Chapter 24: Lymphoma Flashcards
Which age group is most likely to develop the young adult form of Hodgkin disease?
A. 0 to 14 years
B. 15 to 34 years
C. 35 to 49 years
D. Over 50 years
B. 15 to 34 years
Rationale: The young adult form of Hodgkin disease occurs in individuals aged 15 to 34 years, one of the two peaks of incidence in the disease’s bimodal distribution.
Which of the following statements accurately describe Hodgkin disease? (SATA)
A. It usually arises in a single lymph node or a group of lymph nodes.
B. It is more common in females than males, particularly in younger children.
C. It accounts for 15% of cancers in youth aged 15 to 19 years.
D. The disease has a bimodal peak in incidence, with higher rates in early 20s and after 50 years.
E. The young person form occurs in individuals over 50 years of age.
A. It usually arises in a single lymph node or a group of lymph nodes.
B. It is more common in females than males, particularly in younger children.
D. The disease has a bimodal peak in incidence, with higher rates in early 20s and after 50 years.
Rationale: Hodgkin disease typically arises in lymph nodes, accounts for 15% of cancers in adolescents, and has a bimodal incidence pattern. It is slightly more common in males, particularly in younger children, and the young person form occurs in those under 14 years, not over 50.
A 16-year-old male presents with painless swelling of a lymph node in the neck. Based on epidemiological data, which cancer is most likely to be suspected?
A. Non-Hodgkin lymphoma
B. Acute lymphoblastic leukemia (ALL)
C. Hodgkin disease
D. Neuroblastoma
C. Hodgkin disease
Rationale: Hodgkin disease is more common in adolescents and often presents as painless swelling of lymph nodes, fitting the epidemiological data and clinical presentation.
Which factor is associated with an increased risk of Hodgkin disease in children and adolescents?
A. Female gender
B. Age under 10 years
C. Lack of bimodal incidence distribution
D. Male gender, particularly in younger children
D. Male gender, particularly in younger children
Rationale: Hodgkin disease has a slightly increased incidence in males, particularly in younger children, and follows a bimodal incidence pattern.
Which factors are suggested to contribute to the etiology of Hodgkin disease? (SATA)
A. Genetic predisposition
B. Epstein-Barr virus infection
C. Exposure to environmental hazards
D. Vitamin D deficiency
E. Autoimmune disorders
A. Genetic predisposition
B. Epstein-Barr virus infection
C. Exposure to environmental hazards
Rationale: Hodgkin disease is believed to have a genetic link, and studies suggest associations with Epstein-Barr virus and environmental hazards. There is no evidence connecting vitamin D deficiency or autoimmune disorders to the etiology of Hodgkin disease.
What evidence supports the hypothesis of a genetic link in Hodgkin disease?
A. High incidence in individuals with autoimmune disorders
B. Cases reported in family clusters
C. Association with vitamin deficiencies
D. Predominance in older adults
B. Cases reported in family clusters
Rationale: Hodgkin disease has been reported in family clusters, suggesting a possible genetic component to its etiology, along with other contributing factors like infectious agents and environmental hazards.
Which diagnostic tools and studies are used to stage Hodgkin disease? (SATA)
A. Chest x-ray
B. Reed-Sternberg cell analysis
C. MRI of retroperitoneal nodes
D. Liver and renal function tests
E. Serum calcium levels
A. Chest x-ray
B. Reed-Sternberg cell analysis
C. MRI of retroperitoneal nodes
D. Liver and renal function tests
Rationale: Staging of Hodgkin disease involves multiple diagnostic modalities, including imaging (chest x-ray, MRI), laboratory studies (liver and renal function tests), and identification of Reed-Sternberg cells. Serum calcium levels are not typically used for staging Hodgkin disease.
What is the hallmark finding required for the diagnosis of Hodgkin disease?
A. Elevated ESR
B. Presence of Reed-Sternberg cells
C. Retroperitoneal lymph node enlargement
D. Positive gallium scan
B. Presence of Reed-Sternberg cells
Rationale: The definitive diagnosis of Hodgkin disease is made by identifying Reed-Sternberg cells in a lymph node biopsy. Other findings may assist with staging but are not diagnostic.
What is the primary reason for using low-dose radiation in children with Hodgkin disease?
A. To reduce the risk of secondary malignancies
B. To minimize potential long-term growth impairment
C. To enhance the effectiveness of chemotherapy
D. To reduce treatment costs
B. To minimize potential long-term growth impairment
Rationale: Low-dose radiation is used in children who are still growing to minimize the risk of long-term growth impairment caused by high-dose radiation therapy.
Which treatments are commonly used for children with advanced or relapsed Hodgkin disease? (SATA)
A. Autologous stem cell transplant
B. Allogeneic stem cell transplant
C. Radiation therapy
D. Immunotherapy
E. Surgery as a sole treatment
A. Autologous stem cell transplant
B. Allogeneic stem cell transplant
C. Radiation therapy
Rationale: Autologous and allogeneic stem cell transplants, as well as radiation therapy, are treatment options for advanced or relapsed Hodgkin disease. Immunotherapy is not a standard treatment, and surgery alone is not curative for this condition.
- Multiple Choice Question
What is the approximate 5-year survival rate for Hodgkin disease, depending on the stage at diagnosis?
A. 70%
B. 75%
C. 85%-90%
D. 95%-100%
C. 85%-90%
Rationale: The 5-year survival rate for Hodgkin disease ranges from approximately 85% to 90%, depending on the stage at diagnosis and response to therapy.
Which laboratory studies assist in staging Hodgkin disease? (SATA)
A. ESR
B. Serum copper levels
C. Serum potassium levels
D. C-reactive protein
E. Bone marrow biopsy
A. ESR
B. Serum copper levels
D. C-reactive protein
E. Bone marrow biopsy
Rationale: ESR, serum copper levels, C-reactive protein, and bone marrow biopsy are commonly used to evaluate the severity and staging of Hodgkin disease. Serum potassium levels are not typically relevant for staging.
Which factor is most critical in determining the survival rate in children with Hodgkin disease?
A. Age of the child
B. Type of chemotherapy regimen used
C. Stage of disease at diagnosis
D. Genetic predisposition
C. Stage of disease at diagnosis
Rationale: The stage of Hodgkin disease at diagnosis is the most critical factor in determining the prognosis and survival rate. Early-stage disease is associated with higher survival rates.
Which type of pediatric non-Hodgkin lymphoma is associated with 8q24 chromosomal translocation?
A. Lymphoblastic lymphoma
B. Diffuse large B-cell lymphoma
C. Anaplastic large cell lymphoma
D. Small noncleaved cell (Burkitt) lymphoma
D. Small noncleaved cell (Burkitt) lymphoma
Rationale: Burkitt lymphoma is specifically associated with an 8q24 chromosomal translocation.
What are the four types of pediatric non-Hodgkin lymphoma? (SATA)
A. Lymphoblastic lymphoma
B. Small noncleaved cell (Burkitt) lymphoma
C. Diffuse large B-cell lymphoma
D. T-cell leukemia
E. Anaplastic large cell lymphoma
A. Lymphoblastic lymphoma
B. Small noncleaved cell (Burkitt) lymphoma
C. Diffuse large B-cell lymphoma
E. Anaplastic large cell lymphoma
Rationale: The four types of pediatric NHL are lymphoblastic lymphoma, small noncleaved cell (Burkitt) lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma. T-cell leukemia is not a type of NHL.
