Chapter 20 - Hematologic Malignancy Flashcards
Consistency of lymphoma nodes
rubbery
Sore throat can be a symptom of what hematologic condition?
severe neutropenia
prevention and treatment of chemo mucositis
ice chips - vasoconstriction (prevent)
buffered saline - treatment
Two heme cancers that can cause cervical LAD
lymphoma (painless)
CLL
Features that make you think neck mass is a lymphoma
Unexplained fevers and drenching night sweats last month
10% body weight loss over 6 months
These are the B Sx
Fatigue also a sign of NHL
Pruritis and pain after EtOH sign of Hodkin
Percentage of lymphoma patients presenting with B Sx
Hodgkin: 25%
NHL: 40%
Indications for cervical LN biopsy in suspected lymphomas
> 2cm diameter or 1.5x1.5
Persistent LAD >4-6wk
If unfavorable spot, risk of SCC, use FNA first, but may need excisional Bx later if lymphoma cells present
Lab tests to consider with heme malignancy suspicion
CBC Diff, smear, ESR, coag, CMP, LDH
HIV, Viral Hep, uric acid
ENT manifestations of heme cancer
LAD
Nasal obst, facial bone erosion, thyroid infilt, salivary gl
SVC Synd
Cranial palsy
Mental nerve
RLN
Mucosal pallor, epistaxis, petechiae, purp
HDC Transplant complication causing severe xerostomia
Chronic GVHD
Chemo drugs causing Oto toxicity
Cisplatin Vinblastine Nitrogen mustard Arsenic Trioxide Bleomycin
Chemo drugs causing Anosmia
Cytosine arabinoside, MTX
Mucosal cell death/impair regrow
Chemo drugs causing aguesia
Bleomycin
Cisplatin
MTX
Meló ganan
Pathogenesis Mucositis
DNA damage from ROS…inflammation…tissue damage/ulcer…bacteria/fungi/virus
Prevent and Tx mucositis
Prev; hygiene, ice chips 30 min during infusion, Caphosol, glutamine IV, keratinocyte GF
Tx: salt/baking soda q4 rinse 1tsp BS1/2 tsp salt in quart water, analgesic, magic mouthwash (lidocaine, diphenhydramine, sod bicarb, MgAlOH)
