Rheumatology & Haematology — Flashcards

Flashcard 451: What is the most common cause of morbidity in polycythaemia vera? _____

Answer: Thrombosis

Flashcard 452: What phases does chronic myeloid leukaemia present in? _____ → Accelerated phase → Blast crisis / phase

Answer: Chronic phase

Flashcard 453: Chronic myeloid leukaemia may transform to acute _____ leukaemia (2/3rd of cases) Chronic myeloid leukaemia may transform to acute lymphoblastic leukaemia (1/3rd of cases)

Answer: myeloid

Flashcard 454: _____ is a myeloproliferative disorder that leads to erythrocytosis with or without granulocytosis & thrombocytosis

Answer: Polycythaemia vera

Flashcard 455: What is the management of chronic myeloid leukaemia (CML) in the blastic crisis? _____

Answer: Tyrosine kinase inhibitors (TKI) + Induction chemotherapy + Allogeneic hematopoietic stem cell transplant

Extra: Blastic crisis is managed similarly to acute leukemia. Treatment involves a combination of high-dose TKIs (like dasatinib) and induction chemotherapy to return the patient to a second chronic phase, followed by an allogeneic stem cell transplant, which is the only curative option.

Flashcard 456: _____ is a myeloproliferative disorder causing a neoplastic proliferation of mature myeloid cells, especially red blood cells

Answer: Polycythaemia vera

Flashcard 457: Secondary polycythemia (due to hypoxemia) is characterized by _____ SaO2 percentage.

Answer: decreased

Extra: Other causes of secondary polycythemia (like EPO-secreting tumors) may have normal SaO2 but elevated EPO.

Flashcard 458: Chronic myeloid leukaemia is distinguished from a leukemoid reaction (benign neutrophilia) by a(n) low/decreased _____ stain

Answer: leukocyte alkaline phosphatase (LAP)

Flashcard 459: What is the confirmatory investigation for chronic myeloid leukaemia (CML)?\n_____

Answer: Cytogenetics/FISH for BCR-ABL1 (Philadelphia chromosome)

Extra: CML is characterized by the t(9;22) translocation, forming the BCR-ABL1 fusion gene. Confirmation and monitoring are done via Cytogenetics (Karyotyping), FISH, or RT-PCR. Moving forward, quantitative PCR is used to monitor molecular response to TKI therapy.

Flashcard 460: Accelerated phase of CML can present with _____ due to functional neutropenia (even if total WBC is high).

Answer: recurrent infections

Extra: WHO Criteria for Accelerated Phase CML: 1. Blasts 10–19% in PB or BM 2. PB basophils ≥20% 3. Persistent thrombocytopenia (<100 x 10⁹/L) unrelated to therapy or persistent thrombocytosis (>1000 x 10⁹/L) uncontrolled by therapy 4. Increasing spleen size and increasing WBC count unresponsive to therapy 5. Cytogenetic evidence of clonal evolution