HAEMOLYMPHATIC 1 Flashcards

1
Q

what are the 4 types/locations of lymphoma?
which is the most common?

A

multicentric [most common]
cranial mediastinal
alimentary
intranodal

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2
Q

multicentric lymphoma can often lead to enlargement of what organ?

A

hepatosplenomegaly

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3
Q

alimentary lymphomas can be difficult to treat due to high grade and widespread infiltration. however this does not include _________lymphomas

A

rectal

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4
Q

extranodal lymphoma of the skin can be of which two types?

A

-primary cutaneous?
-non-epitheliotrophic?

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5
Q

lymphoma paraneoplastic syndroms:
_______glycaemia
________ammaglobinaemia

A
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6
Q

first step to diagnose lymphoma is FNA/cytology. which kinda of lymphomas can NOT b diagnosed on ctyology?

A

small cell lymphoma

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7
Q

when diagnosing lymphoma using cytology, which lymph nodes should be samples?

A

popliteal node
[avoid submandibular due to it having frequent from dental disease]

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8
Q

what are 3 aspects from this cytolgoy that help diagnose it as a lymphoma?

A

-clumped chromatin/nucleoli
-basophilic cytoplasm[stained darkly]
-mitosis

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9
Q

RELISTEN TO THE PARTS ABT CYTOLOGY

A
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10
Q

what is the next step is diagnosis after FNA/cytology?

A

wedge excisional biopsy

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11
Q

what are two types of additional diagnostics?[after biopsy] immunophenotyping and ____________
what are the 3 types of immunophenotyping?

A

immunophenotyping
PARR

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12
Q

what is immunophenotyping?

A

looks for specific markers on cell to diagnose lymphomas [T vs B cell, CD markers, etc]

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13
Q

describe how immunehistochemistry works

A
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14
Q

describe how flow cytometry works.
what is a limitation of it compared to other techniques?
what is an advantage of it compared to other techniques?

A
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15
Q

describe how PARR works
is it higher in specificity or sensitivity?

A

-assesses clonality in a cell population by looking at a market from T cells OR B cells
-monoclonal: neoplastic/ polyclonal: unique, non-neoplastic

-higher specificity, so neg test does NOT rule out

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16
Q

which haematology findings, although nonspecific, can indicate lymphoma?

A

neutrophilia
thrombocytopenia
lymphopenia
eosinopenia
mild non-regen anaemia
lymphocytosis
reduced cobalamin (B12)

17
Q

there are more lymphomas here as well. check lecture where she circled them

18
Q

along with lymph node enlargement, what are 2 things your could see on diagnostic imaging AXR of lymphoma?

A

-hepatosplenomegaly
-peritoneal effusion[double check why]

19
Q

what is an advantage of ultrasound over AXR in lymphoma diag imaging?

A

-ultrasound detects involvement of other organs
-useful for FNA/biopsy guidance

21
Q

which lymphoma has WORSE prognosis:
-T cell or B cell?

22
Q

what are the 3 drug options for single-agent chemotherapy for lymphoma?
-which provides shortest remission/survival time?

A

prednisone [shortest time, 2-3 mo]
doxorubicin
lomustine

23
Q

what is the main toxicity of prednisolone?

A

iatrogenic hyperadrenocorticism

24
Q

which drug is the best to give as a single agent chemo with 70% CR and 6-7mo survival?

A

doxorubicin

25
what are some (5) toxicities of doxorubicin/epirubicin?
* SEVERE perivascular irritant * Anaphylaxis *acute cardiotoxicity *cumulative, dose-dependant * Nausea * GI effects * Myelosuppression * Nephrotoxicity * Alopecia
26
what are two types of toxicities for loumustine?
-hepatotoxicity -myelosuppression
27
What are two additional lymphoma tx drugs that can be used in multi-drug chemotherapy?
vincristine cyclophosphamide
28
is vincristine phase specific? if so, which? what are some toxicities?
M phase -pereivascular irritant -mylosurpressive, neurotoxicity
29
is cyclophosphamide phase specific? if so, which? what are some toxicities?
-non phase specific -myelosupression GI upset sterile haemorrhagic cystitis alopecia
30
remission: what si the definition of PR? CR?
31
which chemo drug can cross blood-brain barrier, and therefore is good for CNS relapses which are frequent?
cytosine arabinoside [losmustine can as well, dunno why it isnt mentioned]
32
is cytosine arabinoside phase specific? if so, which? what are some (2) toxicities?
S phase -myelosupression -GI upset -these toxicities greater if given by infusion
33
L-asparginase should be given through which route? why?
IM [not IV] due to frequent anaphylaxis
34
what is tumour lysis syndrome? what si the best preventative measure?
-large tumour burden responds n undergoes lysis quickly --->intracellular components released into circulation --->hyperkalaemia, hyperphosphataemia . -best preventative=hydration
35
what is a rescue therapy?
therapy(s) given for a relapse