Podcast
Questions and Answers
Which cytogenetic abnormality is most associated with Myelodysplastic Syndromes (MDS)?
Which cytogenetic abnormality is most associated with Myelodysplastic Syndromes (MDS)?
- Trisomy 8
- t(9:22)
- Del 5q (correct)
- Del 7q
What is a key feature in the diagnosis of Chronic Myelomonocytic Leukemia (CMML)?
What is a key feature in the diagnosis of Chronic Myelomonocytic Leukemia (CMML)?
- Increased Blasts (correct)
- Presence of schistocytes
- Tear drop cells
- Increased reticulin fibers
Which test is essential in confirming a diagnosis of Polycythemia Vera (PCV)?
Which test is essential in confirming a diagnosis of Polycythemia Vera (PCV)?
- Increased platelet count
- Low EPO levels (correct)
- Presence of tear drop cells
- Increased ferritin
Which condition is most likely to present with a 'crap ton of platelets' as a defining characteristic?
Which condition is most likely to present with a 'crap ton of platelets' as a defining characteristic?
In the context of acute conditions, which laboratory study would be performed to rule out sepsis?
In the context of acute conditions, which laboratory study would be performed to rule out sepsis?
Which myeloid marker is positive in both Acute Promyelocytic Leukemia (APML) and Chronic Myelomonocytic Leukemia (CMML)?
Which myeloid marker is positive in both Acute Promyelocytic Leukemia (APML) and Chronic Myelomonocytic Leukemia (CMML)?
What cytogenetic abnormality is associated with Acute Promyelocytic Leukemia (APML)?
What cytogenetic abnormality is associated with Acute Promyelocytic Leukemia (APML)?
What is a common feature of Myelodysplastic Syndromes (MDS)?
What is a common feature of Myelodysplastic Syndromes (MDS)?
Which of the following markers is negative in Chronic Myelomonocytic Leukemia (CMML) but positive in Acute Myeloid Leukemia (AML)?
Which of the following markers is negative in Chronic Myelomonocytic Leukemia (CMML) but positive in Acute Myeloid Leukemia (AML)?
In multiple myeloma, which of the following markers increases due to the presence of abnormal plasma cells?
In multiple myeloma, which of the following markers increases due to the presence of abnormal plasma cells?
Which of the following conditions can exhibit an increased level of LDH?
Which of the following conditions can exhibit an increased level of LDH?
Which of the following is a key distinguishing feature of Non-Hodgkins Lymphoma as opposed to other lymphoid neoplasms?
Which of the following is a key distinguishing feature of Non-Hodgkins Lymphoma as opposed to other lymphoid neoplasms?
What findings in cytochemistry would rule out Chronic Myelomonocytic Leukemia (CMML)?
What findings in cytochemistry would rule out Chronic Myelomonocytic Leukemia (CMML)?
Which genetic marker is associated with Chronic Myeloid Leukemia (CML)?
Which genetic marker is associated with Chronic Myeloid Leukemia (CML)?
In the context of Acute Myeloid Leukemia (AML), which of the following cytogenetic abnormalities is specifically linked to acute promyelocytic leukemia (APML)?
In the context of Acute Myeloid Leukemia (AML), which of the following cytogenetic abnormalities is specifically linked to acute promyelocytic leukemia (APML)?
What is a common immunophenotypic marker for diagnosis in Chronic Lymphocytic Leukemia (CLL)?
What is a common immunophenotypic marker for diagnosis in Chronic Lymphocytic Leukemia (CLL)?
Which cytochemistry test is expected to be positive in Acute Myeloid Leukemia (AML)?
Which cytochemistry test is expected to be positive in Acute Myeloid Leukemia (AML)?
Which condition is NOT on the differential for Chronic Lymphocytic Leukemia (CLL)?
Which condition is NOT on the differential for Chronic Lymphocytic Leukemia (CLL)?
What cytogenetic abnormality is characterized by chromosome del(13q.14.3)?
What cytogenetic abnormality is characterized by chromosome del(13q.14.3)?
In the context of Myelodysplastic Syndromes (MDS), which of the following would typically be ruled out by the presence of a JAK mutation?
In the context of Myelodysplastic Syndromes (MDS), which of the following would typically be ruled out by the presence of a JAK mutation?
Which marker is typically negative in the immunophenotyping of Acute Myeloid Leukemia (AML)?
Which marker is typically negative in the immunophenotyping of Acute Myeloid Leukemia (AML)?
Study Notes
Cytopenias
- Differentials: AML, AMML, CML, CMML, VB12 Def, infections, toxins, drugs, congenital, PNH, aplastic, mf, ida
- Tests and expectations:
- Cytogenetics: Del 5q, Del 7q, Trisomy 8
- BM: Dysplasia, Increased Blasts, Increased cellularity
Myelofibrosis
- My identification technique: Tear drop cells, nRBCs
- Differentials: AML, CML, ALL, CLL, MDS, TB, SLE, Lymphoma, ET, PCV, CMML
- Tests and expectations:
- Antinuclear Antibodies to exclude SLE
- BM to exclude acute leukemia and identify significant reticulin and collagen - fibrosis
- Molecular Studies + Cytogenetics to exclude CML + MDS. Should have JAK2 Mutation
- Microbiology to exclude TB
- DAT to exclude acute hemolysis
Essential Thrombocytosis (ET)
- My identification technique: Crap ton of platelets
- Differentials: PCV, Reactive Thrombocytosis, CML, MF, MDS, IDA
- Tests and expectations:
- BM - Normocellular or slightly hypocellular, increased megakaryocytes, no collagen fibrosis
- Molecular Tests -- Mutation of JAK2 (V617F)
- Cytogenetics negative for t(9:22)
- ESR + CRP rule out reactive thrombocytosis
- Iron Studies Normal
Polycythemia Vera (PCV)
- My identification technique: Crap ton of RBCs
- Differentials: Methemoglobinemia, ET, hypoxia, Renal Disease, IDA
- Tests and expectations:
- Molecular Studies: JAK2 Mutation (V617F)
- EPO Levels Low
- Iron Studies -- Increased Ferritin rules out IDA
- BM: Hypercellularity, Megakaryocytic proliferation and clustering
- Oxygen Saturation -- Differentiates hypoxia association
Thrombotic Thrombocytopenic Purpura (TTP)
- My identification technique: Thrombocytopenia and schistocytes
- Differentials: ITP, HUS, DIC, HELLP, malignancy, autoimmune disorders, sepsis/bacterial infection
- Tests and expectations:
- RFT -- Rule out HUS
- LFT -- Rule out HELLP
- Coagulation Profile -- Rule out DIC
- DAT - Rule out Autoimmune
- Blood Culture -- Rule out Sepsis
- ADAMTS13 Decreased
- Congenital -- ADAMTS13 Mutation
- Acquired -- ADAMTS13 Antibodies
Acute Promyelocytic Leukemia (APML)
- My identification technique: Crap ton of promyelocytes and blasts
- Differentials: AML, ALL, AMML, MDS Transformation, Leukemoid Reaction, Aplastic Anaemia
- Tests and expectations:
- Cytogenetics: T(15:17) PML-RARA
- Immunophenotyping:
- Positive: Myeloid Markers - 13, 33, 117
- Negative: T-Cell Markers - 2, 3, 5, 7, B-Cell Markers - 10, 19, 22, Monocytic - 14, 64
- Cytochemistry:
- Positive: MPO, SBB, Chloroacetate esterase
- Negative: PAS, Acid Phosphatase, a-naphthylacetate esterase
Chronic Myelomonocytic Leukemia (CMML)
- My identification technique: Crap ton of dysplastic monocytes and neutrophils
- Differentials: CML, PCV, ET, MF, MDS, tuberculosis, bacterial endocarditis
- Tests and expectations:
- Cytogenetics:
- T(9:22) -- BCR-ABL negative -- rules out CML
- MDS abnormalities negative
- Immunophenotyping:
- Positive: Myeloid Markers - 13, 33, Monocytic Markers - 14
- Negative: T-Cell Markers - 2, 3, 5, 7, B-Cell Markers - 10, 19, 22
- Cytochemistry:
- Positive: Chloroacetate esterase, a-naphthylacetate esterase
- Negative: PAS, Acid Phosphatase, MPO, SBB
- Cytogenetics:
- BM
- LOW NAP score for CML
- Microbiology negative for TB or other infection
- Molecular studies JAK2 mutations negative
Multiple Myeloma (Myeloma)
- My identification technique: Egg lookin plasma cells
- Differentials: Reactive Plasmacytosis, Plasma Cell Leukemia, Waldenstrom's Macroglobulinemia, Monoclonal Gammopathy
- Tests and expectations:
- Cytogenetics: Del 13q, T(4:14)
- Immunophenotyping: Positive: 38, 56, 58 ,138
- Chemistries:
- Increased: Igs, TP, urea nitrogen, creatinine, calcium
- Decreased: albumin
- Bence Jones protein in urine
- BM: Marrow plasmacytosis
- Xray, CT, MRI
Non-Hodgkins Lymphoma
- My identification technique: Lymphoma Cells
- Differentials: Burkitt's Lymphoma, Mantle Cell Lymphoma, Prolymphocytic Leukemia, CLL, Hairy Cell Leukemia, Diffuse Large B cell Lymphoma, Follicular Lymphoma
- Tests and expectations:
Myelodysplastic Syndromes (MDS)
- My identification technique: Dysplastic cells in either one or all cell lines - pelger huet, hypogranulation, ovalocytes, nRBCs
Acute Lymphoblastic Leukemia (ALL)
- My identification technique: Crap ton of blasts don't stress about type, just write acute leukemia
- Differentials: AML, Non-Hodgkins Lymphoma, Burkitt's Lymphoma, Aplastic Anaemia, IM, Viral
- Tests and expectations:
- Cytogenetics:
- T(9:22) -- Philadelphia chromosome (BCR-ABL)
- T(1:19) -- PBX-E2A
- T(12:21) -- TEL-AML1
- T(v:11) -- v:MLL
- Hyperdiploid
- Hypodiploid
- Immunophenotyping:
- Positive: Blast Markers - 34, TdT, T-Cell Markers - 2, 3, 5, 7, B-Cell Markers - 10, 19, 20
- Cytochemistry:
- Positive: PAS, TdT, HLA-DR, Acid Phosphate
- Negative: MPO, SBB
- Cytogenetics:
Chronic Lymphocytic Leukemia (CLL)
- My identification technique: Crap ton of lymphocytes and smear cells
- Differentials: AML, ALL, CML, HCL, Lymphomas, Bacterial Infection, AIHA, post splenectomy lymphocytosis, stress induced lymphocytosis, MDS, MF, Prolymphocytic Leukemia, IM, Viral
- Tests and expectations:
- Cytogenetics:
- Del(13q.14.3)
- Trisomy 12
- Del(11q)
- Immunophenotyping:
- Positive: T-Cell Markers - 2, 3, 5, 7 (rare), B-Cell Markers - 19, 20, 23, 79
- Negative: FMC7, 10, 38
- Microbiology - Bacterial infection
- DAT - AIHA
- BM
- Cytogenetics:
Acute Myeloid Leukemia (AML)
- My identification technique: Crap ton of blasts don't stress about type, just write acute leukemia. Should see left shift though
- Differentials: ALL, APML, AMML, MDS Transformation, Leukemoid Reaction, Aplastic Anaemia
- Tests and expectations:
- Cytogenetics:
- T(16:16) -- CBFB-MYH11
- T(9:11) -- MLLT3-MLL
- T(6:9) -- DEK-NUP214
- T(3:3) - RPN1-EV11
- T(1:22) - RBM15-MKL1
- T(8:21) - RUNX1-RUNX1T1
- T(15:17) - PML-RARA for APML
- Immunophenotyping:
- Positive: Myeloid Markers - 13, 33, 117, Blast Markers - 34
- Negative: T-Cell Markers - 2, 3, 5, 7, B-Cell Markers - 10, 20, Monocytic - 14, 64
- Cytochemistry:
- Positive: MPO, SBB, Chloroacetate Esterase
- Negative: PAS, Acid Phosphate, a-naphthylacetate esterase
- BM
- Cytogenetics:
Chronic Myeloid Leukemia (CML)
- My identification technique: Crap ton of left shift and basophils
- Differentials: AML, CMML, Reactive neutrophilia, Leukemoid Reaction, PCV, ET, MF
- Tests and expectations:
- Cytogenetics:
- T(9:22) - BCR-ABL
- Negative JAK mutation rules out PCV, ET + MF.
- Cytogenetics:
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Assess your knowledge of various hematological conditions including Cytopenias, Myelofibrosis, and Essential Thrombocytosis. This quiz covers differentials, identification techniques, and important tests related to these conditions. Challenge yourself on the tests and expectations needed to diagnose and differentiate these hematological disorders.
