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PoM II - Final Exam > 10. Neoplasms > Flashcards

10. Neoplasms Flashcards

1
Q

Typical endometrial patient characteristics

A

Post menopausal bleeding; Nulliparious; High BMI; FH of colon CA; Possible PCOS

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2
Q

What cancer is most closely linked to obesity?

A

Endometrial cancer

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3
Q

Sentinel sx of endometrial CA

A

Postmenopausal bleeding

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4
Q

Most effect tx for endometrial CA

A

Surgery;

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5
Q

2nd line tx for endometrial CA

A

Radiation & chemo; Metformin is targeted tx

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6
Q

What is the MoA of Metformin in endometrial CA?

A

PTEN pathway, which is abnormal in almost all endometrial CA

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7
Q

3rd line tx for endometrial CA

A

Progesterone-only HRT

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8
Q

What tx is preferred for elderly pts with endometrial CA?

A

Hormonal

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9
Q

Why would progesterone tx be preferrable for young woman with endometrial CA?

A

Preserves reproductive organs

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10
Q

Tumor suppressor genes MLH1, MSH2,PMS2, and MSH6 are associated with what syndrome?

A

Lynch syndrome

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11
Q

What cancers are most common with Lynch syndrome?

A

Colon & endometrial cancers are most common. Lifetime risk of developing one is 80%.

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12
Q

Is Lynch syndrome a dominant or recessive inheritance?

A

Dominant

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13
Q

When is prophylactic hysterectomy and oophorectomy recommended?

A

Lynch syndrome after age 35 or once childbearing is complete

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14
Q

When should Lynch syndrome patients begin colorectal cancer screening? How frequently?

A

Colonoscopy q1-2 yrs starting at 20-25

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15
Q

When should Lynch syndrome patients begin endometrial biopsy screening? How frequently?

A

Annually beginning at age 30-35

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16
Q

When is the most common type of endometrial cancer?

A

Endometrioid endometrial CA

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17
Q

What are the most aggressive endometrial CA types?

A

Serous & clear cell (not well-understood)

18
Q

When is ovarian cancer most commonly found?

A

Stage 3 or 4

19
Q

What is the cure rate when ovarian cancer is commonly found?

A

30%

20
Q

Typical ovarian CA patient characteristics

A

Postmenopausal; Nulliparious; IBS; FH of Breast CA

21
Q

Ovarian CA tx

A

Surgery (aggressive debulking) + Chemo (taxane & platinum) via intraperitoneal route + Targeted therapy

22
Q

When is surgery contraindicated in ovarian CA?

A

If pt isn’t willing to take chemo.

23
Q

What is the relapse rate of ovarian CA?

A

75%

24
Q

What is one of the most chemo-sensitive cancers?

A

Ovarian

25
Q

What chemo agents are used in recurrent ovarian CA?

A

Bevacizumab (Avastin) & PARP inhibitor olaparib

26
Q

Role of radiation in ovarian ca?

A

Palliative care

27
Q

What cultural group is at highest susceptibility to BRCA1/2 mutations?

A

Ashkenazi Jews

28
Q

What effect do OCPs have on ovarian cancer?

A

50% reduction after 5 yrs of use

29
Q

What is the ovarian cancer risk reduction is offered by tubal ligation and hysterectomy?

A

30-50%

30
Q

What is the gold standard in ovarian CA prevention?

A

Bilateral salpho-oophorectomy (Upto 95% reduction); Also decreases Breast CA risk by 50%

31
Q

What percentage of women with ovarian cancer receive standard of care tx?

A
32
Q

Characteristics of cervical CA patients

A

Postcoital bleeding; Smoker; NL BMI; no GYN care

33
Q

Cervical CA dx - Most common stage

A

Stage 1

34
Q

What chemotherapy agents are used in cervical cancer tx?

A

Bevacizumab (Avastin) for recurrent dz

35
Q

Stage IA cervical CA surgery

A

Cone bx vs. simple hysterectomy

36
Q

Stage IB cervcial CA surgery

A

Radical hysterectomy/LND

37
Q

When is surgery no longer a tx option for cervical CA?

A

Stages beyond 1B not surgical candidates

38
Q

When is exenteration indicated?

A

Palliative care for recurrent cervical cancer

39
Q

What is the most effective cancer screening tool?

A

PAP

40
Q

Can you contract HPV from the vaccine?

A

No. It contains no virus DNA or RNA.

PoM II - Final Exam (12 decks)

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