Lymphomas

The two bimodal peak ages for Hodgkin's disease are 3 to 6 years and 45 to 55 years?
1. True
2. False
What percent of all Hodgkin's disease patients are more than 16 years of age?
1. 25 percent
2. 50 percent
3. 85 percent
True or false: older age is a significantly good prognostic factor in Hodgkin's disease?
1. True
2. False
Lymphadenopathy is seen in where in Hodgkin's disease patients?
1. Cervical
2. Mediastinal
3. Axillary
4. Inguinal
Respiratory distress secondary to mediastinal lymphadenopathy is much more common in NHL or Hodgkins?
1. NHL
2. Hodgkins
3. Equivalent
About one-third of patients with Hodgkin's lymphoma have malaise, anorexia, weight loss, and fever - true or false?
1. True
2. False
What is the classic cell type seen in Hodgkin's disease?
1. Basophilic macrophage
2. Reed Sternberg
3. Hurthle cell
What is the most frequent subtype of Hodgkin's disease?
1. Mixed cellularity
2. Nodular sclerosing
3. Lymphocyte predominate
4. Lymphocyte depletion
What type of Hodgkin's disease has the best prognosis?
1. Mixed cellularity
2. Nodular sclerosing
3. Lymphocyte predominate
4. Lymphocyte depletion
What are the stages of Hodgkin's disease?
1. Chills
2. Fever
3. Night sweats
4. More than 10 wt loss in 6 months
Pruritus with Hodgkin's disease is much more common in kids or adults?
1. Adults
2. Children
3. Equivalent
True or false: Pretreatment CT scans are obtained in all Hodgkin's disease patients?
1. True
2. False
Lung involvement occurs in what percent of patients with Hodgkin's disease?
1. 5 - 10%
2. 15 - 25%
3. 30 - 50%
What does a pleural effusion mean in patients with Hodgkin's disease?
1. Almost always implies malignancy in chest
2. May be due to lymphatic obstruction
What does a pericardial effusion mean patients Hodgkin's disease?
1. Implies malignancy in chest - pericardial extension
2. May be due to lymphatic obstruction
How are both lung and pericardial effusions categorized as in Hodgkin's disease?
1. A status
2. B status
3. E status
After chemotherapy for lymphoma, what is the best test to determine fibrosis vs. residual disease in the lung?
1. Chest CT scan
2. V/Q scan
3. Chest MRI
4. Chest tomography
The accuracy of bipedal lymphangiography for evaluating pelvic and retroperitoneal lymph node involvement exceeds what percent?
1. 75 percent
2. 85 percent
3. 95 percent
T or F: Pulmonary oil embolism is a complication of lymphangiography?
1. True
2. False
What is the sensitivity of CT scan for lymph node involvement in Hodgkin's disease in the abdomen?
1. 95 percent
2. 80 percent
3. 40 percent
4. 25 percent
In what percentage of Hodgkin's disease patients is the spleen involved? The liver involved?
1. 5 percent
2. 20 percent
3. 35 percent
4. 55 percent
In a staging laparotomy for HD, partial splenectomy misses, or is falsely positive in what percent?
1. 2% false negative
2. 5% false negative
3. 10 - 15% false negative
4. 25 - 30% false negative
What percentage of patients have their stage changed by a staging laparotomy for Hodgkin's?
1. 10 percent upstaged
2. 35 - 40% changed either up or down
3. 10 percent downstaged
Is the incidence of positive subdiaphragmatic disease in Hodgkin's higher for suprahyoid cervical lesions versus infrahyoid?
1. Infrahyoid is lower
2. Infrahyoid is higher
3. No difference
Stage 1 Clinical Hodgkin's disease patients with a low risk of positive findings at staging laparotomy include all EXCEPT?
1. Females with clinical stage 1 disease
2. Disease in mediastinum only
3. Males with lymphocyte predominate
4. Females with lymphocyte depletion
Which is more likely with staging laparotomy in patients with clinical stage 3 Hodgkin's disease?
1. More likely to upstage
2. More likely to downstage
True or false: Stage 4 Hodgkin's disease is rare in the very young?
1. True
2. False
Stages ___ and ___ Hodgkin's disease account for 75 percent of all patients.
1. Stage 1 and 2
2. Stage 2 and 3
3. Stage 3 and 4
What is the most common short term complication of a staging laparotomy for Hodgkin's disease? What about long-term complications?
1. Obstruction
2. GI bleeding
3. Diarrhea
T or F: the current drug therapy for Hodgkin's disease (ABVD - Adriamycin, bleomycin, vinblastine, dacarbizide) has a lower risk of sterility than does MOPP?
1. True
2. False
What is the current overall five-year survival for children with Hodgkin's disease?
1. 50 percent
2. 75 percent
3. 90 percent
True or false: testicular azoospermia in Hodgkin's disease is usually reversible?
1. True
2. False
What is the risk of hypothyroidism after radiation therapy for Hodgkin's?
1. 1 in 10
2. 1 in 3
3. 2 in 3
True or false: growth impairment is increased in risk after 35 Gy of radiation therapy, but thyroid dysfunction is increased with only 25 Gy?
1. True
2. False
What is the overall risk of secondary malignancies in Hodgkin's disease?
1. 10 percent
2. 100 percent
3. Don't know
Nitrogen mustard and procarbazine increase the risk ninefold; while splenectomy for Hodgkin's increases the risk 2-fold. What risk?
1. Recurrence of disease
2. Regional recurrence
3. Leukemia
4. Soft tissue sarcoma
The risk of leukemia is maximum for all EXCEPT what group?
1. After combination chemo and radiation
2. Relapse after salvage chemotherapy
3. MOPP chemo versus ABVD
4. Longer remission increases risk of relapse
True or false: the risk of later non-Hodgkin's lymphoma after treatment for Hodgkin's disease cumulatively increases?
1. True
2. False
What is the third most common pediatric malignancy, after leukemia and brain tumors?
1. Hodgkins lymphoma
2. non Hodgkins lymphoma
3. Neuroblastoma
4. Wilm's Tumor
More than 90 percent children with non-Hodgkin's lymphoma fit into one of three subtypes?
1. CHOICE
2. CHOICE
3. CHOICE
4. CHOICE
Epstein-Barr virus DNA and nuclear antigen have been identified in what percentage of African Burkitt's lymphoma?
1. 10 percent
2. 25 percent
3. 75 percent
4. 95 percent
With what congenital and acquired immunodeficiencies is Epstein-Barr virus related non-Hodgkin's lymphoma associated?
1. HIV
2. Wiskott-Aldrich syndrome
3. X-linked lymphoproliferative disease
4. All are associated
True or false: non-Hodgkin's lymphoma has an gradual onset with slow growth, and may involve Peyer's patches or Waldeyer's ring?
1. True
2. False
Which is NOT a site of extranodal involvement in non-Hodgkin's lymphoma?
1. Skin
2. Testes
3. Bone and bone marrow
4. CNS
5. Adrenal
Lymphoblastic lymphoma (25% of cases) usually presents above the diaphragm; what percent have an anterior mediastinal mass?
1. 10 to 15 percent
2. 25 to 30 percent
3. 50 to 75 percent
Most lymphoblastic lymphomas express B or T-cell markers?
1. B cell
2. T cell
3. Neither
If a child has more than 25 percent bone marrow involvement by lymphoblasts, they probably have what?
1. Lymphoblastic non-Hodgkin's lymphoma
2. T-cell lymphoblastic leukemia
3. Hairy cell leukemia
4. Lymphocyte predominant Hodgkins
Small noncleaved cell lymphoma (one-third of cases) is _____ cell tumor (which may have doubling times as fast as 24 hours - Burkitt's or non-Burkitt's)?
1. T cell leukemia
2. B cell leukemia
3. Hairy cell leukemia
The endemic or African form of small noncleaved cell lymphoma usually presents with eye, orbit, or jaw involvement in what percent of patients?
1. 25 percent
2. 50 pecent
3. 75 percent
What percent of sporadic small noncleaved cell and non-Hodgkin's lymphoma occurs in non-blacks?
1. 30 percent
2. 50 percent
3. 75 percent
4. 95 percent
In abdominal lymphoma, the male to female ratio may be as high as 10:1 for small noncleaved cell lymphoma?
1. 10 to 1 male predominant
2. 3 to 1 male predominant
3. 3 to 1 female predominant
4. Equal
In abdominal lymphoma, what percentage involve small bowel?
1. 10 percent
2. 30 percent
3. 60 percent
4. 80 percent
A chronic non-strangulating intussusception in the cecum of pre-adolescents and teenagers is most commonly due to what?
1. Meckel's Diverticulum
2. Intestinal Duplication
3. Lymphoma
4. Polypoid disease
Children with bulky intra-abdominal non-Hodgkin's lymphoma and ascites are high risk for what?
1. Liver metastases
2. CNS involvement
3. Tumor lysis syndrome
True or false: Intraabdominal lymphoma with no acute symptoms or bowel obstruction: bone marrow is positive in 20% and thus avoids laparotomy?
1. True
2. False
Children with more than 25 percent L-3 lymphoblasts in the bone marrow have what?
1. T cell leukemia
2. B cell leukemia
3. Hairy cell leukemia
T or F:If a child has acute abdominal symptoms or obstruction and non-Hodgkin's lymphoma of the bowel is found, it should be resected if localized?
1. True
2. False
Large cell lymphoma (25 percent of cases) occurs in what sites, and is usually widely disseminated.
1. Extranodal
2. Abdominal
3. Head and neck nodes
4. CHOICE
What percentage of non-Hodgkin's lymphoma patients have a positive bone marrow at time of diagnosis?
1. 10 percent
2. 20 percent
3. 30 percent
4. 40 percent
Is lymphangiography or staging laparotomy helpful in non-Hodgkin's lymphoma?
1. Only lymphangiography is useful
2. Staging is useful
3. Neither is helpful
4. Both are helpful
True or false: if a pleural effusion or ascites is present in non-Hodgkin's lymphoma, a sample of fluid can sometimes establish the diagnosis definitively.
1. True
2. False
In the staging of non-Hodgkin's lymphoma, what causes disease to be stage 3?
1. Involvement of both sides of the diaphragm
2. Crossing the midline
3. Lymph node involvement
4. Systemic symptoms
What is the overall disease-free survival for non-Hodgkin's lymphoma?
1. 50 percent
2. 75 percent
3. 90 percent
After induction, how long is the chemotherapy treatment of non-Hodgkin's lymphoma generally continued for?
1. 6 weeks
2. 6 months
3. 12 months
4. 18 months
Do stage 1 and stage 2 non-Hodgkin's lymphoma patients get radiation therapy?
1. Yes
2. No
Stage 4 non-Hodgkin's disease (disseminated disease) get ARA-C, and have a BLANK survival?
1. 10 percent
2. 25 percent
3. 50 percent
4. 75 percent
Children with non-Hodgkin's lymphoma and advanced disease may need prophylactic intrathecal ____, or cranial radiation therapy or both?
1. ARA C
2. Radium seeds
3. Methotrexate
What drugs are used for refractory non-Hodgkin's lymphoma, or for relapses?
1. Bleomycin and Vincristine
2. Cisplatin and Methotrexate
3. VP-16 and ARA-C
True or false: radiation therapy is commonly used in non-Hodgkin's lymphoma?
1. True
2. False
Patients with bone marrow transplantation after the first relapse of non-Hodgkin's lymphoma do better than those with bone marrow transplant for refractory disease-true or false?
1. True
2. False
What is the major cause of failure of bone marrow transplantation for non-Hodgkin's lymphoma?
1. Graft versus Host
2. Rejection
3. ABO incompatability
4. Recurrent tumor
Tumor lysis syndrome (Hyperuricemia secondary to rapid destruction of tumor cells ) is more common in non-Hodgkin's lymphoma than in Hodgkins?
1. True
2. False
Which is NOT a treatment of tumor lysis syndrome?
1. Allopurinol
2. Correct hypokalemia
3. Hyperhydration
4. Alkalinize the urine

Lymphomas

Quiz