Management of Hematologic Neoplasms

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Questions and Answers

What is a common cause of renal insufficiency in patients with multiple myeloma?

Increased calcium levels

Excessive hydration

Accumulation of abnormal proteins (correct)

Increased erythropoietin levels

Which of the following is a risk factor for developing multiple myeloma?

High physical activity

Eating a vegetarian diet

Being male (correct)

Aged under 35 years

What does the term 'CRAB features' refer to in the context of multiple myeloma?

Symptoms related to anemia and fatigue

Specific clinical manifestations including hypercalcemia and renal failure (correct)

Types of chemotherapy drugs used in treatment

Secondary infections associated with treatment

Which of the following conditions is NOT associated with radiation therapy and chemotherapy?

Increased thirst Signup and view all the answers

What abnormal protein is typically elevated in the blood of patients with multiple myeloma?

M-proteins Signup and view all the answers

What is the primary issue that arises in Acute Myeloid Leukemia (AML)?

Uncontrolled growth of myeloid cells Signup and view all the answers

Which of the following does NOT typically present as a symptom of Acute Myeloid Leukemia?

Elevated RBC counts Signup and view all the answers

What is the purpose of the induction phase in chemotherapy for AML?

To rapidly kill as many cancer cells as possible Signup and view all the answers

What is a common complication associated with Acute Myeloid Leukemia?

Bleeding and infection Signup and view all the answers

Which type of stem cells is primarily responsible for producing blood cells such as RBCs and WBCs?

Myeloid stem cells Signup and view all the answers

In AML treatment, what is the aim of the consolidation phase?

To eliminate any remaining cancer cells Signup and view all the answers

What is often the first sign of Acute Myeloid Leukemia in patients?

Loss of appetite Signup and view all the answers

What type of stem cell transplant is most commonly used after induction and consolidation therapies in AML?

Allogeneic stem cell transplant Signup and view all the answers

Which of the following is a recommended nursing intervention for managing patients with Acute Leukemia?

Managing infections and bleeding Signup and view all the answers

During the assessment of a patient with Acute Leukemia, which of the following should be prioritized?

Weight loss and bleeding tendencies Signup and view all the answers

What is the underlying genetic mutation associated with Chronic Myeloid Leukemia (CML)?

Philadelphia chromosome Signup and view all the answers

During which phase of Chronic Myeloid Leukemia (CML) do patients typically exhibit few symptoms and may not be noticeably affected by the disease?

Chronic phase Signup and view all the answers

Which of the following symptoms would indicate the progression of Chronic Myeloid Leukemia into the accelerated phase?

Splenomegaly and bone pain Signup and view all the answers

What is the primary goal of medical management in Chronic Myeloid Leukemia (CML)?

Achieve acute remission or maintain chronic phase Signup and view all the answers

Which treatment is primarily used to block the signals in leukemic cells expressing the BCR-ABL protein?

Imatinib mesylate (Gleevec) Signup and view all the answers

What is a common presenting symptom of Acute Lymphocytic Leukemia (ALL)?

Headache and vomiting Signup and view all the answers

Chronic Lymphocytic Leukemia (CLL) patients usually experience what kind of progression?

Slow and gradual Signup and view all the answers

Which cell type is essential for the diagnosis of Hodgkin's Lymphoma?

Reed-Sternberg cells Signup and view all the answers

What is a characteristic symptom of Hodgkin's Lymphoma?

Enlarged, firm lymph nodes Signup and view all the answers

In which stage of Hodgkin's Lymphoma are two or more lymph node regions on the same side of the diaphragm involved?

Stage 2 Signup and view all the answers

Which of the following is a common symptom of Non-Hodgkin's Lymphoma?

Painless swelling of lymph nodes Signup and view all the answers

What is an important nursing management strategy for patients with Non-Hodgkin's Lymphoma?

Comprehensive patient education on lifestyle modifications Signup and view all the answers

Which group of patients has a better prognosis with Acute Lymphocytic Leukemia (ALL)?

Adolescents and children Signup and view all the answers

Study Notes

Management of Patients with Hematologic Neoplasms

Leukemia: Uncontrolled growth of white blood cells in bone marrow, spreading to lymph nodes, gums, and skin
Myeloid stem cells: Produce non-lymphoid blood cells (RBCs, platelets, WBCs)
Lymphoid stem cells: Produce lymphocytes, crucial for the immune system

Acute Myeloid Leukemia (AML)

Mechanism: Rapid proliferation of abnormal myeloid cells (WBCs) crowds out normal bone marrow function
Symptoms: Anemia, thrombocytopenia, low/high WBC counts, fever, weight loss, bleeding, enlarged liver/spleen, pain
Diagnosis: Complete blood count (CBC), bone marrow analysis
Treatment: Aggressive chemotherapy (induction, consolidation, possible HSCT)
Complications: Bleeding, infection (major causes of death)
Supportive care: Antimicrobials, blood transfusions

Chronic Myeloid Leukemia (CML)

Pathology: Mutation in myeloid stem cell, slow progression, expanding marrow into bone cavities
Stages: Chronic (few symptoms), accelerated, blast crisis (acute leukemia-like)
Symptoms: Weight loss, fatigue, anemia, enlarged spleen, bone pain
Treatment: Imatinib mesylate (Gleevec) blocks signals in leukemic cells, chemotherapy and HSCT
Goal: Keep the disease in chronic phase as long as possible

Acute Lymphocytic Leukemia (ALL)

Characteristics: Uncontrolled proliferation of immature lymphocytes (lymphoblasts) from lymphoid stem cells.
Prognosis: Good in children, less favorable in adults
Symptoms: Pain from enlarged organs (liver, spleen, bones), CNS pain, headache vomiting
Treatment: Chemotherapy, HSCT, monoclonal antibody therapy, corticosteroids (dexamethasone)

Chronic Lymphocytic Leukemia (CLL)

Pathology: Accumulation of abnormal B lymphocytes in blood, lymph nodes, and tissues
Symptoms: Often asymptomatic in early stages, and insidious progression. Later symptoms may include lymphadenopathy, "B" symptoms
Slow progression: Often progresses slowly

Hodgkin's Lymphoma

Mechanism: Malignant B-lymphocytes (Reed-Sternberg cells) develop in a single lymph node, spreading to lymphatic system
Risk factors: Viral infections (HIV, EBV, HHV8), family history, and immune suppressing therapies
Symptoms: Painless, firm lymph nodes, usually in neck and/or chest, B symptoms (fever, night sweats)
Diagnosis: Biopsy of involved lymph node, imaging (x-ray, CT/PET scan), blood tests
Treatment: Varies based on stage, chemo, radiation, and stem cell transplant.
Nursing Management: Risk reduction strategies (smoking cessation) and nutritional advice.

Non-Hodgkin's Lymphoma (NHL)

Origin: Malignant growth of lymphoid tissue, various lymph nodes affected.
Symptoms: Painless swelling in lymph nodes, B symptoms, weight loss, fatigue, fever, weakness
Diagnosis: Biopsy (including bone marrow), imaging (CT/PET scans)
Treatment: Varies based on stage and type.

Multiple Myeloma

Mechanism: Cancer of plasma cells, which normally produce antibodies; production of abnormal proteins (M proteins)
Risk factors: Age, family history
Clinical features: Hypercalcemia, renal insufficiency, anemia, bony lesions (especially back pain), elevated total protein
Diagnosis: Bone marrow biopsy, blood tests (CBC, protein, calcium levels), imaging (especially X-rays)
Treatment: Varies, aggressive hydration, bisphosphonates, corticosteroids.

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Description

This quiz covers the management and pathology of hematologic neoplasms, focusing on leukemia types including Acute Myeloid Leukemia (AML) and Chronic Myeloid Leukemia (CML). It discusses symptoms, diagnosis, treatment options, and complications associated with these conditions. Test your understanding of these critical aspects in hematology.