24 Questions
What is a characteristic of Acute Leukemia cells?
Sticky
What is the primary treatment for AML/ALL?
Chemotherapy
What is the name of the genetic mutation associated with Acute Promyelocytic Leukemia (APML)?
t(15;17)
What is the primary risk factor for developing Chronic Myeloid Leukemia (CML)?
Exposure to ionizing radiation
What is the name of the drug used to treat Chronic Myeloid Leukemia (CML)?
Imatinib
What is the primary characteristic of Chronic Lymphoid Leukemia (CLL)?
Elevated WBC count
What is the name of the cells associated with Hodgkin's Lymphoma?
Reed-Sternberg cells
What is the primary treatment for Non-Hodgkin's Lymphoma?
All of the above
What is the primary diagnostic method for MALT tumors?
Excisional biopsy of the lymph node
Which of the following is a common symptom of Multiple Myeloma?
Pain in the mid thoracic back that worsens when lying down
What is the primary risk factor for developing Multiple Myeloma?
African American heritage
What is the primary indication for referring a patient to an oncologist for Multiple Myeloma?
Presence of anemia with renal insufficiency
What is the primary goal of treatment for Multiple Myeloma?
Prolong survival and improve quality of life
What is the primary characteristic of cancer cell growth?
Uncontrolled cell growth with loss of apoptosis
What is the role of autologous transplant in Multiple Myeloma?
Prolongs the time to first relapse
From which type of cell does myeloma originate?
Plasma cell, a type of B cell
What is the definition of Myelodysplastic Syndrome?
A premalignant disorder that will progress to cancer if left untreated
What is the typical demographic affected by acute leukemia?
Older people, non-Hispanic whites
What is the primary indication for assessing a patient for autologous transplant in Multiple Myeloma?
All patients with MM should be assessed for autologous transplant
What is the primary reason why acute leukemia is considered dangerous?
Without treatment, death is inevitable
What is the significance of 'blast' in a CBC?
It indicates abnormal peripheral blood cells
What is the possible consequence of a high white cell count in acute leukemia?
Leukostasis
Which of the following is a rare clinical presentation of acute leukemia?
Gingival hyperplasia
What is the metabolic abnormality that can occur in acute leukemia?
Hyperphosphatemia
Study Notes
Hematological Malignancies
- Cancer is defined as uncontrolled cell growth with loss of apoptosis (programmed cell death).
- Cancer can occur in any cell in the body, and when it occurs in blood cells, it is known as either Leukemia (from myeloid or lymphoid cells), Lymphoma (from lymphoid tissue), or Myeloma (from plasma cells).
Leukemia
- Leukemia is classified into acute (rapid progression) and chronic (slow progression) types.
- Acute Leukemia:
- Can be myeloid (AML) or lymphoid (ALL)
- Epidemiology: generally affects older people, non-Hispanic whites, and those with genetic disorders, radiation exposure, or chemical exposure
- Signs and symptoms: fatigue, anemia, high white cell count, bleeding/bruising, bone/joint pains, skin manifestations, and pallor
- Acute Leukemia cells are "sticky" and can cause hyperviscosity, making it a medical emergency
- Treatment: chemotherapy (unless palliative care) and specialized treatment for Acute Promyelocytic Leukemia (APML)
- Chronic Leukemia:
- Chronic Myeloid Leukemia (CML): characterized by Philadelphia chromosome translocation BCR-ABL t(9;22), exposure to ionizing radiation is a risk factor, and treatment involves tyrosine kinase inhibitors
- Chronic Lymphoid Leukemia (CLL): affects older people, smudge cells are present, and treatment involves new drugs in pill form
Lymphomas
- Epidemiology: relatives of probands have a 3.5x higher chance of developing lymphoma, higher incidence in people with RA, hemolytic anemia, Crohn Disease, and motor and Celiac disease
- Hodgkin Lymphoma:
- Peak incidence at young ages (20-24) and old ages (80-84)
- Presents with lymphadenopathy, fatigue, and pruritus
- Treatment: complex chemotherapy, radiation therapy, or a combination of both, and BMT or CART therapy
- Non-Hodgkin Lymphoma:
- Affects all races, ages, and socioeconomic status
- Presents with lymphadenopathy, fever of unknown origin, and can be associated with immunodeficiencies
- Diagnosis: excisional biopsy of the LN (FNA's are notoriously poor), and CBC for anemia, thrombocytopenia, and abnormalities of the WBC count
Plasma Cell Dyscrasias - Multiple Myeloma (MM)
- Multiple Myeloma:
- Epidemiology: higher incidence in African Americans, increases with Body Mass Index, and association with agent orange exposure
- Symptoms: mild back pain, anemia, renal insufficiency, and bone disease
- CRAB criteria: calcium deviation, renal insufficiency, anemia, and bone disease
- Pitfalls: worsening hypercalcemia, increased thirst and urination frequency, confusion, and bone lesions with pathological fractures
- Treatment: induction chemotherapy, autologous transplant, and maintenance therapy (no cure, only prolongs survival)
Myelodysplastic Syndrome (MDS)
- MDS is a premalignant disorder that will be cancer if left untreated
- Defined as a pre-malignancy of the bone marrow
This quiz covers the general concepts of cancer, including uncontrolled cell growth, apoptosis, and types of hematological malignancies such as leukemia, lymphoma, and myeloma. Review of marrow components is also included.
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