Week 6

Question 1

Generalized lymphadenopathy

Answer 1

when there is more than 1 lymphnode that is swollen

Question 2

smudge cell

Answer 2

• Fragile cells (predominately B cells) that break when smeared on slide

Question 3

clumping of chromatin

Answer 3

makes lymphocyte look like soccer ball

Question 4

Labs for leukemia

Answer 4

-Flow cytmetry of peripheral blood Look for CD5 to look for CLL

Question 5

Markers seen in CLL

Answer 5

• CD5: usually a T cell marker but it is common to see in CLL
• CD 19: B cell marker

Question 6

Treatment for CLL

Answer 6

• Should only be started if symptomatic

- Natural progression of CLL is Very slow, patients will often die from something else

Question 7

Superior vena cava syndrome

Answer 7

since patient is anemic could be compressing the vena cava

Question 8

Autoimmune hemolytic anemia in setting of CLL

Answer 8

• shows anemia, and peripheral blood smear shows spherocytes
• Why? Because non-neoplastic lymph cells are producing auto-antibodies
• Can also get auto-immune thrombocytopenia

Question 9

Treatment for Autoimmune hemolytic anemia in setting of CLL

Answer 9

• treat symptomatically
• Give corticosteroid as first line treatment
• May have to give low dose chemo to help with sxs down the road

Question 10

acute leukemia sxs

Answer 10

• fever, low weight, decreased apetite, new onset of easy bruising. petichie,

Question 11

labs to diagnose acute leukemia

Answer 11

-CBC: hgb low, HCT low, platelets low,

WBC differential: other cells and high lymphocytes

Question 12

peripheral blood smear of acute leukemia

Answer 12

Large leukocyte with high nucleus to cytoplasm ratio- can barely see cytoplasm

Question 13

treatment for acute leukemia

Answer 13

Goal is to not have any disease left–chemo will wipe out bone marrow allowing it to reset to try and get normal cells back–do NOT want to see blasts

Question 14

Difference between ALL and AML

Answer 14

ALL has ability to enter sanctuary cells and CNS involvement

Question 15

Mortality in ped. ALL population

Answer 15

-infection 47%
-hemorrhage 12%
Infection with additional factor 76.5%

Question 16

Mortality in ped. ALL population

Answer 16

• infection 47%
• hemorrhage 12%
• Infection with additional factor 76.5%

Question 17

Why at risk for infection with ALL

Answer 17

B or T cells not working

Question 18

How would you monitor risk for infection

Answer 18

• CBC: looking for anemia, thrombocytopenia, and neutrophils (if under 200 at risk for infection)