Haematology - Cancer

Question 1

what is myeloma?

Answer 1

a malignancy of plasma cells

Question 2

what produces antibodies?

Answer 2

plasma cells

Question 3

what is a paraprotein?

Answer 3

increased monoclonal Ig production (due to myeloma usually)

Question 4

features of myeloma?

Answer 4

lytic bone lesions (back pain)
marrow failure
renal failure
hypercalcaemia 
anaemia

Question 5

why does renal failure occur in myeloma?

Answer 5

Tamm Horsfall protein produced
combines with free light chains
insoluble casts produced with cause a cast nephropathy

Question 6

Ix for myeloma? results?

Answer 6

FBC (anaemia)
Ca (high)
U+Es/creatinine
urine electrophoresis
serum electrophoresis
CT/MRI

Question 7

Tx for myeloma?

Answer 7

chemo and remission
bisphosphonates
opiates
(symptomatic relief and monitoring by paraprotein level)

Question 8

what is MGUS?

Answer 8

high paraprotein with no evidence of myeloma/organ damage

higher risk of developing myeloma

Question 9

what happens in amyloidosis?

Answer 9

light chains produced precipitate in tissues to form an insoluble beta pleated sheet (amyloid)

Question 10

features of amyloidosis?

Answer 10

nephrotic syndrome
cardiomyopathy
hepatomegaly 
neuropathy 
wt loss
fatigue
malabsorption

Question 11

risk factors for amyloidosis?

Answer 11

MGUS
FHx
inflam conditions
IBD

Question 12

Ix for amyloidosis?

Answer 12

organ biopsy with congo red staining - shows apple green birefringence under polarised light
SAP scan

Question 13

who gets waldenstrom’s macroglobulinaemia?

Answer 13

old men

Question 14

what happens in waldenstrom’s macroglobulinaemia?

Answer 14

disorder of cells that are an intermediate between lymphocyte and plasma cell
IgM paraprotein produced

Question 15

features of waldenstrom’s macroglobulinaemia?

Answer 15

wt loss
hepatosplenomegaly
raynaud’s
bruising

Question 16

who gets AML? features?

Answer 16

old

Question 17

Ix and results for AML?

Answer 17

marrow failure
DIC

blood film = excess myeloblasts
auer rods

Question 18

who gets CLL? features and Ix?

Answer 18

elderly

lymphadenopathy

elevated WBC

Question 19

who gets ALL? features? Ix?

Answer 19

kids

anaemia, infections, bleeding, bone pain

blood film = excess lymphoblasts

Question 20

what is CML?

Answer 20

myeloproliferative disorder of bone marrow cells

RBC, granulocytes, platelets

Question 21

what genetic mutation is assoc with CML?

Answer 21

BCR- ABL1

philadelphia chromosome

Question 22

what are features of CML?

Answer 22

gout
splenomegaly
thrombosis
hypermetabolic

Question 23

Ix and Tx for haematological malignancies?

Answer 23

immunophenotyping

chemo

Question 24

what is hodgkin’s lymphoma a disease of?

Answer 24

B cell disease

Question 25

Ix for hodgkin’s lymphoma? what virus is associated?

Answer 25

blood film = reed sternberg cells

EBV

Question 26

what is Non hodgkin’s lymphome a disease of? Tx?

Answer 26

B or T cells

RCHOP chemo

Question 27

what are features of lymphoma?

Answer 27

night sweats
infections
wt loss
itch 
fatigue
alcohol induced pain 
lymphadenopthy

Question 28

what does lymphoma lymphadenopathy feel like?

Answer 28

rubbery
smooth
non tender
non inflamed
non tethered

Question 29

Ix for lymphoma?

Answer 29

biopsy

CT