Term
| Which lymphoma does not contain Reed-sternberg cells? |
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Definition
- Diffuse Large Cell Lymphoma
- Follicular Lymphoma
- (NHL's) |
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Term
| Classical Hodgkin's LYmphoma evaluation |
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Definition
-H&P
CBC
CT scan (chest, abd, pelvis)
PET-CT
BM biopsy
Cardiac echo
Pulmonary Function Tests |
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Term
| What is the malignant cell in Hodgkin's Lymphoma? |
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Definition
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Term
| What kind of cell is a Reed-sternberg cell? |
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Definition
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Term
| Factors associated with Hodgkin's |
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Definition
- Family Hx
- EBV
-High Standard of living
-immunosupression
-young age
-old age |
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Term
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Definition
I - one LN area (above or below)
II - two LN on same side (above or below)
III - LN's on either side
IV - extra LN locations (bone marrow etc) |
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Term
|
Definition
-Fever
-Night Sweats
-Weight Loss (>10% in 6 mo) |
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Term
| What are the four types of Hodgkin's Lymphoma? |
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Definition
1. Nodular Sclerosing
2. Lymphocyte Depleted
3. Lymphocyte Predominant
4. Mixed Cellularity |
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Term
|
Definition
-radiation for early stage
-ABVD (Adriamycin, Bleomycin, Vinblastine, and Dactinomycin) |
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Term
|
Definition
| 1. Adriamycin=Anthracycline Antibiotics |
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Term
|
Definition
-MOA:
-Uses: Broad spectrum, IV... hodgkin's, testicular cancer,
-SE: low BM toxicity (good combo drug), LUNG toxicity :( cumulative, dose/age/smoking related (Pneumonitis, pulmonary fibrosis) |
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Term
|
Definition
1. Vinblastine, Vincrostine (Oncovin) ... from periwinkle
2. MOA: binds tubulin and blocks metaphase/anaphase
3.Use: Vinblastine (ABVD
4.SE: Vincristine (***Neurotoxicity... peripheral neuropathy, paresthesis... but low incidence of BM depression) |
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Term
|
Definition
1. MOA: alkylating agent, bind to DNA and decrease rep
2. Uses: Hodgkin's, malignant malinoma
3. SE: mild NV |
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Term
| What are three things that have reaaallllyyy low platelet count? |
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Definition
1. ITP (other counts usually normal)
2. Aplastic anemia (everything's low)
3. Acute Leukemia |
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Term
| What causes Acute Lymphocytic Leukemia? |
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Definition
|
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Term
| What tests do we need to diagnose ALL? |
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Definition
-BM biopsy and Aspirate
-BM Cytogenetics
-peripheral blood for flow cytometry (**quickest)
-BM flow cytometry
-BM fish for common genetic abnormalities |
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Term
|
Definition
1. Morphology (size, variability of blasts)
-L1: uniform
-L2: not as uniform
-L3: white inclusion bodies
2. Immunophenotype (pattern of expression of surface Ag) |
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Term
|
Definition
|
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Term
|
Definition
bad:
-male, black, WBC >30k, age <1 or >11, CNS involvement at Dx. #72 |
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Term
|
Definition
1. Induction Chemo, recovery period, Intensification chemo + bone marrow transplant
2. Drugs: hyperCVAD (Cyclophosphamide, vincristine, daunorubicin, Dexamethasone, cytarabine (pyrimidine antagonist), methotrexate.... intrathecal therapy |
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Term
| Cyclophophamide (Cytoxan) |
|
Definition
1. from Nitrogen Mustard
2. MOA: alkylating agent of DNA... inhib DNA replication
3. Prodrug (P450) -> Acrolein (toxic metabolite.. bladder toxicity) and Phosphoramide Mustard
4. Uses: oral... ALL, NHL(CHOP), breast/ovarian cancer
5. SE: **Hemorrhagic cystitis... bladder problems (give Mesna, a thiol drug, as uroprotectant w. lotsa H20) |
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Term
|
Definition
ex. dexamethasone
1. MOA: inhibit mitosis, lympholytic... immunosuppressive
2. Uses: ALL, ACL, Hodgkin's, NHL
3. SEL cushings, peptic ulcers... etc |
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Term
| What kind of drug is methotrexate? |
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Definition
|
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Term
|
Definition
ex. Mehtotrexate
1. MOA: inhibit DHFR, thymidylate/DNA synth
** rescued/reversed by folinic acid (Formyl-tetrahydrofolate)... not folic acid
2. Uses: ALL (intrathecally- direct CNS), Choriocarcinoma (DOC!!!), CNS lymphoma
3. SE: alkyline the urine... to increase excretion
***Teratogen |
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Term
| Where would you find smudge cells? |
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Definition
|
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Term
| Does Follicular Cell lymphoma circulate? |
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Definition
|
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Term
| What the most important test in the initial evaluation of suspected CLL? |
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Definition
- peripheral blood for flow cytometry
- CT Chest Abd Pelvis
- LN Biopsy ... also important |
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Term
| Rai clinical staging for CLL |
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Definition
0: low risk ... lyphocytosis
I: intermediate ... + LAN
II: high ...+organomegally
III: hi ...+... #101 |
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Term
|
Definition
|
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Term
| most common leukemia in western world |
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Definition
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Term
|
Definition
|
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Term
| Are proliferation centers are pathognomonic for CLL/SLL? |
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Definition
|
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Term
|
Definition
significant
- Genetic abnormalities
- VH gene mut
-CD38
-ZAP-70
-beta2microglobulin
-lymphocyte doubling |
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Term
|
Definition
- treat only when it causes Sx
-Rx: FCR (Fludarabine, Cytoxan, Rituxan)
Ri
Slide #111 |
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Term
|
Definition
fluorinated purine analog...
1. MOA: prodrug -> 2-fluoroara-ATP which interferes w. DNA synth/repair by inhibit DNA Pol
#112 |
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Term
|
Definition
MOA: recombinant monoclonal Ab against CD20 Ag on B cells.
Uses: NHL, CLL (combo Tx) #113
SE: |
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Term
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Definition
MOA: cross-linking of DNA
Uses: CLL, NHL
SE: standard |
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Term
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Definition
MOA: deplete leukemic/normal cells by direct Ab-dependent lysis... CD52
Uses: B cell CLL in pt refractory to FCR regimen- IV
SE: monitor for infections! |
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Term
|
Definition
Cyclophosphamide (cytoxan)
Doxorubicin (Hyrdroxdy
#116 |
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Term
| THings to look out for in the management of CLL |
|
Definition
- infections (bc humoral immunity is down)
- Autoimmune complications (Hemolytic anemia, ITP, etc) |
|
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Term
|
Definition
-infectious mononucleosis (EBV)
-CMV
-Toxoplasmosis
-TB
-Inflammatory States
-Cancers (Lymphoma, H & N, Breast) |
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Term
| How do you stage NHL - Nodular Large Cell Lymphoma? |
|
Definition
FLIPI Score
Factors
Slide #146 |
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Term
| Hodgkin's Lymphoma Management |
|
Definition
- Watch and wait
- Chemotherapy (CHOP)
- Rituxan
- #149 |
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Term
|
Definition
-Age
-Bone pain
-Anemia
-renal disfunction
-hypercalcemia
-proteinuria
-neuropathy
-hyperviscocity
-pathologic fractures |
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Term
| What would the serum protein electrophoresis show in a Pt with MM? |
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Definition
- increased monoclonal immunoglobin (usually IgA or G) = M spike
- slightly decreased albumin |
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Term
|
Definition
- lots of perinuclear clearing...(golgi)
- lots of plasma cells (normal is 5%)
- crystals |
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Term
|
Definition
-no clinical critera of myeloma
-radiation is curative
-25% chance of getting myeloma |
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Term
|
Definition
I: Hg >10, Ca: normal or <12mg,
Slide #166 |
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Term
|
Definition
B2 microglobulin
C-reactive protein
Chomosome 13 deletion |
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Term
|
Definition
MP regimen (Melphalan, Prednisone)
VAD regimen (Vincristine, Doxorubicin/Adriamycin, Dexamethasone) |
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Term
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Definition
MOA: inhibits angiogenesis... anti-inflammatory/immunomodulatory... inhibits TNF-alpha, decrease phagocytosis, increase CMI
Uses: MM, leprosy
SE: Teratogenic (Phocomelia), peripheral neuropathy, etc |
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Term
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Definition
MOA: reversible proteasome inhibitor. Block proteosome -> apoptosis. and decrease NF-kB
Uses: MM: Palliative
SE: pheripheral neuropathy, ND, Asthenia, THombocytopenia, neutropenia, fever... |
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