Hematology Overview and Blood Formation
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Questions and Answers

What is a common clinical symptom indicative of Chronic Myeloid Leukemia (CML)?

  • Night sweats (correct)
  • Severe muscle pain
  • Nausea and vomiting
  • Persistent cough

    • In the diagnosis of Chronic Myeloid Leukemia (CML), which cytogenetic finding is crucial for confirmation?

  • Deletion of the long arm of chromosome 5
  • Monosomy of chromosome 7
  • Philadelphia chromosome (t(9;22)) (correct)
  • t(8;14) chromosomal translocation

    • What laboratory test finding is typically expected in a Complete Blood Count (CBC) for a patient with Chronic Myeloid Leukemia?

  • Eosinopenia
  • Thrombocytopenia
  • Leukocytosis (correct)
  • Hypoalbuminemia

    • Which of the following types of cells is typically increased in the peripheral blood smear of a patient with Chronic Myeloid Leukemia?

    <p>Immature myeloid cells (C)</p> Signup and view all the answers

    Which additional test can reveal hypercellularity and granulocytic hyperplasia in Chronic Myeloid Leukemia?

    <p>Bone marrow aspiration and biopsy (B)</p> Signup and view all the answers

    What distinguishes the chronic phase of Chronic Myeloid Leukemia from the accelerated phase?

    <p>Blast percentage in the blood (C)</p> Signup and view all the answers

    Which type of leukemia is characterized by the presence of ≥20% blasts in bone marrow examination?

    <p>Acute Myeloid Leukemia (B)</p> Signup and view all the answers

    What is a common symptom of Acute Myeloid Leukemia?

    <p>Fatigue (C)</p> Signup and view all the answers

    Which of the following markers is NOT typically associated with myeloid leukemia?

    <p>CD14 (D)</p> Signup and view all the answers

    Which cytogenetic finding is typically associated with a favorable risk stratification in Acute Myeloid Leukemia?

    <p>t(8;21) (D)</p> Signup and view all the answers

    What is the primary reason for starting ATRA in Acute Promyelocytic Leukemia (APL)?

    <p>To manage DIC risk (B)</p> Signup and view all the answers

    What do peripheral smears typically show in Acute Lymphoblastic Leukemia?

    <p>Lymphoblasts (C)</p> Signup and view all the answers

    Which lab finding is NOT commonly associated with Acute Lymphoblastic Leukemia during evaluation?

    <p>Elevated serum calcium (C)</p> Signup and view all the answers

    In the context of leukemia, what does the presence of Auer rods in a peripheral smear indicate?

    <p>Acute Myeloid Leukemia (A)</p> Signup and view all the answers

    Which of the following is NOT considered a symptom associated with acute leukemias?

    <p>Weight loss (C)</p> Signup and view all the answers

    Which marker is associated exclusively with T-lineage leukemias?

    <p>CD3 (C)</p> Signup and view all the answers

    What is considered a high-risk genetic abnormality in acute lymphoblastic leukemia?

    <p>t(9;22) (D)</p> Signup and view all the answers

    Which of the following classifications does NOT pertain to Acute Myeloid Leukemia?

    <p>L1 (B)</p> Signup and view all the answers

    In the context of acute lymphoblastic leukemia, what does the presence of blasts in cerebrospinal fluid indicate?

    <p>CNS infiltration (D)</p> Signup and view all the answers

    Which lymphoblastic leukemia classification is characterized by large, heterogenous lymphoblasts with prominent nucleoli?

    <p>L2 (C)</p> Signup and view all the answers

    What is a defining feature of acute promyelocytic leukemia M3?

    <p>t(15;17) genetic translocation (A)</p> Signup and view all the answers

    Which acute myeloid leukemia subtype is characterized by the absence of maturation in myeloblasts?

    <p>M1 (B)</p> Signup and view all the answers

    The presence of Auer rods is a peculiar feature in which type of leukemia?

    <p>Acute Myeloid Leukemia (D)</p> Signup and view all the answers

    What type of leukemia is characterized by small, monomorphic lymphoblasts with regular nuclei and scanty cytoplasm?

    <p>Acute Lymphoblastic Leukemia L1 (C)</p> Signup and view all the answers

    Which imaging technique is commonly used to evaluate CNS involvement in acute leukemias?

    <p>CT scan (B)</p> Signup and view all the answers

    Flashcards

    Acute Leukemia

    A blood disorder characterized by the overproduction of immature white blood cells (blasts) in the bone marrow.

    Acute Promyelocytic Leukemia (APL)

    A severe type of acute myeloid leukemia (AML) with a specific genetic abnormality (t(15;17) translocation)

    Anemia in Acute Leukemia

    A common symptom of acute leukemia due to the bone marrow being unable to produce enough red blood cells.

    Myeloperoxidase (MPO)

    A type of white blood cell marker used in AML diagnosis. It is often found in myeloid blasts.

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    Cytogenetics in AML

    A type of genetic test used in AML diagnosis to detect specific chromosomal abnormalities.

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    Molecular Testing in AML

    A group of genetic tests that can be used in AML diagnosis to detect specific gene mutations.

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    Risk Stratification in AML

    A test to assess the risk of complications in AML. It's used to classify patient into different risk groups.

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    Bone Marrow Examination in Leukemia

    A process of examining the bone marrow for abnormalities, including the presence of leukemia blasts.

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    Special Stains in Leukemia

    A test that involves staining blood cells with specific dyes to identify cells with specific characteristics.

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    What is Chronic Myeloid Leukemia (CML)?

    Chronic Myeloid Leukemia (CML) is a type of cancer affecting white blood cells, specifically the granulocytes, resulting in their uncontrolled production.

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    What is the Philadelphia chromosome?

    A hallmark characteristic of CML is the presence of the Philadelphia chromosome, a genetic abnormality caused by a translocation between chromosomes 9 and 22.

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    What is the BCR-ABL1 fusion gene?

    The Philadelphia chromosome leads to the production of a fusion gene called BCR-ABL1, which results in uncontrolled growth of granulocytes.

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    What are the different phases of CML?

    CML follows a progression with different phases: chronic, accelerated, and blast crisis. The chronic phase is characterized by a low percentage of blast cells (less than 5%).

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    What differentiates the accelerated and blast crisis phases of CML?

    In the accelerated phase, the blast count is higher (5-19%), indicating a more aggressive form of the disease. The blast crisis phase has a high blast cell count (more than 20%) and indicates a more aggressive form of the disease.

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    How is CML diagnosed?

    Laboratory tests, including a complete blood count (CBC) and peripheral blood smear, are essential to confirm the diagnosis of CML.

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    Acute Lymphoblastic Leukemia (ALL)

    A type of blood cancer where abnormal white blood cells called lymphoblasts are produced in large numbers.

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    Acute Myeloid Leukemia (AML)

    A type of blood cancer where abnormal white blood cells called myeloblasts are produced in large numbers.

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    FAB Classification for ALL

    Classification system divides ALL into three sub-types based on morphology (appearance) of the leukemia cells.

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    ALL L1

    A type of ALL with small, similar lymphoblasts with rounded nuclei and scanty cytoplasm. Nucleoli are not visible.

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    ALL L2

    A type of ALL with large, diverse lymphoblasts with irregular nuclei and prominent nucleoli. They have abundant cytoplasm.

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    ALL L3

    A type of ALL with large, uniform lymphoblasts. They have deeply blue-colored cytoplasm with vacuoles and are often called Burkitt's type.

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    FAB Classification for AML

    Classification system for AML based on the morphology and stage of development of the leukemia cells.

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    AML M1

    A type of AML with a high proportion of immature myeloblasts without significant maturation.

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    AML M2

    A type of AML with a mix of both immature myeloblasts and more mature myeloid cells.

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    AML M3

    A specific type of AML with a translocation between chromosomes 15 and 17. It is associated with Auer rods.

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    Study Notes

    Hematology: Overview

    • Hematology is the study of blood and blood disorders.
    • This presentation covers acute and chronic leukemias.
    • Institutions involved include Hawler Medical University, College of Medicine, and the Pathology Department.

    Hematopoiesis

    • Hematopoiesis is the process of blood cell formation.
    • Multipotential hematopoietic stem cells (Hemocytoblasts) differentiate into various blood cell types, including erythrocytes, thrombocytes (platelets), granulocytes (neutrophils, eosinophils, basophils), monocytes, and lymphocytes (B and T cells).
    • Different cytokines (e.g., SCF, EPO, G-CSF, GM-CSF, IL-3, IL-6) regulate differentiation.

    Myeloid Lineage Development

    • Myeloblasts are immature myeloid cells
    • Myeloblasts differentiate into various granulocytes and monocytes.
    • Granulopoiesis is the process of granulocyte formation.
    • Monocytopoiesis is the process of monocyte formation and differentiation to macrophages.
    • The development is displayed as a stepwise process via myelocyte, metamyelocyte, band, and segmented neutrophil stages.
    • Stages of development (e.g., myeloblast, promyelocyte, myelocyte, metamyelocyte, band neutrophil, segmented neutrophil) are shown histologically via images.

    Acute Leukemia

    • Acute leukemias are characterized by rapid proliferation of undifferentiated or immature blood cells.
    • Acute myeloid leukemia (AML) involves abnormal proliferation of myeloid progenitor cells.
    • Acute lymphoblastic leukemia (ALL) involves abnormal proliferation of lymphoid progenitor cells.
    • AML and ALL are classified by morphology and immunophenotype (e.g., myeloblastic, monoblastic) in various stages.
    • FAB classification categorizes AML types.
    • WHO classification, a more current system used in AML.
    • Diagnostic methods include clinical assessment, CBC, peripheral blood smear, bone marrow examination, flow cytometry, cytogenetics, and genomic analysis.
    • Risk stratification determines the prognosis and treatment approach.
    • Some subtypes of AML include Acute Promyelocytic Leukemia (APL), t(15;17)/PML-RARA.

    Chronic Leukemia

    • Chronic leukemias are characterized by the uncontrolled proliferation of mature or near-mature blood cells.
    • Chronic myeloid leukemia (CML) arises from the myeloid lineage, which includes abnormalities of mature granulocytes.
    • Chronic lymphocytic leukemia (CLL) originates from the lymphoid lineage with an increase in mature lymphocytes.
    • Symptoms, physical examination, and laboratory tests (CBC, peripheral blood smear, bone marrow aspiration and biopsy, flow cytometry) aid in diagnosis.
    • Diagnostic features and tests include cytogenetic analysis (detecting Philadelphia chromosome t(9;22), molecular testing (BCR-ABL1 fusion gene) and LDH levels.
    • Phases of chronic myeloid leukemia (CML) are presented, including chronic phase, accelerated phase, and blast crisis phase.

    Diagnosis and Investigations

    • Various diagnostic tools, including: clinical assessment, laboratory tests (CBC, peripheral blood smear, bone marrow examination), flow cytometry, genetics, cytogenetics, and other tests (coagulation testing and imaging) are important.
    • The diagnostic process includes a combination of these features.
    • Patient examples aid in demonstration.

    ALL Classification

    • Acute Lymphoblastic Leukemia is categorized into L1, L2, and L3.

    Other Points

    • Important findings aid in diagnosis, including presence of Auer rods in some conditions.
    • Clinical assessment, physical examination, laboratory tests, cytogenetics, molecular testing (PCR or FISH), flow cytometry, and bone marrow examination are used to identify leukaemia types.
    • These methods help differentiate between various conditions.
    • There are different subtypes and classifications of leukemia, including acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL).
    • Pictures of peripheral blood samples and images of bone marrow are highlighted.

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    Hematology Lecture Notes PDF

    Description

    This quiz explores key concepts in hematology, including the study of blood and blood disorders, hematopoiesis, and myeloid lineage development. Participants will learn about leukemias, blood cell types, and the regulatory factors involved in blood cell differentiation. Ideal for medical students and professionals in the field.

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