ONCC Hematologic Malignancies Flashcards

A patient with acute myeloid leukemia (AML) has a WBC of 120,000/µL. The nurse should prioritize assessment for which life-threatening complication?

Answer: Tumor lysis syndrome and leukostasis

Extreme leukocytosis in AML can cause leukostasis (vascular sludging) and places patients at high risk for tumor lysis syndrome, both of which are oncologic emergencies.

Which laboratory finding is most characteristic of chronic myeloid leukemia (CML)?

Answer: Philadelphia chromosome (BCR-ABL fusion) detected by cytogenetics or PCR

The Philadelphia chromosome (BCR-ABL translocation) is the hallmark genetic abnormality of CML and is the target of tyrosine kinase inhibitor therapy.

A patient with multiple myeloma presents with back pain, fatigue, and a calcium level of 12.5 mg/dL. The nurse recognizes these findings as consistent with:

Answer: The CRAB criteria (hypercalcemia, renal failure, anemia, bone lesions) indicating end-organ damage

The CRAB criteria define myeloma-related organ damage: hyperCalcemia, Renal insufficiency, Anemia, and Bone lesions — guiding treatment initiation.

Which medication class is the first-line targeted therapy for CML and works by inhibiting the BCR-ABL tyrosine kinase?

Answer: Tyrosine kinase inhibitors (e.g., imatinib)

Tyrosine kinase inhibitors such as imatinib, dasatinib, and nilotinib directly inhibit the BCR-ABL oncoprotein driving CML proliferation.

A patient with non-Hodgkin lymphoma is receiving rituximab. The nurse should monitor for which infusion-related reaction most closely during the FIRST infusion?

Answer: Fever, chills, hypotension, and bronchospasm (cytokine release syndrome)

Rituximab commonly causes cytokine release syndrome during the first infusion, manifesting as fever, chills, hypotension, and bronchospasm, requiring close monitoring and rate adjustments.

Hodgkin lymphoma is distinguished from non-Hodgkin lymphoma by the presence of which pathognomonic cell type?

Answer: Reed-Sternberg cells

Reed-Sternberg cells — large binucleate or multinucleate cells with prominent 'owl-eye' nucleoli — are the pathognomonic finding in Hodgkin lymphoma.