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20 Cards in this Set

  • Front
  • Back
What is the main distinction between LEUKEMIAs and LYMPHOMAs?
Primary site of neoplasm:

Leukemias primary in bone marrow.

Lymphomas primary outside BM.
List the 4 most common leukemias.
1.Acute Lymphoblastic Leukemia
2.Acute Myelogenous Leukemia
3.Chronic Myelogenous Leukemia
4.Chronic Lymphocytic Leukemia
(=Small Lymphocytic Lymphoma)
ALL: What does the typical patient with this disease look like? How does the patient look differentr from a pt with
ALL: Pancytopenic (Febrile, Anemic, and Bleeding) Kids
AML: Pancytopenic (Febrile, Anemic, and Bleeding) ADULTS
CML: Elevated WBC's
CLL: Elevated lymphocytes
What is the order of diagnostic investigation(s) in patients with ALL?
1. BM bx
2. X-rays
3. Cytogenetics (phila chromosome is bad t9;22)
AML: What does the typical patient with this disease look like?
AML: Pancytopenic (Febrile, Anemic, and Bleeding). If WBC count is high, signs of lukostasis, or "sludging" may be present (NEURO: Confusion -->stupor; PULMONARY: DOE--> resp distress; VASCULAR: DIC, retinal hemorrhage, MI, acute limb ischaemia, renal vein thrombosis).
AML is subdivided into 8 different types, M0 thru M7, based on the neoplastic cell type and cytogenetics. What are some important ones to know? Why?
AML M3: Acute promyelocytic leukemia--associated with DIC. Treated with chemo with includes all-trans retinoic acid). t(15;17)
AML M4: Eosinophilic variant = good
AML M5: Associated with gingival hyperplasia
CML: What does the typical patient with this disease look like? Describe both physical findings and labs.
CML: **UNLIKE AML, CML will NEVER p/w bleeding; rather, CML patients p/w fatigue, night sweats, and lo-grade temp.
--p/w wicked high WBC counts.
--Splenomegaly (Massive & huge)
--Basophilia on smear
--DEFINED by presence of Philadelphia chromosome t(9;22)
CML: What is the treatment for this disease?
While BM transplant presents the only hope for a cure, imatinib mesylate (Gleevec) can help treat by inhibiting the tyrosine kinase activity of the BCR-ABL concogene (philadelphia--which is responsible for the CML phenotype).
What is the weird wacky lab that is characteristic of CML?
CML: Aside from the aforemetioned BCR;ABL translocation, in CML you will see "LO-LAP" (decrease in Leukocyte Alkaline Phosphatase)
What is the weird wacky lab that is characteristic of CML?
"Smudge" cells on smear (these are leukocytes damaged during smear preparation as a result of cell fragility).
What is CLL?
CLL is a crossover between Leukemia and Lymphoma. Equivalent with SLL (Small Lymphocytic Lymphoma), CLL is a clonal malignancy of B cells (98%) with a median age of onset of 65.
What is the natural course of CLL?
Often asymptomatic at presentation, CLL follows an indolent course with a slowly progressive accumulation of long-lived small lymphocytes. Treatment is supportive during early indolent CLL, but complications down the road can include Autoimmune Hemolytic anemias and immune thrombocytopenia.
What is the main diagnostic lab feature in CLL?
Flow cytometry will reveal predominance of lymphocytes expressing both CD 19 and CD 5 markers. (CD19 is B, and CD 5 is T)
What is the main distinction between Non-Hodgkin's and Hodgkins Lymphomata?
NHL: Monoclonal B or T prolif.
Hodgkin's: Lymph malignancy of proliferating germinal ctr cell.
What is the distinction between NHL and Hodgkin's vis-a-vis
-Age of presentation?
-Lymph node involvement?
-AGE: NHL varies; Hodgkin's has Bimodal age distribution, first peak at 20-30 years & 2nd peak at >50 years.
-Nodes: NHL noncontiguous; Hodgkin's contiguous, with cervical +/- mediastinal LAD.
Distinguish the presentation of NHL from that of Hodgkin's?
NHL and Hodgkin's both p/w painless LAD and B SYMPTOMS (hi fever, night sweats, or wt loss). However, Hodgkin's also presents with pruritus.
Distinguish the physical examination findings of NHL from those of Hodgkin's?
NHL and HD both p/w HSM.

NHL: Systemic LAD with HSM
What is tumor lysis syndrome? What does one see happen to levels of K+, phosphate, uric acid, and calcium?
TLS: Rapid tumor cell death releases intracellular contents
--> Increases in Potassium, Phosphate, and Urate
--> DECREASES in calcium.
What is the best prognosis-type of NHL?

What type of NHL bears the worst prognosis?
Best: Small follicular

Worst: Large diffuse
What is the treatment for Mucosal Associated Lymph Tumor (MALT)?
Treat MALT with antibiotix!! (h. pylori is culprit)