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Foundations III > Lymphomas > Flashcards

Lymphomas Flashcards

1
Q

Where do T cells mature?

A

thymus

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2
Q

What are the 3 types of lymphocytes and which are most prevalent?

A
  1. T-cell (80%)
  2. B-cell (15%)
    3 NK cell (<5%)
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3
Q

Where do B cells mature??

A

Mature in bone marrow, then go into circulation

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4
Q

Primary lymph organs

A

Bone marrow and thymus

-Where B cells and T cells mature and differentiate

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5
Q

Secondary Lymph organs

A

Where mature antigen specific B and T cells interact with APC and each other

Ex. Spleen, Lymph nodes, tonsils, MALT

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6
Q

NK cells

A
  • kill cancer cells

- Live 40-60 years

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7
Q

Non- Hodgkin’s Lymphoma: Staging

A

Stage I: lymph node

Stage II: lymph node in two places

Stage III: multiple lymph nodes and crosses the diaphragm

Stage IV: multiple lymph nodes, Invasion of major organs and bones

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8
Q

Non-Hodgkin’s Lymphoma: Labs

A

LDH - often elevated

Beta 2 microglobulin- often elevated

Uric Acid - elevated

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9
Q

Non-Hodgkin’s Lymphoma: Dx

A

CT scan - check nodes

PET scan - check for biological activity

Biopsy lymph nodes**

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10
Q

Cutaneous T-cell lymphoma

A

-scaly rash (looks like psoriasis), but doesn’t respond to steroids or vitamin D

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11
Q

Non-Hodgkin’s Lymphoma: Tx

A

Elderly patient:

  • low grade: watchful waiting
  • CVP (cyclophosphamide, vincristine, prednisone)

Younger patient/curative intent:
-CHOP +/-Rituxan
cyclophosphamide, doxyrubicin, oncovin, and prednisone

[CHOP is harsher and less well tolerated]

Very high risk:
Autologous stem cell transplant

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12
Q

Hodgkin’s Disease

A
  • Reed-sternberg cells***
  • Bimodal (20s-50s)

Labs: EBV titer since this can be cause

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13
Q

Hodgkin’s Staging: A versus B

A

A - no constitutional symptoms

B - constitutional symptoms (fever, night sweats, weight loss)

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14
Q

Hodgkin’s: Treatment

A

Early or in bulky disease: Radiation

Standard Chemo:
AVBD (Adriamycin, bleomycin, vinblastine, and dacarbaine)

Prognosis: generally good! :)

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15
Q

Hodgkin’s Disease: increased risk for other malignancies

A
  • leukemia
  • gastric CA
  • Lung CA
  • breast CA
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16
Q

Multiple Myeloma: etiology

A

Plasma cell (B cells)

17
Q

Multiple Myeloma: clinical manifestation

A 
Anemia****
Bony pain (back pain)**
Kidney disease  (AKI)
  • Fatigue
  • Infections
  • hyperviscous blood due to immunoglobulins (retinal vein engorgement)
18
Q

What causes the kidney disease in multiple myeloma?

A

-hypercalcemia
or
-accumulation of gammaglobulins in tubules

19
Q

What causes the cytopenias/anemia and bony pain?

A

osteoclast activating factors that eat bone marrow

20
Q

Multiple Myeloma: Labs

A

CBC: anemia*
CMP: Total protein elevated, decreased albumin, Na+ (low)
Peripheral smear: Rouleaux formation**
SPEP: M-spike****
Immunofixation: monoclonal protein (IgG, IgA, or IgM)

24 hour urine (UPEP): Bence Jones proteins

21
Q

Multiple myeloma staging depends on what two things?

A
  1. Beta 2 Micro

2. Albumin

22
Q

Multiple Myeloma: indications to treat

A

CRAB I

Calcium (increasing)
Renal insufficiency
Anemia
Bone-lytic lesions
Infections
23
Q

Multiple Myeloma: treatment

A

Ex.
Velcade + Decadron
Revlamid + Decadron
Thalidomide + Decadron

Younger patient:
consider autologous stem cell transplant

Monthly IV bisphosphonate - zoledronic acid

24
Q

AKI in Multiple Myeloma

A

-Vigorous hydration
-Zoledronic Acid
+/- calcitonin
+/- loop diuretic

25
Q

Hypercalemia

A

Stones, bones, groans, moans, and psychiatric overtones

groans = constipation
psychiatric overtones = confusion

26
Q

Monoclonal gammopathy of undetermined significance (MGUS)

A

-elevated IgG, IgA, or IgM on SPEP

but, no other symptoms

27
Q

Waldenstrom Macroglobinemia

A
  • Diseased B cells that contain lymphocytic and plasma cell parts
  • Proliferation of IgM macromolecule, very large and hyperviscosity
  • No lytic lesions
28
Q

Waldenstrom: Dx

A

SPEP: IgM spike**

Physical Exam: retinal vein engorgement (sausage link)

29
Q

Waldenstrom: Tx

A
  • emergent plasmapheresis

- chemotherapy

Foundations III (34 decks)

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