Mohammed is Tired

WBCs
1. Non Neoplastic
  1. Leukocytosis
    1. Neutrophilic leukocytosis
    2. Lymphocytosis
    3. Eosiniophilia
    4. Monocytosis
    5. Leukaemoid Reaction
      1. reactive and excessive leucocytosis
2. Neoplastic
  1. Lymphoid Neoplasms
  2. Myeloid neoplasms
  3. Histiocytic neoplasms
3. Leukemia Vs Lymphoma
  1. Lymphoma
4. Leukemia
  1. Acute myeloblastic leukemia(AML)
  2. Chronic myelocytic leukemia (CML)
  3. Chronic lymphocytic leukemia (CLL)
History Taking
1. Anemia symptoms
  1. Fatigue, weakness
  2. Blood in stools
  3. Easy bruising
  4. Heavy menstruation
  5. dyspnea
2. Lymphoid symptoms /signs
  1. Infections
  2. Swelling of lymph nodes
  3. Tender lymph nodes
  4. Order of nodal enlargement
3. Past medical, surgical history
  1. Frequent infections
  2. Bleeding disorders
  3. Radiotherapy
  4. Recent trauma causing bleeding
  5. Surgery to GI
  6. Transplant surgery
4. Drug history
  1. Drug currently taking
  2. OTC’s especially NSAIDs
  3. Anticoagulant therapy
  4. Vitamins, supplements especially Iron, B12
  5. Allergies
  6. Drug allergies
5. Family history
  1. Same condition in a family member
  2. Hemophilia, von willebrand’s
  3. Leukemia (Philadelphia chromosome)
  4. Sickle cell anemia
  5. Thalassemia
Investigations
1. CBC and Blood film
  1. Determine the Blast count
  2. To differ the type of Blast: Myeloblast or Lymphobast (AML or ALL?)
  3. To make a total & differential WBC count
  4. To study the RBC count and morphology
2. Confirming
  1. FISH
    1. used to detect the BCR-ABL gene and to monitor the disease during treatment
  2. PCR
    1. can find the BCR-ABL fusion gene and other molecular abnormalities
    2. Is more sensitive than FISH
    3. can be used to monitor the expression quantitively
  3. Bone marrow aspiration
    1. Removes a sample of the fluid with a needle.
  4. Bone marrow biopsy
    1. Removal of a small amount of solid tissue using a needle
Chronic Myeloid Leukemia
1. Clonal proliferation of granulocytic precursor cells.
2. Stages
  1. Chronic Stage
  2. Accelerated Stage
  3. Blastic Stage
3. Morphology
  1. Marked leukocytosis , neutrophils at various stages of development
4. Risk factors
5. Philadelphia Chromosome
6. Management
  1. Pharmacological
    1. Tyrosine kinase inhibitors
      1. Imatinib Mesylate
  2. Hematopoietic stem cell transplantation
    1. Autologous
    2. Allogeneic
    3. Umbilical Cord
  3. Other Treatment
    1. Chemotherapy
    2. Interferon Therapy
    3. Radiation Therapy

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Mohammed is Tired

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	Created by murtadha alshaye over 7 years ago