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20 Cards in this Set
- Front
- Back
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121. The patient presents with shortness of breath, confusion, and blurry vision. His white cell count is over 100,000. What is the best initial therapy?
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a. Acute leukemia can sometimes present with an extremely high white cell count.
b. When the count goes above 100,000, the cells result in a sludging of the blood vessels of the brain, eyes and lungs. c. CLL rarely does this, because lymphocytes are much smaller and do not include vessels. d. Luc or stasis is treated with leukapheresis!!! which removes white cells via centrifugation of blood. e. Hydroxyurea is also added to lower the white cell count. |
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122. Presentation of Myelodysplasia?
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a. Present in elderly patients with:
1. pancytopenia 2. elevated MCV 3. the reticulocyte count 4. Macroovalocytes. 5. There is a special neutrophil with two lobes called a “Pelger-Huet Cell”. 6. Look for a normal B12 level. 7. There'll be a small number of blasts, but not enough to be considered acute leukemia. 8. Myelodysplasia is like a mild, slowly progressive pre-leukemia syndrome. |
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123. Note: just as cervical dysplasia may sometimes progress to cervical cancer, myelodysplasia may progress to acute leukemia.
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Note: just as cervical dysplasia may sometimes progress to cervical cancer, myelodysplasia may progress to acute leukemia.
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124. Most common cause of death with myelodysplasia?
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a. Not leukemia. Most patients die of infection or bleeding.
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125. Treatment of myelodysplasia?
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a. Largely supportive with transfusions as needed.
b. Azacitazine is a specific therapy for myelodysplasia (MDS). c. Those with the 5Q minus syndrome are treated with lenalidomide. |
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126. With what type of leukemia are Auer rods associated?
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a. AML.
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127. With what significant comorbidity is M3, acute promyelocytic leukemia associated?
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a. DIC. This is the most frequently tested information about acute leukemia.
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128. Which drug has tremendous efficacy in decreasing transfusion dependence in myelodysplasia?
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a. Lenalidomide
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129. presentation of chronic myelogenous leukemia ( CML)?
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a. Look for an elevated white cell count that is predominately neutrophils.
b. Splenomegaly is frequent. |
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130. Best initial diagnostic test for chronic myelogenous leukemia?
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a. Leukocyte alkaline phosphatase (LAP) score.
b. In elevated neutrophils count with a low LAP score is CML. c. Reactive high white counts from infection even elevated LAP!!! d. LAP is up in normal cells, not CML. |
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131. What is most accurate test for chronic myelogenous leukemia (CML)?
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a. Philadelphia chromosome
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132. Which type of myeloproliferative disorder has the highest risk transformation into acute leukemia?
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a. CML
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133. Best initial therapy for CML?
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a. Imatinib (Gleevec).
b. Bone marrow transplantation is the only way to cure CML, but this is never the best initial therapy, because imatinib leads to 90% hematologic remission with no major adverse effects. c. Dasatinib and nilotinib are tyrosine kinase inhibitors;they can be used as first-line therapy or as an alternative in those not responding to imatinib. |
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134. Presentation of chronic lymphocytic leukemia (CLL)?
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a. CLL exclusively presents in patients > 50 years old with an elevated white cell count is described as “normal appearing lymphocytes.”
b. CLL is often asymptomatic, and is described as being found on “routine” testing. |
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135. Best initial diagnostic test for CLL?
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a. Peripheral blood smear shows “smudge” cells, which are ruptured nuclei of lymphocytes. They are like squished jelly donuts.
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136. Stage 0 CLL?
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a. Elevated white cell count alone
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137. Stage 1 CLL?
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a. Enlarged lymph nodes
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138. Stage 2 CLL?
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a. Spleen enlargement
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139. Stage 3 CLL?
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a. anemia
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140. Stage 4 CLL?
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1. Low platelets
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