What is the primary characteristic distinguishing acute leukemia from chronic leukemia?
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Overview of acute and chronic leukemias, their pathophysiology, diagnostic criteria, and treatment modalities.
By mastering this deck, learners will be able to accurately differentiate leukemia subtypes, understand their underlying mechanisms, interpret diagnostic findings, and select appropriate treatment strategies, enhancing clinical decision-making and patient management skills.
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| # | Front | Back | Hint |
|---|---|---|---|
| 1 | What is the primary characteristic distinguishing acute leukemia from chronic leukemia? | Acute leukemia is characterized by the rapid proliferation of immature blast cells leading to marrow failure, whereas chronic leukemia involves the proliferation of more mature, differentiated lymphoid or myeloid cells with a slower clinical course. | Think 'acute' = rapid onset and 'chronic' = slow progression. |
| 2 | Which cell type is predominantly involved in Acute Myeloid Leukemia (AML)? | AML involves the proliferation of myeloblasts, which are immature myeloid precursor cells. | Myeloblasts = AML; remember 'Myeloid' in AML. |
| 3 | What is the hallmark genetic abnormality often seen in Acute Promyelocytic Leukemia (APL)? | The t(15;17) translocation resulting in the PML-RARA fusion gene. | Remember '15 and 17' for APL translocation. |
| 4 | Describe the typical presentation of Chronic Lymphocytic Leukemia (CLL). | CLL often presents with lymphadenopathy, splenomegaly, and an increased number of mature-looking but functionally incompetent lymphocytes, commonly in elderly patients. | Think 'slow-growing' lymphoid proliferation. |
| 5 | Which immunophenotypic marker is most characteristic of CLL cells? | CD5 positivity on B lymphocytes. | CD5 is also seen on T cells, but in CLL, B cells aberrantly express it. |
| 6 | What is the typical age demographic for Chronic Myeloid Leukemia (CML)? | CML predominantly affects adults aged 40-60 years. | Remember 'middle-aged adults' for CML. |
| 7 | Which genetic abnormality is pathognomonic for CML? | The Philadelphia chromosome, resulting from the t(9;22)(q34;q11) translocation, producing the BCR-ABL fusion gene. | Think 'Ph' for Philadelphia. |
| 8 | What is the primary treatment for CML in chronic phase? | Tyrosine kinase inhibitors (TKIs), such as imatinib, which target the BCR-ABL fusion protein. | TKI = targeted therapy for BCR-ABL. |
| 9 | Which leukemia subtype is characterized by the presence of Auer rods? | Acute Myeloid Leukemia (AML). | Auer rods are needle-shaped inclusions seen in myeloblasts. |
| 10 | How does the presentation of Acute Lymphoblastic Leukemia (ALL) differ between children and adults? | ALL is most common in children, presenting with symptoms like fatigue, bleeding, and infections, while in adults, it may present more aggressively with higher risk of CNS involvement. | Remember 'ALL in children' for prevalence. |
| 11 | What is the mainstay of treatment for acute leukemia? | Induction chemotherapy aimed at achieving remission, often followed by consolidation and maintenance therapy. | Think 'induction' to induce remission. |
| 12 | Which agent is commonly used in the treatment of APL due to its differentiation-inducing properties? | All-trans retinoic acid (ATRA). | ATRA promotes maturation of promyelocytes. |
| 13 | Name one significant complication associated with APL treatment. | Differentiation syndrome (also called retinoic acid syndrome), which can cause pulmonary infiltrates, fever, and hypotension. | Be vigilant for 'differentiation' complications. |
| 14 | What is the typical prognosis difference between chronic and acute leukemias? | Chronic leukemias generally have a slower progression with better long-term prognosis compared to acute leukemias, which require urgent treatment and may have poorer outcomes if untreated. | Think 'chronic = slow, acute = rapid'. |
| 15 | Which subtype of leukemia is most associated with the presence of the BCR-ABL fusion gene? | Chronic Myeloid Leukemia (CML). | BCR-ABL = hallmark of CML. |
| 16 | In which leukemia is the 'smudge cell' a common peripheral blood finding? | Chronic Lymphocytic Leukemia (CLL). | Smudge cells are fragile lymphocytes seen on blood smear. |
| 17 | What is the typical treatment approach for chronic lymphocytic leukemia in asymptomatic patients? | Watchful waiting or observation until symptoms or disease progression occur. | No immediate treatment unless symptomatic. |
| 18 | Which leukemia subtype is often associated with prior exposure to radiation or chemotherapy? | Therapy-related acute myeloid leukemia (t-AML). | Think 'therapy-related' as secondary leukemia. |
| 19 | What is the significance of blast percentage in diagnosing acute leukemia? | A blast count of ≥20% in blood or bone marrow confirms the diagnosis of acute leukemia. | The 20% threshold defines 'acute'. |
| 20 | Which diagnostic modality is definitive for leukemia classification? | Bone marrow biopsy with cytogenetic and immunophenotypic analysis. | Biopsy + genetics = accurate classification. |
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