Liquid tumors

Question 1

Follicular lymphoma- Eti

Answer 1

Indolent- Gene translocation prevents apoptosis. 25% of NHL. Onset at 60, can transform to diffuse B cell lymphoma

Question 2

Follicular lymphoma-Sx

Answer 2

Painless lymphadenopathy, comes & goes, no sweat, fevers or weight loss

Question 3

Follicular lymphoma-Dx

Answer 3

Lymph biopsy- follicular pattern of growth

Question 4

Follicular lymphoma-Tx

Answer 4

Less invasive therapies, observation, Rituximab- . Rarely BMT

Question 5

Follicular lymphoma-Prognosis

Answer 5

Early treatment doesn’t improve survival, advanced stage not curable

Question 6

Diffuse Large B-cell- Eti

Answer 6

Most common, aggressive, 60s, potentially curable

Question 7

Diffuse Large B-cell- Sx

Answer 7

Extra nodal involvement, night sweats, weight loss,

Question 8

Diffuse Large B-cell- Dx

Answer 8

Lymph biopsy

Question 9

Diffuse Large B-cell- Tx

Answer 9

Cytotoxic chemo:
R- Rituxumab
C- cyclophosphamide
H- doxorubicin
O- vincristine
P- Predinsone
BMT for recurrence

Question 10

Burkitt lymphoma- Eti

Answer 10

Highly aggressive, rare, more common in children, rapid progression-> CNS

Question 11

Burkitt lymphoma-Sx

Answer 11

Intraabdominal mass , peripheral lymphadenopathy,

Question 12

Burkitt lymphoma- Tx

Answer 12

70-80% cure rate, high dose, intensive chemo- cyclophosphamide, CNS therapy,

Question 13

Multiple myeloma- Eti

Answer 13

High incidence in african american, second most common hematologic malignancy, 60s, No cure

Question 14

Multiple myeloma- Sx

Answer 14

CRAB

HyperCalcemia, Renal dysfunction, Anemia, Bone pain-spine & long bones

Question 15

Multiple myeloma- Dx

Answer 15

M-protien in serum or urine, Bence-jones protein,

Question 16

Multiple myeloma- Tx

Answer 16

Bisphosphonates, steroids, immunomodulatory agents- high dose dexamethasone

Question 17

Acute Myeloid Leukemia- Eti

Answer 17

Most common acute leukemia in adults, 64 YO, males, prior nine marrow issues or chemo

Question 18

Acute Myeloid Leukemia- Sx

Answer 18

Gingival hyperplasia, bleeding (petechiae)& bruising, constitutional symptoms

Question 19

Acute Myeloid Leukemia- Dx

Answer 19

high blast count, BMB-85% myeloblasts & auer rods

Question 20

Acute Myeloid Leukemia- Tx

Answer 20

Chemo- 1 week + 1 month hospital stay, consolidation chemo, Allogenic BMT

Question 21

Chronic Myeloid Leukemia- Eti

Answer 21

20% of adult leukemia, 65 YO, Philadelphia chromosome

Question 22

Chronic Myeloid Leukemia- Sx

Answer 22

Hepatosplenomegaly (abd pain, satiety, shoulder pain) , bleeding, fatigue,

Question 23

Chronic Myeloid Leukemia- Dx

Answer 23

Philadelphia chromosome, hypercellular BMB, leukocytosis

Question 24

Chronic Myeloid Leukemia- Tx

Answer 24

Imatinib- tyrosine kinase inhibitor,

Question 25

Acute Lymphoid Leukemia- Eti

Answer 25

Most common in children, highly curable, can occur in adults, B or T cell lineage

Question 26

Acute Lymphoid Leukemia- Sx

Answer 26

Anemia, bone pain, hepatosplenomegaly, CNS involvement, lymphadenopathy

Question 27

Acute Lymphoid Leukemia- Dx

Answer 27

BMB- High blast count

Question 28

Acute Lymphoid Leukemia- Tx

Answer 28

Muliple cycles of combination chemo, CNS prophylaxis

Question 29

Chronic Lymphocytic Leukemia- Eti

Answer 29

Men, elderly, most common in W. hemisphere, b-lymphocytes,

Question 30

Chronic Lymphocytic Leukemia- Sx

Answer 30

Abnormal CBC-Lymphocytosis, constitutional, lymphadenopathy,

Question 31

Chronic Lymphocytic Leukemia- Dx

Answer 31

Persistant lymphocytosis, Rai/Benet staging,

Question 32

Chronic Lymphocytic Leukemia- Tx

Answer 32

Wait & watch, no cure, combination chemo if indicated

Question 33

Chronic Lymphocytic Leukemia- Complications

Answer 33

Transformation, infection due to comp. immune sx, secondary malignancy