ONCC Hematologic Malignancies Flashcards

A patient who received an allogeneic stem cell transplant develops a diffuse skin rash, severe diarrhea, and elevated bilirubin 3 weeks post-transplant. The nurse recognizes this presentation as:

Answer: Acute graft-versus-host disease (GVHD)

Acute GVHD classically presents in the first 100 days post-allogeneic transplant with a triad of skin rash, diarrhea, and hepatic dysfunction (elevated bilirubin) as donor T-cells attack host tissues.

Which measure is most effective in reducing the risk of infection in a patient with severe neutropenia (ANC <100/µL) following intensive chemotherapy?

Answer: Strict hand hygiene by all staff and visitors as the primary protective measure

Strict hand hygiene by all healthcare workers, visitors, and the patient remains the single most effective infection prevention strategy in severely neutropenic patients.

The International Prognostic Index (IPI) for non-Hodgkin lymphoma includes which factors?

Answer: Age, LDH level, performance status, stage, and number of extranodal sites

The IPI score is calculated from five clinical factors: age >60, elevated LDH, ECOG performance status >1, Ann Arbor stage III/IV, and >1 extranodal site, stratifying prognosis.

A patient with multiple myeloma is receiving a bisphosphonate (zoledronic acid). Which adverse effect requires regular dental evaluation before and during therapy?

Answer: Osteonecrosis of the jaw (ONJ)

Bisphosphonate therapy, especially intravenous agents, significantly increases the risk of osteonecrosis of the jaw, making pre-treatment dental evaluation and ongoing oral hygiene critical.

CAR T-cell therapy can cause a potentially fatal immune complication characterized by high fever, hypotension, hypoxia, and multi-organ dysfunction. This is called:

Answer: Cytokine release syndrome (CRS)

Cytokine release syndrome is a major toxicity of CAR T-cell therapy caused by massive cytokine secretion from activated CAR T-cells, leading to systemic inflammatory response and potential multi-organ failure.

Waldenström's macroglobulinemia is characterized by the overproduction of which immunoglobulin?

Answer: IgM

Waldenström's macroglobulinemia is a lymphoplasmacytic lymphoma that produces large amounts of monoclonal IgM, which can cause hyperviscosity syndrome.