Hematologic Disorders: Acute Lymphoblastic Leukemia (ALL)

Study Notes

Week 8: Hematologic Disorders

Acute Lymphoblastic Leukemia (ALL) is prevalent in children around 4 years old.
Symptoms include fever, bone pain, headache, and vomiting.
Possible complications include bone marrow depression, leading to anemia, thrombocytopenia, and neutropenia.
Peripheral blood shows lymphoblasts, often positive for CD10.
Down syndrome increases the risk of ALL by 10-20 times.
ALL may affect testes and central nervous system.
Lymphocyte development shows TdT positivity and expression of CD5, CD7, CD2, and CD3 in pre-B and pre-T blasts.
Acute Myeloid Leukemia (AML) primarily affects adult males.
Peripheral blood smear may show anemia, thrombocytopenia, and myeloblasts.
Myeloblasts are MPO positive and often present Auer rods.
Auer rods are pathognomonic for AML and result from MPO accumulation; they can lead to Disseminated Intravascular Coagulation (DIC).
Philadelphia chromosome is a genetic hallmark of Chronic Myeloid Leukemia (CML).
It leads to the synthesis of tyrosine kinase protein; tyrosine kinase inhibitors are used in CML treatment.
Chronic Lymphocytic Leukemia (CLL) is characterized by disorder of naive B lymphocytes, not blasts.
Commonly affects individuals around age 60; patients are often asymptomatic initially.
Symptoms can include fevers and sweats.
CLL cells express CD5 and are B-cell in origin.
Autoantibodies in certain conditions are not produced by malignant cells but by non-neoplastic cells, notably Reed-Sternberg cells.
Reed-Sternberg cells are derived from B cells and are characterized by CD15+ and CD30+ expression.

Week 9: Cardiovascular Disorders

Angina Pectoris is primarily caused by atherosclerosis of coronary arteries, leading to plaque buildup.
Stable angina occurs without pain at rest; it manifests as chest pain during exercise or stress.
Unstable angina presents with pain at rest, with or without exertion.
Myocardial Infarction (MI) diagnosis relies on cardiac troponin levels, which rise after 4 hours and persist for 7-10 days.
CK-MB levels rise after 6-12 hours; they return to baseline after 48 hours, indicating potential reinfarction.
Risks following MI include arrhythmias within the first 4 days, and risk for free wall rupture or tamponade between 5-10 days.
Dressler Syndrome occurs weeks later, characterized by immune-mediated chest pain, worsened by deep breathing or lying flat; treated with NSAIDs or steroids.

Week 10: Respiratory Disorders

Emphysema is common among smokers and results from an imbalance in proteases, leading to trapped air and damage primarily in upper lung regions.
Alpha-1 antitrypsin deficiency also contributes to emphysema, particularly affecting lower lobes.
Asthma is characterized by reversible bronchoconstriction, often triggered by allergic stimuli and common in children.
Common triggers for asthma include upper respiratory infections, allergens, stress, exercise, cold air, and aspirin.
Symptoms of asthma include dyspnea, wheezing, cough, hypoxia, decreased inspiratory/expiratory ratio, and reduced peak flow; mucus plugging can cause airway obstruction.
Kartagener's Syndrome involves chronic sinusitis, bronchiectasis, male infertility, and situs inversus, inherited in an autosomal recessive manner.
Silicosis results from inhalation of silica dust from materials like quartz or granite, primarily affecting upper lobes and common in settings like foundries and mines.
Asbestosis is caused by inhalation of asbestos fibers, typically affecting lower lobes and found in shipbuilding and plumbing industries.

Week 12: Gastrointestinal Disorders

Gastroesophageal Reflux Disease (GERD) is characterized by the backflow of gastric juices into the esophagus due to lower esophageal sphincter (LES) dysfunction.
Common risk factors for GERD include alcohol, smoking, obesity, fatty foods, caffeine, and hiatal hernia.
Barrett's Esophagus is a consequence of chronic GERD, marked by metaplasia where squamous epithelium transforms into intestinal epithelium.