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Flashcards in Onc - Lymphomas Deck (17):
0

Patient with suspected non-Hodgkin's lymphoma – best initial test? CBC finding? Lab that correlates with worse severity? Staging procedures?

Excisional biopsy (not needle aspiration)

Normal CBC

High LDH

CT of chest-abdomen-pelvis and bone marrow biopsy

1

Non-Hodgkin Lymphoma staging? And treatment?

Stage:
1 - lymph node group (chemoradiation)
2 - 2 or more lymph node groups on same side of the diaphragm (chemoradiation)
3 - both sides of diaphragm (CHOP and rituximab)
4 - widespread disease (CHOP and rituximab)

2

CHOP?

C – cyclophosphamide
H - Adriamycin (hydroxydaunorubicin)
O – vincristine (Oncovin)
P – prednisone

3

Hodgkin lymphoma – smear will show? Prognosis based on?

Read-Sternberg cells

Lymphocyte predominant – best prognosis
Lymphocyte Depleted – worst prognosis

4

Treatment for Hodgkin lymphoma?

Stage 1 and 2 – chemoradiation

Stage 3, 4, or anyone with constitutional symptoms: ABVD
Adriamycin
Bleomycin
Vinblastine
Dacarbazine

5

Risks of radiation?

#Solid tumors (breast, thyroid, long)
#Premature coronary artery disease

6

Female Patient undergoes chemoradiation for Hodgkin's lymphoma – future cancer screening?

Breast cancer screening eight years after treatment

7

Adverse affects of:
1. Doxorubicin
2. Vincristine
3. Bleomycin
4. Cyclophosphamide
5. Cisplatin

1. Cardiomyopathy
2. Neuropathy
3. Lung fibrosis
4. Hemorrhagic cystitis
5. Renal and ototoxicity

8

Immunoglobulins in multiple myeloma versus Waldenström macroglobulinemia?

IgG/IgA versus IgM

9

Patient with suspected multiple myeloma – initial test?

X-ray for lytic bone lesions

10

Marker that corresponds with the severity of multiple myeloma?

Peripheral blood smear finding?

Definition of myeloma?

Beta-2 microglobulin

Rouleaux

Greater than 10% plasma cells in bone marrow

11

Anion gap in myeloma?

Decreased (IgG is catatonic, increasing Cl and bicarb levels)

12

Finding of technetium bone scan in multiple myeloma?

Nuclear bone scan?

Normal – lytic lesions do not pick up nuclear isotope

Increased uptake

13

Medical Treatment for multiple myeloma? Best therapy?

Combination dexamethasone with Lenalidomide

Bone marrow transplant

14

Patient with monoclonal gammopathy without other findings of multiple myeloma – likely diagnosis? next step?

MGUS

Biopsy to look for myeloma

15

Waldenström Macroglobulinemia – Pathogenesis? Clinical features?

Overproduction of IgM leading to hyperviscosity

#Blurry vision/vertigo
#Engorged blood vessels
#Mucosal bleeding
#Raynaud phenomenon

16

Waldenström Macroglobulinemia – Best initial therapy? Long-term treatment?

Plasmapheresis;

rituximab, prednisones, cyclophosphamide

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