MCQ Quiz- Lymphomas

MCQ Quiz: Lymphomas

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Lymphomas are a diverse group of blood cancers that originate in the lymphatic system. Broadly classified into Hodgkin and Non-Hodgkin lymphoma, their treatment has seen remarkable evolution, with targeted immunotherapies now joining traditional chemotherapy as cornerstones of care. For PharmD students, a solid understanding of lymphoma classification, treatment regimens, and the management of therapy-related toxicities is crucial for providing optimal patient care in the complex field of oncology.

1. The definitive histological hallmark used to diagnose classic Hodgkin Lymphoma is the presence of which type of cell?

  • Plasma cells
  • Reed-Sternberg cells
  • Myeloid blast cells
  • T-lymphocytes


Answer: Reed-Sternberg cells

2. Lymphomas are broadly categorized into two main types: Hodgkin Lymphoma and what other type?

  • Acute Lymphoblastic Leukemia
  • Non-Hodgkin Lymphoma
  • Multiple Myeloma
  • Chronic Lymphocytic Leukemia


Answer: Non-Hodgkin Lymphoma

3. The monoclonal antibody rituximab targets the CD20 antigen, which is found on which type of cells, making it a cornerstone of therapy for many B-cell Non-Hodgkin Lymphomas?

  • B-lymphocytes
  • T-lymphocytes
  • Natural killer cells
  • Macrophages


Answer: B-lymphocytes

4. The standard first-line chemotherapy regimen for many types of Non-Hodgkin Lymphoma is known by what acronym?

  • ABVD
  • FOLFIRI
  • R-CHOP
  • CMF


Answer: R-CHOP

5. Nivolumab, a drug studied for use in advanced-stage classic Hodgkin Lymphoma, belongs to which class of immunotherapy?

  • Monoclonal antibody targeting CD20
  • CAR-T cell therapy
  • PD-1 checkpoint inhibitor
  • Cancer vaccine


Answer: PD-1 checkpoint inhibitor

6. The staging of lymphomas often refers to “B symptoms.” Which of the following is considered a B symptom?

  • Localized lymph node swelling
  • Itchy skin
  • Unexplained fever, drenching night sweats, and significant weight loss
  • A persistent cough


Answer: Unexplained fever, drenching night sweats, and significant weight loss

7. Which of the two main types of lymphoma is more common?

  • Hodgkin Lymphoma
  • Non-Hodgkin Lymphoma
  • They occur with equal frequency
  • Neither is a common cancer


Answer: Non-Hodgkin Lymphoma

8. Hodgkin Lymphoma typically spreads in which manner?

  • Randomly and unpredictably to distant sites
  • Primarily to the brain and spinal cord
  • In a contiguous, orderly fashion from one lymph node region to the next
  • Only through the bloodstream


Answer: In a contiguous, orderly fashion from one lymph node region to the next

9. The “R” in the R-CHOP regimen for Non-Hodgkin Lymphoma stands for what drug?

  • Raloxifene
  • Regorafenib
  • Rituximab
  • Radiation


Answer: Rituximab

10. The study of Nivolumab + AVD in advanced-stage classic Hodgkin Lymphoma represents a potential “change in standard of care” by incorporating what?

  • A more intensive chemotherapy regimen
  • Immunotherapy into the first-line treatment setting
  • A stem cell transplant upfront
  • Daily radiation therapy


Answer: Immunotherapy into the first-line treatment setting

11. Most Non-Hodgkin Lymphomas arise from which type of lymphocyte?

  • T-cells
  • B-cells
  • NK cells
  • All types are equally common


Answer: B-cells

12. A common long-term complication of chemotherapy and radiation used to treat Hodgkin Lymphoma is:

  • An increased risk of secondary malignancies
  • Improved cardiovascular health
  • A stronger immune system
  • A decreased risk of all future cancers


Answer: An increased risk of secondary malignancies

13. A key role for the pharmacist in managing a patient on R-CHOP is counseling on the prevention and management of:

  • Infusion-related reactions to rituximab
  • Myelosuppression from chemotherapy
  • Nausea and vomiting
  • All of the above


Answer: All of the above

14. An “indolent” Non-Hodgkin Lymphoma is one that is typically:

  • Very aggressive and fast-growing
  • Slow-growing and may not require immediate treatment
  • Found only in children
  • Always cured with a single cycle of chemotherapy


Answer: Slow-growing and may not require immediate treatment

15. A patient receiving Nivolumab for Hodgkin Lymphoma should be monitored for what specific class of side effects?

  • Chemotherapy-induced nausea and vomiting
  • Immune-related adverse events (irAEs) such as pneumonitis or colitis
  • Severe cardiotoxicity
  • Hemorrhagic cystitis


Answer: Immune-related adverse events (irAEs) such as pneumonitis or colitis

16. The “Introduction to Hodgkin Lymphoma” lecture would cover the characteristic bimodal age distribution of the disease, which peaks in:

  • Early childhood and late old age
  • Young adulthood and again after age 55
  • The teenage years only
  • Middle age only (40-50 years old)


Answer: Young adulthood and again after age 55

17. Diffuse Large B-Cell Lymphoma (DLBCL) is an example of what type of Non-Hodgkin Lymphoma?

  • An indolent (low-grade) lymphoma
  • An aggressive (high-grade) lymphoma
  • A T-cell lymphoma
  • A type of Hodgkin Lymphoma


Answer: An aggressive (high-grade) lymphoma

18. The “AVD” in the Nivolumab + AVD regimen for Hodgkin Lymphoma stands for:

  • Asparaginase, Vincristine, Doxorubicin
  • Alemtuzumab, Vinblastine, Dacarbazine
  • Adriamycin (doxorubicin), Vinblastine, Dacarbazine
  • Acyclovir, Valganciclovir, Didanosine


Answer: Adriamycin (doxorubicin), Vinblastine, Dacarbazine

19. A pharmacist’s role in the care of lymphoma patients includes ensuring appropriate supportive care, such as:

  • Prophylaxis against tumor lysis syndrome
  • Management of nausea and vomiting
  • Growth factor support for neutropenia
  • All of the above


Answer: All of the above

20. Unlike Hodgkin Lymphoma, Non-Hodgkin Lymphoma is more likely to:

  • Spread in an unpredictable pattern
  • Be diagnosed at an early stage
  • Involve only a single lymph node
  • Be characterized by Reed-Sternberg cells


Answer: Spread in an unpredictable pattern

21. The rationale for adding Nivolumab to the AVD regimen is to potentially improve efficacy while avoiding the toxicity of which chemo agent from the standard ABVD regimen?

  • Doxorubicin
  • Vinblastine
  • Dacarbazine
  • Bleomycin (known for pulmonary toxicity)


Answer: Bleomycin (known for pulmonary toxicity)

22. Which component of the R-CHOP regimen is a corticosteroid used to induce apoptosis in lymphocytes?

  • Cyclophosphamide
  • Doxorubicin
  • Vincristine
  • Prednisone


Answer: Prednisone

23. Accurate staging of lymphoma is critical for determining:

  • The patient’s preferred treatment
  • The prognosis and appropriate treatment strategy
  • The cost of the medication
  • The brand of chemotherapy to be used


Answer: The prognosis and appropriate treatment strategy

24. Brentuximab vedotin is an antibody-drug conjugate used in some types of lymphoma. It works by:

  • Stimulating the immune system with a checkpoint inhibitor
  • Targeting the CD30 antigen and delivering a potent chemotherapy agent
  • Inhibiting the CD20 antigen on B-cells
  • Blocking the PD-1 receptor


Answer: Targeting the CD30 antigen and delivering a potent chemotherapy agent

25. A key difference between Hodgkin Lymphoma and Non-Hodgkin Lymphoma is:

  • NHL is a single disease, while HL has many subtypes.
  • HL is a diverse group of diseases, while NHL is a single entity.
  • HL is generally considered one of the most curable cancers, especially in early stages.
  • HL is never treated with chemotherapy.


Answer: HL is generally considered one of the most curable cancers, especially in early stages.

26. The “H” in the R-CHOP regimen stands for doxorubicin (brand name Hydroxydaunorubicin). This agent is well-known for what dose-limiting toxicity?

  • Nephrotoxicity
  • Cardiotoxicity
  • Pulmonary fibrosis
  • Peripheral neuropathy


Answer: Cardiotoxicity

27. An introduction to lymphomas for a pharmacy student would emphasize that they are cancers originating from:

  • Epithelial cells
  • Myeloid cells
  • Lymphocytes
  • Red blood cells


Answer: Lymphocytes

28. Before administering rituximab, patients are often premedicated with acetaminophen, diphenhydramine, and sometimes a corticosteroid to prevent:

  • An infusion-related reaction
  • Nausea and vomiting
  • Tumor lysis syndrome
  • Anemia


Answer: An infusion-related reaction

29. In lymphoma treatment, a “complete response” means:

  • The tumor has shrunk by at least 50%.
  • The disappearance of all signs of the cancer.
  • The patient feels slightly better.
  • The tumor has stopped growing but is still present.


Answer: The disappearance of all signs of the cancer.

30. The Ann Arbor staging system for lymphoma uses Roman numerals (I-IV) based on:

  • The size of the largest tumor.
  • The number and location of affected lymph node regions.
  • The patient’s age.
  • The type of lymphocyte involved.


Answer: The number and location of affected lymph node regions.

31. Follicular lymphoma is a common type of:

  • Indolent (slow-growing) B-cell Non-Hodgkin Lymphoma.
  • Aggressive T-cell Non-Hodgkin Lymphoma.
  • Classic Hodgkin Lymphoma.
  • Nodular lymphocyte-predominant Hodgkin Lymphoma.


Answer: Indolent (slow-growing) B-cell Non-Hodgkin Lymphoma.

32. For a patient with lymphoma receiving highly emetogenic chemotherapy, a pharmacist would recommend an antiemetic regimen including:

  • An NK1 receptor antagonist, a 5-HT3 receptor antagonist, and a corticosteroid.
  • Over-the-counter meclizine only.
  • Low-dose prochlorperazine as needed.
  • A scopolamine patch.


Answer: An NK1 receptor antagonist, a 5-HT3 receptor antagonist, and a corticosteroid.

33. The role of the immune system in fighting cancer is the basis for using which class of drugs in lymphoma?

  • Alkylating agents
  • Checkpoint inhibitors like nivolumab
  • Anthracyclines like doxorubicin
  • Vinca alkaloids like vincristine


Answer: Checkpoint inhibitors like nivolumab

34. The “P” in R-CHOP stands for prednisone. Which of the following is NOT a common side effect of short-term corticosteroid use?

  • Hyperglycemia
  • Insomnia
  • Increased appetite
  • Cardiotoxicity


Answer: Cardiotoxicity

35. A pharmacist evaluating a new trial in lymphoma must first identify:

  • The type of lymphoma being studied (e.g., HL vs. NHL, B-cell vs. T-cell).
  • The cost of the study medication.
  • The number of research sites.
  • The journal’s impact factor.


Answer: The type of lymphoma being studied (e.g., HL vs. NHL, B-cell vs. T-cell).

36. A major goal of therapy for aggressive Non-Hodgkin Lymphoma is:

  • Cure.
  • Palliative symptom control only.
  • To transition it to an indolent form.
  • To avoid all treatment-related toxicity.


Answer: Cure.

37. Vincristine, part of the CHOP regimen, is known for causing which dose-limiting toxicity?

  • Myelosuppression
  • Nausea and vomiting
  • Peripheral neuropathy
  • Renal failure


Answer: Peripheral neuropathy

38. The addition of immunotherapy to standard chemotherapy for lymphoma has generally led to:

  • Worse patient outcomes.
  • No change in patient outcomes.
  • Improved patient outcomes.
  • Increased cost with no benefit.


Answer: Improved patient outcomes.

39. A pharmacist’s introduction to Non-Hodgkin Lymphoma would emphasize that it is:

  • A single, uniform disease.
  • A diverse group of more than 60 different subtypes.
  • Always slow-growing and indolent.
  • A cancer of the red blood cells.


Answer: A diverse group of more than 60 different subtypes.

40. A patient with Hodgkin Lymphoma has disease in lymph nodes on both sides of the diaphragm. According to the Ann Arbor staging system, this would be at least:

  • Stage I
  • Stage II
  • Stage III
  • Stage IV


Answer: Stage III

41. The use of PET scans in lymphoma management is primarily for:

  • Staging the disease and assessing response to treatment.
  • Guiding radiation therapy.
  • Determining the need for surgery.
  • Measuring the patient’s white blood cell count.


Answer: Staging the disease and assessing response to treatment.

42. Which of the following is an example of an aggressive B-cell Non-Hodgkin Lymphoma?

  • Follicular Lymphoma
  • Chronic Lymphocytic Leukemia
  • Burkitt Lymphoma
  • Mycosis Fungoides


Answer: Burkitt Lymphoma

43. The development of targeted therapies and immunotherapies has significantly changed the standard of care for what?

  • Both Hodgkin and Non-Hodgkin Lymphomas.
  • Only T-cell lymphomas.
  • Only early-stage Hodgkin Lymphoma.
  • Only indolent Non-Hodgkin Lymphoma.


Answer: Both Hodgkin and Non-Hodgkin Lymphomas.

44. A patient receiving rituximab should be monitored for the reactivation of which virus?

  • Influenza
  • Hepatitis B
  • Varicella-Zoster
  • Epstein-Barr Virus


Answer: Hepatitis B

45. For a PharmD student, understanding lymphoma treatment is a key part of what broader subject area?

  • Oncology pharmacotherapy.
  • Infectious disease.
  • Cardiology.
  • Public health.


Answer: Oncology pharmacotherapy.

46. Tumor Lysis Syndrome (TLS) is a potential oncologic emergency in fast-growing lymphomas. Prophylaxis for TLS often includes:

  • Aggressive hydration and allopurinol.
  • A single dose of an antibiotic.
  • A blood transfusion.
  • An antiemetic regimen.


Answer: Aggressive hydration and allopurinol.

47. The “C” in the R-CHOP regimen stands for:

  • Carboplatin
  • Cisplatin
  • Cytarabine
  • Cyclophosphamide


Answer: Cyclophosphamide

48. Why is an accurate diagnosis distinguishing HL from NHL crucial?

  • Because the treatment strategies and prognosis are significantly different.
  • For insurance billing purposes only.
  • It is not crucial, as they are treated identically.
  • To determine the patient’s eligibility for a clinical trial.


Answer: Because the treatment strategies and prognosis are significantly different.

49. An important role of the pharmacist is to educate lymphoma patients that chemotherapy can cause myelosuppression, which increases the risk of:

  • Infection, anemia, and bleeding.
  • High blood pressure.
  • Hair growth.
  • Improved kidney function.


Answer: Infection, anemia, and bleeding.

50. The study of new agents like Nivolumab in the frontline setting for Hodgkin Lymphoma aims to:

  • Increase treatment-related toxicity.
  • Improve efficacy and/or reduce long-term toxicity compared to the old standard of care.
  • Make treatment more expensive.
  • Lengthen the duration of therapy.


Answer: Improve efficacy and/or reduce long-term toxicity compared to the old standard of care.

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