Blood Cancers

Question 1

Mirror image nuclei cells

Answer 1

Hodgkin’s lymphoma - Reed Steinberg

Question 2

Symptoms and signs of Hodgkin’s

Answer 2

Rubbery lymph nodes
Obstruction - mediastinal - svc and bronchial obstruction
Direct invasion from mediastinal into lungs - pleural effusion
Systemic symptoms - wl and night sweats
Hepatosplenomegaly

Question 3

Treatment of a1 or II H lymphoma

Answer 3

Radiotherapy and short course of chemotherapy

Question 4

H lymphoma more severe

Answer 4

ABVD

Adriamycin, bleomycin, vinblastine, decarbazine

Question 5

Treatment of low grade lymphoma

Answer 5

Chlorambucil
Alpha interferon
Rituzimab

Question 6

Treatment of high grade lymphoma

Answer 6

R chop 
Rituximab
Cyclophosphamide
Hydroxydanurubicin
Oncovin- vincristine 
Prednisolone

Question 7

When do you see Auer rods

Answer 7

Acute myeloid leukaemia

Question 8

When do you get CNS involvement with marrow failure and infiltration of spleen and liver etc

Answer 8

Acute lymphoblastic leukaemia

Question 9

When do you get gum hypertrophy

Answer 9

Acute myeloid leukaemia

Question 10

Commonest childhood cancer and rare in adults

Answer 10

Acute lymphoblastic leukaemia

Question 11

Support for AML and ALL

Answer 11

Blood/platelet transfusions
Allopurinol to prevent tumour lysis syndrome
IV fluids

Question 12

If don’t see blasts on blood film but do on BM biopsy

Answer 12

Acute myeloid leukaemia

Question 13

Chemotherapy for ALL

Answer 13

Remission induction - VPLAD - vincristine, prednisolone, l-asparaginase, daunorubicin
Consolidation
CNS prophylaxis - methotrexate
Maintenance - prolonged for 2 years

Question 14

Chemotherapy for aml

Answer 14

Daunorubicin and cytarabine

Question 15

Signs and symptoms of chronic myeloid leukaemia

Answer 15

Myeloproliferative disorder 
Mostly chronic and insidious 
Weight loss, fever, night sweats, fatigue 
gout
Bleeding
Abdominal discomfort-splenomegaly

Question 16

Indicator of better prognosis in CML

Answer 16

Philadelphia chromosome - tk activity therefore can target this with imatinib

Question 17

Rai staging of cll

Answer 17

0 - lymphocytosis alone
1 - lymphocytosis + lymphadenopathy
2 - lymphocytosis + splenomegaly or hepatomegaly
3 - lymphocytosis + anaemia
4 - lymphocytosis + thrombocytopenia

Question 18

Blood cancer causing back pain

Answer 18

Myeloma

Question 19

t(9;22) gene translocation

Answer 19

CML - Philadelphia chromosome

Question 20

What is Burkitt’s lymphoma

Answer 20

uncommon, very high grade non Hodgkin’s B-cell lymphoma endemic to west Africa

Question 21

What virus is Burkitt’s lymphoma associated with

Answer 21

EBV

Question 22

Features of Burkitt’s lymphoma

Answer 22

Symmetrical painless lymphadenopathy, systemic B symptoms (fever, sweats and weight loss), CNS involvement and bone marrow infiltration. Classically also develops a large jaw tumour

Question 23

Gene translocation T15:17

Answer 23

Acute pro-myelocytic leukaemia

Question 24

Gene translocation T8:14

Answer 24

Burkitt’s Lymphoma

Question 25

Gene translocation T14:18

Answer 25

Follicular Lymphoma

Question 26

Gene translocation T11:14

Answer 26

Mantle Cell Lymphoma

Question 27

Microscopy in burkitts

Answer 27

‘starry sky’ appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells