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LEUKEMIA/LYMPHOMAS
MLT 126: HEMATOLOGY AND COAGULATION - EXAM #5
| Question | Answer |
|---|---|
| What is the general definition of a leukemia? | an overproduction of immature or mature, myelocytic or lymphocytic WBCs, which causes anemia and thrombocytopenia |
| Define a lymphoma | malignant lymph node-centric tumor that can also affect certain WBCs (lymphocytes) in the bone marrow |
| What is the main difference between acute leukemia and chronic leukemia? | acute=excess in immature WBCs with elevated leukocytosis chronic=excess in mature WBCs with varying total WBC range |
| Describe what causes Leukemia | gene translocation and certain alterations in gene expression can cause the development of one or more malignant, hematopoietic stem cells. this results in abnormal cell formation |
| Why is WHO Leukemia classification utilized more in the modern age? | takes into account sign and symptoms alongside cytogenetic, immunophenotypical markers, cytochemical staining, and cell morphology, which shorten the time it takes to classify a leukemia |
| If there are greater than or equal to 20% blasts, acute myelogenous leukemia is then diagnosed, according to what system? Why is that? | WHO classification; we conduct more testing to shorten the amount of time it takes to diagnose leukemia |
| If there are greater than or equal to 30% blasts, acute myelogenous leukemia is then diagnosed, according to what system? | FAB system |
| Correct this statement: If someone (is lacking/has an excess amount of) tumor suppressor genes, this will negate cell proliferation and allow the tumor to grow | is lacking |
| True or false: Lymphoma is the leading cause of death in 1-19yr olds | false; Leukemias |
| What are the two criteria FAB uses to diagnose a Leukemia? | cellular morphology, cytochemical stain reactions |
| Which stains are used to differentiate ALL from AML? | Sudan Black B, Myeloperoxidase, Periodic Acid-Schiff, Specific and Non-Specific Esterase |
| Describe the principle of Sudan Black B stain. What results does it yield? | its a lipophilic dye that binds irreversibly to granulocytes. Myeloblasts=strong positive, Monocytes vary, Lymphoid cells=negative |
| Which stain detects enzymes from in primitive myelo/monoblasts? How does it work? | Myeloperoxidase; benzidine oxidizes and forms a stable black color in the presence of hydrogen peroxide |
| What are the results of the Myeloperoxidase stain? | Myeloblasts=strong positive, Monocytes weak positive, Lymphoblasts cells=negative |
| What is the principle of the Periodic Acid-Schiff (PAS) stain? | PAS produces aldehydes due to the oxidation of glycogen, carbs and mucoproteins by periodic acid |
| Which stain would produce dark red granulation of lymphoblasts (positive), leaving the myeloblasts negative and monoblasts a weak positive? | PAS stain |
| What is the principle of the Esterase stains? | Diazo salt formations induce color changes. Specific=black for positives Non-Specific=red for positives |
| Non-Specific Esterase stain differentiates between (blank) and (blank). What are the results? | Myeloblasts/Monoblasts; positive=monoblasts, negative=myeloblasts |
| Which stain is used to separate monocytic from granulocytic precursors? | Specific Esterase |
| Which stain uses overproduction of isoenzyme 5 to differentiate T-lymphocytic to B-lymphocytic leukemia? | Acid phosphate; pos=T-cell (hairy cells) |
| What is the principle of the TdT stain, and what are the possible results? | relies on anti-TdT to bind to immature B-cell/T-cell markers and produces color changes based on the cell. pos=immature lymphocytes, neg=myeloid cells |
| Define Immunophenotyping | antigen-antibody reaction analysis to identify cells based on the antigenic markers it presents via flow cytometry organization |
| What are the CD markers for Myeloblasts. Which other blast series shares these same markers? | CD13, CD15, CD33, CD117; monoblasts |
| CD117 is shared between which cell types | myeloblasts, monoblasts, lymphoblasts |
| CD56 and CD16 are marker for | NK lymphocytes |
| CD4 and CD8 are markers for | helper and suppressor T-cells |
| CD42b, CD61, CD31, and Factor VIII are all marker for | Megakaryoblastic cells |
| CD2, CD3, CD5, CD7 are all markers for | T-cells |
| What are the CD markers for B-cells | CD10, CD19, CD20, CD22 |
| Antiglycoprotein is a marker for | RBCs |
| Define Acute Leukemia | a sudden onset disease that causes an overproduction of immature, non-functional cells in the bone marrow |
| True or false: The hallmark findings of Acute Leukemia include 20-90% blast cells and a hypocellular bone marrow that blocks capillaries | false; hypercellular bone marrow |
| In Acute Leukemia, RBC count and PLTS would be (blank), with the later contributing to infectious susceptibility | decreased (excess bleeding, anemia) |
| What defines Acute Myelogenous Leukemia? | due to a gene transcription error, the bone marrow continues to make blast cells, but they only develop up to a certain point. |
| What laboratory criteria is needed to diagnose AML? | between sever leukopenia and severe leukocytosis, thrombocytopenia, anemia, macrocytosis WHO=20%< blasts, FAB=30%<blasts |
| Which AML is defined by the presence of non-descript blasts that are lacking the granules for proper staining, but contain CD13 and CD33 markers | FAB M0/AML Minimally Differentiated |
| Describe FAB M1 | otherwise known as AML Without Differentiation, this occurs in kids younger than 18months where the majority of their cells are myeloblasts do not mature further |
| Which AML is known to cause gingival bleeding and petechiae in middle age people, and has blast cells that show proof of maturation? | AML with Maturation/FAB M2 |
| Describe FAB M3 | Acute Promyelocytic Leukemia is an AML variant that causes abnormal promyelocytes (can be hyper- or hypo-granular). causes non-specific symptoms like hematuria, petechiae, and fatigue |
| Which common AML has an increase 20%< of both myelocytic and monocytic precursors? | FAB M4/Acute Myelomonocytic anemia |
| Which subclass of FAB M5 is made up of mainly monoblasts? | FAB M5a (Acute Monoblastic Leukemia) |
| True or false: FAB M5 has an increase monocytic cells and decrease in granulocytic cells | true |
| Which FAB classification has a predominance of erythroid cells? | FAB M6 (Acute/Pure Erythroid Leukemia) |
| CD41, CD61, and CD42 are markers often found in FAB M7, otherwise known as | Acute Megakaryoblastic Leukemia |
| Which AML with CD13 and CD33 markers usually comes up as negative for cytochemical staining? | Acute Basophilic Leukemia |
| What defines Acute Lymphoblastic Leukemia? | overproduction of mature lymphoid cells in the bone marrow due to a gene mutation, meaning that they do not mature and do not die; primarily affects 3-5yr olds |
| The inequal production of cells in Acute Lymphoblastic Leukemia can cause (blank) | thrombocytopenia, neutropenia, and bone pain |
| A positive PAS stain and positive TdT, alongside CD19, CD20, CD2, and CD5 would diagnoses | Acute Lymphoblastic Leukemia |
| Which Lymphoblastic FAB division is common in children, known for its scant cytoplasm and a majority committed B-cell lymphoblastic population? | FAB L2 (Precursor B-cell Leukemia) |
| Describe Burkitt Type FAB L3 | the leukemic phase of Burkitt's Lymphoma, categorized by large lymphoblasts having basophilic cytoplasm with vacuoles |
| Which ALL condition has an increase in T-cell committed lymphoblasts? | Precursor T-cell Leukemia (FAB L1) |
| What general leukemia term is categorized based on an overproduction of mature lymphocytes | Chronic Leukemia |
| Chronic Lymphocytic Leukemia is often a B-cell disease. What makes CLL so dangerous for patients? | they will often die of infection due to a disturbed antibody production |
| Define Chronic Monocytic Leukemia | a condition affecting middle age people where there is an increase in large mature monocytes with irregular nuclei and cytoplasmic pseudopods |
| Which class of Chronic Lymphocytic Leukemia involves the bone marrow and blood lymphocytosis? | Stage 0 |
| What would Stage 1 of CLL consist of? | Lymphocytosis with large lymph nodes |
| What are the general lab results for Chronic Lymphocytic Leukemia | 30-200x10^9/L, majority mature small lymphs, T-cells with cleft or clover shaped nuclei, visible nucleoli, neutropenia, thrombocytopenia, anemia |
| What CD markers would be found in T-cell CLL | CD2, CD3, CD8 |
| What CD markers would be found in B-cell CLL | CD5, CD22, CD24 |
| Describe Prolymphocytic Leukemia and its corresponding lab results | B-cell disease with extreme lymphocytosis (over 350,000mm3) with a majority of them being prolymphocytes. contains CD19, CD20, CD22, CD24 |
| Which CLL common in males is known for having an excess of B-cell that have phagocytic abilities? Which marker is used to definitively confirm its diagnosis | Hairy Cell Leukemia; CD25 |
| Define a neoplasma | single clone of a cell that massively proliferates B-cells |
| Describe Multiple Myeloma | the hyperproliferation of one type of immunoglobulin (IgG), causing increase catabolism of normal immunoglobulins, the later represented in the eventual renal insufficiency due to damaged glomerular filtration |
| What can cause Multiple Myeloma | genetics or exposure to radiation, pesticides, chemicals, etc., resulting in the activation of osteoclasts that then cause nerve pain. relative lymphocytosis, anemia, and RBC rouleaux is seen |
| What protein is often found in the urine lab results for Multiple Myeloma | Bence Jones protein |
| Describe Burkitt Type FAB L3 | the leukemic phase of Burkitt's Lymphoma, categorized by large lymphoblasts having basophilic cytoplasm with vacuoles |
| Which ALL condition has an increase in T-cell committed lymphoblasts? | Precursor T-cell Leukemia (FAB L1) |
| What general leukemia term is categorized based on an overproduction of mature lymphocytes | Chronic Leukemia |
| Chronic Lymphocytic Leukemia is often a B-cell disease. What makes CLL so dangerous for patients? | they will often die of infection due to a disturbed antibody production |
| Define Chronic Monocytic Leukemia | a condition affecting middle age people where there is an increase in large mature monocytes with irregular nuclei and cytoplasmic pseudopods |
| Which class of Chronic Lymphocytic Leukemia involves the bone marrow and blood lymphocytosis? | Stage 0 |
| What would Stage 1 of CLL consist of? | Lymphocytosis with large lymph nodes |
| What are the general lab results for Chronic Lymphocytic Leukemia | 30-200x10^9/L, majority mature small lymphs, T-cells with cleft or clover shaped nuclei, visible nucleoli, neutropenia, thrombocytopenia, anemia |
| What CD markers would be found in T-cell CLL | CD2, CD3, CD8 |
| What CD markers would be found in B-cell CLL | CD5, CD22, CD24 |
| Describe Prolymphocytic Leukemia and its corresponding lab results | B-cell disease with extreme lymphocytosis (over 350,000mm3) with a majority of them being prolymphocytes. contains CD19, CD20, CD22, CD24 |
| Which CLL common in males is known for having an excess of B-cell that have phagocytic abilities? Which marker is used to definitively confirm its diagnosis | Hairy Cell Leukemia; CD25 |
| Define a neoplasma | single clone of a cell that massively proliferates B-cells |
| Describe Multiple Myeloma | the hyperproliferation of one type of immunoglobulin (IgG), causing increase catabolism of normal immunoglobulins, the later represented in the eventual renal insufficiency due to damaged glomerular filtration |
| What can cause Multiple Myeloma | genetics or exposure to radiation, pesticides, chemicals, etc., resulting in the activation of osteoclasts that then cause nerve pain. relative lymphocytosis, anemia, and RBC rouleaux is seen |
| What protein is often found in the urine lab results for Multiple Myeloma | Bence Jones protein |
| Describe Burkitt Type FAB L3 | the leukemic phase of Burkitt's Lymphoma, categorized by large lymphoblasts having basophilic cytoplasm with vacuoles |
| Which ALL condition has an increase in T-cell committed lymphoblasts? | Precursor T-cell Leukemia (FAB L1) |
| What general leukemia term is categorized based on an overproduction of mature lymphocytes | Chronic Leukemia |
| Chronic Lymphocytic Leukemia is often a B-cell disease. What makes CLL so dangerous for patients? | they will often die of infection due to a disturbed antibody production |
| Define Chronic Monocytic Leukemia | a condition affecting middle age people where there is an increase in large mature monocytes with irregular nuclei and cytoplasmic pseudopods |
| Which class of Chronic Lymphocytic Leukemia involves the bone marrow and blood lymphocytosis? | Stage 0 |
| What would Stage 1 of CLL consist of? | Lymphocytosis with large lymph nodes |
| What are the general lab results for Chronic Lymphocytic Leukemia | 30-200x10^9/L, majority mature small lymphs, T-cells with cleft or clover shaped nuclei, visible nucleoli, neutropenia, thrombocytopenia, anemia |
| What CD markers would be found in T-cell CLL | CD2, CD3, CD8 |
| What CD markers would be found in B-cell CLL | CD5, CD22, CD24 |
| Describe Prolymphocytic Leukemia and its corresponding lab results | B-cell disease with extreme lymphocytosis (over 350,000mm3) with a majority of them being prolymphocytes. contains CD19, CD20, CD22, CD24 |
| Which CLL common in males is known for having an excess of B-cell that have phagocytic abilities? Which marker is used to definitively confirm its diagnosis | Hairy Cell Leukemia; CD25 |
| Define a neoplasma | single clone of a cell that massively proliferates B-cells |
| Describe Multiple Myeloma | the incurable, hyperproliferation of one type of immunoglobulin (IgG), causing increase catabolism of normal immunoglobulins, the later represented in the eventual renal insufficiency due to damaged glomerular filtration |
| What can cause Multiple Myeloma | genetics or exposure to radiation, pesticides, chemicals, etc., resulting in the activation of osteoclasts that then cause nerve pain. relative lymphocytosis, anemia, and RBC rouleaux is seen |
| What protein is often found in the urine lab results for Multiple Myeloma | Bence Jones protein |
| Describe Waldenstrom's Primary Macroglobuinemia | plasma cell proliferation disorder that causes an excess in IgM production that impairs platelet function due to coating |
| True or false: Waldenstrom's and Multiple Myeloma both cause bone pain | false; only Multiple Myeloma due to osteoclast activation |
| What are the lab results for Waldenstrom's Primary Macroglobuinemia | chronic anemia and bleeding, mature lymphocytes and plasma cells in blood, absolute lymphocytosis with normal total leukocyte count, decreased PLTS, rouleux, cryoglobulins (protein precipitants that dissolve in heat) |
| Define Lymphomas and what differentiates them from Leukemia | lymphoma=proliferation of one or more cells that destroys the nodes' structure (hodgkins vs non-hodgkins) leukemia=overproduction of one cell type (immature or mature) |
| What viral infections may lead to a Lymphoma? | H. pylori, EBV, HIV |
| What clinical signs are considered to be hallmarks of Hodgkin's Lymphoma? | firm-to-touch lymph nodes, low grade fever, weight loss |
| What occurs in the later stage of Hodgkin's lymphoma? | lymphocytes, monocytes, and other WBCs cells begin to infiltrate the lymph nodes. reed-sternberg cells appear |
| Which is the most common type of Non-Hodgkins Lymphoma | Diffuse large B-cell lymphoma |
| What affects can Diffuse Large B-cell Lymphoma have on a patient's lab results? | large B-cells that have CD10 markers, |
| Which Epstein-Barr Virus-related lymphoma cause sporadic, high proliferation of lymphocytes that have basophilic, vacuolated cytoplasm | Burkitt's lymphoma |
| Describe Sezary Syndrome/Mycosis fungoides` | T-cell mutation that causes them migrate to the skin, causing excessive sagging. in a PBS, T-cells tend to have cerebriform-like nucleus with clumped chromatin. is CD2, CD3, CD4, and CD5 positive |
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