| A | B |
|---|
| leukemia is | cancer of the bone marrow |
| leukemia most common in these pts | children,young adults |
| leukemia classified according to | cell type |
| leukemia related to this chemical | benzene |
| leukemia pathophysiology | pleuripotent stem cells lack differentiation, bone marrow gets replaced by blast cells |
| pancytopenia is | anemia, thrombocytopenia, leukopenia |
| leukemia most common type | ALL |
| most common in adult men, avg. age 65, with slow proliferation | AML |
| apoptosis, eventually blast crisis in 3-4 years, leading to death | CML |
| proliferation of B lymphocytes over 15 yrs. | CLL |
| clinical symptoms of pancytopenia | nosebleeds, petechia, pallor, hematuria, tachycardia, dyspnea, fever, bone pain, |
| dx for leukemia | decrease plts, dec. rbc', low or nl wbc's, blast cells on peripheral smear |
| key dx tool for leukemia | bone marrow bx; adults use sternum |
| tx for leukemia is 3 stages | induction, consolidate, maintenance chemo |
| remission is | no detection of abnl cells in marrow |
| relapse is | recurrence of abnl cells |
| induction | induce remission, often prednisone, vincristine, asparaginase, doxyrubicin 4-6 weeks |
| consolidation | CNS prophylaxis for prevent leukemia into CNS, lp injection into spinal fluid (methotrexate, etc.); possible radiation |
| % of CNS involvement with tx | 10% |
| % of CNS involvemen without tx | 80% |
| maintenance | small doses of combos for up to a year, 6-metaptopurine, methotrexate, vincristine, prednisone, etc (more common wtih Adult ALL) |
| tumor lysis syndrome, metabolic complications | wbc count high , rapid destruction of wbc,potentially fatal, incr. potassium, uric acid, phosphate |
| prevent tumor lysis syndrome by | inc. fluids, alkalynyzing urine, allopurinol |
| common symptoms/signs of pancytopenia | infection, bleeding |
| bone marrow transplants cure rate | 30-60% |
| lympohoma possible etiology | EBV implicated |
| age group for lymphoma | 20's and 50'5 |
| pathophysiology of lymphoma | enlargemetn of lymph nodes, spreads to spleen, lung, liver, bone |
| positive diagnostic flag for lymphoma | Reed - Sternberg giant cell |
| Hodgkin's lymphoma | asymptomatic, painless enlargemetn of cervical lymph nodes |
| B symptoms | poor prognosis (fever, night sweats, pruritis) |
| lymphoma tx | radiation, chemotherapy |
| what Ravi was doing to distract us during the studying | vaccuuming the room |
| 6 mos. vessicant drugs | MOPP (mechlorethemine, onchov__ (vincristine), procarbasine, prednisione) |
| easy delivery, less side effects, less risk of leukemia, can use for stage 3 & 4 | ABVD (adriamycin, bleomycin, vinblastine, decarbazine) |
| side effects of chemo for lymphoma | nausea, vomiting and late secondary side effects |
| Non Hodgkin's lymphoma | occurs at any age, more often 50&60's, 7x more common than Hodgkins, s/s related to the site of the dz. |
| Non Hodgkin's lymphoma tx | chemo, maybe add in radiation |
| Polycythemia Vera | overproduction of rbc production |
| P vera signs | hypervolmia, hyperviscostiy, hypercoagulabilty |
| hgb in P vera | >18 |
| hct in P vera | >55 |
| P vera symptoms/signs | headache, plethora, dyspnea, thrombosis, splenomegaly, paresthesias, tendency to bleed |
| P vera treatment | phlebotomy |
