Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Hematology, oncology > Hodgkin Lymphoma > Flashcards

Hodgkin Lymphoma Flashcards

1
Q

subtypes of classical hodgkin lymphoma

A

1) nodular sclerosis
2) mixed cellularity
3) lymphocyte rich
4) lymphocyte depleted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

demographics of HL

A

bimodal (first peak around 20, second around 65)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how staging generally work

A

lymph node distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

typical presentation

A
  • asymptomatic LAD OR incidental mediastinal mass picked up on CXR (which can cause chest discomfort or respiratory symptoms if large)
  • LAD, fatigue, and/or pruritus often recognized to have begun weeks to months before patient is evaluated for cHL
  • b symptoms in 40% of patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pattern of disease involvement? How common is marrow involvement?

A
  • cervical nodes most commonly affected followed by mediastinal nodes
  • spread to adjacent lymph nodes
  • marrow involvement rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

cell of origin

A

B-cell lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

staging workup

A

CT and ***PET/CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

diagnosis of HL

A

Excisional lymph node biopsy w/ Reed-Sternberg cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

prognosis

A

Survival rates = Good. Cure obtained in 80% of all patients. 5-year survival of >90% in early, and 75% in advanced-stage disease.
Hodgkin lymphoma is a highly curable disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

treatment in general and regimen for limited stage

A

ABVD chemo followed by XRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ABVD regimen

A

doxorubicin/bleomycin/vinblastine/dacarbazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Standard of care for relapsed/refractory HL

A

high-dose chemotherapy (ICE) followed by autologous HSCT w/ brentuximab consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Definition of bulky disease

A

Tumors in the chest that are at least ⅓ as wide as the chest, or tumors in other areas that are at least 10 centimeters (about 4 inches) across

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical course

A

Generally slow progression but tempo is variable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

2 major subtypes of HL

A
  • Classic HL

- Nodular lymphocyte predominant HL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lymph node appearance in patients with cHL

A
  • nontender, firm, rubbery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is weight loss defined as a b symptom

A

Unexplained loss of greater than 10% of body weight over 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fever features in Hodgkin’s

A
  • more noticeable in the evening

- gradually becomes more severe and continuous with time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

less common presentations of hodgkin’s

A
  • alcohol-associated pain (uncommon but highly specific for HL)
  • liver disease
  • skin lesions
  • bone involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

laboratory presentation of HL

A
  • hypercalcemia (increased cailcitriol production)
  • anemia (multifactorial)
  • eosinophilia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Systemic exertion intolerance disease treatment

A

Regularly scheduled office visits
CBT
Graded exercise therapy
sleep hygiene education

22
Q

First-line treatment of acute low back pain

A

Nonpharmacologic therapy (eg acupuncture, massage, spinal manipulation, superficial heat) (most patients will improve over time, regardless of treatment)

23
Q

Boards recommendation on patient that is really nonadherent

A

send warning letter that relationship may be terminated (assuming patient is medically stable and alternative care is available)

24
Q

immunophenotype of classical HL

A

CD15 and CD30

- usually CD20 negative

25
Q

primary general goal of HL treatment

A

HL is highly curable so goal is to balance risk of recurrence with toxicity of treatment (toxicity is becoming leading cause of cancer related mortality)

26
Q

Limitation of CT for evaluating disease burden in HL

A
  • can’t detect residual disease after treatment

- can’t distinguish between necrosis and/or fibrosis and active disease

27
Q

Stage I HL

A

involvement of a single lymph node

28
Q

Stage II HL

A

involvement of 2 or more lymph node regions

29
Q

Major distinction in categorization of limited stage HL

A

Favorable and unfavorable prognosis

30
Q

2 most commonly used definitions of favorable disease

A
  • European Organization for Research and Treatment of cancer (EORTC)
  • German Hodgkin Study Group (GHSG)
31
Q

Limited stage favorable definition per EORTC

A

patients age 50 or under; without large mediastinal adenopathy; with an erythrocyte sedimentation rate (ESR) of less than 50 mm/h and no B symptoms (or with an ESR of less than 30 mm/h in those who have B symptoms); and disease limited to three or fewer regions of involvement

32
Q

Limited stage favorable definition per GHSG

A

no more than two sites of disease; no extranodal extension; no mediastinal mass measuring one-third the maximum thoracic diameter or greater; and ESR less than 50 mm/h (less than 30 mm/h if B symptoms present)

33
Q

distinction in management between unfavorable and favorable limited stage disease

A

Less chemo and less intense radiation

34
Q

Advanced stage HL refers to

A

Stage III and IV disease

35
Q

stage III definition

A

Nodal involvement on both sides of the diaphragm

36
Q

stage IV definition

A

Diffuse or disseminated involvement of 1 or more extranodal organs or tissues

37
Q

Stage IV management

A

Induction chemo +/- consolidation radiotherapy (controversial)

38
Q

Definition of primary refractory disease

A

Patients who don’t attain a complete remission after initial therapy

39
Q

Management of relapsed disease

A

Conventional chemoRT OR high dose chemo and autologous HCT

40
Q

What management of relapsed disease depends on

A

How far out relapse occurs

HCT usually if early relapse

41
Q

Score used for advanced stage stratification

A

International prognostic score (IPS)

42
Q

Advanced stage management in general

A

Main treatment is combination chemotherapy, radiation therapy may be used for selected patients as consolidation

43
Q

Therapy-related complications to know in general for HL

A

Delayed complications presenting years after treatment secondary malignancies, cardiac disease, radiation-induced hypothyroidism

44
Q

Distinctive Morphologic feature of reed sternberg cells

A
  • bilobed nucleus (sometimes multinucleated)
45
Q

scoring system used for response assessment

A

Deauville

46
Q

immunophenotype

A

CD20-, CD15+, CD30+

47
Q

Reed sternberg cell immunophenotype

A

CD15 and CD30 positive

48
Q

Evidence for radiation in unfavorable early stage classic HL

A

PFS benefit but no OS

49
Q

Management of patient on ABVD with interim PET of 4 or 5

A

Escalate to BEACOPP

50
Q

Is CHF from doxorubicin a concern for patients without CHF?

A

No. Cumulative exposure for ABVD is well below threshold that puts people at risk for CHF.

51
Q

What is the biggest mortality risk for Hodgkin’s patients who have achieved a cure?

A

Nonhematologic secondary malignancies (related to an underlying deficiency in their immune systems)

52
Q

Early stage Hodgkin lymphoma management

A

2 cycles of ABVD followed by radiation

Hematology, oncology (218 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions