Oncology

Question 1

Oncologic emergencies (4)

Answer 1

hypercalcemia
spinal cord compression (tx with steroids)
pericardial tamponade
tumor lysis syndrome

Question 2

Risk with lobular carcinoma insitu of breast

Answer 2

increased breast cancer in both breasts

Question 3

Dx of MGUS (3)

Answer 3

IgG spike <10% plasma cells in marrow

Bence Jones protein

Question 4

Sx of multiple myeloma (4)

Answer 4

hypercalcemia/lytic bone lesions
normocytic anemia
renal failure
cord compression

Question 5

Dx of multiple myeloma (5)

Answer 5

monoclonal spike on electrophoresis
lytic bone lesions
marrow >10% plasma cells
rouleaux formation
Bence Jones proteins

Question 6

Waldenstrom’s macroglobulinemia dx

Answer 6

IgM>5g/dL

hyperviscosity

Question 7

Types of Hodgkin’s lymphoma (4)

Answer 7

nodular sclerosing (most common)
mixed cellularity (Reed Sternberg cells)
lymphocyte predominant
lymphocyte deplete (worst prognosis)

Question 8

Tx of Hodgkin’s lymphoma

Answer 8

stage I,II, IIIA use radiotheraphy

stage IIIB or IV use chemotherapy

Question 9

Risks for non-Hodgkin’s lymphoma

Answer 9

HIV
organ transplant
EBV, HTLV-1
hx of H. pylori
autoimmune disease (MALT)

Question 10

Lymph node suspicion

Answer 10

LN >1cm over 4 weeks needs bx

Question 11

Tx for NHL

Answer 11

CHOP therapy:

cyclocphosphamide, hydroxydaunomycin, oncovin, prednisone

Question 12

Difference between acute and chronic leukemias

Answer 12

Acute-immature blast cells with no function, progresses rapidly
Chronic-some blast cells but have partial function, less rapid progression

Question 13

Dx of acute leukemia

Answer 13

WBC 1000 to 100,000
increased blasts in periphery
marrow replaced by blasts
pancytopenia

Question 14

Sx of acute leukemias

Answer 14

neutropenia with infections
testicular involvement in ALL
skin nodules in AML
hepatosplenomegaly
thrombocytopenia with bleeding

Question 15

Types of acute leukemias

Answer 15

ALL-children less than 15,

AML- adults, t(15:17), tx with retinoic acid

Question 16

Chronic lymphocytic leukemia findings

Answer 16

most common >50yrs
least aggressive leukemia
indolent
mature, defective lymphocytes

Question 17

Dx of CLL

Answer 17

50,000 to 100,000 WBCs
pancytopenia
smudge cells
flow cytometry and blood smear with clonal B cell population

Question 18

Chronic myeloid leukemia findings

Answer 18

over 40y/o
indolent course, then can convert to blast crisis
t(9:22)

Question 19

Dx of CML

Answer 19

50,000 to 200,000 WBCs with L shift
eosinophilia
decreased leukocyte alkaline phosphate (LAP)
thrombocytosis

Question 20

Tx for CML

Answer 20

imatinib

Question 21

Dx of polycythemia vera (4)

Answer 21

Hct>50%
decreased EPO levels
elevated B12 and uric acid
bone marrow bx

Question 22

Tx for polycythemia vera

Answer 22

repeat phlebotomy

Question 23

Dx of myelodysplastic syndromes (5)

Answer 23

dysplastic marrow with blasts or ringed sideroblasts
decreased reticulocyte count
Howell-Jolly bodies
basophilic stippling

Question 24

Tx for myelodysplastic syndromes

Answer 24

RBC and platelet transfusions

Question 25

Dx of essential thrombocythemia

Answer 25

hypogranular, abd platelets
increased megakarocytes in marrow
platelets > 600,000