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11 Oncology Flashcards

1
Q

MC CA in women

A

Breast

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2
Q

MC cause of CA related death in women

A

Lung

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3
Q

MC CA in mend

A

Prostate

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4
Q

MC cause of CA related death in men

A

Lung

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5
Q

MOA PET

A

Detects fluorodeoxyglucose molecules

Used to identify metastases

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6
Q

What do cytotoxic T cells need to attach tumors?

A

MHC complex

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7
Q

What do natural killer cells need to attack tumor cells?

A

Nothing - they can attack independently

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8
Q

Hyperplasia

A

increase in number of cells

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9
Q

Metaplasia

A

Replacement of one tissue without another

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10
Q

Dysplasia

A

Altered size, shape and organization

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11
Q

CEA

A

Colon CA

Half-life: 18 days

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12
Q

AFP

A

Liver CA

Half-life: 5 days

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13
Q

CA 19-9

A

Pancreatic CA

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14
Q

CA 125

A

Ovarian CA

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15
Q

Beta-HCG

A

Testicular CA, choriocarcionoma

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16
Q

PSA

A

Prostate CA
Highest sensitivity, low specificity
Half-life: 18 days

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17
Q

NSE

A

Small cell lung CA, neuroblastoma

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18
Q

BRCA 1/2

A

Breast cancer

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19
Q

Chromogranin A

A

Carcinoid tumor

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20
Q

Ret oncogene

A

Thyroid medullary CA

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21
Q

Cancer transformation requires:

A

1) Heritable alteration in genome

2) Loss of growth regulation

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22
Q

Latency period

A

Time between exposure and formation of clinically detectable tumor

  • Initiation (carcinogen acts with DNA)
  • Promotion of cancer cells
  • Progression of cancer cells to clinically detectable tumor
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23
Q

Epstien bar virus

A 
Burkitt's lymphoma (8;14 translocation)
Nasopharyngeal CA (c-myc)
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24
Q

Human papillomavirus

A

Cervical cancer

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25
Q

Helicobacter pylori

A

Gastric cancer

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26
Q

Hep B, Hep C

A

Hepatocellular carcinoma

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27
Q

What stages is most vulnerable to radiation therapy?

A

M phase

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28
Q

How is damage done via radiation therapy?

A

Formation of oxygen radicals

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29
Q

Target of radiation therapy?

A

DNA - both oxygen radicals and XRT damages it

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30
Q

Fractionated XRT doses

A

Allows for repair of normal cells
Allows re-oxygenation of tumor
Allows redistribution of tumor cells in cell cycle

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31
Q

Very radiosensitive tumors?

A

Seminima

Lymphoma

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32
Q

Very radioresistant tumors?

A

Epithelial

Sarcoma

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33
Q

Why are large tumors resistant to XRT?

A

Less responsive to XRT due to lack of oxygen in the tumor

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34
Q

Brachytherapy

A

Source of radiation is placed in or next to tumor

Delivers, high concentrated doses of radiation

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35
Q

Cell cycle-specific agents

A

5-FU, Methotrexate

Exhibit plateau in cell-killing ability

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36
Q

Cell cycle-nonspecific agents

A

Linear response to cell killing

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37
Q

Tamoxifen

A

Blocks estrogen receptors
Decreases short-term (5 year) risk of breast CA by 45%
(1% risk of blood clots, 0.1% risk of endometrial CA)

38
Q

Taxol

A

Promotes microtubule formation and stabilization that cannot be broke down
Cells are ruptured

39
Q

What chemo agents can cause pulmonary fibrosis?

A

Bleomycin

Busulfan

40
Q

AE of cisplatin

A

Platinum alkylating agent

Nephrotoxic, neurotoxic, ototoxic

41
Q

AE of carboplatin

A

Platinum alkylating agent

Bone marrow suppression

42
Q

AE of vincristine

A

Microtubule inhibitor

Peripheral neuropathy, neurotoxic

43
Q

AE of vinblastin

A

Microtuble inhibitor

Bone marrow suppression

44
Q

Alkylating agents

A

Transfer alkyl groups

Form convalent bonds to DNA

45
Q

Cyclophosphamide

A

Alkylating agent - acrolein is the active metabolite
AE: gonadal dysfunction, SIADH, hemorrhagic cystitis
Mesna can help with hemorrhagic cystitis

46
Q

Levamisole

A

Antihelminthic dug

Stimulates immune system against cancer

47
Q

Methotrexate

A

Inhibits dihydrofolate reductase - inhibits purine and DNA synthesis
AE: Renal toxicity, radiation recall

48
Q

Leucovorin rescue

A

Folinic acid

Reverses effects of methotrexate by re-supplying folate

49
Q

5-Fluorouracil

A

Inhibits thymidylate synthetase - inhibits purine and DNA synthesis
Leucovorin increases toxicity of 5FU

50
Q

Doxorubicin

A

DNA intercalator - O2 radical formation

AE: heart toxicity (secondary to O2 radicals at total dose >500mg/m2)

51
Q

Etoposide

A

Inhibits topoisomerase (normally unwinds DNA)

52
Q

Which chemo agents are least myelosuppressive?

A

Bleomycin
Vincristine
Busulfan
Cisplatin

53
Q

Granulocyte colony-stimulating factor

A

Used for neutrophil recovery after chemo

AE: sweet’s syndrome (acute febrile neutropenic dermatitis)

54
Q

When is resection indicated of a normal organ to prevent cancer?

A

Breast - BRCA 1/2 with strong family history

Thyroid - RET proto-oncogene with family history of thyroid CA

55
Q

Retinoblastoma RB1

A

Tumor suppressor gene
Chromosome 13
Involved in cell cycle regulation

56
Q

p53

A

Tumor suppressor gene
Chromosome 17
Inovlved in cell cycle (normal gene induces cell cycle arrest and apoptosis; abnormal gene allows unrestrained cell growth)

57
Q

APC

A

Tumor suppressor gene
Chromosome 5
Cell cycle regulation and movement

58
Q

DCC

A

Tumor suppressor gene
Chromosome 18
Cell adhesion

59
Q

bcl

A

Tumor suppressor gene

Apoptosis

60
Q

ras

A

Proto-oncogene

G protein defect

61
Q

src

A

Proto-oncogene

Tyrosine kinase defect

62
Q

sis

A

Proto-oncogene

Platelet-derviced growth factor receptor defect

63
Q

erb B

A

Proto-oncogene

Epidermal growth factor receptor defect

64
Q

myc

A 
Proto-oncogene
Transcription factors (c-myc, n-myc, l-myc)
65
Q

Li-Fraumeni syndrome

A

Defect in p53 gene

Childhood sarcomas; breast CA, brain tumors, leukemia, adrenal CA

66
Q

Colon CA

A

APC, p53, DCC, K-ras
APC thought to be the initial step in the evolution of CRC
Does NOT go to bone

67
Q

Coal tar

A

Larynx, skin, bronchial CA

68
Q

Beta-naphthylamine

A

Urinary tract CA, bladder CA

69
Q

Benzene

70
Q

Asbestos

A

Mesothelioma

71
Q

Suspicious supraclavicular nodes

A

Neck, breast, lung, stomach (Virchow’s node), pancreas

72
Q

Suspicious axillary node

A

Lymphoma*
Breast
Melanoma

73
Q

Suspicious periumbilical node

A

Pancreas (Sister Mary Joseph’s node)

74
Q

Ovarian metastases

A

Stomach (Krukenberg tumor)

Colon

75
Q

Bone metastases

A

Breast*

Prostate

76
Q

Skin metastases

A

Breast

Melanoma

77
Q

Small bowel metastases

78
Q

Clinical trial - phase I

A

Is it safe and at what dose? (healthy people)

79
Q

Clinical trial - phase II

A

Is it effective?

80
Q

Clinical trial - phase III

A

Is it better than existing therapy?

81
Q

Clinical trial - phase IV

A

Implementation and marketing (after release for sale)

82
Q

Induction therapy

A

Sole treatment

Used for advanced disease or when no other treatment exists

83
Q

Primary (neoaduvant) therapy

A

Chemo given first

Followed by another, secondary therapy

84
Q

Adjuvant therapy

A

Combined with another modality

Given after other therapy is used

85
Q

Salvage therapy

A

For tumors that fail to respond to initial chemotherapy

86
Q

Prognostic indicators for survival after resection of hepatic colorectal metastases?

A 
Disease-free interval >12 months
Tumor number <3
CEA <200
Size <5cm
Negative nodes
87
Q

Which type of tumor has improvements in chemotherapy after debulking surgery?

A

Ovarian cancer

88
Q

What solid tumors are curable with chemo only?

A

Hodgkin’s and non-Hodgkin’s lymphoma

89
Q

T-cell lymphomas

A 
HTLV-1 (skin lesions)
Mycosis fungoides (Sezary cells)
90
Q

HIV-related malignancies

A

Kaposi’s sarcoma

Non-Hodgkin’s lymphoma

91
Q

Vascular epidermal growth factor

A

Cause angiogenesis

Involved in tumor metastasis

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