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Clin Med I Exam #4 > 6 Leukemia, Lymphoma, MM > Flashcards

6 Leukemia, Lymphoma, MM Flashcards

1
Q

What are the three B symptoms?

A
  • Weight loss
  • Fever
  • Night sweats
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2
Q

Leukemia is CA of what (2)?

A
  • Bone marrow

- Lymphatic system

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3
Q

What are the four types of Leukemia?

A
  • Acute Myeloid Leukemia (AML)
  • Chronic Myeloid Leukemia (CML)
  • Acute Lymphoblastic Leukemia/Lymphoma (ALL)
  • Chronic Lymphocytic Leukemia (CLL)
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4
Q

What is the most common type of Leukemia in ADULTS? What is the median age?

A

Acute Myeloid Leukemia (AML)

- Age 65 years

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5
Q

What cancer is associated with chemical exposure/radiation or myelodysplastic syndrome (MDS) as risk factors?

A

Acute Myeloid Leukemia (AML)

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6
Q

What do labs for Acute Myeloid Leukemia (AML) show?

A

Pancytopenia

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7
Q

How do you calculate ANC and what is the normal range?

A

ANC = WBC x % neutrophils

- Normal ANC is 2500-7000

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8
Q

What two findings will be seen on peripheral smear/bone marrow aspiration and biopsy for Acute Myeloid Leukemia (AML)?

A
  • Auer rods

- Leukemic blasts

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9
Q

What two factors will improve prognosis for Acute Myeloid Leukemia (AML)?

A
  • Younger age

- No comorbidities

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10
Q

What syndrome is at risk for progression to AML?

A

Myelodysplastic Syndrome (MDS)

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11
Q

What two diseases are often asymptomatic and found routinely on CBC?

A
  • Myelodysplastic Syndrome (MDS)

- Chronic Myeloid Leukemia (CML)

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12
Q

What is the only possible cure for Myelodysplastic Syndrome (MDS)?

A

Donor bone marrow transplant

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13
Q

What condition is considered an oncologic emergency and associated with high mortality rate?

A

Tumor Lysis Syndrome

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14
Q

What might cause Tumor Lysis Syndrome?

A

Chemotherapy initiation (within 1 day)

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15
Q

What cancer is associated with BCR-ABL1/Philadelphia chromosome?

A

Chronic Myeloid Leukemia (CML)

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16
Q

What are the three phases of Chronic Myeloid Leukemia (CML), and in which phase are patients most commonly diagnosed?

Which of the three has the best prognosis?

A
  1. Chronic phase: most common (85% diagnosed here) AND best prognosis
  2. Accelerated phase
  3. Blast crisis phase
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17
Q

What is the only possible cure for Chronic Myeloid Leukemia (CML)?

A

Donor stem cell transplant

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18
Q

What three complications should be considered with Chronic Myeloid Leukemia (CML), and which two are considered an emergency?

A
  • Tumor lysis syndrome = emergency
  • Hyperviscosity syndrome
  • Hyperleukocytosis = emergency
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19
Q

What is the most common type of Leukemia in CHILDREN? What is the median age?

A

Acute Lymphoblastic Leukemia/Lymphoma (ALL)

- Ages 2-5 years

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20
Q

What are the three subtypes of Acute Lymphoblastic Leukemia/Lymphoma (ALL), and which is most common?

A
  • Precursor B-cell ALL: most cases of childhood ALL
  • T-cell ALL
  • Mature B-cell ALL aka Burkitt cell
21
Q

Of the three subtypes of Acute Lymphoblastic Leukemia/Lymphoma (ALL), which two have the more favorable prognosis?

Which of the three typically presents at an older age?

A

The two B-cells:

  • Precursor B-cell ALL
  • Mature B-cell ALL aka Burkitt cell
  • T-cell ALL: older age
22
Q

What five symptoms are most commonly associated with Acute Lymphoblastic Leukemia/Lymphoma (ALL)?

A
  • LAD
  • Hepatosplenomegaly
  • Pallor
  • Bone/MSK pain
  • Fever
23
Q

What finding will be seen on peripheral smear/bone marrow aspiration and biopsy for Acute Lymphoblastic Leukemia/Lymphoma (ALL)?

A

Lymphoblasts

24
Q

Of the four types of leukemia, which is seen ONLY in adults? What is the median age?

A

Chronic Lymphocytic Leukemia (CLL)

- Age 70 years

25
Q

Which type of cancer involves B-cell lymphocytosis?

A

Chronic Lymphocytic Leukemia (CLL)

26
Q

Which two symptoms are often seen with Chronic Lymphocytic Leukemia (CLL)?

A
  • Organomegaly (lymph, spleen, liver)

- Skin involvement

27
Q

What are the two stages of Chronic Lymphocytic Leukemia (CLL), and how do you differentiate between the two (think symptoms)?

A
  • Indolent stage: often asymptomatic

- Advanced stage/Terminal phase: inclusion of B symptoms

28
Q

Of the cancers we discussed in class, what is the only one where observation is considered appropriate treatment? When/with what stage is this considered?

A

Asymptomatic or early stage 1 of Chronic Lymphocytic Leukemia (CLL)

29
Q

Lymphoma is CA of what? Provide five examples of organs which might be affected?

A

CA of lymphocytes

  • Lymph nodes
  • Spleen
  • Thymus
  • Bone marrow
  • Tonsils/adenoid
30
Q

What are the two types of Lymphoma? Which is more common?

A
  • Hodgkin Lymphoma (HL)

- Non-Hodgkin Lymphoma (NHL): more common

31
Q

What cancer involves EBV as a possible risk factor?

A

Hodgkin Lymphoma (HL)

32
Q

What finding will be seen on peripheral smear for Hodgkin Lymphoma (HL)?

A

Reed-Sternberg cells

33
Q

What three symptoms may be seen with both Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL)?

A
  • Painless LAD
  • Mediastinal mass
  • B symptoms
34
Q

What is the recommended treatment for Hodgkin Lymphoma (HL), and what two potential progressions/complications should be considered?

A

Combination chemotherapy + radiation

- Can lead to other cancer or heart disease

35
Q

What cancer involves severe pain after alcohol?

A

Hodgkin Lymphoma (HL)

36
Q

What is the age range affected by Hodgkin Lymphoma (HL)? What is the median age affected by Non-Hodgkin Lymphoma (NHL)?

A
  • HL: 15-34 years

- NHL: 66 years

37
Q

What are the two stages of Non-Hodgkin Lymphoma (NHL), and how does the tumor in each stage progress?

A
  • Indolent stage = slow-growing mass

- Advanced stage = rapidly growing mass

38
Q

What three diagnostic tools can be used for Non-Hodgkin Lymphoma (NHL)?

A
  • Biopsy (prefer 2+ cm lymph nodes)
  • CT/PET scan
  • Bone marrow aspiration and biopsy
39
Q

How does treatment differ for the the two stages of Non-Hodgkin Lymphoma (NHL)?

A
  • Indolent = radiation alone

- Aggressive = chemotherapy

40
Q

Which cancer involves the malignancy of plasma cells?

A

Multiple Myeloma (MM)

41
Q

Which cancer is more commonly seen in African Americans?

A

Multiple Myeloma (MM)

42
Q

What four symptoms are often associated with Multiple Myeloma (MM)?

A
  • Back pain
  • Neurologic changes
  • Bone pain
  • Fatigue
43
Q

What diagnostic tool can be an early indication of malignancy for Multiple Myeloma (MM), and what two findings are often seen?

A

Protein Electrophoresis shows:

  • Paraproteins (in blood = hyperviscosity; in urine = renal failure)
  • M spike
44
Q

What cancer is associated with anemia and Rouleaux formation?

A

Multiple Myeloma (MM)

45
Q

What could be found in the urine of a patient with Multiple Myeloma (MM)?

A

Bence-Jones proteins

46
Q

What two findings could be seen on axial skeleton x-rays of a patient with Multiple Myeloma (MM)?

A
  • Lytic lesions

- Generalized osteoporosis

47
Q

What does CRAB stand for and what cancer is it associated with?

A

Multiple Myeloma (MM)

  • Calcium
  • Renal insufficiency
  • Anemia
  • Bone lesions
48
Q

What condition involves bleeding from mucous membranes, visual issues from retinopathy, neuro sx?

What cancer is it often associated with?

A

Hyperviscosity syndrome

- Associated with Multiple Myeloma (MM)

49
Q

What treatment is recommended for a patient with Multiple Myeloma (MM), and why?

A

IV bisphosphonates to prevent bone mass loss

Clin Med I Exam #4 (7 decks)

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