Hematology 1 > LEUKEMIA > Flashcards

LEUKEMIA Flashcards

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1
Q

malignant neoplasm of the blood-forming tissues of the BM, spleen, and lymphatics

A

leukemia

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2
Q

old way of classifying leukemia

A

French-American-British classification

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3
Q

t or f. more blasts will lead to a shorter and more fatal disease

A

true

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4
Q

what is increased in shift to the left?

A

more younger forms of WBCs in the PBS

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5
Q

normal M:E ratio in adults

A

2:1 to 4:1

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6
Q

M:E ratio in leukemic patients

A

10:1

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7
Q

type of anemia that is commonly present in cases of acute leukemia

A

normocytic, normochromic

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8
Q

acute vs chronic leukemia (3 each)

A

acute

  • short duration of symptoms
  • immature cell forms in BM
  • increased total WBC ct

chronic

  • long duration of symptoms
  • mature cell forms in BM
  • low to extremely high WBC ct
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9
Q

new way of classifying leukemia

A

WHO classification

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10
Q

2 basis in classifying leukemia accdg to FAB:

A

morphology of cells in Romanowsky-stained smear

based on cytologic and histochemical characteristics

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11
Q

2 cytochemical stains used

A

myeloperoxidase

sudan black b

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12
Q

romanowsky composition (2)

A

methylene blue

eosin y/eosin b

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13
Q

romanowsky stain examples

A

wright’s, giemsa, may-grunwald

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14
Q

MPO and SBB of lymphocytic leukemias

A

MPO negative

SBB negative

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15
Q

most common form of childhood leukemia

A

acute lymphocytic leukemia (ALL)

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16
Q

ALL subtypes

A

L1, L2, L3

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17
Q

which ALL is called Burkitt-type of leukemia

A

ALL L3

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18
Q

basis of classification for ALL (6)

aic ncc

A
  • age
  • immunologic markers
  • cell size
  • nucleus and nucleolus
  • chromatin
  • cytoplasm
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19
Q

ALL that has nuclear and cytoplasmic vacuoles

A

ALL L3

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20
Q

ALL present in 70% of children

A

ALL L1

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21
Q

ALL present in 70% of adults

A

ALL L2

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22
Q

rare in children and adult

A

ALL L3

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23
Q

immunologic marker: CD24

A

ALL L3

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24
Q

immunologic marker: CD10

A

ALL L1

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25
immunologic marker: TdT only
ALL L2
26
cell size: small blasts
ALL L1
27
cell size: hetero large blasts
ALL L2
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cell size: homo large blasts
ALL L3
29
cytochemistry: PAS positive ORO positive
ALL L1 and ALL L2
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cytochemistry: MGP positive ORO positive
ALL L3
31
most common type of leukemia in the elderly
chronic lymphocytic leukemia (CLL)
32
CLL characteristics: (2)
- persistent lymphocytosis | - increased number of smudge and rieder cells
33
nuclear remnants of the lymphocytes; thumbprint appearance
smudge cells
34
lymphocytes with notched, lobulated or cloverleaf-like nucleus
rieder cells
35
clinical variations of CLL (3) | hlp
- hairy cell leukemia - lymphosarcoma cell leukemia - prolymphocytic leukemia
36
lymphocyte with little cytoplasmic projections
hairy cell
37
stain used to detect hairy cell
TRAP + | tartrate resistant acid phosphatase
38
MPO and SBB of non-lymphocytic leukemia (myelogenous leukemia)
MPO positive | SBB positive
39
2 groups of myelogenous leukemia
acute myelogenous leukemia | chronic myelogenous leukemia
40
AML types:
M0-M7
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AML that is negative for both MPO and SBB
M0
42
AML origin for M0-M3
myelocytic
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AML M0 name
AML with minimal differentiation
44
AML M1 name
AML without maturation
45
AML M2 name
AML with maturation
46
AML M3 name
acute promyelocytic leukemia
47
AML types with auer rods (5)
``` M1 M2 M3 M4 M6 ```
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most common subtype of AML
AML M2
49
AML associated with DIC and faggot cells
AML M3
50
generalized overactivation of the coagulation and fibrinolytic system of the body (clot formation and bleeding)
disseminated intravascular coagulation (DIC)
51
tests to detect DIC (2)
PF 1 + 2 ("prothrombin fragment") | D-dimer test
52
related conditions with DIC (TOMASA)
- tissue trauma - obstetric complications - mucus-secreting tumors - acute infections (malaria, G- septicemia) - snake bites - acute promyelocytic anemia
53
WBC with bundles of auer rods
faggot cells
54
WBC with linear projections of primary granules
auer rods
55
AML M3 subtype name and characteristics
AML M3V: APL, microgranular variant | butterfly/bowtie/apple core nuclei
56
AML M4 origin
myelocytic | monocytic
57
AML M4 name
acute myelomonocytic leukemia (AMML) | naegeli monocytic leukemia
58
2nd most common subtype of AML
AML M4
59
AML M4 subtype name and characteristics
AML M4E: AMML with increased marrow eosinophils
60
AML M5 origin
monocytic
61
AML M5 name
acute monocytic leukemia (AMoL) | schilling leukemia
62
AML M5 subtypes name and characteristics (2)
AML M5a: AMoL, poorly differentiated - seen in children - >80% monoblasts in BM AML M5b: AMoL, well differentiated - seen in adults - <80% monoblasts in BM
63
AML M6 origin
erythrocytic | myelocytic
64
AML M6 name
acute erythroleukemia | di guglielmo's syndrome
65
type of anemia in M6
macrocytic and normochromic anemia
66
t or f. normal erythroid cells should be positive in PAS?
false
67
t or f. erythroid cells in AML M6 is positive in PAS
true
68
AML M7 origin
megakaryocytic
69
AML M7 name
acute megakaryocytic leukemia
70
what immunocytochemistry stain is used to diagnose AML M7?
factor VIII stain
71
AML cytochemical stains used (6) | mss nnf
``` MPO SBB specific esterase NSE butyrate NSE acetate factor VIII stain ```
72
AML cytochemical reaction: MPO SBB SE = positive
myelocytic origin M1, M2, M3, M4 M6 - positive or negative
73
AML cytochemical reaction: NSE butyrate NSE acetate = positive
monocytic origin M4, M5
74
CML name
chronic myelogenous leukemia | chronic granulocytic leukemia
75
CML characteristic
Ph1 | Philadelphia chromosome
76
how many percent of patients with CML have Ph1 chromosome?
90%
77
in a normal individual, where are ABL and BCR gene found respectively?
ABL - long arm of chromosome 9 | BCR - long arm of chromosome 22
78
in patients with CML, what happens to his/her chromosome 9 and 22?
long arm of C9 with ABL gene translocates with BCR gene in long arm of C22 therefore producing BCR-ABL fusion gene in long arm of C22/ Philadelphia chromosome
79
what gene causes CML and where it is found?
BCR-ABL fusion gene in the long arm of chromosome 22
80
clinical syndrome resembling leukemia
leukemoid reaction
81
test to distinguish leukemoid reaction vs CML
leukocyte (neutrophil) alkaline phosphatase test | LAP/NAP
82
LAP/NAP test principle
increased LAP activity can be observed in NORMAL neutrophils
83
only leukocyte that has alkaline phosphatase activity
neutrophil
84
method used for LAP/NAP staining
kaplow's method
85
normal LAP score
20-100
86
conditions with increased LAP score (4)
3rd trimester of pregnancy polycythemia vera infections intoxication all of these are characterized by leukemoid reaction
87
conditions with decreased LAP score (4)
CML PNH sideroblastic anemia myelodysplastic syndrome
Hematology 1
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