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52 Cards in this Set
- Front
- Back
what conditions is eosinophilia seen in?
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type I hypersensitivity, invasive helminthic infection, polyarteritis nodosa, addison's disease (cortisol deficiency)
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when is basophilia seen?
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chronic myeloproliferative disorders
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atypical lymphocytosis?
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due to infection or drugs, antigenically stimulated lymphocytes have prominent nucleoli and abundant blue cytoplasm
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antibody detected early/late in infectious mono?
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early: antiviral capsid antigen (VCA) antibodies;
late: anti-epstein barr nuclear antigen (EBNA) antibodies |
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most sensitive cell to destruction by radiation?
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lymphocytes
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when see lymphopenia?
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HIV, immunnodeficiency, immune destruction (SLE), corticosteroids, radiation
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when see monocytosis?
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chronic infection, autoimmune disease, malignancy
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gender epidemiology of leukemias?
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male > female
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leukemia risk factors?
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chromosomal abnormalities, ionizing radiation, chemicals, alkylating agents, chronic myeloproliferative diseases, paroxysmal nocturnal hemoglobinuria, cigarette smoking, immunodeficiency diseases
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most common leukemia in children (newborn - 14 yo)?
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acute lymphoblastic leukemia (ALL)
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most common leukemia in 15-39 yo?
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acute myeloblastic leukemia (AML)
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most common leukemias in 40-60 yo?
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acute myeloblastic leukemia (AML) and chronic myelogenous leukemia (CML)
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most common leukemia in >60 yo?
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chronic lymphocytic leukemia (CLL)
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clinical findings in acute leukemia?
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fever, bleeding, fatigue, bone pain
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common organs of mets in ALL?
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CNS, testicles
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lab findings in acute leukemia?
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blasts in peripheral blood, normocytic to macrocytic anemia, thrombocytopenia, hypercellular bone marrow with >20% blasts
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lab findings in chronic leukemia?
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some evidence of maturation of cells, normocytic to macrocytic anemia, thrombocytopenia, hypercellular bone marrow with <10% blasts
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which chronic leukemia is exception to clinical finding of thrombocytopenia?
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CML, thrombocytosis occurs in 40% of cases
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chronic myeloproliferative disorders?
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polycythemia vera, chronic myelogenous leukemia, myeloid metaplasia with myelofibrosis, essential thrombocythemia
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absolute polycythemia?
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increase in bone marrow production of rbcs resulting in increased rbc count and rbc mass
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appropriate absolute polycythemia?
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hypoxic stimulus for EPO
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mutation in polycythemia vera?
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JAK2 gene on short arm of chromosome 9 (same mutation may manifest as myelofibrosis and myeloid metapolasia or essential thrombocythemia)
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clinical findings in polycythemia vera?
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hepatosplenomegaly, ruddy face, thrombotic event, impaired CNS circulation, pruritis after bathing, peptic ulcer disease, gout
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best initial lab test for polycythemia vera?
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decreased EPO
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risk factors for CML?
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ionizing radiation and benzene
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mutation in CML?
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philadelphia chromosome (t9;22 translocation): BCR-ABL fusion gene
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basophilia is prominent in which leukemia?
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CML
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CML prognosis?
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~90% 5 year survival
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pathogenesis of myelofibrosis and myeloid metaplasia?
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ineffective erythropoiesis, dysplastic megakaryocytes, immature granulocytes, reactive myelofibrosis; marrow fibrosis occurs earlier than in other chronic myeloproliferative diseases
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clinical findings in myelofibrosis and myeloid metaplasia?
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massive splenomegaly with portal HTN; splenic infarcts with left-sided pleural effusions
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treatment for myeloproliferative diseases?
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hydroxyurea
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lab findings in myelodysplastic syndromes?
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severe pancytopenia, ringed sideroblasts, myeloblasts <20%
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myelodysplastic syndromes may progress to which leukemia?
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AML (acute myeloblastic leukemia)
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clinical findings in AML?
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DIC, gum infiltration
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characteristic histological finding in AML?
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auer rods: fused azurophilic granules in cytosol (NOT in CML)
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mutation in acute promyelocytic leukemia?
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t(15;17) translocation
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subtypes of ALL?
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early pre-B cell, pre-B cell, B cell, and T cell
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mutation associated with favorable prognosis in early pre-B cell ALL?
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t(12;21) translocation
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clinical presentation of T cell ALL?
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anterior mediastinal mass or acute leukemia
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markers in B cell vs T cell ALL?
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B is CD10(+), T is CD10(-), both are TdT(+) [terminal deoxynucleotidyl transferase]
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lab findings in ALL?
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>20% lymphoblasts in peripheral blood, normocytic anemia with thrombocytopenia
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adult T cell leukemia association?
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human T cell leukemia virus (HTLV-1)
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pathogenesis of adult T cell leukemia?
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activation of TAX gene, which inhibits the tp53 suppressor gene
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bone lesions associated with adult T cell leukemia?
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lytic: due to lymphoblast release of osteoclast-activating factor, associated with hypercalcemia
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lab findings in adult T cell leukemia?
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>20% lymphoblasts in peripheral blood, CD4(+), TdT(-)
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most common overall leukemia?
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CLL
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which leukemia has increased incidence of immune hemolytic anemia?
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CLL
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lab findings in CLL?
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lymphoblasts <10%, 'smudge' cells
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precursor cell in CLL?
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virgin B cells
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only leukemia without lymphadenopathy?
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hairy cell leukemia (HCL)
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clinical findings in HCL?
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splenomegaly, absence of lymphadenopathy, hepatomegaly, autoimmune vasculitis and arthritis
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lab findings in HCL?
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pancytopenia, leukemic cells with hair-like projections, increased reticulin fibers in bone marrow, (+)TRAP stain
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