oncology

Question 1

Acute Myeloid Leukemia

Answer 1

Peak incidence 65yo 
risk factors
myelodysplastic syndromes
environment--> radiation, chemo
genetic--> down syndrome fanconi anemia

Question 2

AML clinical features

Answer 2

Leukemia cutis (nodular skin lesions wi a purple or gray- blue color
gingival hyperplasia
CNS involvement HA, visual field changes

Question 3

Diagnostic test for AML

Answer 3

Initial–> CBC and peripherally blood smear

Confirm–> bone marrow aspiration and biopsy

Question 4

AML peripheral blood smear

Answer 4

Auer rods in lymphoblasts

Question 5

AML histochemical

Answer 5

Myleoperoxidase positive

Question 6

AML cytogenetics

Answer 6

t(15;17) translocation

causes the retinoic acid receptor to change

Question 7

AML common chemo treatment

Answer 7

cytarabine
antrhacyclines (daunorubicin)
ATRA (all-trans-retinoic acid) in APL

Question 8

Tumor lysis syndrome

Answer 8

At risk for causing kidney failure most seen after cytotoxic tx. of ALL AML and NHL

Question 9

Tumor lysis syndrome electroylte abnormalities

Answer 9

Hyperkalemia
hypocalcemia
hyperuricemia
hyperphosphatemia

Question 10

Tumor lysis syndrome clinical features

Answer 10

Nausea/ vomiting diarrhea
hematuria, 
seizures
cardiac arrhythmias
tetany muscle cramps

Question 11

Prophylaxis of tumor lysis syndrome

Answer 11

all–> hydration
low to intermediate risk–> allopurinol
high risk–> rasburicase

Question 12

PUKE calcium for electrolytes affecte in tumor lysis syndroem

Answer 12

Phosphorus elevated
Uric acid elevated
K is elevated
Calcium is decreased

Question 13

Leukostasis

Answer 13

Complication of AML
excess leukocytes
>150,000
cerebral and pulm complications DIC
tx. hydroxyurea

Question 14

neutropenic fever

Answer 14

is a decrease patients absolute neutrophil count <500

Question 15

Tx for neutropenic fever

Answer 15

admission
broad spectrum abx
(zosyn, cefepime, meropenem, Imipenem-cilastatin)

Question 16

Hypersplenism

Answer 16

Pathomechanism: overactive spleen → cells are removed from the blood faster than normal → ↓ of a single or combination of cell lines, including possible cytopenia (pancytopenia, leukopenia, anemia, and thrombocytopenia) → reactive bone marrow hyperplasia (unless defective bone marrow is the cause of splenomegaly)

Question 17

Hypersplenism features

Answer 17

enlarges spleen

low levels of one or more types of blood cells –> anemia, thrombocytopenia, leukopenia, pancytopenia

Question 18

Intermittent fever with periods of high temperature for 1–2 weeks, followed by afebrile periods for 1–2 weeks. Relatively rare but very specific for what?

Answer 18

Pel Ebstein fever

Hodgkin lymphoma

Question 19

patient presents with intermittent fever
Alcohol-induced pain, and Pruritus
what is the most likely diagnosis?

Answer 19

Hodgkin lymphoma

Question 20

Non-caseating granulomas

Reed-Sternberg cells on biopsy

Answer 20

Hodgkin lymphoma

Question 21

Proximal muscle weakness, dry mouth
Active muscle contraction or repeated muscle tapping increases reflex activity.
Muscle strength improves after muscle use.

Answer 21

Lambert-Eaton myasthenic syndrome
Presynaptic voltage-gated calcium channels (VGCC) autoantibodies
Associated with SCLC

Question 22

Cushing syndrome–> exogeneous ACTH

associated with what cancers?

Answer 22

Neoplastic tissue produces exogenous ACTH (occasionally with CRH) → increased cortisol in the adrenal glands
SCLC
Pancreas
CNS

Question 23

SIADH–> exogenous ADH associated with what cancers?

Answer 23

Neoplastic tissue produces ADH → increased free-water reabsorption and retention + hyponatremia
SCLC