Hem/Onc

Lymphoma

Non-Hodgkin Lymphoma Etiology Proliferation of lymphocytes inside lymph nodes and spleen Similar to CLL → NHL is solid, CLL is liquid Stages 1 → 1 lymph node group 2 → ≥2 lymph node groups on one side of diaphragm 3 → Both sides of diaphragm 4 → Widespread Pathologic classification B-Cell Follicular Middle-aged Indolent,...

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Leukemia

Leukemoid Reaction ↑ WBC after infection Acute inflammatory response Neutrophils Left shift Distinguish from leukemia → LAP (Lymphocyte alkaline phosphatase) ↑LAP → Leukemoid reaction ↓LAP → CML or another leukemia AML/ALL Etiology ALL Children 85% cured Poor prognosis Age <1y, >10y WBC >50k t(9;22) CNS involvement ↑ incidence in Down syndrome...

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Polycythemias

Polycythemia Vera Etiology JAK2 protein mutation All cells rise → RBC most prominent Hyperviscosity Presentation Older patient with Hyperviscosity Syndrome Headache Blurred vision Tinnitus Pruritus → After warm shower → ↑Basophils Hypertension Fatigue Splenomegaly Bleeding → From engorged vessels Easy bruising Thrombosis CHF Diagnosis Best initial → CBC ↑Hematocrit >60% ↑PLT ↑WBC Normal...

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Anemia (General)

Anemia Etiology Microcytic Iron deficiency Thalassemia Sideroblastic Anemia of chronic disease Macrocytic B12 deficiency Folate deficiency Sideroblastic Alcoholism Liver disease Hypothyroidism Myelodysplastic syndrome Drugs Azathioprine 6-MP Hydroxyurea Methotrexate Zidovudine Phenytoin Cold agglutinins → cell clumping → False ↑MCV Normocytic Rapid blood loss Eventually iron deficiency → Microcytic Rapid hemolysis Eventually ↑Retic → Macrocytic...

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