Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MD2 Medicine > Lymphoma and Myeloma > Flashcards

Lymphoma and Myeloma Flashcards

(47 cards)

Start Studying
1
Q

What is significant weight loss?

A

10% of baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What questions on history would you ask if you suspected malignancy?

A 
FHx of malignancy
Past radiation/chemotherapy
Use of immunosuppressive agents for transplantation
Exposure to pesticides
Infections
- HIV
- HBV
- HCV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What symptoms may make you suspicious of a low platelet count?

A

Bruising
Bleeding when brushing teeth
Epistaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How large is the spleen usually on CT?

A

7-11 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What considerations are taken into account when deciding if a lymph node needs to be biopsied?

A

Significant enlargement
Persistent for >4-6 weeks
Progressive increase in size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which type of biopsy is most useful for lymph nodes?

A

Excisional, rather than FNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Richter’s transformation?

A

CLL transforms into large B cell lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What investigations are performed to stage a lymphoma?

A

Clinical history for B symptoms
PET scan
Bone marrow aspirate and trephine (BMAT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What part of the body are PET scans not good at assessing in the context of malignancies?

A

Brain, because it uses a lot of glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What investigations are performed to enable treatment planning in lymphoma?

A 
Bloods
- FBE
- UEC
- LDH
Assessment of cardiac function - gated blood pool scan (GBPS)/echocardiogram
Assessment of viral status > give prophylaxis where appropriate
- HBV
- HIV
- CMV
- EBV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is cardiac function assessed before treatment is started for cancer?

A

Use of cardiotoxic chemoagents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common form of non-Hodgkin lymphoma?

A

Diffuse large B cell lymphoma (DLBCL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the age distribution of DLBCL?

A

Incidence increases with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does DLBCL arise?

A

De novo

Transformation from lower grade disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the treatment for DLBCL?

A

R-CHOP

  • Rituximab = anti-CD20 mAb
  • Cyclophosphamide = alkylating agent > damages DNA
  • (Hydroxy) doxorubicin = intercalating agent > damages DNA
  • (Oncovin) vincristine = binds to tubulin > prevents cell duplication
  • Prednisolone = corticosteroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does prophylaxis against tumour lysis involve?

A

Hydration > good glomerular filtration
Monitor electrolytes
Drugs to lower uric acid - allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens in tumour lysis?

A

High K
High phosphate
High urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When is a high dose of methotrexate given as CNS prophylaxis in DLBCL?

A

Gonadal/BM involvement
High LDH
Has high risk of CNS disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is DLBCL curable?

Study These Flashcards
A

In many patients, yes

20
Q

What is a low grade non-Hodgkin’s lymphoma?

Study These Flashcards
A

Follicular lymphoma

21
Q

What is the treatment for follicular lymphoma?

Study These Flashcards
A

Watch and wait

Chemotherapy +/- radiotherapy

22
Q

What grade is Burkitt lymphoma?

23
Q

What imaging may be required before biopsying a lymph node?

Study These Flashcards
A

CT to assess extent and location
PET can be useful to determine which node to biopsy
US can be useful to biopsy superficial lymphadenopathy

24
Q

Why is an FNA never done when biopsying for suspected lymphoma?

Study These Flashcards
A

Architecture critical for diagnosis of lymphoma

25
What are the characteristic cells seen in Hodgkin lymphoma?
Reed-Sternberg cells
26
What CD markers are positive in Hodgkin lymphoma?
CD15 | CD30
27
What staging regime is used to stage Hodgkin lymphoma?
Ann Arbor staging, like in DLBCL
28
What percentage of lymphomas are Hodgkin lymphoma?
15%
29
What age group typically gets Hodgkin lymphoma?
Bimodal distribution - Adolescents-young adults - Elderly
30
Is Hodgkin lymphoma curable?
Over 70% curable
31
How is treatment stratified in Hodgkin lymphoma?
According to - Stage - Site
32
How do PDL inhibitors work?
PDL1 and PDL2 on tumour PD1 and PD2 on T cells Give mAbs that inhibit PDL > T cells remain active > kill tumour
33
What is one of the side effects of PDL inhibitors?
Autoimmune disease
34
When treating Hodgkin lymphoma, what should be considered as part of long-term management?
Minimisation of long-term toxicity
35
In whom is monoclonal gammopathy of uncertain significance (MGUS) common?
Elderly
36
What are the diagnostic criteria for MGUS?
Serum monoclonal protein low Monoclonal bone marrow plasma cells <10% No evidence of end organ damage due to clonal plasma cell disorder No bone lesions on skeletal x-ray (if performed) No clinical/lab features of amyloidosis/light chain deposition disease
37
What are CRAB symptoms?
``` C = Ca elevation in blood R = renal insufficiency A = anaemia B = lytic bone lesions/osteoporosis ```
38
What are the investigations of paraprotein?
``` Bone marrow examination Skeletal survey > look for lytic lesions - Skull - Spine - Long bones Spinal MRI if back pain/suspected cord compression ```
39
What is smouldering myeloma?
Monoclonal protein in serum at 3+ g/100 mL OR monoclonal plasma cells 10+% in bone marrow/tissue biopsy No evidence of end-organ damage due to clonal plasma cell disorder
40
What is symptomatic myeloma?
Monoclonal plasma cells in bone marrow 10+% and/or biopsy-proven plasmacytosis Monoclonal protein in serum and/or urine Myeloma-related organ dysfunction - At least 1 CRAB symptom
41
How is myeloma treated?
Chemotherapy Transfusions if anaemic Bisphosphonates/denosumab +/- radiotherapy for bone disease
42
What is the mechanism of action of denosumab?
RANK-L inhibitor
43
What does treatment of bone disease in myeloma improve?
Symptoms, not overall survival
44
What medical emergencies can occur due to myeloma?
``` Hypercalcaemia Spinal cord compression Renal failure Hyperviscosity Infections ```
45
What does initial chemotherapy for myeloma depend on?
Age Stage Comorbidities
46
Is myeloma curable?
Considered incurable, except with allogeneic transplantation | - Not standard of care
47
When should you suspect myeloma in a patient?
Fracture/bone pain without precipitating event - X-ray shows lytic lesions/severe osteoporosis/crush fractures Unexplained anaemia with rouleaux on blood film and high ESR High total protein despite normal/low albumin Unexplained hypercalcaemia Unexplained renal failure

MD2 Medicine (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions