Lymphoma and Myeloma Flashcards Preview

Hugh's MD2 Core Conditions and Presentations > Lymphoma and Myeloma > Flashcards

Flashcards in Lymphoma and Myeloma Deck (27):
1

What are the CRAB features?

Hypercalcaemia

Renal impairment

Anaemia

Lytic bone lesions

2

In which type of myeloma are the bone lesions sclerotic?

Poems

3

What is immunoparesis?

Relative deficiency in endogenous, protective Ig, that is replaced by pathological paraprotein

4

What is lymphoma?

Malignant tumours of lymphoid tissue (not arising primarily from bone marrow)

5

What are Reid-Sternberg cells?

Binucleated giant cells (owl eyed) typically seen in Hodgkin lymphoma

6

How is treatment divided in Hodgkin lymphoma?

<2A - Local radiotherapy only

>2B - Local radiotherapy and chemotherapy

7

Define CHOPR, define how it's cycled

Cyclophosphamide - haemorrhage cytitis, and renal impairment

Hydroxydaunorubicin (adriamycin) - cardiac toxicity

Oncovin (vincintine) - peripheral neuropathy

Prednisolone

Rituximab

 

CHO on day one and P on day 1 to 5 is one cycle, do a cycle every 3 weeks or so depending on bone marrow response

8

Which lymphoma would you expect in young patients?

Hodgkin lymphoma

Burkitt

Lymphoblastic

Anaplastic large cell

9

Where does Hodgkin lymphoma typically present?

Neck and mediastinal nodes

10

Which type of lymphoma is common in the groin?

T-cell lymphoma

11

A polyclonal process is typical of benign or malignant lymphoma?

Benign

12

A monoclonal process is typical of benign or malignant lymphoma?

Malignant

13

Describe the light chain phenotype in malignant myeloma?

It is restricted to cappa or lambda

14

Which lymphoma has a classic starry sky appearance on histopath?

Burkitt lymphoma

15

How do nodes in Hodgkin lymphoma feel on palpation?

Rock hard

16

What are the major side effects of each of the CHOPR drugs?

Cyclophosphamide - haemorrhage cytitis, and renal impairment

Hydroxydaunorubicin (adriamycin) - cardiac toxicity

Oncovin (vincintine) - peripheral neuropathy

Prednisolone

Rituximab - Lymphopenia

17

What characteristic urine feature do you get in multiple myeloma? What is it?

Bence-Jones protein

Light chains

18

What is MGUS? How is it significant?

Monoclonal gammopathy of undetermined significance - paraprotein is present in the absent of myeloma

 

People with it are at higher risk of developing myeloma

19

Are Ix are specific for diagnosing MM?

Serum and urine electrophoresis

B-2 Microglobulin

Bone marrow examination

Xray skull, spine and long bones

20

How is MM treated?

Melphalan

Cyclophosphamide

Thalidomide

Bone marrow transplant

Plasmapheresis to reduce paraprotein if causing symptoms

Bisphosphonates for bone

21

What des MM look like on bone marrow biopsy?

>5% plasma cell

With irregular morphology - increase blue in cytoplasm

22

When does MGUS become myeloma?

When there are

- CRAB symptoms

- Bone marrow >10% plasma cells

23

When should you suspect MM?

Pathological fracture

Unexplained renal failure

Unexplained hypercalcaemia

Unexplained anaemia with rouleax (staking of RBCs)

High total protein despite low/normal albumin

24

What do you see on low power views of Hodgkin lymphoma LNs?

Nodularity and sclerosis

25

What is the name of the staging system in lymphoma?

Ann Arbor staging classification

26

How does follicular lymphoma present?

Painless, slow growing lymphadenopathy

27

What are the three classic Ix finding in Burkitt's?

Vacuolated cytoplasm

High LDH

Starry sky pattern