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Hematologic Malignancies Flashcards

7 cards from real AOCNP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient with CLL is found to have del(17p) on FISH testing. Which targeted therapy is the preferred first-line agent for this high-risk mutation?

    Answer: Ibrutinib

    Del(17p) CLL is resistant to chemoimmunotherapy due to loss of p53; ibrutinib (a BTK inhibitor) is preferred first-line.

  2. Which of the following is the most common cytogenetic abnormality in multiple myeloma that confers a standard-risk prognosis?

    Answer: Hyperdiploidy

    Hyperdiploidy, typically involving odd-numbered chromosomes, is the most common cytogenetic finding in myeloma and is associated with standard risk.

  3. A patient on venetoclax for AML develops tumor lysis syndrome (TLS). Which lab finding is NOT a feature of TLS?

    Answer: Hypercalcemia

    TLS causes hypocalcemia (not hypercalcemia) because phosphate released from lysed cells binds calcium, lowering serum levels.

  4. A 45-year-old with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) achieves complete remission after CAR-T cell therapy. What is the most serious early toxicity to monitor for in the first 2 weeks?

    Answer: Cytokine release syndrome (CRS)

    CRS is the most common and potentially life-threatening early toxicity after CAR-T therapy, caused by massive cytokine release from activated T cells.

  5. In the revised International Prognostic Index (R-IPI) for DLBCL, which of the following is NOT one of the five adverse prognostic factors?

    Answer: Bone marrow involvement

    The R-IPI uses age >60, elevated LDH, ECOG PS >1, Ann Arbor stage III/IV, and >1 extranodal site; bone marrow involvement per se is not a standalone factor.

  6. A patient with polycythemia vera (PV) develops a new stroke. Which mutation drives the majority of PV cases and is used for diagnosis?

    Answer: JAK2 V617F

    JAK2 V617F is present in >95% of PV cases and is central to the 2016 WHO diagnostic criteria.

  7. Which surface marker combination is most characteristic of hairy cell leukemia (HCL)?

    Answer: CD19+, CD20+, CD11c+, CD25+, CD103+

    HCL classically expresses CD19, CD20, CD11c, CD25, CD103, and annexin A1, distinguishing it from other B-cell lymphoproliferative disorders.

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