T3 - Leukemia / Hodgkins Disease

Question 1

What I’d Leukemia?

Answer 1

Uncontrolled growth of WBCs (leukocytes)

Question 2

What are the three general categories of leukemia?

Answer 2

Acute Lymphocytic Leukemia (ALL)

Acute Myelocytic Leukemia (AML)

Chronic Myeloid Leukemia (CML)

Question 3

Which type of leukemia is most common in Peds?

Answer 3

ALL

Question 4

What condition is associated with an increased risk of leukemia?

Answer 4

Down Syndrome

Question 5

S/S of leukemia

Answer 5

Pallor

Easy bruisability (petechie and ecchymosis)

Swollen Joints

Arthraliga

Bone tenderness

Infection

Question 6

What is purpose of Bone Aspiration test?

Answer 6

Defines leukemia type

Question 7

What is purpose of CBC test?

Answer 7

Determine which blood cell type is low

Question 8

What is purpose of Spinal Tap?

Answer 8

Determine if CSF contains leukemia cells

Question 9

What is purpose of chest xray?

Answer 9

Rule out mediastinal mass (common in T cell type of ALL)

Question 10

Which body system is especially targeted for prophylaxis?

Answer 10

CNS

Question 11

How many stages of chemo treatment for ALL?

Answer 11

3

• conduction
• consolidation
• maintenance

Question 12

Chemo drugs for ALL

Answer 12

Vincristine

Prednisone

Asparaginase

Daunomycin

VP16 (etoposide)

Ara-C (cytarabine)

Question 13

Chemo drugs for CML

Answer 13

Cytarabine

Dacinomycin

Question 14

What is the main alternative treatment to traditional chemo?

Answer 14

Bone marrow transplant

Question 15

What percentage of ALL patients are expected to achieve remission?

Answer 15

95%

Question 16

Which is more difficult to treat, AML or ALL?

Answer 16

AML

Question 17

What is the first sign of Hodgkins Disease?

Answer 17

unilateral, nontender enlargement of CERVICAL NODE

Question 18

S/S of Hodgkins Disease

Answer 18

cervical node enlargement

painless, progressive enlargement of lymph nodes

liver / spleen enlargement

Question 19

How many stages of Hodgkins Disease?

Answer 19

four

Question 20

What is the major mode of therapy w/ Hodgkins Disease?

Answer 20

Radiation

Question 21

What are the two main radiation fields used in treating Hodgkins Disease?

Answer 21

Mantle field (extends from mandible to the diaphragm)

Inverted Y field (extends from diaphragm to the lower border of the pelvis)

*the bladder, rectum, and some of the intestines are shielded

Question 22

Hodgkins Disease:

S/E of Radiation on the Mantle Field

Answer 22

dry mouth,

loss of taste,

swallowing discomfort,

skin redness and dry peeling in treatment fields,

loss of hair at the back of the neck and under the arms,

decreased WBC,

fatigue,

N/V

Question 23

Hodgkins Disease:

S/E of Radiation on the Inverted Y Field

Answer 23

Fatigue,

N/V/D,

decreased WBC,

skin dryness and redness [most likely in groin area]

Question 24

What is VAMP treatment with Hodgkins Disease?

Answer 24

a combo of meds used to treat Stage I or II of Hodgkins

• Vinblastine
• Adriamycin
• Methotrexate
• Prednisone

Question 25

What is VEPA treatment for Hodgkins Disease?

Answer 25

Patients with Stage I or II Hodgkin’s Disease with an unfavorable pathology or Stage III or Stage IV will receive a different combo of meds called VEPA

• Vinblastine
• Etoposide (VP-16)
• Prednisone
• Adriamycin

Question 26

Which type of cells are diagnostic for Hodgkin’s Disease?

Answer 26

Reed-Sternburg Cells