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SBL > CA detection > Flashcards

CA detection Flashcards

1
Q

Possible physical findings associated with tumors

A

sensation of a mass; invasion of skin, blood, and/or nerves; obstruction of GI, airway, blood/lymph vessels; spinal cord compression

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2
Q

Stridor is indicative of…

A

an airway obstruction

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3
Q

Sxs of superior vena cava syndrome

A

venous distension of neck, venous distension of chest wall, facial edema and plethora, upper arm edema

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4
Q

Pemberton’s sign

A

exaggeration of findings when arms are raised above the head

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5
Q

Post-menopausal female “menstruating again” may indicate…

A

uterine cancer

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6
Q

Hemorrhage in tumors may cause what side effects besides seeing blood in body fluid

A

pain, iron-deficiency anemia

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7
Q

Important things to consider in history-taking for CA detection

A

palpable and/or visible mass, obstructive signs/symptoms, hemorrhage

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8
Q

Important things to consider in physical examination for CA detection

A

palpable mass, indications of invasion, compression, effusions

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9
Q

Biomarker for adenexal mass

A

CA-125

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10
Q

Three components of cancer staging

A

tumor size/invasion, lymph node metastasis, distant metastases

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11
Q

Four routes of metastatic spread

A

lymphatic, hematogenous, transcoelomic, canalicular

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12
Q

First LN tumor cells travel to as they metastasize

A

sentinel

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13
Q

At time of diagnosis, where should you look for possible metastasis?

A

lymph nodes (may require radiographic eval)

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14
Q

Most common route of sarcoma metastasis

A

hematogenous

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15
Q

Most common route of carcinoma metastasis

A

lymphatic

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16
Q

What manifestation of metastatic cancer might you identify before a patient has a known cancer diagnosis?

A

fatigue/weight loss, bone or back pain, HA/localizing neuro signs, obstruction or compression

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17
Q

Sister Mary Joseph nodule

A

umbilical metastasis from ovarian carcinoma

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18
Q

Virchow node

A

supraclavicular lymphadenopathy (typically L sided), often associated with thoracic abdominal carcinoma

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19
Q

Indicators of a primary tumor

A

solitary, no other cancer diagnosis, location unusual for mets, typical demographic

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20
Q

Indicators of a metastatic tumor

A

multiple, history of other CA, location more typical for mets, unusual

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21
Q

Myeloma tumor marker

A

B2 microglobulin

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22
Q

Medullary thyroid carcinoma tumor marker

A

calcitonin

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23
Q

Back pain decades after “definitive” breast cancer therapy may be indicative of…

A

osseous metastasis to the spine

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24
Q

Paraneoplastic syndrome

A

tumor secretes substances that evokes the elaboration of other factors and produces a physiologic response

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25
Q

Mass effects

A

airway obstruction, invasion and rupture of vessels, SVC syndrome, spinal cord compression

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26
Q

Humoral hypercalcemia of malignancy lab values

A

elevated Ca, low phosphorus, low PTH

27
Q

What can cause a hypercalcemic/hypophosphatemic state if it isn’t PTH driven?

A

PTH-rP

28
Q

CAs associated with high PTHrP levels

A

squamous carcinomas, cancer of the breast, GI and GU tracts

29
Q

Symptoms associated with high PTHrP levels

A

mental status changes due to high Ca levels, muscle weakness, polyuria, renal insufficiency

30
Q

Symptoms associated with SIADH

A

increasing lethargy and weakness, nausea, vomiting, HA, confusion

31
Q

SIADH lab values

A

low plasma sodium, low serum osmolality, high urine osmolality

32
Q

Secretion of ADH/AVP causes…

A

retention of free water, diluted serum and mental status changes

33
Q

CA most commonly associated with SIADH

A

small cell neuroendocrine carcinoma; may also be associated with GI/GU carcinomas and lung

34
Q

Cushing syndrome sxs

A

hypertension, unintentional weight loss, muscle weakness, metabolic alkalosis, hypokalemia

35
Q

Cushing syndrome lab levels

A

high cortisol, high ACTH

36
Q

Second most common paraneoplastic syndrome in small cell neuroendocrine carcinoma

A

Cushing syndrome

37
Q

CA associated with Cushing syndrome (paraneoplastic)

A

lung, bronchial carcinoid tumors, pancreatic islet tumors, medullary thyroid carcinoma, pheochromocytoma

38
Q

Eaton-Lambert myasthenic syndrome pathology

A

mediated by antibodies to voltage-gated Ca channels

39
Q

Local therapy candidates

A

sarcomas, non-melanoma skin cancer, in situ carcinomas

40
Q

Adjuvant therapy process

A

Surgery followed by chemo and/or radiation therapy

41
Q

Neoadjuvant therapy process

A

Chemo and/or radiation therapy followed by surgery, more chemo and/or radiation

42
Q

For what types of diseases would surgery not be indicated?

A

metastatic diseases and leukemia/lymphoma

43
Q

Mechanisms of radiation therapy

A

external beam radiation, intensity modulated radiotherapy, brachytherapy, systemic radionucleotides

44
Q

External beam radiation

A

linear accelerator delivering direct radiation beams to affected sites

45
Q

Brachytherapy

A

very localized high-dose therapy delivered continuously for a prolonged time through implanted devices

46
Q

Systemic radionucleotides

A

specifically useful for thyroid cancers and diseases, metabolism of iodine results in ingestion of radionucleotide by cells

47
Q

When may radiation therapy be considered?

A

part of adjuvant or neoadjuvant therapy, contraindication of surgery, palliation

48
Q

Possible targets of systemic CA therapy

A

receptor status (growth factor or hormone stimulation), antigens or receptor targets

49
Q

CAR-T therapy

A

chimeric antigen receptor therapy, t cells manipulated to express a binding domain for a specific tumor-associated antigen

50
Q

Indication for stem cell transplantation

A

therapy that involves ablation of bone marrow such as hematopoietic neoplasms, advanced solid tumors that need a high dose of cytotoxic chemotherapy

51
Q

Types of stem cell transplantation

A

allogenic, syngeneic, autologous

52
Q

Disadvantages of CA-125 test

A

not specific for malignant ovarian tumors

53
Q

Options for prostate cancer screenings

A

prostate-specific ag test, digital rectal exam

54
Q

Disadvantages of PSA and DRE for prostate CA screen

A

PSA elevation may be due to benign or inflammatory conditions, DRE identifies a tumor after it has become advanced

55
Q

How often should a woman get a pap smear?

A

every 3 years

56
Q

Advantages of Pap smear

A

effective tool that identifies pre-cancerous lesions before invasive CA even arises

57
Q

Breast CA screening pros/cons

A

management changes year to year and by recommending body, harms may outweigh benefits, CA may be over diagnosed, mammography should be done 50-75 biennially

58
Q

Breast self-exam

A

allows familiarity with subtle changes, can be started at an early age, frequency of every month, check axilla and skin changes, avoid checking prior to or during menstrual cycles

59
Q

Testing guidelines for BRCA-1/-2 testing

A

family history of breast or ovarian cancer in multiple relatives, relatives diagnosed at a young age, or in a male relative; personal diagnosis before age 45

60
Q

BRCA positive prophylactic therapy options

A

double mastectomy, bilateral salpingo-oopherectomy, hormone therapy, increased screening and self exam

61
Q

Options for colon carcinoma screening

A

fecal immunochemical test, high-sensitivity guaiac-based fecal occult blood test, fecal DNA test, colonoscopy

62
Q

Who should have a low-dose annual CT for lung carcinoma screening?

A

current smokers, 30-pack-year history of smoking, those who quit smoking in the last 15 years

63
Q

Ovarian CA prevention

A

prophylactic salpingectomy/oopherectomy

SBL (21 decks)

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