Question 1
Question
Leukemias - cancer of the body's blood-forming tissues:
Acute Myeloid Leukemia
Chronic Myeloid Leukemia
Acute Lymphocytic Leukemia
Chronic Lymphocytic Leukemia
Note: Acute leukemia involves the immature cells, called [blank_start]stem[blank_end] cells, whereas chronic leukemia develops in [blank_start]mature[blank_end] cells. Myeloid = bone marrow and [blank_start]RBCS[blank_end], lymphocytic = [blank_start]WBCs[blank_end].
Lymphomas(cancer beginning in lymphocytes)
- Non-Hodgkin’s Lymphoma
More [blank_start]common[blank_end], more likely to be in older patients. Begins in [blank_start]any[blank_end] nodes.
- Hodgkin’s Lymphoma
Hodgkin's lymphoma is marked by the presence of [blank_start]Reed-Sternberg[blank_end] cells, which a physician can identify using a microscope. In Non-Hodgkin lymphoma, these cells are not present. Typically begins in the [blank_start]upper[blank_end] body, such as the neck, chest or armpits.
Answer
-
stem
-
mature
-
RBCS
-
WBCs
-
common
-
any
-
Reed-Sternberg
-
upper
Question 2
Question
Choose the incorrect epidemiology statement.
Answer
-
Blood cancers combined are the 5th most common cancer in NZ
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Lymphoma most common in 35-50 year olds
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Leukemia most common childhood cancer
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21,000 people living with blood cancers in NZ
Question 3
Question
Which of these is not a risk factor for leukemia?
Question 4
Question
Select ALL the risk factors for NON-Hodgkin's lymphoma.
Question 5
Question
There are no widely recommended screening tests for leukemias and lymphomas but they may be identified through routine bloodwork.
Question 6
Question
Clinical Presentation:
Coughing / [blank_start]chest[blank_end] pain
Fever / chills
Frequent [blank_start]infections[blank_end]
[blank_start]Itchy[blank_end] skin or rash
Loss of [blank_start]appetite[blank_end] or nausea
[blank_start]Night[blank_end] sweats
Persistent [blank_start]weakness[blank_end] and fatigue
Shortness of [blank_start]breath[blank_end]
[blank_start]Swollen[blank_end], painless lymph nodes in neck, armpits, or groin
Answer
-
chest
-
infections
-
Itchy
-
appetite
-
Night
-
weakness
-
breath
-
Swollen
Question 7
Question
Leukemia diagnosis:
- Signs and symptoms
- Complete [blank_start]blood cell count[blank_end]
- [blank_start]Bone marrow[blank_end] biopsy
Lymphoma diagnosis:
- Signs and symptoms
- [blank_start]Lymph Node[blank_end] biopsy/extraction
- Complete blood cell count
- Bone marrow biopsy
- [blank_start]Imaging[blank_end] (look for signs in other parts of your body)
Answer
-
blood cell count
-
Bone marrow
-
Lymph Node
-
Imaging
Question 8
Question
Prognosis:
Leukemia -
Children (ALL) - [blank_start]90[blank_end]% cured
Adults (ALL) - [blank_start]80-90[blank_end]% achieve remission
Adults (AML) - [blank_start]60-70[blank_end]% achieve remission
+ 70% 5-year survival ALL.
Lymphoma:
HL - 5-year survival [blank_start]86%[blank_end]
NHL:
Localized - [blank_start]72%[blank_end]
Regional - 72%
Distant - [blank_start]55%[blank_end]
Answer
-
90
-
80-90
-
60-70
-
86%
-
72%
-
55%
Question 9
Question
Treatment – Acute Lymphocytic Leukemia.
1. Induction of remission - [[blank_start]vincristine, steroid, anthracycline[blank_end], +/- [blank_start]imatinib[blank_end]] = 1-2 months
2. Consolidation (intensification) [same drugs, high doses] = [blank_start]2-4[blank_end] months
3. Maintenance [[blank_start]methotrexate, 6MP[blank_end], +/- imatinib] = 2 [blank_start]years[blank_end]
CNS treatment/prophylaxis (may be continued through all phases):
Intrathecal [methotrexate]
High dose [blank_start]IV[blank_end] methotrexate
[blank_start]Radiation[blank_end]
Question 10
Question
Treatment – Chronic Lymphocytic Leukemia:
Watch and [blank_start]wait[blank_end]
Once symptoms appear / disease progressing: Many different combinations of standard [blank_start]chemotherapy[blank_end] used, in addition to [blank_start]targeted[blank_end] therapy, and/or monoclonal antibodies [[blank_start]rituximab, imatinib[blank_end]].
HSCT (Stem Cell Transplants) a possibility for high risk patients.
Answer
-
wait
-
chemotherapy
-
targeted
-
rituximab, imatinib
Question 11
Question
Treatment – Non-Hodgkin’s Lymphoma
Chemotherapy – [blank_start]6-8[blank_end] cycles of combination therapy over several months:
- [blank_start]CHOP[blank_end] [Cyclophosphamide, Doxorubicin, Vincristine, Prednisone]
- R-CHOP [add [blank_start]Rituximab[blank_end] if CD20 positive]
- [blank_start]CVP[blank_end] [Cyclophosphamide, Vincristine, Prednisone]
- [blank_start]ICE[blank_end] [Ifostamide, Carboplatin, Etoposide]
Radiation and HSCT are also options for high risk patients .
Answer
-
6-8
-
CHOP
-
Rituximab
-
CVP
-
ICE
Question 12
Question
Select all drugs in the CHOP chemo combo.
Answer
-
Cyclophosphamide
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Doxorubicin
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Docetaxel
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Vincristine
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Prednisone
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Cisplatin
Question 13
Question
Monitoring intrathecal CT:
- Every [blank_start]dose[blank_end], check symptoms - Headache, [blank_start]visual[blank_end] changes, fatigue, [blank_start]balance[blank_end] issues, soreness/[blank_start]bruise[blank_end] at entry?
- [blank_start]Weekly[blank_end] labs for blood cell [blank_start]count[blank_end]
- Check for signs of infection [blank_start]daily[blank_end]
Answer
-
dose
-
visual
-
balance
-
bruise
-
Weekly
-
count
-
daily
Question 14
Question
What are the signs/symptoms of Febrile Neutropenia?
Answer
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Fever (>38.3 C or > 38.0 C over 1 hour) and ANC <500 cells/mm^3
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Fatigue/weakness ANC <500 cells/mm^3
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Fever (>38.3 C or > 38.0 C over 1 hour) and ANC <300 cells/mm^3
-
Fatigue/weakness ANC <300 cells/mm^3
Question 15
Question
Watch and wait is an appropriate strategy for which type of blood cancer?