Flashcards in Onc - Lymphomas Deck (17):
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)
CT of chest-abdomen-pelvis and bone marrow biopsy
Non-Hodgkin Lymphoma staging? And treatment?
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)
C – cyclophosphamide
H - Adriamycin (hydroxydaunorubicin)
O – vincristine (Oncovin)
P – prednisone
Hodgkin lymphoma – smear will show? Prognosis based on?
Lymphocyte predominant – best prognosis
Lymphocyte Depleted – worst prognosis
Treatment for Hodgkin lymphoma?
Stage 1 and 2 – chemoradiation
Stage 3, 4, or anyone with constitutional symptoms: ABVD
Risks of radiation?
#Solid tumors (breast, thyroid, long)
#Premature coronary artery disease
Female Patient undergoes chemoradiation for Hodgkin's lymphoma – future cancer screening?
Breast cancer screening eight years after treatment
Adverse affects of:
3. Lung fibrosis
4. Hemorrhagic cystitis
5. Renal and ototoxicity
Immunoglobulins in multiple myeloma versus Waldenström macroglobulinemia?
IgG/IgA versus IgM
Patient with suspected multiple myeloma – initial test?
X-ray for lytic bone lesions
Marker that corresponds with the severity of multiple myeloma?
Peripheral blood smear finding?
Definition of myeloma?
Greater than 10% plasma cells in bone marrow
Anion gap in myeloma?
Decreased (IgG is catatonic, increasing Cl and bicarb levels)
Finding of technetium bone scan in multiple myeloma?
Nuclear bone scan?
Normal – lytic lesions do not pick up nuclear isotope
Medical Treatment for multiple myeloma? Best therapy?
Combination dexamethasone with Lenalidomide
Bone marrow transplant
Patient with monoclonal gammopathy without other findings of multiple myeloma – likely diagnosis? next step?
Biopsy to look for myeloma
Waldenström Macroglobulinemia – Pathogenesis? Clinical features?
Overproduction of IgM leading to hyperviscosity
#Engorged blood vessels