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Path questions imperialendo.co.uk > Leukaemia & lymphoma > Flashcards

Leukaemia & lymphoma Flashcards

1
Q

Choose the most appropriate answer from the list.

  • 70
  • 20
  • 30
  • 40
  • 50
  • 500
  • 5000
  • 80
  • 100
  • 1000

Number of B cells /μL required to diagnose CLL

A

5000

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2
Q

Choose the most appropriate answer from the list.

  • 70
  • 20
  • 30
  • 40
  • 50
  • 500
  • 5000
  • 80
  • 100
  • 1000

% of CLL patients older than 65 years at time of diagnosis

A

70

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3
Q

Choose the most appropriate answer from the list.

  • 70
  • 20
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  • 40
  • 50
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  • 5000
  • 80
  • 100
  • 1000

% of cases that present with no anaemia or thrombocytopenia, with three or more areas of lymphoid involvement (Rai Stages I and II, Binet Clinical Stage B)

A

50

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4
Q

Choose the most appropriate answer from the list.

  • 70
  • 20
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  • 40
  • 50
  • 500
  • 5000
  • 80
  • 100
  • 1000

% of CLL patients in which one or more cytogenetic abnormalities have been found

A

80

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5
Q

Choose the most appropriate answer from the list.

  • 70
  • 20
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  • 40
  • 50
  • 500
  • 5000
  • 80
  • 100
  • 1000

% of cases which have the most common abnormality: del 13q.14

A

50

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6
Q

Choose the most appropriate treatment option from the list.

  • Allogenic blood transfusion
  • Dosatinib
  • Allogenic stem cell transplantation
  • Fresh frozen plasma
  • Autologous blood transfusion
  • Golimumab
  • Autologous stem cell transplantation
  • Hydroxychloroquine
  • Azathioprine
  • IFN-α infusion
  • Daunorubicin infusion
  • Imatinib
  • Donor granulocyte infusion
  • Methotrexate
  • Donor lymphocyte infusion
  • None of the above

A 50 year old man presents with weight loss, fatigue and night sweats. He is diagnosed with chronic myeloid leukaemia and treatment is commenced. Several months later it becomes clear that he is resistant to the main class pharmaceutical agents that were used.

A

Allogenic stem cell transplantation

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7
Q

Choose the most appropriate treatment option from the list.

  • Allogenic blood transfusion
  • Dosatinib
  • Allogenic stem cell transplantation
  • Fresh frozen plasma
  • Autologous blood transfusion
  • Golimumab
  • Autologous stem cell transplantation
  • Hydroxychloroquine
  • Azathioprine
  • IFN-α infusion
  • Daunorubicin infusion
  • Imatinib
  • Donor granulocyte infusion
  • Methotrexate
  • Donor lymphocyte infusion
  • None of the above

A 57 year old woman is known to have chronic myeloid leukaemia. She presents acutely unwell, with 25% myeloblasts on her blood film, and is appropriately treated. 24 months later she relapses.

A

Donor lymphocyte infusion

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8
Q

Choose the most appropriate treatment option from the list.

  • Allogenic blood transfusion
  • Dosatinib
  • Allogenic stem cell transplantation
  • Fresh frozen plasma
  • Autologous blood transfusion
  • Golimumab
  • Autologous stem cell transplantation
  • Hydroxychloroquine
  • Azathioprine
  • IFN-α infusion
  • Daunorubicin infusion
  • Imatinib
  • Donor granulocyte infusion
  • Methotrexate
  • Donor lymphocyte infusion
  • None of the above

A 60 year old woman presents with weight loss and lethargy. On examination, she is cachectic with splenomegaly. Her white cell count is 150 x 109/l. Her blood film showed 25% myeloblasts. Cytogenetic analysis showed presence of the Philadelphia chromosome.

A

Allogenic stem cell transplantation

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9
Q

Choose the most appropriate treatment option from the list.

  • Allogenic blood transfusion
  • Dosatinib
  • Allogenic stem cell transplantation
  • Fresh frozen plasma
  • Autologous blood transfusion
  • Golimumab
  • Autologous stem cell transplantation
  • Hydroxychloroquine
  • Azathioprine
  • IFN-α infusion
  • Daunorubicin infusion
  • Imatinib
  • Donor granulocyte infusion
  • Methotrexate
  • Donor lymphocyte infusion
  • None of the above

A 55 year old man presents with weight loss and lethargy. On examination, he is cachectic with splenomegaly. His white cell count was 135 x 109/l. Cytogenetic analysis showed presence of the Philadelphia chromosome.

A

Imatinib

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10
Q

Choose the most appropriate treatment option from the list.

  • Allogenic blood transfusion
  • Dosatinib
  • Allogenic stem cell transplantation
  • Fresh frozen plasma
  • Autologous blood transfusion
  • Golimumab
  • Autologous stem cell transplantation
  • Hydroxychloroquine
  • Azathioprine
  • IFN-α infusion
  • Daunorubicin infusion
  • Imatinib
  • Donor granulocyte infusion
  • Methotrexate
  • Donor lymphocyte infusion
  • None of the above

A 57 year old man with a history of chronic myeloid leukaemia presents with night sweats, fatigue and weight loss. He was started on first line therapy 6 months ago but his doctor is concerned that he has relapsed. He wants to try a new treatment option.

A

Dosatinib

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11
Q

Choose the most appropriate treatment option from the list.

  • IFN-α
  • Dosatinib
  • Hydroxycarbamide
  • Chemotherapy + all-trans-retinoic acid
  • Allogeneic stem cell transplantation
  • Chemotherapy (R-CHOP regimen)
  • Imatinib
  • Chemotherapy (ABVD regimen)
  • Chlorambucil
  • Chemotherapy (R-CVP regimen)
  • Cyclosphosphamide
  • Donor lymphocyte infusion
  • Monitor clinically and give annual influenza vaccine
  • Radiotherapy and 6-8 cycles of chemotherapy

A 50 year old man presented with fatigue, lethargy and weight loss. On examination, he was pale and had gross splenomegaly. His blood film showed an increase in white blood cells (both myelocytes and mature granulocytes). Cytogenetic analysis showed a t(9;22) chromosomal translocation.

A

Imatinib

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12
Q

Choose the most appropriate treatment option from the list.

  • IFN-α
  • Dosatinib
  • Hydroxycarbamide
  • Chemotherapy + all-trans-retinoic acid
  • Allogeneic stem cell transplantation
  • Chemotherapy (R-CHOP regimen)
  • Imatinib
  • Chemotherapy (ABVD regimen)
  • Chlorambucil
  • Chemotherapy (R-CVP regimen)
  • Cyclosphosphamide
  • Donor lymphocyte infusion
  • Monitor clinically and give annual influenza vaccine
  • Radiotherapy and 6-8 cycles of chemotherapy

A 74 year old patient has been diagnosed with chronic myeloid leukaemia and 6 months after starting therapy with the first line drug has shown no improvement in FBC or cytogenetics. His physician switches him to another drug.

A

Dosatinib

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13
Q

Choose the most appropriate treatment option from the list.

  • IFN-α
  • Dosatinib
  • Hydroxycarbamide
  • Chemotherapy + all-trans-retinoic acid
  • Allogeneic stem cell transplantation
  • Chemotherapy (R-CHOP regimen)
  • Imatinib
  • Chemotherapy (ABVD regimen)
  • Chlorambucil
  • Chemotherapy (R-CVP regimen)
  • Cyclosphosphamide
  • Donor lymphocyte infusion
  • Monitor clinically and give annual influenza vaccine
  • Radiotherapy and 6-8 cycles of chemotherapy

A 48 year old patient with chronic myeloid leukaemia becomes acutely unwell. A peripheral blood film shows 30% myeloblasts.

A

Allogeneic stem cell transplantation

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14
Q

Choose the most appropriate treatment option from the list.

  • IFN-α
  • Dosatinib
  • Hydroxycarbamide
  • Chemotherapy + all-trans-retinoic acid
  • Allogeneic stem cell transplantation
  • Chemotherapy (R-CHOP regimen)
  • Imatinib
  • Chemotherapy (ABVD regimen)
  • Chlorambucil
  • Chemotherapy (R-CVP regimen)
  • Cyclosphosphamide
  • Donor lymphocyte infusion
  • Monitor clinically and give annual influenza vaccine
  • Radiotherapy and 6-8 cycles of chemotherapy

A 59 year old patient with chronic myeloid leukaemia has been found to be positive for the Philadelphia chromosome several years following his stem cell transplantation.

A

Donor lymphocyte infusion

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15
Q

Choose the most appropriate treatment option from the list.

  • IFN-α
  • Dosatinib
  • Hydroxycarbamide
  • Chemotherapy + all-trans-retinoic acid
  • Allogeneic stem cell transplantation
  • Chemotherapy (R-CHOP regimen)
  • Imatinib
  • Chemotherapy (ABVD regimen)
  • Chlorambucil
  • Chemotherapy (R-CVP regimen)
  • Cyclosphosphamide
  • Donor lymphocyte infusion
  • Monitor clinically and give annual influenza vaccine
  • Radiotherapy and 6-8 cycles of chemotherapy

A 61 year old patient with chronic myeloid leukaemia has not responded to different tyrosine kinase inhibitors available.

A

Allogeneic stem cell transplantation

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16
Q

A patient has a leukaemia with a 9;22 translocation. Rank the following diagnoses given this information, with the most likely diagnosis given first.

A) AML

B) ALL

C) CML

D) Acute promyelocytic leukaemia

A

(C) Is the likeliest diagnosis as it the translocation is found in 95% of patients with CML. First line therapy is Imatinib, ABL kinase inhibitor, which would be started in the chronic phase of the CML. (B) Philadelphia chromosome is found in around 25-30% of ALL patients and is associated with a poor prognosis. (A) AML with Philadelphia chromosome is a rare aggressive acute leukaemia, fewer than 1% of new cases. t(8:21) may be found. (D) Acute Promyelocytic leukaemia is associate with t(15:17) translocation in 95% of cases.

17
Q

Choose the most appropriate answer from the list

  • Acute lymphoblastic leukaemia
  • Genital warts
  • Acute myeloid leukaemia
  • Hairy cell leukaemia
  • AIDS
  • Hodgkin’s lymphoma
  • Cerebral lymphoma
  • Hyperparathyroidism
  • Chronic lymphocytic leukaemia
  • Marfan’s syndrome
  • Chronic myeloid leukaemia
  • Neisseria meningitidis
  • Colles’ fracture
  • Non-Hodgkin’s lymphoma
  • Cushing’s disease
  • Retroperitoneal fibrosis

Yoko is an 80 year old woman referred to you for investigation after a blood test shows anaemia and marked lymphocytosis. Her only complaint is “tiredness”. Physical examination reveals painless lymphadenopathy and a blood smear shows smudge cells. What is the single most likely diagnosis?

A

Chronic lymphocytic leukaemia

18
Q

Choose the most appropriate answer from the list

  • Acute lymphoblastic leukaemia
  • Genital warts
  • Acute myeloid leukaemia
  • Hairy cell leukaemia
  • AIDS
  • Hodgkin’s lymphoma
  • Cerebral lymphoma
  • Hyperparathyroidism
  • Chronic lymphocytic leukaemia
  • Marfan’s syndrome
  • Chronic myeloid leukaemia
  • Neisseria meningitidis
  • Colles’ fracture
  • Non-Hodgkin’s lymphoma
  • Cushing’s disease
  • Retroperitoneal fibrosis

John is a 40 year old man complaining of fatigue, night sweats and unintentional weight loss. A blood test shows anaemia and leucocytosis, and physical examination reveals splenomegaly. Bone marrow biopsy cytogenetic analysis indicates the presence of the Philadelphia chromosome. What is the single most likely diagnosis?

A

Chronic myeloid leukaemia

19
Q

Choose the most appropriate answer from the list

  • Acute lymphoblastic leukaemia
  • Genital warts
  • Acute myeloid leukaemia
  • Hairy cell leukaemia
  • AIDS
  • Hodgkin’s lymphoma
  • Cerebral lymphoma
  • Hyperparathyroidism
  • Chronic lymphocytic leukaemia
  • Marfan’s syndrome
  • Chronic myeloid leukaemia
  • Neisseria meningitidis
  • Colles’ fracture
  • Non-Hodgkin’s lymphoma
  • Cushing’s disease
  • Retroperitoneal fibrosis

Paul is a 71 year old man with anaemia, fever and unintentional weight loss. Physical examination reveals splenomegaly. A blood test shows anaemia, neutropaenia and thrombocytopaenia, and a blood smear shows irregularly shaped cells exhibiting filament-like cytoplasmic projections. What is the single most likely diagnosis?

A

Hairy cell leukaemia

20
Q

Choose the most appropriate answer from the list

  • Acute lymphoblastic leukaemia
  • Genital warts
  • Acute myeloid leukaemia
  • Hairy cell leukaemia
  • AIDS
  • Hodgkin’s lymphoma
  • Cerebral lymphoma
  • Hyperparathyroidism
  • Chronic lymphocytic leukaemia
  • Marfan’s syndrome
  • Chronic myeloid leukaemia
  • Neisseria meningitidis
  • Colles’ fracture
  • Non-Hodgkin’s lymphoma
  • Cushing’s disease
  • Retroperitoneal fibrosis

George is a 58 year old man found collapsed at home. Physical examination reveals pallor and hepatosplenomegaly. A blood test shows anaemia, leucocytosis and thrombocytopaenia, and a blood smear shows blast cells and Auer rods. His medical records indicate he was prescribed cyclophosphamide three years ago. What is the single most likely diagnosis?

A

Acute myeloid leukaemia

21
Q

Choose the most appropriate answer from the list

  • Acute lymphoblastic leukaemia
  • Genital warts
  • Acute myeloid leukaemia
  • Hairy cell leukaemia
  • AIDS
  • Hodgkin’s lymphoma
  • Cerebral lymphoma
  • Hyperparathyroidism
  • Chronic lymphocytic leukaemia
  • Marfan’s syndrome
  • Chronic myeloid leukaemia
  • Neisseria meningitidis
  • Colles’ fracture
  • Non-Hodgkin’s lymphoma
  • Cushing’s disease
  • Retroperitoneal fibrosis

Ringo is a four year old boy with Down syndrome who presents in A+E with pallor, tachycardia, petechiae and testicular enlargement. A blood test shows anaemia, thrombocytopaenia and leucocytosis, and a blood smear reveals blast cells. What is the single most likely diagnosis?

A

Acute lymphoblastic leukaemia

22
Q

Choose the most appropriate answer from the list

  • Alcohol
  • Epstein Barr virus
  • Asbestos
  • Helicobacter pylori
  • BCR-ABL fusion gene
  • Human immunodeficiency virus
  • Benzene
  • Human herpesvirus 8
  • Cigarette smoking
  • Human T-cell lymphotrophic virus I
  • Coeliac disease
  • Irradiation
  • Crohns disease
  • Malaria
  • Down syndrome
  • Ulcerative colitis

A strong aetiological link to a type of lymphoma with a histological appearance of ‘owl’s eyes’

A

Epstein Barr virus

23
Q

Choose the most appropriate answer from the list

  • Alcohol
  • Epstein Barr virus
  • Asbestos
  • Helicobacter pylori
  • BCR-ABL fusion gene
  • Human immunodeficiency virus
  • Benzene
  • Human herpesvirus 8
  • Cigarette smoking
  • Human T-cell lymphotrophic virus I
  • Coeliac disease
  • Irradiation
  • Crohns disease
  • Malaria
  • Down syndrome
  • Ulcerative colitis

Associated with the development of a lymphoma which is most common in southern Japan, West Africa and the Caribbean basin.

A

Human T-cell lymphotrophic virus I

24
Q

Choose the most appropriate answer from the list

  • Alcohol
  • Epstein Barr virus
  • Asbestos
  • Helicobacter pylori
  • BCR-ABL fusion gene
  • Human immunodeficiency virus
  • Benzene
  • Human herpesvirus 8
  • Cigarette smoking
  • Human T-cell lymphotrophic virus I
  • Coeliac disease
  • Irradiation
  • Crohns disease
  • Malaria
  • Down syndrome
  • Ulcerative colitis

Related to the development of enteropathy-associated T-cell lymphoma.

A

Coeliac disease

25
Q

Choose the most appropriate answer from the list

  • Alcohol
  • Epstein Barr virus
  • Asbestos
  • Helicobacter pylori
  • BCR-ABL fusion gene
  • Human immunodeficiency virus
  • Benzene
  • Human herpesvirus 8
  • Cigarette smoking
  • Human T-cell lymphotrophic virus I
  • Coeliac disease
  • Irradiation
  • Crohns disease
  • Malaria
  • Down syndrome
  • Ulcerative colitis

A mucosa-associated lymphoid tumour may regress if this is eradicated.

A

Helicobacter pylori

26
Q

Choose the most appropriate answer from the list

  • Alcohol
  • Epstein Barr virus
  • Asbestos
  • Helicobacter pylori
  • BCR-ABL fusion gene
  • Human immunodeficiency virus
  • Benzene
  • Human herpesvirus 8
  • Cigarette smoking
  • Human T-cell lymphotrophic virus I
  • Coeliac disease
  • Irradiation
  • Crohns disease
  • Malaria
  • Down syndrome
  • Ulcerative colitis

Has a causal role in primary effusion lymphoma.

A

Human herpesvirus 8

Path questions imperialendo.co.uk (44 decks)

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