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Oncology > Awesome review > Flashcards

Awesome review Flashcards

1
Q

BRCA 1 and 2 gene on which chromosomes

A

BRCA 1 on chromo 17

BRCA 2 on chromo 13

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2
Q

HERR+ breast mass - what do you treat with?

A

Trastuzumab

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3
Q

ER+ breast mass - what do you treat with?

A

If premenopausal - tamoxifen

If postmenopausal - aromatase inhibitor

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4
Q

If breast mass is infiltrating ductal carcinoma, how to treat?

A 
Wide excision w/clean margins + RT
IF:
LN neg, no adjuvant chemo if 1cm OR pos, yes adjuvant chemo
Tamoxifen/AI if ER+
Trastuzumab if HERR+
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5
Q

Most important prognostic factor when investigating a breast cancer is?

A

Lymph node status

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6
Q

Highest risk factors for breast cancer

A

Lady that with strong family history that wears no deodorant with early menarche, zero pregnancies and late menopause

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7
Q 
Menstruating woman with persistent lump when examined mid cycle.
Mammo negative.
Ultrasound mixed echo.
Fine needle asp biopsy negative.
What is next step?
A

Excisional biopsy

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8
Q

Best management of lymphedema

A

Progressive resistance training

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9
Q

Best two medications for menopausal symptoms

A

Citalopram

Venlafaxine

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10
Q

Name 3 estrogenic Effects of tamoxifen (SERM)

A

3x incr risk of endometrial ca
Incr bone density
Incr VTE
Incr hypercalcemia (if Ca++

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11
Q

Treatment for Paget’s disease of the breast without mass

A

Local wide resection

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12
Q

Treatment for Paget’s disease of the breast with underlying mass

A

Treat as if breast cancer

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13
Q

Leading solid tumor causing hypercalcemia is?

A

Breast cancer

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14
Q

Frequency of mammograms in general population

A

Biennial (every other year) in patients age 50-74 per USPTF

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15
Q

Frequency of mammograms in patients recently treated for breast cancer

A

Annually

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16
Q

> 30 female
Ascus +
HPV +
What to do?

A

Colposcopy!

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17
Q

> 30 female
Ascus +
HPV negative
What to do

A

Repeat pap in 1 year only

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18
Q

> 30 female
Ascus negative
HPV +
What to do?

A

Repeat pap in 6 months to 1 year with HPV DNA

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19
Q

What age to screen for cervical cancer ?

A

Start at age 21

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20
Q

Maintenance schedule of cervical cancer screening in females >30

A

Pap smear + HPV DNA testing every 5 years (if negative)

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21
Q

Stop Pap smearing women over the age of…?

A

65

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22
Q

Pap smear showing ASCUS, what’s next?

A

Reflex HPV testing

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23
Q

Cervical cancer screening for high risk Patients that have multiple partners with STDs and HIV

A

Pap smears annually

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24
Q

What does ascus stand for

A

Atypical cells of u determined significance

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25
Q

Clue cells + treatment with?

A

Metronidazole 500 BID X 7 days

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26
Q

Gardasil protects from which HPV serotypes?

A

6, 11, 16, 18

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27
Q

When is HPV vaccination contraindicated ?

A

During pregnancy

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28
Q

What other vaccines should be avoided in pregnancy?

A

HPV
MMR
Herpes
Yellow fever

Ok for …
Hepatitis B
Influenza
Pneumococcal

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29
Q

Hysterectomy with cervix removed for benign etiology. When do perform next pap?

A

No more pap - ever

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30
Q

Hysterectomy with cervix removed for cervical cancer. When to perform next Pap smear?

A

Blind sweep vaginal walls

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31
Q

Treatment for invasive cervical cancer

A

Paclitaxel
Carboplatin
Bevacizumab

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32
Q

Who gets screened with pelvic ultrasound for ovarian cancer?

A

Dermatomyositis

Ovarian or breast family history

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33
Q

Treatment of ovarian cancer

A

Hysterectomy
Salphingo oophorectomy
Omentectomy
Chemo - paclitaxel

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34
Q

Treatment of prostate cancer

A 
Anti androgens 
Flutamide
Nilutamide
Biclutamide
Help to block flare of prostate cancer when LHRHs used which causes increase in testosterone
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35
Q

Psa above what level will light up prostate cancer on bone scan?

A

PDs >10

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36
Q

Side effects of LHRH (leuprolide)

A

Hot flashes

Osteoporosis treat with bisphosphonates

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37
Q

Side effects of anti androgens

A

Impaired night vision
DONT give vitamin A

Breast tenderness

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38
Q

First line therapy for multiple myeloma

A

Thalidomide or lenolidomide

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39
Q

Patient failed first line therapy for multiple myeloma - what to give next? And prophylaxis medication?

A

Bortezamib

And acyclovir

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40
Q

Family history of prostate cancer add this medication to decrease risk of getting prostate cancer

A

Finasteride

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41
Q

Urinary retention can falsely increase which lab value?

A

PSA

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42
Q

Treatment for metastatic prostate cancer refractory to LHRH agonists and anti androgens ?

A

Radium 223 (decreases pain and mortality)

The following only decreased mortality:
Abiraterone-prednisone
Enzalutamide
Docetaxel + prednisone

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43
Q

Which COPD medication causes acute urinary retention in the elderly?

A

Tiotropium

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44
Q

Most common presentation of lung cancer

A

Persistent or increasing cough
Hemoptysis
Obstructive pneumonitis

ALWAYS IMAGE BEFORE PROCEDURE

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45
Q

Metastatic non small cell cancer treatment

A

Erlotinib/Gefitinib

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46
Q

Treatment of small cell lung cancer limited to one hemithorax

A

Chemo
Radiation lung
Radiation brain (prophylactic)

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47
Q

Treatment for extensive small cell lung cancer

A

Chemo

Radiation brain

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48
Q

Treatment lung adenocarcinoma Exon 21 mutation on EGFR

A

Afatinib

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49
Q

Treatment of advanced adenocarcinoma of lung

A

Carboplatin + pemetrexel

50
Q

Medication given to patients with brain edema with ring enhancing lesion

A

Dexamethasone

Also give anti seizure medication to prevent and treat seizures

51
Q

USPTF RECOMMENDATION for low dose CT chest

A

55-80 year old
30 pack years
Still smoking or quit no more than 15 years ago

52
Q

Cisplatin is the poster boy of emesis. How to prevent?

A

Granisetron/ondansetron plus dexamethasone plus
Aprepitant

(Substance p / neurokinin antagonist)

53
Q

Refractory nausea and vomiting prior to chemo. What medication to give now?

A

Alprazolam

54
Q

Pain in shoulder with radiation of ulnar aspect of hand and little finger. What do you suspect and how to detect it?

A

Pancoast tumor

Diagnose with CXR

55
Q

Which lung cancer can cause marantic endocarditis like multiple myeloma or lupus?

A

Adenocarcinoma

56
Q

What prevents a patient with squamous cell cancer from being a surgical candidate?

A

Hemorrhagic effusion (mets)

57
Q

Most important prognostic factor in a patient with advanced non small cell lung cancer

A

Poor performance status

58
Q

Pan coast tumor causing chest movement asymmetry is considered worsening prognosis - why

A

Phrenic nerve now involved

59
Q 
Which lung cancers are associated with these paraneoplastic syndromes?
Gynecomastia 
Hypercalcemia 
Eaton Lambert 
ACTH producing 
SIADH
A 
Large cell 
Squamous cell 
Small cell
Small cell 
Small cell
60
Q

Which lung cancer is usually found in the periphery as a coin lesion

A

Adenocarcinoma

61
Q

Treatment for squamous cell 2cm within carina plus ipsilateral hilar adenopathy and lymph node +

A

Resection
Chemo
RT

62
Q

Treatment for Adenocarcinoma >2cm from carina with lymph node negativity

A

Resection

Chemo

63
Q

Treatment for Large cell carcinoma at carina and contralateral lymph node

A

Chemo

RT

64
Q

Definitive treatment of SVC syndrome

A

RT is superior to chemo ESP if no specified cancer identified

65
Q

Lung cancer completely refractory to all pain medications like opiates. What do u use next

A

Strontium 89

66
Q

Hospice care considered if you have less than ___ months to live

A

6 months

67
Q

Which group of testicular germ cell cancer is responsive to radiation ?

A

Seminomas!!!

Always do RT unless extensive disease beyond RP nodes (then do chemo)

68
Q

Which group of germ cell testicular cancers make high amounts of alphafetoprotein and bHCG?

A

Non seminomas

69
Q

Steps for male symmetrical gynecomastia

A 
Check testosterone and estradiol levels 
If estradiol  elevated 
Check ultrasound testes
If normal
CT adrenals r/o germ cell Tumor
70
Q

Best two kinds of Hodgkin’s lymphoma and worse two kinds

A

Best
Lymphocyte predominance and modular sclerosis

Worst
Mixed cellularity and lymphocyte depletion

71
Q

Treatment for Hodgkin’s disease

A

ABVD +/- RT

Doxorubicin
Blew thin
Vinblastine
Dacarbazine

72
Q

Hodgkin’s relapse or poor response to first line treatment - now what?

A

High dose chemo and autologous stem cell transplant

73
Q

Hodgkin’s lymphoma failing chemo and stem cell transplant !! Now what ??

A

Brentuximab

74
Q

Two common Side effects of brentuximab

A

Neuropathy

Neutropenia

75
Q

Hodgkin’s lymphoma spread of cancer is …

A

Contiguously

76
Q

Non Hodgkin lymphoma spread of cancer is …

A

Hematogenously

77
Q

Type of non Hodgkin lymphoma is follicular lymphoma with translocation …

A

(t 14:18)

78
Q

Type of non Hodgkin lymphoma is diffuse large B cell lymphoma on gene …

A

BCL 6

79
Q

Diagnose non Hodgkin lymphoma by …

A

Excisional biopsy of lymph nodes (ESP if there is a supraclavicular LN)

80
Q

Primary treatment for non Hodgkin lymphoma

A

R CHOP or CVP

Rituximab
Cyclophosphamide 
Hydroxydaunorubicin (doxorubicin)
Oncovin (vincristine)
Prednisone/prednisolone
81
Q

Treatment of non Hodgkin lymphoma relapse

A

Chemo

Stem cell transplant

82
Q

Name five poor prognostic factors of non Hodgkin lymphoma

A

Age > 60
Serum LDH increased
Performance status

83
Q

HPV serotypes associated with cervical cancer

A

HPV 16, 18, 31

84
Q

Treatment of follicular small cell lymphoma found on lymph node with preserved architecture in asx patient.

A

Local RT

85
Q

Treatment of large cell lymphoma

A

RCHOP

86
Q

Patient with small cell lung cancer with recurrent pleural effusions - what to do?

A

Talc instillation

87
Q

Patient with breast cancer, non small cell lung cancer or lymphoma now with recurrent pleural effusions. What to do?

A

Chemotherapy

88
Q

Treatment of multiple myeloma with end organ damage

A

Lenolidomide
Melphalan
Prednisone

89
Q

Treatment of multiple myeloma RELAPSE; what kind of prophylaxis do you need?

A

Bortezomib

Acyclovir for herpes zoster ppx

90
Q

How to monitor MGUS which can transform into MM

A

Follow up labs (CBC Chem serum protein electrophoresis serum FLC assay) every 6 months

91
Q

Smoldering asymptomatic multiple myeloma monitoring schedule

A

Follow up Myeloma protein every 2 months

92
Q

Bone marrow shows plasmacytoid lymphocytes - what is the diagnosis?

A

Waldenstrom’s macroglobulinemia

93
Q

Treatment of waldenstrom’s macroglobulinemia

A

Plasmapheresis for the hyper-viscosity and fludarabine

purine analog interferes with DNA synthesis

94
Q

Treatment of pancreatic cancer with no mets

A

Pancreaticduodenectomy and still give chemo with gemcitabine and nab-paclitaxel

95
Q

Treatment of Pancreatic cancer with mets

A

Palliative stent placement
Gemcitabine
Nab-Paclitaxel

96
Q

Treatment for severe pruritus in end stage pancreatic cancer

A

Biliary stent

97
Q

Diabetes makes one more prone to which cancer?

A

Pancreatic cancer !

98
Q

Diagnosis for hyperglycemia with scaly necrotizing dermatitis

A

Glucagonoma

99
Q

Osmolar gap in patients with diarrhea caused by VIPoma. What is the treatment?

A

Ocreotide

100
Q

What micronutrient deficiency causes hyperglycemia

A

Chromium deficiency

101
Q

What micronutrient deficiency causes necrotic rash

A

Zinc deficiency

102
Q

Sentinel loop sign is found in?

A

Acute pancreatitis

103
Q

Eponym for migratory thrombophlebitis

A

Trousseau’s syndrome

104
Q

Eponym for palpable gallbladder

A

Courvoisier’s sign

105
Q

Test 5HIAA for which cancer?

A

Carcinoid cancer

106
Q

Best surveillance for liver cancer ?

A

Liver ultrasounds NOT AFP

107
Q

Cirrhotic Patient with >1 cm liver lesion - what’s next step

A

3 phase CT scan / MRI with contrast

108
Q

First line treatment of hepatocellular carcinoma

A

Resection or transplant

109
Q

Which agent has been shown survival benefit in hepatocellular carcinoma

A

Sorafinib

110
Q

Which thyroid cancer associated with MEN 2 and 3?

A

Medullary thyroid cancer

RET protooncogene with calcitonin increased

111
Q

Treatment of medullary thyroid cancer

A

Total thyroidectomy

112
Q

Best management for papillary and follicular thyroid carcinoma after surgical removal

A

Radioactive iodine ablation

113
Q

Why doesn’t radioactive iodine ablation work for medullary thyroid cancer

A

Because iodine is not taken up by C cells !!!

114
Q

Follow this lab level to look for medullary thyroid cancer recurrence

A

Calcitonin

115
Q

Lab value to follow to rule out Papillary and follicular cancer recurrence

A

Thyroglobulin level

116
Q

Diagnostic test needed for aromatase inhibitors?

A

DXA scan due to osteoporosis risk

117
Q

When do you give Prophylaxis/prevention for breast Cancer?
Premenopausal- Tamoxifen
Postmenopausal- AI

A

Gail Model Risk > 1.7%
Lobular carcinoma in situ
Atypical hyperplasia

118
Q

Treat anal cancer of anal margin

A

Surgery

119
Q

Treat anal cancer of anal canal mucosa

A

External beam radiation and 5FU/Mitomycin

120
Q

In addition to colonoscopies, what other postoperative surveillance needed for colorectal cancer stage 3?

A

Physical examination
CEA every 3-6 months
CT scans chest and abdomen annually for 3-5 years

Oncology (1 decks)

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