COCN COCN Hematologic Malignancies 1 — Questions and Answers
Question 1: Which type of leukemia is most commonly diagnosed in adults over 65 years old in the United States?
- Acute lymphoblastic leukemia (ALL)
- Chronic lymphocytic leukemia (CLL) (Correct answer)
- Acute myeloid leukemia (AML)
- Chronic myeloid leukemia (CML)
Correct answer: Chronic lymphocytic leukemia (CLL)
CLL is the most common adult leukemia in the US, predominantly affecting older adults.
Question 2: A patient with multiple myeloma is at highest risk for which skeletal complication?
- Pathologic fractures (Correct answer)
- Osteosarcoma
- Osteoporosis without fracture risk
- Joint effusions
Correct answer: Pathologic fractures
Myeloma cells stimulate osteoclasts and inhibit osteoblasts, leading to lytic lesions and pathologic fractures.
Question 3: The Philadelphia chromosome, resulting from a translocation between chromosomes 9 and 22, is the hallmark of which leukemia?
- Acute lymphoblastic leukemia
- Hairy cell leukemia
- Chronic myeloid leukemia (CML) (Correct answer)
- Chronic lymphocytic leukemia
Correct answer: Chronic myeloid leukemia (CML)
The t(9;22) translocation creates the BCR-ABL fusion gene, which drives CML and is targeted by imatinib.
Question 4: Which staging system is used specifically for non-Hodgkin lymphoma and Hodgkin lymphoma?
- TNM staging
- Ann Arbor staging (Correct answer)
- FIGO staging
- Durie-Salmon staging
Correct answer: Ann Arbor staging
The Ann Arbor staging system (Stages I–IV) classifies lymphoma based on the number and location of involved lymph node regions.
Question 5: A nurse is caring for a patient with multiple myeloma. Which lab finding is most indicative of disease activity?
- Elevated serum albumin
- Elevated serum protein electrophoresis (M-protein spike) (Correct answer)
- Low ESR
- Normal beta-2 microglobulin
Correct answer: Elevated serum protein electrophoresis (M-protein spike)
The M-protein spike on SPEP reflects the monoclonal immunoglobulin produced by malignant plasma cells.
Question 6: Tumor lysis syndrome is most likely to occur in patients receiving treatment for which hematologic malignancy?
- Chronic lymphocytic leukemia in early stage
- Hairy cell leukemia
- Bulky or rapidly proliferating lymphomas and acute leukemias (Correct answer)
- Low-grade follicular lymphoma
Correct answer: Bulky or rapidly proliferating lymphomas and acute leukemias
TLS occurs when rapid cell destruction releases intracellular contents, most common in high-burden, rapidly proliferating cancers.
COCN COCN Hematologic Malignancies 1
Which type of leukemia is most commonly diagnosed in adults over 65 years old in the United States?