David Shared "Heme Exam 2" - 37 Picmonics
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Heme Exam 2
Cell Cycle Phases
- Characteristics
- G0 Phase
- Growth Arrest
- G1 Phase
- G1 Check By Rb And p53
- S Phase
- DNA Mismatch Repair
- DNA Synthesis
- G2 Phase
- G2 Check
- M Phase
- Mitosis And Cytokinesis
3 mins
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
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
3 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
3 mins
Chronic Myelogenous Leukemia (CML)
- Pathophysiology
- BCR-ABL
- 9;22 Translocation
- Philadelphia Chromosome
- Signs & Symptoms
- Tyrosine Kinase
- Low Alkaline Phosphatase
- Splenomegaly
- Considerations
- Blast Crisis
- Age 30 to 90 Years
- Responds to Imatinib
3 mins
Follicular Lymphoma
- Derives from Germinal Center
- Occurs in adults
- T14;18
- BCL 2 overexpression
- BCL 2 inhibits apoptosis
- Indolent
- Generalized lymphadenopathy
- Bone marrow involvement
2 mins
Burkitt's Lymphoma
- Adolescents or young adults
- C-myc gene moves next to heavy chain Ig gene
- T 8;14
- Starry sky appearance
- Sheets of lymphocytes with interspersed macrophages
- Jaw lesion in endemic (African) form
- Pelvis or abdomen in non endemic form (American form)
- Associated with EBV
2 mins
Diffuse Large B Cell Lymphoma
- Epidemiology
- Most Common Non-Hodgkin’s Lymphoma
- Usually in Older Adults
- 20% in Children
- Features
- May be Mature T Cell in Origin
- Derives from Germinal Center
- GI Tract and Brain
2 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
2 mins
Mantle Cell Lymphoma
- Older Males
- Activation of Cyclin D Gene
- T 11;14
- CD5
- Poor Prognosis
55 secs
Adult T Cell Lymphoma
- Caused by HTLV 1
- Japan, West Africa, Caribbean
- Present with cutaneous lesions
- Aggressive
1 min
Mycosis Fungoides / Sézary Syndrome
- Mechanism
- Neoplastic CD4+ Cells
- Adults 40 - 60 Years Old
- Mycosis Fungoides
- Neoplastic CD4+ Cells Infiltrate Skin
- Rashes Or Plaques
- Pautrier's Abscesses
- Sézary Syndrome
- Neoplastic CD4+ Spread from Skin to Systemic Involvement
- Sézary Cells With "Cerebriform Nuclei"
2 mins
Non-Hodgkin's Lymphoma Assessment
- Cause
- Lymphatic Cancer
- Non-Contiguous Spread
- B or T Cells
- Assessment
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Mediastinal or Abdominal Mass
- Considerations
- Older Adults
- > 60 Subtypes
2 mins
Leukemia Assessment
- Etiologic Factor
- Immature WBCs
- Presenting Signs and Symptoms
- Recurrent Infections
- Easy Bruising
- Bleeding
- Fatigue
- Weight Loss
- Bone Pain
- Clinical Findings
- Anemia
- May Have Normal or High WBC Count
2 mins
Leukemia Interventions
- Diagnosis
- Bone Marrow Aspiration
- X-Rays
- Interventions
- Chemotherapy
- Bleeding Precautions
- Neutropenic Precautions
- Strict Asepsis
- Bone Marrow Transplant
- Blood Transfusions
- Monitor Temperature Elevations
- Adequate Nutrition
- Imatinib (Gleevec) for Chronic Myelogenous Leukemia (CML)
3 mins
Severe Combined Immunodeficiency (SCID)
- Both B and T Cell Deficiency
- Recurrent Viral, Bacterial, Fungal, Protozoal Infections
- Defective Interleukin (IL) 2 Receptor
- X-Linked
- Adenosine Deaminase Deficiency
- Failure to Synthesize MHC II Antigens
- Treat with Bone Marrow Transplant
2 mins
Bruton's Agammaglobulinemia
- Pathophysiology
- X-linked Recessive
- Defective Bruton Tyrosine Kinase
- Blocks B Cell Maturation
- Signs & Symptoms
- Decreased Immunoglobulins of All Classes
- Bacterial Infections After Six Months
- Maternal IgG Protects Before Six Months
2 mins
Thymic Aplasia (DiGeorge Syndrome)
- Pathophysiology
- DiGeorge Syndrome
- 22q11 Deletion
- Failure to Develop Third and Fourth Pharyngeal Pouches
- Signs and Symptoms
- Undeveloped Thymus
- T Cell Deficiency
- Recurrent Viral and Fungal Infections
- Undeveloped Parathyroids
- Hypocalcemia
- Tetany
- Aortic Defects
- Congenital Heart Defects
- Diagnosis
- Absent Thymic Shadow on CXR
2 mins
Hyper IgM Syndrome
- Pathophysiology
- Deficient CD40 Ligand on Helper T-cells
- Defective CD40 Receptor on B-cells
- Inability to Class Switch
- Signs and Symptoms
- Pyogenic Abscess
- Decreased IgG, IgA, IgE
4 mins
Common Variable Immunodeficiency
- Pathophysiology
- Defect in B Cell Maturation
- Decreased Plasma Cells
- Decreased Immunoglobulins
- Signs & Symptoms
- Sinopulmonary Infections
- Increased Risk of Autoimmune Disease
- Lymphoma
1 min
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