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Hematology/Oncology > lymphoma > Flashcards

lymphoma Flashcards

1
Q

what is the epidemiology of Chronic Lymhocytic Leukemia (CLL)

A

dz of older age median age of 72 y.o

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2
Q

what would be the absolute lymphocyte count be in CLL

A

5,000 mm and these lymphocytes are small B cells
+CD19, 20, 23 (B cell Ags)
as well as being + for the T cell Ag CD5

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3
Q

What would are the signs of CLL

A 
most pts are diagnosed on CBC
fatigue and lymphadenopathy
Anemia and thrombocytopenia
Decreased IgG
Nucleus same size as cell
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4
Q

the rai system 0

A

lymphocytosis and no lyphadenopathy

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5
Q

rai system 1

A

lymphocytosis and lynphadenoapthy

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6
Q

rai system 2

A

lymphocytosis and splenomegaly +/- lymphadenopathy

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7
Q

rai system 3

A

lymphocytosis and anemia d/t CLL

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8
Q

rai system 4

A

lymphocytosis and thrombocytopenia d/t CLL

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9
Q

CLL tx rai 0 or 1

A

observation

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10
Q

CLL tx rai 2,3 or 4 and signs of weight loss

A

FLudarabine, cytoxan
fludarabine
bendamustine

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11
Q

what are the signs of hairy cell leukemia

A

cytopenias inculding fever, bleeding, fatigue and SOB
Splenomegaly is common
Lymphadenopathy is not
+CD19&20,11c,103

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12
Q

what is the Tx for hairy cell leukemia

A

purine analogs

Cladribine

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13
Q

Malt and Mucosoal associated lymphoid tissue

A

most have t(11:18)
fusion of API12:MLT that inhibits apoptosis
cells are CD20+ and CD5 neg
caused by h. pylori d/t chronic Ag stimulation

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14
Q

Follicular lymphomas

A

2nd MC of adult lymphomas

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15
Q

what are the criteria for FLIPI

A 
age > 60
Increased LDH
Ann arbor III or IV
Hgb<12
extra nodal dz
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16
Q

Follicular lymphomas characteristics

A

positive B cell CD 10&20

Tx is reserved for pt with

17
Q

Burkitts lymphoma is endemic where

A

sub sahara africa where pt present with Jaw mass

18
Q

what is the cause if Bukitts lymphoma

A

EBV infection

19
Q

What does the CD test positive for

A

10,19,20

and oncogene c-MYC

20
Q

how is burkitts tx

A

high dose chemotherapy

21
Q

what is sezarys syndrome, mycosis fungoides

A

most present with an III defined diffuse red rash
circulating tumor cell in this disease called sezary
once the disease forms plaques, nodules or lymphadenopathy its called mycosis fungoides

22
Q

what is the treatment for sezary’s syndrome

A

light therapy

psoralens or topical steroids

23
Q

how does hodgkins lymphoma present

A

presents with central lymphadenopathy and frequently B symptoms fever weight loss, sweats, +/- puritis
spreads from one adjacent nodal group to the next
Bi modal freq peak age 30 and 70
1/2 are associated with EBV

24
Q

what does Hodgkins lymphoma look like

A

Reed sternberg cell
multi-lobed nucleus owl appearance
CD 30+
Reactive cells: polys, macrophages, Eos & fibroblasts

25
Q

what is the treatment for hodgkins

A

ABVD
Adriamycin
Bleomycin
Vinblastine and DTIC

26
Q

what is multiple myeloma

A

disease of mature functioning B cells which are characterized by the production and over production of Immunoglobulins

27
Q

what is the immunoglobulin in waldenstroms macroglobulinemia

A

IgM

28
Q

what is the immunoglobulin in multiple myeloma

A

usually IgG but may be IgA or rarely IgD

29
Q

what is the median age at presentation?

A

65 yo

2x frequent in african americans as in caucasians

30
Q

what does the mnemonic CRAB used for

A 
multiple myeloma
hyper-Calcemia
Renal failure
Anemia
lytic Bone lesions
>10% monoclonal plasma cells in the bone marrow
serum monoclonal IgG or IgA >3g/dL
31
Q

what are symptoms of multiple myeloma

A

bone pain, particularly back pain
pathological fracture
hypercalcemia

32
Q

what is the TX of MM

A

make sure end organ damage is minimized
keep well hydrated
Call hematologist
packed red blood cells for anemia
If candidate for hematopoietic stem cell transplant avoid alkylating agents: Lenalidomide, Dexamethasone, Bortezomib
If not candidate use melphalan, steroids, bortezomib, proteasome

33
Q

who does waldenstrom macroglobulinemia affect

A

pt >65 y.o.

cells are positive for CD 19, 20 and surface IgM

34
Q

what are the main symptoms of waldenstrom macroglobulinemia

A

hyper viscosity d/t elevated IgM
lethargy, confusion, weakness, anemia
bones lesions absent
peripheral neuropathy

35
Q

what is the Tx for waldenstrom macroglobulinemia

A

plasmapharesis

rituximab & cyclophosphamide

Hematology/Oncology (7 decks)

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