Hodgkin's Disease

Question 1

What is Hodgkin’s disease?

Answer 1

A malignancy of unknown etiology usually arising in the lymph nodes

Question 2

is hodgkin’s disease curable

Answer 2

very curable

Question 3

What cell is associated with HD

Answer 3

Reed- Sternberg cell

Question 4

When was HD discovered?

Answer 4

1832 Thomas Hodgkin

-discovered in dead people

Question 5

Who is the disease most prevalent in?

Answer 5

common in young people

Question 6

Incidence rates:

biomodal age distribution

Answer 6

first peak 15-34

second @ 50

Question 7

Incidence rate:

2002

Answer 7

7000 new cases, 3700 male, 3300 female

1400 deaths, 800 male, 600 female

Question 8

incidence rate:

2007

Answer 8

8190 new, 4470 male, 3720 female

1070 deaths, 770 male, 300 female

Question 9

incidence rate:

2017

Answer 9

8260 new, 4650 male, 3610

1070 deaths, 630 male, 440 female

Question 10

9x increase in ____ sex sibs

Answer 10

same

Question 11

5x increase in ____ sex sibs

Answer 11

opposite

Question 12

3x increase with _____ degree relation

Answer 12

first

Question 13

subcategories of Hodgkin’s Disease

Answer 13

Classic Hodgkin Lymphoma (CHL)
LRHL
MCHL
NSHL
LDHL
Nodular Lymphocyte predominant Hodgkin Lymphoma
NLPHL

Question 14

LRHL

Answer 14

• early stages
• 5% of all hodgkins cases
• stage 1/ stage 2
• Infrequent systemic sym (10%)
• more common in males
• upper body

Question 15

MCHL

Answer 15

• mix of all types
• -lymphocytes, epithelial histocytes, neutrofills, plasma (inflammatory)
• more common in older folks (38)
• Associated with HIV
• in males
• abdomen and spleen

Question 16

NSHL

Answer 16

• 75% of all hodgkin’s cases
• 20’s and 30’s, 50-55
• equal distribution b/w males and females
• neck or chest
• *** MOST COMMON

Question 17

NLPHL

Answer 17

• 5% of Hodgkin’s cases
• asymptomatic young men
• cervical, axillary & inguinal LN
• 30-55 years
• early stages
• • longer survival times
• variant of reed-stern cell. Referred to as popcorn cell because of look

Question 18

CHL

Answer 18

• 95% diagnosed
• main characteristic is the reed- stern cell
• B symptomatic: fever, night sweats, weight loss

Question 19

LDHL

Answer 19

• rarest of the 4
• common in men
• 30’s- those with HIV
• worst prognosis
• -advanced disease (b symptoms)
• abdomen adenopathy
• spleen, liver, bone marrow

Question 20

What staging system does Hodgkin’s use?

Answer 20

Ann Arbor and costwold

* higher stage=bad prognosis

Question 21

Signs and symptoms

Answer 21

• cervical, supraclavicular, mediastinal LN, splenomegaly
• B symptoms (40%)
• elevated sedimentation rate and elevated alkaline phosphatase

Question 22

paritis

Answer 22

severe itching

Question 23

malaise

Answer 23

just don’t feel good

Question 24

erythmatis rash

Answer 24

reddening of skin

Question 25

most common above diaphragm

Answer 25

80%

Question 26

how much below diaphragm?

Answer 26

about 10%

Question 27

elevated sedementation rate

Answer 27

how fast blood count falls to bottom of test tube

Question 28

How do they diagnose Hodgkin's disease

Answer 28

``` history and physical X-rays (CT and PET) labs biopsy of lung LN (enlarged) Stages (1B, 2B, 3, 4) ```

Question 29

Clinical features of Hodgkins Disease

Answer 29

``` painless lymphadenopathy fever night sweats weight loss pruitus alcohol-induced pain ```

Question 30

Non- Hodgkin's Lymphoma

Answer 30

generalized painless lymphadenopathy vague abdominal discomfort back pain gastrointestinal complaints

Question 31

Treatment

Answer 31

radiation chemo combo -depending on how old

Question 32

during treatment, what is the therapists job?

Answer 32

provide education and support for pt

Question 33

treatment symptoms

Answer 33

``` hypothyroidism reduction in bone marrow percarditis pnuemonitis myelopathy transient aspermia secondary cancers ```

Question 34

___% of early stage disease curable

Answer 34

90

Question 35

___% of advanced stage curable

Answer 35

80

Question 36

what is the mantle

Answer 36

lymph above diaphragm

Question 37

What is the invertedY

Answer 37

below the diaphragm

Question 38

how often is MOPP used

Answer 38

not much anymore

Question 39

BEACOPP - bleomycin - adriomycin - cyclophosphomide - oncovin - procarbisine - prednisine

Answer 39

developed by german Hodgkin's study group toxic, but benefit outweighs risk used for younger people

Question 40

about ____-_____ of patients develop breast cancer 15 years post radiation

Answer 40

20-50