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Clin Medicine - Hem/Onc > Oncology > Flashcards

Oncology Flashcards

1
Q

______ ______ ______ is a primary disease of children which effects T or B lymphocytes

A

Acute Lymphocyte Leukemia

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2
Q

What Sx may a patient with ALL experience?

A 
Lymphadenopathy
Malaise
Fever
Bleeding
Hepatosplenomegaly
Weight Lose
Bone Pain
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3
Q

How is ALL treated in general?

A

Aggressive combination chemotherapy

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4
Q

How long is chemo therapy treatment in ALL in the induction phase?

Consolidation phase?

Maintenance phase?

A

Induction: 2 weeks, 4-6 cycles

Consolidation: Several Months

Maintenance: 2 -3 years

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5
Q

What can also be considered when treating ALL?

A

Bone marrow transplant

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6
Q

___% of children with ALL will be cured with chemotherapy

A

80%

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7
Q

T/F: ALL has a higher mortality rate in children than in adults

A

False

It has a higher mortality rate in adults

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8
Q

______ _____ ______ is the most common leukemia which affects people 50 years or older and males more commonly than females.

It is characterized by clonal proliferation and accumulation of mature-appearing B-lymphocytes in blood and lymphoid tissues

A

Chronic Lymphocyte Leukemia

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9
Q

_____ _____ ______ is used for the staging of CLL

A

RAI Staging System

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10
Q

In CLL….

A ___ deletion would be indicative of a worse prognosis

A

17p deletion

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11
Q

25% of CLL patients are asymptomatic….

What Sx could you see in a patient with CLL?

A 
Fatigue 
Night Sweats
Weight Loss
Frequent/Persistent Infection
Lymphadenopathy (Cervical, often painless)
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12
Q

What is commonly seen in a bone marrow biopsy in a patient with ALL?

A

> 20% Lymphoblasts

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13
Q

What would be seen on a peripheral smear in a patient with CLL?

A

Smudge Cells (Fragile B cells)

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14
Q

T/F: A CLL patient may appear anemic on CBC

A

True

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15
Q

In a patient with CLL, what would you expect the lab values to be in a…..

Nuetrophil Count?

A

Low

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16
Q

How do the B lymphocytes appear in a patient with CLL?

A

Small

Abnormal

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17
Q

When is observation consider in treatment of CLL?

A

Observation is considered if the disease is indolent

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18
Q

CLL is considered chronic when lymphocytes are >100,000.

What is the the recommended treatment at this point?

A

Chemotherapy

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19
Q

Radiation is considered in CLL to control what?

When would surgery be considered?

A

Radiation: To control bulky adenopathy

Surgery: Diagnostic only

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20
Q

What is the only curative measure in regards to CLL treatment?

A

Bone Marrow Transplant

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21
Q

______ _________ ______ is the most common form of leukemia in adults and often involves cell deficiency, hyperleukocytosis, CNS leptomenigeal involvement, DIC< or Tumor lysis syndrome.

A

Acute Myelogenous Leukemia

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22
Q

In a patient with AML….

what would the Sx of RBC deficiency be?

Thrombocytopenia?

Neutropenia?

A

RBC: Pallor, fatigue, dyspnea

Thrombocytopenia: Petechiae, hematoma, bleeding

Neutropenia: Sepsis, Cellulitis, PNA

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23
Q

What hyperleukocytosis?

What problems can this cause?

A

Hyperleukocytosis: > 100,000 blasts

This can obstruct capillaries and smaller arteries

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24
Q

In a patient with AML….

What would the Sx of CNS Leptomeningeal involvement be?

A

HA
AMS
Cranial Nerve changes

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25
_____ occurs in any form of leukemia and is common in MS
DIC
26
What is unique on a blood smear in a patient with AML?
Auel Rod
27
What is commonly seen on a CBC in a patient with AML?
CBC would show a leukocytosis with WBC >100,000
28
What would a bone marrow biopsy show in a patient with AML?
>20% Myeloblasts
29
What is the treatment of choice in a patient with AML? What treatment option can be considered?
Chemotherapy Stem Cell Transplant
30
_____ _____ _____ is a lethal complication of chemotherapy that results in metabolic abnormalities and often renal failure
Tumor Lysis Syndrome
31
__________ ________ _______ is a slower progressing disease when compared to AML where too many WBCs are made in the bone marrow.
Chronic Myelogenous Leukemia
32
What are the THREE phases of CML?
1. Chronic 2. Accelerated 3. Acute
33
In a patient with CML.... What would the blood smear show? What additional "lab findings" may be positive or present
Blood Smear: Philadelphia Chromosome FISH for bcr/abl (quantitative) RT-PCR for bcr/abl (qualitative) Tumor marker and causative lesion
34
What is the only curative treatment for CML?
Allogeneric bone marrow transplantation
35
What class of medications can be used to treat CML
Tyrosine Kinase Inhibitors (Imatinib)
36
T/F: Chemotherapy can be used to treat CML
True
37
_______ ________ is most common in men ages 20-40 then >50 (bimodal) and is commonly associated with EBV. This is a result of immune dysfunction and an infectious cancer commonly referred to as "next-door disease".
Hodgkin's Lymphoma
38
________ lymphoma is commonly associated with EBV ________ lymphoma is commonly associated with H pylori infection
Burkitt's Lymphoma MALT Lymphoma
39
Hodgkin's Lymphoma refers to a group of cancers characterized by what THREE things?
1. Lymphadenopathy 2. Hepatosplenomegaly 3. Reed-Sternberg Cells
40
Where may a patient with Hodgkin's lymphoma experience PAINLESS lymphadenopathy? What other Sx are present?
Cervical, Supraclavicular, Mediastinal Fever Weight Loss Night Sweats SOB
41
A excisional lymphode biopsy in Hodgkin's Lymphoma would show what?
Reed-Sternberg Cells
42
What may a CXR show in a patient with Hodgkin's lymphoma?
A Mediastinal Mass
43
How is Hodgkin's lymphoma treated? When should scans be ordered after treatment is initiated? When is radiation started?
Chemo therapy Re-scan in 2-3 weeks to determine response Radiation should always follow chemotherapy
44
If a hodgkin's lymphoma patient relapses after treatment what should be considered?
High dose chemotherapy and stem cell transplant
45
What side effect of radiation should be watched out for?
Neutropenia
46
Which is more highly curable, hodgkins or non-hodgkin's lymphoma
Hodgkins
47
Symptoms and presentation of Non-hodgkin's lymphoma are fairly similar. However, patient with Non-hodgkin's lymphoma have _______ lymphadenopathy which causes what?
Bulk lymphadenopathy ``` Jaundice Hydronephrosis SVC Syndrome Bowel Obstruction Wasting ```
48
T/F: Anemia, leukopenia, and thrombocytopenia are not common in non-hodgkin's lymphoma but may be present
True
49
About 90% of non-hodgkin's lymphomas are derived from __ lymphocytes
B-lymphocytes
50
When evaluating for Hogdkin's or Non-Hodgkin's lymphoma what diagnostic tests should be run?
1. CT Chest/Abdomen/Pelvis 2. PET Scan 3. BMBx
51
Treatment for non-hodgkins lymphoma varies.... Describe some of the ways non-hodgkin's lymphoma can be treated
Watch and wait Invasive chemotherapy (w/ or w/o radiation) Bone Marrow trasplantation Tumor lysis prophylaxis
52
What classes of medications are often used in the treatment of non-hodgkin's lymphoma?
Protease Inhibitors HDAC Inhibitors TK Inhibitors
53
_____ _______ is a malignancy of plasma cells
Multiple Myeloma
54
What is the "classic triad" in a patient with multiple myeloma?
1. Plasmacytosis (BMBx showing >5% plasma cells) 2. Bone lytic lesions on XR (no on PET scan) 3. "M-protein" in serum/urine (SPEP/UPEP)
55
What Sx my a patient with multiple myeloma be experiencing?
1. BACK PAIN 2. Fatigue (anemia) 3. Renal insufficiency
56
What labs should be ordered in a patient with multiple myeloma?
1. CBC 2. CMP (need to assess Ca2+) 3. Albulmin 4. Serum-free light chains 5. Quant IgG 6. SPEP/UPEP
57
What studies (imaging, procedures) should be done?
1. BMBx | 2. Skeletal Survey
58
In a patient with multiple myeloma..... What would be seen on blood smear? On serum protein electrophoresis (SPEP)? (this is the hallmark of the disease) In the urine?
Blood Smear: Rouleaux Formation SPEP: "M-spike" Urine: Bence-Jones proteins
59
How is multiple myeloma primarily treated? When is radiation considered?
Chemotherapy Radiation is used for pain management
60
What is the only effective treatment for long term survival?
Autologous bone marrow transplantation
61
This oncologic emergency is commonly associated with lung cancer. Sx include.... ``` Orthopnea Cervico facial edema Fatigue Cyanosis of the face Horner's Syndrome ```
Superior vena cava (SVC) syndrome
62
What might a CXR showed in a patient with SVC syndrome?
Right sided mediastinal mass
63
In a patient with SVC syndrome, why would an MRI be ordered
To assess for obstruction or clot
64
How is SVC syndrome treated?
1. Radiation 2. Chemotherapy 3. Anti-coagulation 4. Steroids 5. Stenting 6. Possible bypass
65
______ ______ ________ is an oncologic emergency that commonly involves breast, lung, thyroid, kidney, and prostate cancers. Sx include.... Progressively worsening Back Pain (>90%) Weakness Bladder/Bowel dysfunction Sensory loss
Spinal Cord Compression
66
In a patient with spinal cord compression, what is the most concerning symptom that would signal urgent intervention?
Weakness
67
What imaging study can Dx spinal cord compression 90% of the time? What is the most sensitive study?
Xray MRI
68
How is spinal cord compression managed?
1. Dexamethasone (immediately) 2. Consult Neurosurgery 3. Consult radiation oncology
69
_____ ______ is an oncologic emergency that occurs in ~30% of cancer patients primarily in the cerebral hemisphere. Sx include.... ``` Headache Focal Weakness Seizure Cognitive changes Edema ```
Brain Metastases
70
What two imaging studies should be done in a patient with brain metastases?
1. CT Head (w. and w/o contrast) | 2. MRI (w/ contrast)
71
How are brain metastases treated?
1. Steroids 2. Consult radiation oncology 3. Neurosurgery
72
______ _______ is an oncologic emergency commonly associated with lymphoma, leukemia, and melenoma. Sx include.... Nervous system involvement Headache Numbness Vision changes
Carcinomatous Meningitis
73
How is carcinomatous meningitis diagnosed?
Lumbar puncture showing.... Opening pressure >160 mm Elevated CSF protein Decreased CSF glucose Increase CSF WBCs
74
How is carcinomatous meningitis treated?
Intrathecal chemotherapy | Radiation

Clin Medicine - Hem/Onc (2 decks)

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