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Questions and Answers
Questions and Answers
Which of the following is a key difference between Hodgkin's lymphoma and Non-Hodgkin's lymphoma?
Which of the following is a key difference between Hodgkin's lymphoma and Non-Hodgkin's lymphoma?
- Hodgkin's lymphoma generally has a more variable prognosis compared to the typically favorable outcome of Non-Hodgkin's lymphoma.
- Hodgkin's lymphoma typically presents with widespread, non-contiguous lymph node involvement, while Non-Hodgkin's lymphoma is more localized.
- Hodgkin's lymphoma typically spreads in a contiguous fashion from one lymph node region to the next, unlike Non-Hodgkin's lymphoma. (correct)
- Hodgkin's lymphoma is more strongly associated with immunodeficiency states than Non-Hodgkin's lymphoma.
What is the most common age range for the initial diagnosis of Hodgkin's lymphoma?
What is the most common age range for the initial diagnosis of Hodgkin's lymphoma?
- 60-80 years
- 3rd decade (20-29 years) (correct)
- 40-60 years
- Under 10 years
Which of the following viruses is most strongly implicated in the aetiology of Hodgkin's lymphoma?
Which of the following viruses is most strongly implicated in the aetiology of Hodgkin's lymphoma?
- Cytomegalovirus (CMV)
- Human immunodeficiency virus (HIV)
- Epstein-Barr virus (EBV) (correct)
- Human papillomavirus (HPV)
A patient presents with painless, rubbery lymphadenopathy in the cervical region and reports experiencing alcohol-induced pain in the affected nodes. Which of the following conditions is most strongly suggested by these findings?
A patient presents with painless, rubbery lymphadenopathy in the cervical region and reports experiencing alcohol-induced pain in the affected nodes. Which of the following conditions is most strongly suggested by these findings?
Which of the following clinical findings in a patient with suspected Hodgkin's lymphoma would be classified as a 'B symptom' and indicate a potentially worse prognosis?
Which of the following clinical findings in a patient with suspected Hodgkin's lymphoma would be classified as a 'B symptom' and indicate a potentially worse prognosis?
In the Ann Arbor staging system for Hodgkin's lymphoma, which stage is characterized by involvement of lymph node groups on both sides of the diaphragm?
In the Ann Arbor staging system for Hodgkin's lymphoma, which stage is characterized by involvement of lymph node groups on both sides of the diaphragm?
Which of the following is a characteristic finding on a lymph node biopsy that is diagnostic for Hodgkin's lymphoma?
Which of the following is a characteristic finding on a lymph node biopsy that is diagnostic for Hodgkin's lymphoma?
A patient with Stage IA Hodgkin's lymphoma is treated with chemotherapy and radiotherapy. What is the approximate 5-year survival rate expected for this patient?
A patient with Stage IA Hodgkin's lymphoma is treated with chemotherapy and radiotherapy. What is the approximate 5-year survival rate expected for this patient?
Which of the following factors is associated with a worse prognosis in Hodgkin's lymphoma?
Which of the following factors is associated with a worse prognosis in Hodgkin's lymphoma?
What is the typical age distribution for Non-Hodgkin's lymphoma?
What is the typical age distribution for Non-Hodgkin's lymphoma?
Which of the following aetiological factors is most closely associated with the development of Non-Hodgkin's lymphoma?
Which of the following aetiological factors is most closely associated with the development of Non-Hodgkin's lymphoma?
A patient presents with generalized lymphadenopathy and oropharyngeal involvement (Waldeyer's ring). Which type of lymphoma is most likely?
A patient presents with generalized lymphadenopathy and oropharyngeal involvement (Waldeyer's ring). Which type of lymphoma is most likely?
A patient with low-grade Non-Hodgkin's lymphoma who is asymptomatic may require which of the following?
A patient with low-grade Non-Hodgkin's lymphoma who is asymptomatic may require which of the following?
Multiple myeloma arises from the malignant proliferation of which type of cell?
Multiple myeloma arises from the malignant proliferation of which type of cell?
What is the typical age range for the diagnosis of multiple myeloma?
What is the typical age range for the diagnosis of multiple myeloma?
Which of the following clinical features is a direct result of bone destruction caused by multiple myeloma?
Which of the following clinical features is a direct result of bone destruction caused by multiple myeloma?
Which of the following complications is a direct result of bone marrow infiltration by malignant plasma cells in multiple myeloma?
Which of the following complications is a direct result of bone marrow infiltration by malignant plasma cells in multiple myeloma?
Which of the following laboratory findings is most suggestive of multiple myeloma?
Which of the following laboratory findings is most suggestive of multiple myeloma?
A patient with multiple myeloma is experiencing bone pain. Which of the following treatments is most appropriate for managing this symptom?
A patient with multiple myeloma is experiencing bone pain. Which of the following treatments is most appropriate for managing this symptom?
What is the term for the premalignant condition that is often associated with multiple myeloma?
What is the term for the premalignant condition that is often associated with multiple myeloma?
Questions and Answers
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Flashcards
Flashcards
Hodgkin's vs. Non-Hodgkin's
Hodgkin's vs. Non-Hodgkin's
Hodgkin's is typically nodal and contiguous, has a good outcome, and isn't usually linked to immunodeficiency.
Hodgkin's peak incidence
Hodgkin's peak incidence
Around their 30s
Hodgkin's etiology
Hodgkin's etiology
Though unknown, EBV (infectious mononucleosis) is a suggested factor.
Hodgkin's clinical features
Hodgkin's clinical features
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Hodgkin's staging
Hodgkin's staging
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Hodgkin's investigations
Hodgkin's investigations
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Hodgkin's treatment
Hodgkin's treatment
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Non-Hodgkin's peak incidence
Non-Hodgkin's peak incidence
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Non-Hodgkin's etiology
Non-Hodgkin's etiology
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Non-Hodgkin's clinical features
Non-Hodgkin's clinical features
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Non-Hodgkin's management
Non-Hodgkin's management
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Multiple myeloma cause
Multiple myeloma cause
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Multiple myeloma incidence
Multiple myeloma incidence
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Multiple myeloma features
Multiple myeloma features
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Multiple myeloma investigations
Multiple myeloma investigations
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Multiple myeloma management
Multiple myeloma management
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Study Notes
Study Notes
- Notes on Hodgkin's and Non-Hodgkin's Lymphomas and Multiple Myeloma
Hodgkin's vs. Non-Hodgkin's Lymphoma
- Hodgkin's lymphoma typically presents with nodal involvement, unlike Non-Hodgkin's.
- Hodgkin's lymphoma spreads contiguously, while Non-Hodgkin's does not.
- Hodgkin's lymphoma generally exhibits a good outcome, whereas Non-Hodgkin's has variable outcomes.
- Hodgkin's lymphoma is not usually associated with immunodeficiency, unlike Non-Hodgkin's.
Hodgkin's Lymphoma
- Peak incidence occurs in the third decade of life.
- Etiology is unknown but EBV (infectious mononucleosis) is suggested as a contributing factor.
Hodgkin's Lymphoma: Clinical Features
- Lymphadenopathy is a key feature, typically cervical and contiguous.
- Lymph nodes are painless, non-tender, and rubbery in consistency.
- Alcohol-induced pain in affected lymph nodes can occur.
- Constitutional 'B' symptoms are common:
- Anorexia and fatigue.
- Fever.
- Night sweats.
- Weight loss exceeding 10% in 6 months.
- Pruritus and erythematous rash can manifest.
- Mediastinal involvement may occur:
- Hilar lymphadenopathy can lead to bronchial compression and SVC obstruction.
- Hepatosplenomegaly is possible.
Hodgkin's Lymphoma: Staging (Ann Arbor System)
- Stage I: Single lymph node region affected.
- Stage II: Two lymph node regions on the same side of the diaphragm are involved.
- Stage III: Lymph node groups on both sides of the diaphragm are affected.
- Stage IV: Widespread disease outside the lymphatic system, such as lung involvement.
Hodgkin's Lymphoma: Investigations
- FBC may reveal normochromic normocytic anemia.
- Elevated ESR is typically observed.
- LFTs/U&Es/bone profile/LDH are assessed.
- CXR/CT scans are performed.
- Lymph node biopsy is crucial for identifying Reed-Sternberg cells.
- Bone marrow examination is rarely needed.
Hodgkin's Lymphoma: Treatment
- Early-stage disease (IA/IIA) is treated with chemotherapy and radiotherapy.
- Advanced-stage disease requires combination chemotherapy.
- Complete remission is achievable in 60-90% of cases.
- Prognosis is stage-dependent:
- 90% 5-year survival rate for Stage I.
- Presence of B symptoms indicates a worse prognosis.
Non-Hodgkin's Lymphoma
- Peak incidence increases with age; rare in individuals under 40.
- Etiology includes:
- Immunodeficiency.
- Infections.
- Ionizing radiation.
- Carcinogenic chemicals.
- Inherited disorders affecting DNA damage and repair.
Non-Hodgkin's Lymphoma: Clinical Features
- Generalized lymphadenopathy is common.
- Oropharyngeal involvement (Waldeyer's ring).
- Bone marrow infiltration.
- This can lead to anemia, recurrent infections and hemorrhage.
Non-Hodgkin's Lymphoma: Management
- Low-grade disease may not require immediate treatment if asymptomatic, or intermittent oral chemotherapy may be used.
- High-grade disease is treated with combination chemotherapy (30% cure rate).
Multiple Myeloma
- Arises from malignant transformation of plasma cells (terminally differentiated B cells).
- Malignant transformation leads to monoclonal expansion, resulting in secretion of Ig or light chains (paraproteins).
- Peak incidence occurs between 40-80 years old.
Multiple Myeloma: Clinical Features
- Typically has a long asymptomatic phase known as MGUS (monoclonal gammopathy of undetermined significance).
- Bone destruction:
- Myeloma cells stimulate osteoclasts, leading to bone destruction, osteolytic lesions, and elevated serum Ca2+.
- Bone marrow failure:
- Marrow infiltration causes anemia, thrombocytopenia, neutropenia, and recurrent infections.
- Renal failure:
- Due to deposition and accumulation of paraproteins.
- Hyperviscosity syndrome:
- Can cause headache and dizziness.
- Amyloidosis:
- Development of abnormal protein cells that deposit in parts of the body.
Multiple Myeloma: Investigations
- FBC is used to detect bone marrow failure.
- Raised ESR and Ca2+ are common findings.
- U&Es can demonstrate renal damage.
- Protein electrophoresis demonstrates monoclonal paraprotein.
- Bence-Jones proteins in urine may be present.
Multiple Myeloma: Management
- Treatment is initiated only if there is evidence of organ damage.
- Chemotherapy is used for bone marrow failure or bone lesions.
- Most patients respond, but relapse is common.
- Radiotherapy is useful for managing bone pain.
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