelodysplastic syndrome criteria
Dyserythropoesis
sideroblasts (possibly ringed) ; multinuclear; Howell-Jowell body and nuclear fragments
Myelodiysplastic syndrome criteria
Dysmyelopoiesis
hypogranulation; usually hyposegmented PMNs with abnormal chromatin patterns (pseudo -Pelger Huet); occ. Hypersegmented in bone marrow; mixed eos and baso granules; "hybrid" myelomonocytes - confirmed by double esterase stain
Myelodysplastic syndrome
Dysmegakaryopoiesis
micromegakaryocytes; abnormal granulation (hypo or agranular); giant platelets
FAB classification of MDSs
Refractory Anemia
1. WBC count
2.FE stores inc or dec?
3.ringed sideroblasts
4.blast in blood?
1.<3,900
2.increased
3.NO
4.rare
FAB Classification of MDSs
(RARS) Refractory Anemia with Ringed Sideroblasts
1. similar to RA plus
a. ringed sideroblasts?
b.iron ?
c.normal rbc also but_____
1.a.>15% ringed sideroblasts
b.iron not incorporated properly
c.erythroid dimorphism
FAB classification of MDSs
(RAEB) Refractory Anemia with Excess Blasts
1.apearance of rbc,wbc and plt
2.___% myeloblast in bonemarrow
3.____%in blood
4. previously known as___
1.5% to 20% myeloblast in bone marrow
2. <5% myeloblasts in blood
3.smouldering leukemia
FAB Classifications of MDSs
(DAEB-T) Refractory Anemia with Excess Blast in Transformation
1.____% myeloblast in BM
2.___%myeloblast in blood
3.any inclusion may be present?
4.MDS with the highest conversion rate to___
1.20% to 30% myeloblast in BM
2. > 5% myeloblast in blood
3.Auer rods
4.ANLL
FAB Classification of MDSs
Chronic Myelomonocytic Leukemia
-a leukemia but yet may have typical dyspoiesis of MDSs
-WBC will be inc however monocytes, promonocytes an dgranulocytes and immature granulocytes will be present
Secondary Myelodysplastic Syndromes
Causes:
-secondary to treatment of other malignancy
-toxins
1.Define Leukemia
2.Def Lymphoma
3.What are lymphoid tissues
1.Leukemia: malignancy involving blood and/or marrow
2.Lymphoma: localized malignany in lyphoid system
3.-sites for Ag recognition and processing
-lymphopoeisis
Lymphomas
1.Diagnosis
2.Staging
1.must biopsy node. Look at cell size type, pattern within the node
2.How far has it spread? How many organs are involved, etc.
1.What is Hodgkin's Lymphoma
2.Cell characteristics
1.Proliferation of benign inflammatory cells (lymphocytes, histiocytes, plasma cells, and eos)interspered with Reed-sterberg Cell (malignant)
2.large bi/poly lobulated nucleus; "owl eyes", origin of cell is unknown
Non Hodgkin's Lymphoma
1.______ malignancy
2.Working Formulation Classification
a.Low Grade
b.Intermediate Grade
c.High Grade
1.lymphocytic malignancy
2.Low grade:slow, can manage, but not really treat.Longest survival, not curable, not responsive to therapy
b.Intermediate: diffclt to manage and treat.WORSE prognosis
c.High: shortest survival, but catch soon enough, can treat subset can be cured
Example: Burkitt's lymphoma
Burkitt's Lymphoma
1.___ cell derivation
2.associated with _____
3.seen in ____ and
1.B cell
2.Epstein Barr Virus
3.children and adults with AIDS
Cutaneous T-cell Lymphomas
1.2 related disorders
1.Mycosis Fungoides: skin lymphoma, characteristic lesions, as progress involve other organs
Sezary Syndrome:Malignant cells in blood, skin and other organs, appear as mature lymphs with convoluted , cerebriform nuclear folds
Name all Plasma Cell Disorders
-Solitary Plasmacytoma
-Multiple Myeloma
-Plasma Cell Leukemia
-Waldenstrom's Macroglobulinemia
-Momoclonal Gammopathy of Uncertain Significance
-Heavy Chain Disease
Solitary Plasmacytoma
Definition
Malignant clone of plasma cells localized to one area of bone or soft tissue.
!High tendency to develop Multiple Myeloma
Multiple Myeloma
Definition and characteristics of plasma cells
Malignant proliferation of plasma cells in the bone marrow.
few plasma cell in blood and are immature;abnormal nuclear features:may lose halo, russell bodies, Flame cell if IgA, decreased RBC,WBC and plt
!Osteolytic Lesion:
Plasma cell produce osteoclast activating factor and serum Ca++ and Phosporus incrased.
Monoclonal Ig production IgG then IgA, rarely IgD/IgE
Multiple Myeloma
1.SPEP vs IEP
2.Malignant Plasma cells secrete ____ to normal plasma cells and create:
3.Result of polymerization of immunoglobulins
1.suppressor substance; decreased normal Igs,increased infection-death
2.RBC rouleaux; increase plasma viscosity; bind platelet and clotting factors
Plasma Cell Leukemia
1.Usually seen in terminal acute phase of ____
2.Rarely: Primary Plasma cell leukemia
1.Multiple Myeloma: plasma cells in blood
2.many immature plasma cells in blood
Waldenstrom's Macroglobulinemia
Definition and characteristics
Loss of regulation of clone of cells which appear to be the lymphocytes in blood and marrow
Characteristics: Hyperviscosity= neurological problems, rouleaux, cryoglobulin(protein ppt)(reynauds phenomenon), bleeding problems
Monoclonal production of IGM
Monoclonal Gammopathy of Uncertain Significance (MGUS)
1.3% of all adults are___y.o.

Heavy Chain Disease
2.excessive production of__
1. >70 years
2. Heavy Chain Disease