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AMK Miscellaneous > Blood Cancers > Flashcards

Blood Cancers Flashcards

1
Q

Which white blood cells come from the common myeloid progenitor?

A

Basophil
Neutrophil
Eosinophil
Monocyte/macrophage

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2
Q

Which white blood cells come from the common lymphoid progenitor?

A

Natural killer cells
T cell
B cell/plasma cell

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3
Q

What protein is present in the urine of patients with myeloma?

A

Bence-Jones

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4
Q

What investigation is carried out to find the bence-jones protein?

A

Urine protein electrophoresis

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5
Q

What would a patient with myeloma present with?

A

Bone pain - typically back ache

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6
Q

What is the treatment for myeloma?

A

Incurable, relapsing/remitting disease

transplant and thalidomide

transplant candidates - thalidomide and dexamethosone

non-transplant candidates -
supportive care

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7
Q

What is myeloma normally associated with?

A

osteolytic bone disease
anaemia
renal failure
hypercalcaemia

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8
Q

What investigation is used to confirm multiple myeloma? (after bench-jones has been found)

A

skeletal survey

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9
Q

Simply, what is the problem caused by leukaemia?

A

Too many white blood cells, not enough red blood cells

so can’t fight infection

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10
Q

What are the symptoms of acute lymphocytic leukaemia?

A 
easy bruising
fatigue
dyspnoea
dizziness
bleeding 
recurrent infections
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11
Q

What is ALL characterised by?

A

early precursor cells replacing haematopoietic cells of the bone marrow and further infiltrating other body organs

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12
Q

What are the key diagnostic features of ALL?

A

presence of risk factors
lymphadenopathy
hepatosplenomegaly
pallor, ecchymoses, or petechiae

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13
Q

What are the risk factors of ALL?

A

<6 years old - most common blood cancer in kids
mid to late 30s
mid 80s

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14
Q

What is the diagnostic approach for ALL?

A

bone marrow biopsy/peripheral blood smear - hypercellularity and infiltration by leukaemic lymphoblasts (at least 20% for definitive diagnosis)

other tests:
FBC with differential
peripheral blood smear
serum electrolytes
LFT
U&amp;E
coagulation profile
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15
Q

What is the treatment of ALL?

A 
combination chemotherapy
- prednisone
- vincristine
- anthracyclines
etc.

stem cell transplant

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16
Q

What is the definition of chronic lymphocytic leukaemia?

A

Indolent lymphoproliferative disorder in which monoclonal B lymphocytes are predominantly found in peripheral blood

17
Q

What is the disorder called when monoclonal B lymphocytes are found in the lymph nodes?

A

small lymphocytic lymphoma

18
Q

What are the key diagnostic factors of CLL?

A

shortness of breath and fatigue
lymphadenopathy
splenomegaly
presence of risk factors

19
Q

risk factors for CLL

A

age >60

20
Q

What is the first step in CLL diagnosis?

A

FBC with differential - shows an absolute clonal lymphocytosis

21
Q

What is the rai staging system of CLL?

A 
0 - lymphocytosis
1 - lymphadenothay and lymphocytosis
2 - lymphadenopathy and spleno/hepatomegaly
3 - lymphocytosis and anaemia 
4 - lymphocytosis and thrombocytopaenia
22
Q

Management of CLL?

A

initially (assymptomatic) don’t require treatment - just observation

advanced - chemoimmunotherapy or ibrutinib

23
Q

What is the definition of acute myelogenous leukaemia?

A

life threatening disorder than commonly occurs in older adults

clonal expansion of myeloid blasts in the bone marrow, peripheral blood, or extramedullary tissues.

24
Q

What is diagnostic for AML?

A

> 20% myeloid bone marrow blasts
or
the presence of specific clonal cytogenetic abnormalities

25
Q

What are the key diagnostic features for AML?

A

pallor

ecchymoses or petechiae

26
Q

What are the risk factors of AML?

A 
previous chemo
age >65
previous haematological dyspoiesis
genetic factors
benzene exposure
radiation exposure
constitutional karyotype abnormalities
27
Q

Investigations for AML?

A

FBC with differential - anaemia, macrocytosis, leukocytosis, neutropenia, thrombocytopenia

peripheral blood smear - blasts on film and Bauer rods

coagulation panel

baseline -
serum electrolytes
U&E, LFT
serum lactate dehydrogenase

28
Q

Treatment for AML?

A

intensive chemotherapy
- cytarabine
plus others

29
Q

What are the risk factors for chronic myeloid leukaemia?

A

middle aged - 40-60

30
Q

Investigations for CML?

A

FBC - elevated WBC, anaemia, normal platelet, thrombocytosis (chronic or accelerated phases), or thrombocytopenia (accelerated or blast crisis)

metabolic profile - elevated potassium, LDH, or uric acid

bone marrow biopsy - for cytogenetics - Philadelphia chromosome

peripheral blood smear - used for monitoring - peripheral blood basophils >20%

31
Q

Management of CML?

A

imatinib

AMK Miscellaneous (22 decks)

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