Aaron Shared "HEME" - 16 Picmonics

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HEME

Acute Lymphoblastic Leukemia (ALL)
Ages < 15
May Present with Bone Marrow Involvement in Children
Mediastinal Mass in Adolescents
TdT Positive
CALLA Positive
t(12;21) Better Prognosis
Spread to CNS and Testes
Most Responsive to Chemotherapy
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2 mins
Chronic Lymphocytic Leukemia (CLL)
Signs and Symptoms
Age > 60 Years
B Cell Neoplasm
Smudge Cells
Often Asymptomatic
Cold IgM Autoimmune Hemolytic Anemia
Warm IgG Autoimmune Hemolytic Anemia
Richter's Transformation
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3 mins
Hairy Cell Leukemia
Pathophysiology
Mature B Cell Tumor
Signs and Symptoms
Splenomegaly
Diagnosis
Flow Cytometry
Cells Have Filamentous Hair-Like Projections
Stains TRAP Positive
Dry Tap on Bone Marrow Aspiration
Treatment
Cladribine
Pentostatin
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2 mins
Acute Myelogenous Leukemia (AML)
Myeloblasts Increase on Peripheral Smear
Median Onset 60 Years
T 15;17 M3 Subtype
Auer Rods
Disseminated Intravascular Coagulation (DIC) is a Common Presentation
M5 Gum Infiltration
Responds to Vitamin A
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3 mins
Chronic Myelogenous Leukemia (CML)
Age 30 to 90 Years
BCR-ABL
9;22 Translocation
Philadelphia Chromosome
Tyrosine Kinase
Low Alkaline Phosphatase (ALK-P)
Splenomegaly
Blast Crisis can Accelerate and Transform to AML or ALL
Imatinib (Gleevec)
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2 mins
Azathioprine (Imuran)
Mechanism
Antimetabolite
Prodrug of 6-mercaptopurine (6-MP)
Inhibits Synthesis of Nucleic Acids
Indications
Autoimmune Disorders
Kidney Transplantation
Side Effects
Myelosuppression
Increased Toxicity with Allopurinol Use
Pancreatitis
Malignancy
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3 mins
Fluorouracil (5-FU)
Mechanism
Antimetabolite
"Thymine-less Death"
Indications
Slow-growing Solid Tumors
Co-administered with Leucovorin for Stomach Cancer
Basal Cell Carcinoma (Topical)
Side Effects
Myelosuppression
Mucositis
Severe Diarrhea
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3 mins
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
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1 min
Bleomycin
Indications
Testicular Cancer
Hodgkin's Lymphoma
Mechanism of Action
Induces Free Radical Formation
Breaks in DNA Strands
Side Effects
Pulmonary Fibrosis
Skin Changes
Mucositis
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1 min
Dactinomycin (Actinomycin D)
Indications
Wilms' Tumor
Rhabdomyosarcoma
Ewing's Sarcoma
Gestational Trophoblastic Malignancy
Mechanism
Intercalates DNA
Side Effect
Myelosuppression
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2 mins
Doxorubicin (Adriamycin)
Indications
Solid Tumors
Lymphomas and Leukemias
Mechanism
Free Radical Production
Intercalates DNA
Prevents Double Helix from Sealing
Side Effect
Cardiotoxicity
Dexrazoxane Decreases Toxicity
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1 min
Busulfan
Indications
CML
Bone Marrow Ablation
Mechanism
Cross-links DNA
Side Effects
Myelosuppression
Pulmonary Fibrosis
Hyperpigmentation
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1 min
Cyclophosphamide
Mechanism
Requires Bioactivation by Liver
Cross-links DNA
Guanine N7 Position
Indications
Autoimmune Disorders
Leukemia
Lymphoma
Solid Tumors
Side Effects
Myelosuppression
Hemorrhagic Cystitis
Prevent with Mesna
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3 mins
Vincristine (Oncovin)
Mechanism
Vinca Alkaloid
Inhibits Microtubules
Indications
Leukemias
Lymphomas
Side Effects
Peripheral Neuropathy
Paralytic Ileus
Considerations
Vesicant
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2 mins
Cisplatin
Indications
Carcinomas
Ovarian
Bladder
Lung
Testicular
Mechanism
Cross-Links DNA
Side Effects
Ototoxicity
Nephrotoxicity
Treat with Amifostine and Chloride Diuresis
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2 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins

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