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58 Cards in this Set

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ALL
kids
very responsive to therapy
CD 10 or CALLA + cells are most treatable
may spread to CNS and testes
AML
Auer Rods
Myeloblasts
adults
CLL
older adults
infiltration of bone marrow, peripheral blood, lymph nodes, spleen, liver, other
CD16,20; CD5+, CD10-
smudge cells on smear
Warm Ab hemolytic anemia.
Hypogammaglobulinemia
Hairy Cell Leukemia
B-cell w/ hair like filamentous projections
stain for tartrate-resistant acid phosphatase (TRAP)

Responds to aalpha-IFN, 2-chlorodeoxyadenosine and deoxycoformycin

Pancytopenia
splenomegaly
CML
neoplastic clonal prolif of myeloid stem cells;
9, 22; bcr-abl
Marked leukocytosis
Middle to late myeloid precuros cells; few blasts
Decrease in leukocyte alk phos
Prominent splenomegaly
What is the role of Auer Rods in DIC?
Seen in peroxidase-positive cytoplasmic inclusions of granulocytes and myeloblasts
AML
Rx- releases Auer rods-> DIC
9,22
CML
8,14
Burkitt's c-myc
14,18
Follicular- bcl2
15,17
AML- responds to all-trans retinoic acid
11,22
Ewing
11,14
Mantle Cell
What is different between polycythemia vera and other polycythemia?
decreased epo
What are some features of poly vera?
erythrocytosis
moderate increase in circulateing granulocytes/platelets
splenomegaly
Sludging hematocrit leads to thrmbotic or hemorrhagic phenomena
what is the DDx of polycythemia?
chronic hypoxia- pulm disease or algo asi
innapropriate epo- polycystic kidney disease
endocrine- pheo, cushings
Chronic Idiopathic myelofibrosis?
extensive extramedullary hematopooiesis in spleen, liver.
myelofibrosis of bone marrow.

smear- tear drop RBCs
anemia and Splenomegaly
What are the postulated pathogenesis factors in Chronic idiopathic myelofibrosis?
Megakaryocyte prolif-> PDGF -> TGF-B -> fibroblastic change

Megas are spared in marrow fibrotic process and increase in number-> prominent BM megakaryocytosis.
Multiple Myeloma
malignant plasma cell tumor
end-stage derivative of B lymphocytes that is clearly identifiable as a plasma cell
lytic leasions in bone
sever bone pain

M protein- IgG origA
Bence Jones protein
increased ESR
Poker Chip RBCs

Anemia
Infection
Hypercalcemia
Renal insufficiency
Amyloidosis
Waldenstrom macroglbulinemia
Lympoplasmacytic lymphoma
Serum IgM immunoglobulin of kappa or lambda
Plasmacytoid lymphocytes
no bone lesions
men > 50
slow course

Hyperviscosity- retinal vasc dilation; hemorrhaage, confusion and other CNS changes, emergency plasmapheresis to prevent blindness
Abnl bleading- vasc and platelet dysfunction 2ry to serum protein abnlty
MGUS
5-10% of healthy people
M protein, but not too high
no bence-jones
What is rouleau formation?
RBCs like poker chips
Hodgkin's
malignant neoplasm that resembles inflamm disorder
young adults, men
nodular sclerosis-> women
EBV in 50%

Reed sternberg
What is the reed-sternberg cell?
owl-eyes
binucleated or multinucleated giant cells w/ eosinophilic inclusion-like nucleoli
severity is directly correlated w/ # of RS cells

Lacunar cells in nodular sclerosis
What is lymphocyte rich Hodgkins?
large numbers of lymphos and histios and few RS cells
fibrous bands and lacunar cells
upper mediastinum or lower cervical nodes
good prognosis
What is mixed cellular hodgkins?
many RS, many lymphos
intermediate prognosis
25%
What is lymphocyte depleted hodgkins?
rare
few lymphos
some RS
poor prognosis
old men w/ disseminated disease
What are some characteristics of non-hodgkin's lymphomas?
HIV and immunosuppressed
Multiple peripheral nodes
common extranodal involvement; non-contiguous spread
Majority involve B cells
No hypergammaglobulinemia
Fewer constitutional symps
Peak 20-40
small lymphocytic lymphoma
B cell, indolent, old
diffuse effacement of lymph node architecture
widespread nodal involvement; spleen, liver, bone marrow all involved
CLL like, CD 19,20; and CD5+, CD10-
Follicular lymphoma
B cell lymphoma- indolent, old
most common of non-hodgkin
angulated grooved cells- surface IgG and CD19,20
14,18; bcl2
mantle cell lymphoma
11,14; bcl1; cyclin D gene
similar to small lymphocytic lymphoma
MALT type lymphoma
chronic inflamm or autoimmune disease
salivary glands, thyroid, stomach (H. pylori)
Diffuse Large B Cell
odler, but can occur in kids
large, extranodal; wide-spread aggressive dissemination
rare leukemic involvemen
80% B
20% T
Precusor T lymphoblastic lymphoma/leukemia
convoluted nuclei
kids
thymic lymphocytes
progress to T-ALL
aggressive
Burkitt lymphoma
B cell lymphoma- maxilla or mandible in africa
american form in abdominal organs
EBV infection
Starry-sky apperance- abundant cellular debris taken up by non-neoplastic macros
related to B-ALL
8,14- c-myc
Mycosis Fungoides
erthematous eczematoid or psoriasiform
cerebriform nuclei
Pautrier microabscesses
CD4T
Sezary- leukemic form
What type of AML is most associated with DIC?
M3
What is M1 type of AML?
no maturation
What is M3 type of AML?
promyelocitic
What is M6 type of AML?
acute erythroleukemia
What is M7 type of AML?
acute megakaryoblastic leukemia
When you think gynecologic issues what blood abnlty to you think of?
DIC
What are the MCV, MCH, and MCHC changes in megaloblastic anemia?
MCV is high
MCH is high
MCHC is normal
What is the Rx for CLL?
Chlorambucil
alkylating agents
What is Cisplatin used for?
teste mets
What is Dacarbazine used for?
Melanoma
refractory hodgkins
various sarcomas
What is vinblastine used for?
Hodgkins
Non-Hodgkins
choriocarcinoma
lymphosarcoma
neuroblastoma
what gene goes with Burkitt?
c-myc, 8,14
B doesn't come with B
Follicular is bcl-2, 14,18
what gene is associated with follicular?
bcl-2; 14,18
How do you stain for Hairy B?
Tartrate-resistant acid phosphatase
What does Chromium 51 measure?
Red cell survival
What is nitroblue tetrazolium used for?
evals granulocytic phagocyte function in chronic granulomatous disease
What CD is Reed-Sternberg known for?
CD30
What is the first increase in blood with hemolytic destruction?
Haptoglobin
Where does most of the leg drain? and what doesn't drain from there?
most drains through the saphenous
lateral dorsum of the foot goes through the short saphenous to the popiteal fossa
What is the product that is no longer created in aspirin?
Thromboxane A2
What type of kidney stones are found in leukemias?
Uric Acid- from purine breakdown
How do P. vivax and P. ovale relapse?
they leave hypnozoites in the liver
What can happen in late stages of CML and polycythemia vera?
the bone marrow can burn out and you can develop fibrosis of the BM
Myeloid metaplasia with myelofibrosis