Lecture 4 Neoplasm

Question 1

Major S/S of Acute Lymphoblastic Leukemia (ALL)

Answer 1

Patient presentation S/S: children will have bone pain and refuse to stand/walk. Hepatosplenomegaly & lymphadenopathy

Question 2

Dx of of Acute Lymphoblastic Leukemia (ALL)

Answer 2

20%> lymphoblastic on smear or BM biopsy
&
translocation of 12 & 21 or translocation of 9 & 22 (PHIL Chrom)

Question 3

Major S/S of Acute Myeloid Leukemia (AML)

Answer 3

FBIs (fever, bleeding, infection)
Aggresive Leukemia

Question 4

Dx of of Acute Myeloid Leukemia (AML)

Answer 4

> 20% myeloids on Smear.
& Auer rods on smear.
cytogenetics and molecular testing.

Question 5

Major S/S of Chronic Lymphocytic Leukemia (CLL)

Answer 5

Constitutional S/S + hepatosplenomegaly,
recurrent infection, lymphadenopathy

Question 6

Dx of Chronic Lymphoblastic Leukemia (CLL)

Answer 6

> 5,000 lymphocyte count
Smudge cells

Question 7

Major S/S of Chronic Myeloid Leukemia (CML)

Answer 7

asymptomatic most of time, splenomegaly.
Blast crisis >20% (rapidly progress w/constitutional symptoms here) & anemia

Question 8

Dx of Chronic Myeloid Leukemia

Answer 8

Philadelphia chromosome, high basophil, neutrophil, eosinophil
BEN leukocytosis
Blast >20%

Question 9

Major S/S of Plasma Cell Myeloma (Multiple Myeloma MM)

Answer 9

Usually bone pain from malignant cells invading bone and forming tumors
Kidney s/s (flank pain etc)

Question 10

Dx of Plasma Cell Myeloma (Multiple Myeloma MM)

Answer 10

Light chain proteins (Bence Jones protein —>CKD)
Proteinuria, hypercalcemia CKD (due to renal damage).
Translocation in chrom 14

Question 11

Major S/S of Hodgkins Lymphoma

Answer 11

asymptomatic, painless lymphadenopathy, constitutional s/s

Question 12

Dx of Hodgkins Lymphoma

Answer 12

Reed-Sternberg cells present in lymph node tumor (EBV) frequently found in Genome of RS cells (Biopsy)

Question 13

Major S/S of Non-Hodgkins Lymphoma

Answer 13

constitutional symptoms,
Painless lymphadenopathy
2 serious oncological emergencies (superior vena cava obstruction & spinal cord compression). Infection, bone metastasis, and joint effusions occur as well.

Question 14

Dx of Non-Hodgkins Lymphoma

Answer 14

EBV & human T cell leukemia virus (HTLV-1) are present
Atypical lymphocytes in biopsy, elevated LDH

Question 15

Staging

Answer 15

Stage 1
1 lymph node area/lymphoid organ
1 area of a single organ outside of lymph system

Stage 2
2+ groups of lymph nodes on same side
Isolated above or below the diaphragm

Stage 3
Lymph node areas above and below diaphragm
On both left and right sides

Stage 4
Spread widely into at least one organ outside lymph system
Bone marrow, liver, lung

Question 16

Complications of Cancer

Answer 16

-Tumor lysis syndrome (TLS)
Due to idiopathic or other reasons tumors lyse
Leading to hyperkalemia, hyperuricemia, nucleic acid floating, & hypocalcemia
-DIC
-Infection
Leukemia, induced neutropenia, myeloablative therapy
-Cancer return or new form of cancer

Question 17

Paraneoplastic Syndromes:

Answer 17

excess production of hormones and cytokines ex// Expressive ADH—>hyponatremia & ACTH —> Cushings