Oncology Flashcards
Oncologic emergencies (4)
hypercalcemia
spinal cord compression (tx with steroids)
pericardial tamponade
tumor lysis syndrome
Risk with lobular carcinoma insitu of breast
increased breast cancer in both breasts
Dx of MGUS (3)
IgG spike <10% plasma cells in marrow
Bence Jones protein
Sx of multiple myeloma (4)
hypercalcemia/lytic bone lesions
normocytic anemia
renal failure
cord compression
Dx of multiple myeloma (5)
monoclonal spike on electrophoresis lytic bone lesions marrow >10% plasma cells rouleaux formation Bence Jones proteins
Waldenstrom’s macroglobulinemia dx
IgM>5g/dL
hyperviscosity
Types of Hodgkin’s lymphoma (4)
nodular sclerosing (most common) mixed cellularity (Reed Sternberg cells) lymphocyte predominant lymphocyte deplete (worst prognosis)
Tx of Hodgkin’s lymphoma
stage I,II, IIIA use radiotheraphy
stage IIIB or IV use chemotherapy
Risks for non-Hodgkin’s lymphoma
HIV organ transplant EBV, HTLV-1 hx of H. pylori autoimmune disease (MALT)
Lymph node suspicion
LN >1cm over 4 weeks needs bx
Tx for NHL
CHOP therapy:
cyclocphosphamide, hydroxydaunomycin, oncovin, prednisone
Difference between acute and chronic leukemias
Acute-immature blast cells with no function, progresses rapidly
Chronic-some blast cells but have partial function, less rapid progression
Dx of acute leukemia
WBC 1000 to 100,000
increased blasts in periphery
marrow replaced by blasts
pancytopenia
Sx of acute leukemias
neutropenia with infections testicular involvement in ALL skin nodules in AML hepatosplenomegaly thrombocytopenia with bleeding
Types of acute leukemias
ALL-children less than 15,
AML- adults, t(15:17), tx with retinoic acid
Chronic lymphocytic leukemia findings
most common >50yrs
least aggressive leukemia
indolent
mature, defective lymphocytes
Dx of CLL
50,000 to 100,000 WBCs
pancytopenia
smudge cells
flow cytometry and blood smear with clonal B cell population
Chronic myeloid leukemia findings
over 40y/o
indolent course, then can convert to blast crisis
t(9:22)
Dx of CML
50,000 to 200,000 WBCs with L shift
eosinophilia
decreased leukocyte alkaline phosphate (LAP)
thrombocytosis
Tx for CML
imatinib
Dx of polycythemia vera (4)
Hct>50%
decreased EPO levels
elevated B12 and uric acid
bone marrow bx
Tx for polycythemia vera
repeat phlebotomy
Dx of myelodysplastic syndromes (5)
dysplastic marrow with blasts or ringed sideroblasts
decreased reticulocyte count
Howell-Jolly bodies
basophilic stippling
Tx for myelodysplastic syndromes
RBC and platelet transfusions
Dx of essential thrombocythemia
hypogranular, abd platelets
increased megakarocytes in marrow
platelets > 600,000
