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

Reed-Sternberg cells (CD15+, CD30+, usually CD20−) are the malignant cells of classical Hodgkin lymphoma and are required for histologic diagnosis.

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

Stage IV in the Lugano classification indicates diffuse or disseminated extranodal organ involvement (e.g., bone marrow, liver, lung parenchyma), which signals widely disseminated 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

Rituximab is an anti-CD20 chimeric monoclonal antibody that targets CD20-expressing B cells through antibody-dependent cellular cytotoxicity and direct apoptosis, improving outcomes in DLBCL when added to CHOP chemotherapy.

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

The five IPI factors are age >60 years, elevated serum LDH, ECOG performance status ≥2, Ann Arbor Stage III or IV, and >1 extranodal site of disease involvement.

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

CNS prophylaxis is generally reserved for high-risk aggressive lymphomas (e.g., high-IPI DLBCL, primary testicular or renal lymphoma); indolent follicular lymphoma has very low CNS risk and does not routinely require prophylaxis.

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP Hematologic Malignancies 2