⁨⁨⁨⁨⁨أسئلة المحاضرة السادسة أورام باطنة الدلتا
32 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the most common type of leukemia found in children?

  • Acute Undifferentiated Leukemia (AUL)
  • Acute Myeloid Leukemia (AML)
  • Acute Lymphoblastic Leukemia (ALL) (correct)
  • Chronic Myeloid Leukemia (CML)

    • Which predisposing factor is NOT associated with leukemia?

  • Low-salt diet (correct)
  • Viral infection
  • Genetic disorders
  • Pollution

    • What clinical manifestation is MOST commonly associated with decreased red blood cells (RBCs) in leukemia?

  • Purpura
  • Fever
  • Pallor (correct)
  • Weight loss

    • What laboratory finding indicates an unfavorable prognosis in leukemia?

    <p>WBC count greater than 50,000</p> Signup and view all the answers

    Which of the following is NOT a typical investigation for diagnosing leukemia?

    <p>MRI scan</p> Signup and view all the answers

    What is the pathogenesis of leukemia primarily characterized by?

    <p>Stop of maturation of blast cells</p> Signup and view all the answers

    Which statement regarding the clinical picture of leukemia is correct?

    <p>Unexplained fever is a symptom to consider leukemia.</p> Signup and view all the answers

    Which type of leukemia is NOT mentioned as occurring in pediatrics?

    <p>Chronic Lymphocytic Leukemia (CLL)</p> Signup and view all the answers

    What characterizes L1 subtype of Acute Lymphoblastic Leukemia (ALL)?

    <p>Small cell with mild basophilia of cytoplasm</p> Signup and view all the answers

    Which of the following is true regarding M3 subtype of Acute Myeloid Leukemia (AML)?

    <p>Pro-myelocytic leukemia</p> Signup and view all the answers

    What is the primary use of cytogenetic studies in leukemia diagnosis?

    <p>To detect specific translocations</p> Signup and view all the answers

    Which specific surface antigens are expressed in Pre B ALL blasts?

    <p>CD19, 22, 79a, 10</p> Signup and view all the answers

    What age range is considered a bad prognostic criterion for ALL?

    <p>Under 1 year or over 10 years</p> Signup and view all the answers

    Which of the following types of leukemia is characterized by the presence of undifferentiated cells?

    <p>M0</p> Signup and view all the answers

    In T ALL, which surface antigens are typically expressed?

    <p>CD2, 3, 5, 7</p> Signup and view all the answers

    What type of leukemia is associated with the favorable translocation t(12,21)?

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

    Which clinical manifestation would most likely indicate a significant decrease in platelets (PLT) in a patient with leukemia?

    <p>Purpura</p> Signup and view all the answers

    What percentage of pediatric leukemia cases is Acute Lymphoblastic Leukemia (ALL)?

    <p>75%</p> Signup and view all the answers

    Which of the following factors is considered a possible predisposing factor for leukemia?

    <p>Genetic disorders</p> Signup and view all the answers

    In the pathogenesis of leukemia, what is primarily halted, resulting in increased blast cell numbers?

    <p>Cell maturation</p> Signup and view all the answers

    Which investigation is NOT typically used to ascertain the type of leukemia?

    <p>Lumbar puncture</p> Signup and view all the answers

    What hallmark finding in a Complete Blood Count (CBC) may indicate hyperleukocytosis in leukemia?

    <p>WBC count &gt; 100,000</p> Signup and view all the answers

    Which of the following is NOT a symptom commonly associated with leukemia?

    <p>Increased appetite</p> Signup and view all the answers

    How is leukocytosis characterized in patients with leukemia?

    <p>Increase in WBC count</p> Signup and view all the answers

    How does the classification of Acute Lymphoblastic Leukemia (ALL) vary among its subtypes?

    <p>Subtypes differ in cell size and specific basophilia characteristics.</p> Signup and view all the answers

    Which subtype of Acute Myeloid Leukemia (AML) is characterized by mature myeloid cells?

    <p>M2</p> Signup and view all the answers

    Which of the following surface antigens is expressed by T Acute Lymphoblastic Leukemia (T ALL)?

    <p>CD5, CD2, CD3, CD7</p> Signup and view all the answers

    What is the significance of the translocation t(9,22) in leukemia prognosis?

    <p>It is associated with a poor prognosis in ALL.</p> Signup and view all the answers

    In the context of leukemia classifications, what criteria define a bad prognosis for Acute Lymphoblastic Leukemia (ALL)?

    <p>Age under 1 or over 10 years.</p> Signup and view all the answers

    Which investigation is commonly used to detect specific translocations in leukemia?

    <p>Cytogenetic studies</p> Signup and view all the answers

    What characterizes the M3 subtype of Acute Myeloid Leukemia (AML)?

    <p>Promyelocytic leukemia</p> Signup and view all the answers

    Which of the following tests is NOT typically used in leukemia diagnosis?

    <p>Electrocardiogram</p> Signup and view all the answers

    Study Notes

    Leukemia Overview

    • Leukemia is a malignant blood cell disease affecting white blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs), mainly WBCs.
    • It is the most common malignant disease in children.
    • Acute lymphoblastic leukemia (ALL) accounts for approximately 75% of leukemia cases.
    • Acute myeloid leukemia (AML) accounts for approximately 15-20% of cases.
    • Chronic myeloid leukemia (CML), acute undifferentiated leukemia (AUL), and acute lymphoblastic acute myeloid leukemia (AMLL) account for approximately 5% of cases.
    • Chronic lymphocytic leukemia (CLL) is not typically seen in children.
    • ALL is the most common type of leukemia in children.

    Etiology

    • The causes of leukemia are multifactorial.
    • Predisposing factors include chemical exposure, radiation, pollution, genetic disorders (e.g., Down syndrome), and viral infections.

    Pathogenesis

    • Leukemia is characterized by the uncontrolled proliferation of immature blood cells (blasts) in the bone marrow.
    • This immature cell proliferation stops maturation of blast cells, increasing the number of blast cells in the bone marrow at the expense of other cell types.

    Clinical Picture

    • Common clinical manifestations include pallor (due to low red blood cell count), purpura (due to low platelet count), fever (due to low white blood cell count), and generalised lymphadenopathy.
    • These characteristics may not always appear together.
    • Other potential signs include splenomegaly, hepatomegaly, central nervous system (CNS) involvement, facial palsy, testicular infiltration, bone pain, arthralgia or arthritis, and unexplained fever or weight loss.
    • Suspect leukemia if unexplained fever, anemia, or purpura are present.

    Investigations

    • Complete blood count (CBC) and blood film are used for the initial diagnosis.
    • CBC can indicate anemia, thrombocytopenia, and leukocytosis (elevated WBC count) or more rarely leukopenia (low WBC count).
    • Blast cells may be present in the blood film.
    • WBC count greater than 50,000/µL is often associated with a poorer prognosis.
    • Hyperleukocytosis (WBC count > 100,000/µL) is also a poor prognostic indicator.

    Diagnosis of Leukemia

    • Bone marrow aspiration is essential for diagnosing leukemia.
    • The test looks for an increased percentage of blast cells in the bone marrow.
    • The normal bone marrow blast count is less than 5%.
    • If the suspected blast percentage in the bone marrow aspiration is 5–25%, repeat the test after two weeks to see if the blast cell percentage has progressed to above 25%.

    Subtypes of Leukemia

    • By cytochemical study with different stains like P.A.S. and acid phosphatase to further classify leukemia.

    • Leukemia subtypes are classified using the French-American-British (FAB) classification system, typically based on the morphological characteristics of the cancerous white blood cells.

      • ALL encompasses subtypes like L1, L2, and L3 based on the appearance.
      • AML comprises subtypes such as M0-M7 as well.

    Flowcytomertic and Cytogenetic Tests

    • Flowcytomertic tests are used to classify leukemia based on the surface antigens on the blasts.
    • Examples include CD markers (CD19, 22, 79a, and 10) for Pre B-ALL, and CD2,3,5,7 for T-ALL.
    • Cytogenetic tests (e.g., detecting certain translocations) are also used for specific diagnostics, with specific outcomes considered favorable (e.g., t(12,21)), and others unfavorable (e.g., t(9,22), 11q23).

    Other Investigations

    • Other investigations, such as chest X-ray (CXR), abdominal ultrasound (Abdominal U/S), liver function tests, and kidney function tests, may be performed to aid in the assessment of other organ systems.
    • Serum uric acid, immunophenotyping and cytogenetic studies are also important.

    Bad Prognostic Criteria (ALL)

    • Age, less than one year or greater than ten years.
    • Male sex
    • Black race
    • White blood cells (WBCs) greater than 50,000 per \µm3.
    • Severe thrombocytopenia.
    • Mediastinal lymph node enlargement
    • Huge Splenomegaly

    Risk Group Stratification

    • The Children Oncology Group (COG) criteria categorizes leukemia patients into different risk groups based on their initial white blood cell count and the absence or presence of extramedullary disease manifestation or involvement like CNS.

    Treatment and relapse

    • Treatment options for leukemia usually involve induction regimens, CNS prophylaxis, and maintenance therapy.
    • Relapse can involve medullary, CNS, and/or testicular relapses.
    • Differential diagnoses for similar symptoms include pancytopenia, purpura, arthritis, and hepatosplenomegaly (HSM). Additional differential diagnoses include conditions like lymphadenopathy, fever of unknown origin (FUO), and pallor.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Leukemia Notes PDF

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser