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43 Cards in this Set
- Front
- Back
Severe reduction in neutrophils: drug toxictity most common cause |
Agranuocytosis
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Malignancy of blood forming organs, arrested/distorted wbc maturation
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Leukemia
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Malignant disorder of lymphoid tissue
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Lymphoma
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Reduction in neutrophils that may be due to supression of bone marrow production (tumors, granulomatous infections) or destruction of neutrophils (SLE, RA, drug interactions). |
Neutropenia
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This condition of an enlarged spleen leading to sequestration of rbcs, wbcs and platelets alone and in combination, is especially prevalent in alcoholics who have spelenic congestion and enlargement due to liver cirrhosis |
Hyperspelism
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Name four conditions that may lead to destruction of neutrophils and neutropenia
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1. Immune disoreders (SLE, RA)
2. Splenomegaly 3. Hypersplenism (alcoholics) 4. Increased peripheral utilization (bacteial or fungal infections) |
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Elevated white blood cell counts with circulating immature white cells, stimulating myeloid leukemia
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Leukemoid Reaction
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Characterized by wbc toxic granulations, cytoplsmic vacuoles, Dohle bodies, and absence of circulating blasts and nucleated red blood cells: |
Leukemoid reaction
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Increased lymphocytes on CBC- seen with viral infections, especially infectious mononucleosis (IM) and CMV- peripheral smear shows large lymphocytes with abundant pale blue cytoplasm
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Lymphocytosis
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Cancer of immature cells that arise from the myeloid progenitor cells of the bone marrow
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Acute Myeloid Leukemia
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Cancer characterized by the proliferation of immature cells that arise from the myeloid progenitor cells of the bone marrow
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Acture Myeloid Leukemia
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This disease causes anemia, neutropenia, thrombocytopenia, and an outpouring of immature cells, including blasts and nucleated RBCs into the peripheral blood
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AML
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Gingival hyperplasia may occur in this disease because monoblasts often show solid organ infiltration
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AML
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In AML, blasts sometimes accumultae in extramedullary tissue to produce tumors referred to as
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Myeloid Sarcoma - such tumors can appear anywhere in the body and may precede other manifestations of AML by several months
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This condition presents with anemia and thrombocytopenia, lekuocyte count that is high, low or normal, and a blast count greater than 20% in peripheral blood
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AML
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Distinctive red-staining, rod-like cytoplasmic structures occuring only in myeloblasts- stain strongly for MPO.
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Auer Rods - most reliable morphologc feature for distinguishing AML from ALL.
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_______ greater than 20% is required for the diagnosis of AML.
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Blasts
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The presence of MPO or Sudan Black stain is evidence of what?
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Myeloid Origin
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______ activity is used to identify cells of monocytic lineage.
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Nonspecific Esterase (NSE)
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High levels of which three things reflect cell mass and increased rate of lysis of abnormal cells?
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1. Serum Uric Acic
2. Serum LDH 3. B2-microglobulin Uric acid indicates cell death b/c its the end priduct of nucleic acid breakdown. |
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This type of AML can be treated with all trans retinoic acid, which matures cells by inhibiting the effects of the PML-RAR alpha receptor.
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M3
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A malignant bone marrow neoplasm of lymphocyte precursors
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Acute Lymphoblastic Leukemia (ALL)
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Most common malignancy in childhood, 75% of cases under the age of 6 years
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ALL
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The clinical features of this disease are palor, weakness, anemia, petechial hemorrhage, bone pain, and fever (mimics viral infection).
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ALL - clinical features relate directly to the replacement of normal bone marrow elements by lymphoblast.
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This disease has hypercellular bone marrow with >25% blasts and no MPO activity.
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ALL
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What are the three classifications of ALL?
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1. Morphologic (FAB)
2. Immunologic 3. Cytogenic |
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The use of ______ and a panel of monoclonal antibodies to T cell and B cell associated antigens will identify almost all cases of ALL.
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TdT assay
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About 85% of all cases of ALL are which type?
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Precursor B cell type
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Which cell marker is present in about 80% of cases of B-ALL and associated with a good prognosis?
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CD10
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The lymphoblasts in precursor T-Cell ALL are derived from cells in which stage of T-cell development?
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Thymocyte stage
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Which T cell markers are expressed in a high percentage of precursor T-cell ALL?
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CD2, CD5, and CD7.
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Lymphoblastic neoplasms of both precursor T cell and B cell type may present primarily as what?
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Extramedullary Tumors
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_______ mutations involve a loss of function, or balanced translocations producing fusion proteins that drive lymphoblast proliferation.
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B-ALL - hyperdiploidy is the most common chromosomal change and is associated with favorable prognosis.
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40-50% of T-cell ALL involve which chromosomal abnormality?
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Translocations - up to 70% have gain of function mutations
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______ involvement is the most significant extramedullary manifestation of ALL.
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CNS involvement - usually seen in T-ALL . The CNS is the most common site of relapse so it must be frequently monitored.
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An acquired chronic lymphoproliferative disorder of clonal B lymphocytes.
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Chronic Lymphocytic Leukemia (CLL) - most common leukemis in US and Europe - usually elderly males
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Neoplastic counterpart of a subpopulation of B cells co-expressing B cell markers (CD19 and CD20) and T-cell marker CD-5
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CLL
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The hallmark of this disease is the presence of persistent peripheral blood lymphocytosis consisting of mature appearing lymphocytes:
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CLL
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Patients with this disease complain of weakness, nightsweats, weight loss, are prone to pneumonia due to altered immunity, lymph adenopathy, spenomegaly, and hyperslenism contributing to pancytopenia:
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CLL
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Occurs in 5-10% of cases of CLL and is characterized by development of rapidly progressive lymphoma - transformation is heralded by fever, weight loss, abdominal pain, lymphadeopathy and worsening cytopenias:
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Richter Syndrome
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Most common transformation occuring in 15% of CLL patients which causes a gradual increase in circulating prolymphocytes which is the stage between lymphoblast and mature lymphocyte
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Prolymphocytoid Transformation of CLL
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A neoplasm of mature B lymphocytes named for characteristic fine cytoplasmic projections - 2% of all leukemias - usually affects middle aged white males
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Hairy Cell Leukemia
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This disease presents with often massive splenomegaly, pancytopenia, and dry tap bone marrow aspirations (due to reticulin deposition- a type of bone marrow fibrosis)
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Hairy Cell Leukemia
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