AOCNP Hematologic Malignancies 2

Question 1

Reed-Sternberg cells, large binucleated cells with prominent 'owl-eye' nucleoli, are pathognomonic of which disease?

Accepted Answer

Classical Hodgkin lymphoma

Answer

Diffuse large B-cell lymphoma (DLBCL)

Answer

Chronic lymphocytic leukemia

Answer

Follicular lymphoma

Question 2

The Lugano classification (updated Ann Arbor staging) for lymphoma designates Stage IV disease as:

Accepted Answer

Diffuse or disseminated involvement of one or more extralymphatic organs with or without lymph node involvement

Answer

Involvement of two or more lymph node regions on the same side of the diaphragm

Answer

Involvement of lymph node regions on both sides of the diaphragm

Answer

Involvement of one extralymphatic organ without lymph node disease

Question 3

R-CHOP is the standard first-line regimen for diffuse large B-cell lymphoma (DLBCL). What does the 'R' represent and what is its mechanism?

Accepted Answer

Rituximab — an anti-CD20 monoclonal antibody that depletes B cells

Answer

Romidepsin — a histone deacetylase inhibitor targeting T-cell lymphomas

Answer

Revlimid (lenalidomide) — an immunomodulatory agent

Answer

Ruxolitinib — a JAK1/2 inhibitor

Question 4

The International Prognostic Index (IPI) for aggressive non-Hodgkin lymphoma includes which of the following five adverse factors?

Accepted Answer

Age >60, elevated LDH, ECOG PS ≥2, Stage III–IV, >1 extranodal site

Answer

Age >60, bone marrow involvement, elevated LDH, B symptoms, Stage III–IV

Answer

Elevated LDH, low albumin, elevated beta-2 microglobulin, ECOG PS ≥2, Stage IV

Answer

Age >60, elevated LDH, low hemoglobin, Stage III–IV, >1 nodal site

Question 5

A patient with follicular lymphoma grade 1–2 requires CNS prophylaxis. Is this standard practice?

Accepted Answer

No, CNS prophylaxis is not routinely indicated for low-grade follicular lymphoma

Answer

Yes, all lymphoma patients require CNS prophylaxis

Answer

Yes, because follicular lymphoma frequently transforms to involve the CNS

Answer

No, CNS prophylaxis is only indicated for Hodgkin lymphoma

Question 6

Burkitt lymphoma is characterized by translocation of the MYC oncogene, most commonly t(8;14). Which virus is most strongly associated with the endemic (African) form of Burkitt lymphoma?

Accepted Answer

Epstein-Barr virus (EBV)

Answer

Human herpesvirus 8 (HHV-8)

Answer

Human T-lymphotropic virus type 1 (HTLV-1)

Answer

Hepatitis C virus (HCV)

Question 7

A patient with Hodgkin lymphoma achieves complete remission after ABVD chemotherapy. What is the standard surveillance approach regarding PET-CT imaging after treatment completion?

Accepted Answer

Routine PET-CT surveillance is not recommended after complete remission due to low yield and radiation risk; symptom-directed evaluation is preferred

Answer

PET-CT every 3 months for 5 years regardless of symptoms

Answer

Annual PET-CT for 10 years is standard of care

Answer

PET-CT only if the patient develops a new palpable lymph node