•Gingival overgrowth is a common side effect of phenytoin.

Other causes:
-Anticonvulsants (such as phenytoin, phenobarbital, vigabatrin, ethosuximide, topiramate and primodone NOT common for valproate)
-Calcium channel blockers (antihypertensives such as nifedipine, amlodipine, and verapamil).
-The dihydropyridine derivative isradipidine can replace nifedipine and does not induce gingival overgrowth.
-Cyclosporine, an immunosuppressant.

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-Acute promyelocytic leukemia (APL) has the highest curability.

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•Imatinib

-In ALL and CML with philadelphia chromosome.

-Common side effects include vomiting, diarrhea, muscle pain, headache, and rash. Severe side effects may include fluid retention, gastrointestinal bleeding, bone marrow suppression, liver problems, and heart failure.
-Use during pregnancy may result in harm to the fetus.

-Imatinib works by stopping the Bcr-Abl tyrosine-kinase.
-This can slow growth or result in programmed cell death of certain types of cancer cells.

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•Blast crisis is the cause of death in the majority of patients with CML.

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•What are the myeloproliferative disorder?

Group of disease consisting of:

-Chronic myelocytic leukemia
-Myelofibrosis
-Polycythemia rubra vera
-Essential thrombocythemia.

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-Chronic lymphocytic leukaemia (CLL) is the most common variety of leukaemia. And the most benign.

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-Loss of chromosome 17p or mutation in the TP53 gene, which resides at this genetic locus, is a powerful prognostic marker and predictor of response to therapy in patients with CLL.

-A mutation in TP53 is present in < 10% of patients at presentation but rises to 30% of cases at relapse. This test
should be performed in all patients prior to the initiation of therapy.

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-Rarely, CLL transforms to an aggressive high-grade lymphoma, called Richter’s transformation.

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-Recently, a more potent type 2 anti-CD20 antibody, obinutuzumab, has become available and produces better responses in combination with chlorambucil than rituximab in patients with CLL.

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-Fludarabine should be avoided in autoimmune hemolytic anemia as it aggravates anemia in ttt of CLL.

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In HL:

-A normochromic, normocytic anaemia or lymphopenia is present, this is a poor prognostic factor.

-An eosinophilia or a neutrophilia may be present.

-Bulky disease (> 10 cm in a single node mass) is an adverse prognostic feature.

-LDH measurements showing raised levels are an adverse prognostic feature.

-ABVD chemotherapy can cause cardiac and pulmonary toxicity, due to doxorubicin and bleomycin, respectively.

-The incidence of infertility and secondary myelodysplasia/AML is low with the above regimen.

-Brentuximab vedotin is an antibody–drug conjugate directed against CD30 on the Reed–Sternberg cell surface. Can produce good responses in patients who have failed, or are not suitable for, an autologous transplant and can be a ‘bridge’ to an allogeneic transplant.

-Reed-Sternberg cell is the hallmark of Hodgkin’s disease. Rarely, found in:

1-Infectious mononucleosis,
2-Recurrent Burkitt’s lymphoma and
3-CLL.

-High alkaline phosphatase (biliary obstruction) indicates involvement of lymph nodes in porta hepatis.

-Adriamycin = doxorubicin.

-Hasenclever prognostic index for advanced HL. "Quiz"

-Differences between HL&NHL." Writing "
-Indications of chemo /radiotherapy."Writing"

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-Rigidity (an increase in resistance to passive movement).

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-The most disabling symptoms of parkinsonism are due to bradykinesia, manifested as a slowness of voluntary movement and a reduction in automatic movements such as swinging of the arms while walking.

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(Myerson sign)

•Repetitive tapping (about twice per second) over the bridge of the nose produces a sustained blink response in Parkinson.

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•Amantadine

Side effects include restlessness, confusion, depression, skin rashes, edema, nausea, constipation, anorexia, postural hypotension, and disturbances of cardiac rhythm.

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-The most common early side effects of levodopa are nausea, vomiting, and hypotension, but cardiac arrhythmias may also occur.

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-Levodopa therapy is contraindicated in patients with psychotic illness or narrow-angle glaucoma.

-It should not be given to patients taking monoamine oxidase A inhibitors or within 2 weeks of their withdrawal, because hypertensive crises may result.

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-Diarrhea is sometimes troublesome.
-Because rare cases of fulminant hepatic failure have followed its use, tolcapone should be avoided in patients with preexisting liver disease.

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-The most common cause of stroke in children is Sickle cell anemia.

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-Mycophenolate mofetil is used for induction and maintenance in renal lupus.

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Causes of death in SLE
-In early age:
Death is usually because of infection (mostly opportunistic), renal or cerebral disease.

-In later age:
Accelerated atherosclerosis is common, MI.

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