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Questions and Answers
What is the peak age of onset for Acute Lymphoblastic Leukemia (ALL)?
What is the peak age of onset for Acute Lymphoblastic Leukemia (ALL)?
Which of the following is NOT a common clinical manifestation of Acute Lymphoblastic Leukemia (ALL)?
Which of the following is NOT a common clinical manifestation of Acute Lymphoblastic Leukemia (ALL)?
What is the typical survival rate for Chronic Myelocytic Leukemia (CML) without treatment?
What is the typical survival rate for Chronic Myelocytic Leukemia (CML) without treatment?
Which of the following is a characteristic of Chronic Lymphocytic Leukemia (CLL)?
Which of the following is a characteristic of Chronic Lymphocytic Leukemia (CLL)?
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What is the typical 5-year survival rate for Acute Lymphoblastic Leukemia (ALL) with treatment?
What is the typical 5-year survival rate for Acute Lymphoblastic Leukemia (ALL) with treatment?
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Which of the following is a characteristic of Chronic Leukemias?
Which of the following is a characteristic of Chronic Leukemias?
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What is the most common type of non-Hodgkin lymphoma in children?
What is the most common type of non-Hodgkin lymphoma in children?
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Which of the following is NOT a common clinical feature of extranodal non-Hodgkin lymphoma?
Which of the following is NOT a common clinical feature of extranodal non-Hodgkin lymphoma?
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Which of the following is the most common type of leukemia in children?
Which of the following is the most common type of leukemia in children?
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Which of the following is a common chromosomal abnormality seen in Acute Lymphoblastic Leukemia (ALL)?
Which of the following is a common chromosomal abnormality seen in Acute Lymphoblastic Leukemia (ALL)?
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Which of the following is NOT a common risk factor for the development of Hodgkin's lymphoma?
Which of the following is NOT a common risk factor for the development of Hodgkin's lymphoma?
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What is the primary difference between Acute Lymphoblastic Leukemia (ALL) and Lymphoblastic Lymphoma?
What is the primary difference between Acute Lymphoblastic Leukemia (ALL) and Lymphoblastic Lymphoma?
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What is the characteristic histological finding of the Reed Sternberg cell in Hodgkin's lymphoma?
What is the characteristic histological finding of the Reed Sternberg cell in Hodgkin's lymphoma?
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Which of the following is NOT a general type of leukemia?
Which of the following is NOT a general type of leukemia?
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What is the principal pathogenetic problem in acute leukemias?
What is the principal pathogenetic problem in acute leukemias?
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What is the most common cause of cancer death in children under 15 years of age?
What is the most common cause of cancer death in children under 15 years of age?
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Which of the following is a characteristic feature of acute myeloblastic leukemia (AML)?
Which of the following is a characteristic feature of acute myeloblastic leukemia (AML)?
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What is the most common treatment for Hodgkin's lymphoma?
What is the most common treatment for Hodgkin's lymphoma?
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Which of the following is the most common cause of neutrophilia?
Which of the following is the most common cause of neutrophilia?
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What is the primary diagnostic test used to confirm infectious mononucleosis?
What is the primary diagnostic test used to confirm infectious mononucleosis?
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Which of the following is the most common clinical presentation of reactive lymphadenitis?
Which of the following is the most common clinical presentation of reactive lymphadenitis?
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Which of the following is the most common cause of encephalitis in immunocompetent individuals?
Which of the following is the most common cause of encephalitis in immunocompetent individuals?
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Which of the following is the most common clinical presentation of cat-scratch disease?
Which of the following is the most common clinical presentation of cat-scratch disease?
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Which of the following is a characteristic of stage III Hodgkin Lymphoma or Non-Hodgkin Lymphoma?
Which of the following is a characteristic of stage III Hodgkin Lymphoma or Non-Hodgkin Lymphoma?
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According to the Cotswold Modification of Ann Arbor Staging, what is the criteria for stage IV Hodgkin Lymphoma or Non-Hodgkin Lymphoma?
According to the Cotswold Modification of Ann Arbor Staging, what is the criteria for stage IV Hodgkin Lymphoma or Non-Hodgkin Lymphoma?
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What is the criteria for stage II Hodgkin Lymphoma or Non-Hodgkin Lymphoma according to the Cotswold Modification of Ann Arbor Staging?
What is the criteria for stage II Hodgkin Lymphoma or Non-Hodgkin Lymphoma according to the Cotswold Modification of Ann Arbor Staging?
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Which of the following conditions is characterized by an increase in neutrophils?
Which of the following conditions is characterized by an increase in neutrophils?
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What is the causative agent of mononucleosis?
What is the causative agent of mononucleosis?
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What is the criteria for stage I Hodgkin Lymphoma or Non-Hodgkin Lymphoma according to the Cotswold Modification of Ann Arbor Staging?
What is the criteria for stage I Hodgkin Lymphoma or Non-Hodgkin Lymphoma according to the Cotswold Modification of Ann Arbor Staging?
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What is the criteria for stage E Hodgkin Lymphoma or Non-Hodgkin Lymphoma according to the Cotswold Modification of Ann Arbor Staging?
What is the criteria for stage E Hodgkin Lymphoma or Non-Hodgkin Lymphoma according to the Cotswold Modification of Ann Arbor Staging?
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Which of the following conditions is caused by inflammation of the brain?
Which of the following conditions is caused by inflammation of the brain?
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What is the causative agent of Cat-Scratch Disease?
What is the causative agent of Cat-Scratch Disease?
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Which of the following conditions is characterized by swollen lymph nodes in response to an infection or other stimulus?
Which of the following conditions is characterized by swollen lymph nodes in response to an infection or other stimulus?
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Which of the following is the most common cause of cat-scratch disease?
Which of the following is the most common cause of cat-scratch disease?
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Which of the following is a characteristic feature of cat-scratch disease in children?
Which of the following is a characteristic feature of cat-scratch disease in children?
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Which of the following is a potential complication of cat-scratch disease?
Which of the following is a potential complication of cat-scratch disease?
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Which of the following is the most common cause of reactive lymphadenitis in children?
Which of the following is the most common cause of reactive lymphadenitis in children?
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Which of the following is a characteristic finding in reactive lymphadenitis due to viral infections?
Which of the following is a characteristic finding in reactive lymphadenitis due to viral infections?
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Which of the following is the most common cause of encephalitis in immunocompetent individuals?
Which of the following is the most common cause of encephalitis in immunocompetent individuals?
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What is the primary diagnostic test used to confirm infectious mononucleosis?
What is the primary diagnostic test used to confirm infectious mononucleosis?
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Which of the following conditions is characterized by an increase in neutrophils?
Which of the following conditions is characterized by an increase in neutrophils?
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Which of the following is a characteristic feature of cat-scratch disease in children?
Which of the following is a characteristic feature of cat-scratch disease in children?
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What is the causative agent of Cat-Scratch Disease?
What is the causative agent of Cat-Scratch Disease?
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Which of the following is a potential complication of cat-scratch disease?
Which of the following is a potential complication of cat-scratch disease?
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Which of the following is the most common cause of reactive lymphadenitis in children?
Which of the following is the most common cause of reactive lymphadenitis in children?
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Which of the following is a characteristic finding in reactive lymphadenitis due to viral infections?
Which of the following is a characteristic finding in reactive lymphadenitis due to viral infections?
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Which of the following is the most common clinical presentation of cat-scratch disease?
Which of the following is the most common clinical presentation of cat-scratch disease?
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Which of the following conditions is characterized by swollen lymph nodes in response to an infection or other stimulus?
Which of the following conditions is characterized by swollen lymph nodes in response to an infection or other stimulus?
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Study Notes
Acute Lymphoblastic Leukemia (ALL)
- Peak age: 2-10 years old
- 80% of cases occur in children
- Normal WBC count with excessive lymphoblasts
- With treatment, 75% of children remain free of disease in > 5 years
Clinical Manifestations of Leukemia
- Bone marrow replacement of normal parenchyma by neoplastic cells
- Alteration of stem cell: differentiated cell
- Symptoms:
- Fatigue
- Leukopenia
- Anemia
- Thrombocytopenia
- Bleeding diathesis
- Skin rash
- Systemic alteration
- Decrease immunologic functions
- Hepatosplenomegaly
- Infiltration of the gums
- Nonspecific symptoms:
- Fever
- Weight loss
- Petechia
- Echymosis
- Purpura
Chronic Leukemias
- Usually affects older adults
- Median age of onset: 65 years old
- Represents 1/3 of all leukemias
- Male predominance: 2:1
- Predominant cells are mature cells of the bone marrow (“Well differentiated” lymphocytes)
- Characterized by the accumulation of lymphocytes in the blood and lymphocytic organs
- Often patients are asymptomatic and can have anemia
- Two main types:
- Chronic Myelocytic Leukemia (CML)
- Chronic Lymphocytic Leukemia (CLL)
Chronic Myelocytic Leukemia (CML)
- Age of onset: 25-60 years old
- Poor prognosis, only 3 years of survival rate
- Characterized by WBC count of 50,000 to 300,000 with increased granulocytes in all states of maturation
- 90% have Philadelphia chromosome
Hodgkin’s Lymphoma
- Characterized by Reed Sternberg cell (owl eyes nuclei)
- Prognosis: Good
- Treatment: Chemotherapy (ABVD, BEACOPP)
Leukemias Classification
- Four general types:
- Acute Lymphoblastic Leukemia (ALL)
- Acute Myeloblastic Leukemia (AML)
- Chronic Lymphocytic Leukemia (CLL)
- Chronic Myeloid Leukemia (CML)
Acute Leukemias
- Principal pathogenetic problem: block in differentiation
- Abrupt stormy onset
- Laboratory findings: Absolute leukocytosis (>100,00 WBC/ul but >50% is 25% of marrow population
- The disease usually affects all ages, but usually occurs in younger patients
- Predominant cell type: BLAST cells (immature cells)
- Leading cause of cancer death in children under 15 years of age and the seventh most common form of cancer death overall
Acute Leukemias (continued)
- Two major types:
- Acute Myeloblastic Leukemia (AML)
- Common in infants and middle age or older
- Mean age: 50 years old
- Characterized by normal WBC count with excessive myeloblasts
- Auer Rods may be seen within leukemic cells in the blood
- Acute Myeloblastic Leukemia (AML)
Non-Hodgkin Lymphoma
- Classification based on:
- Cell type:
- Precursors cells: B cells, T cells
- Mature cells: natural killer (NK) cells
- Location (nodal or extranodal)
- Tumor grade
- Cell type:
- Clinical features:
- Nodal disease:
- B symptoms (20-50%)
- Lymphadenopathy
- Hepatosplenomegaly
- Cytopenias (decrease RBC, WBC, platelets)
- Extranodal disease:
- GI (15%): inflammation can evolve to ulcer and perforation of stomach or small intestine
- Liver/spleen: diffuse hepatosplenomegaly
- Skin: rash
- Bone: pathologic fractures (pain-swelling)
- CNS: epidural SCC, peripheral nerve infiltration, CNS lymphoma (1%)
- Nodal disease:
Cat-Scratch Disease
- Caused by Bartonella henselae
- Disease of childhood (90% younger than 18 years old)
- Regional lymphadenopathy (most frequent axilla and neck)
- Nodal enlargement approximately 2 weeks after feline scratch
- Nodal inflammation could last 2-4 months
- Complications:
- Encephalitis
- Osteomyelitis
- Thrombocytopenia
- Treatment: supportive, broad-spectrum ophthalmic drops (Fluroquinolones)
- Systemic antibiotics are recommended for moderate to severe disease
- Treat immunocompromised patients with doxycycline, azithromycin, trimethoprim/sulfamethoxazole, and ciprofloxacin
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Description
Test your knowledge on the clinical manifestations of Acute Lymphoblastic Leukemia (ALL) such as bone marrow alterations, symptoms like fatigue and bleeding diathesis, and systemic effects like decreased immunologic functions. Explore the peak age of 2-10 years, normal WBC count with excessive lymphoblasts, and treatment outcomes.