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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
Mass effects
airway obstruction, invasion and rupture of vessels, SVC syndrome, spinal cord compression
26
Humoral hypercalcemia of malignancy lab values
elevated Ca, low phosphorus, low PTH
27
What can cause a hypercalcemic/hypophosphatemic state if it isn't PTH driven?
PTH-rP
28
CAs associated with high PTHrP levels
squamous carcinomas, cancer of the breast, GI and GU tracts
29
Symptoms associated with high PTHrP levels
mental status changes due to high Ca levels, muscle weakness, polyuria, renal insufficiency
30
Symptoms associated with SIADH
increasing lethargy and weakness, nausea, vomiting, HA, confusion
31
SIADH lab values
low plasma sodium, low serum osmolality, high urine osmolality
32
Secretion of ADH/AVP causes...
retention of free water, diluted serum and mental status changes
33
CA most commonly associated with SIADH
small cell neuroendocrine carcinoma; may also be associated with GI/GU carcinomas and lung
34
Cushing syndrome sxs
hypertension, unintentional weight loss, muscle weakness, metabolic alkalosis, hypokalemia
35
Cushing syndrome lab levels
high cortisol, high ACTH
36
Second most common paraneoplastic syndrome in small cell neuroendocrine carcinoma
Cushing syndrome
37
CA associated with Cushing syndrome (paraneoplastic)
lung, bronchial carcinoid tumors, pancreatic islet tumors, medullary thyroid carcinoma, pheochromocytoma
38
Eaton-Lambert myasthenic syndrome pathology
mediated by antibodies to voltage-gated Ca channels
39
Local therapy candidates
sarcomas, non-melanoma skin cancer, in situ carcinomas
40
Adjuvant therapy process
Surgery followed by chemo and/or radiation therapy
41
Neoadjuvant therapy process
Chemo and/or radiation therapy followed by surgery, more chemo and/or radiation
42
For what types of diseases would surgery not be indicated?
metastatic diseases and leukemia/lymphoma
43
Mechanisms of radiation therapy
external beam radiation, intensity modulated radiotherapy, brachytherapy, systemic radionucleotides
44
External beam radiation
linear accelerator delivering direct radiation beams to affected sites
45
Brachytherapy
very localized high-dose therapy delivered continuously for a prolonged time through implanted devices
46
Systemic radionucleotides
specifically useful for thyroid cancers and diseases, metabolism of iodine results in ingestion of radionucleotide by cells
47
When may radiation therapy be considered?
part of adjuvant or neoadjuvant therapy, contraindication of surgery, palliation
48
Possible targets of systemic CA therapy
receptor status (growth factor or hormone stimulation), antigens or receptor targets
49
CAR-T therapy
chimeric antigen receptor therapy, t cells manipulated to express a binding domain for a specific tumor-associated antigen
50
Indication for stem cell transplantation
therapy that involves ablation of bone marrow such as hematopoietic neoplasms, advanced solid tumors that need a high dose of cytotoxic chemotherapy
51
Types of stem cell transplantation
allogenic, syngeneic, autologous
52
Disadvantages of CA-125 test
not specific for malignant ovarian tumors
53
Options for prostate cancer screenings
prostate-specific ag test, digital rectal exam
54
Disadvantages of PSA and DRE for prostate CA screen
PSA elevation may be due to benign or inflammatory conditions, DRE identifies a tumor after it has become advanced
55
How often should a woman get a pap smear?
every 3 years
56
Advantages of Pap smear
effective tool that identifies pre-cancerous lesions before invasive CA even arises
57
Breast CA screening pros/cons
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
Breast self-exam
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
Testing guidelines for BRCA-1/-2 testing
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
BRCA positive prophylactic therapy options
double mastectomy, bilateral salpingo-oopherectomy, hormone therapy, increased screening and self exam
61
Options for colon carcinoma screening
fecal immunochemical test, high-sensitivity guaiac-based fecal occult blood test, fecal DNA test, colonoscopy
62
Who should have a low-dose annual CT for lung carcinoma screening?
current smokers, 30-pack-year history of smoking, those who quit smoking in the last 15 years
63
Ovarian CA prevention
prophylactic salpingectomy/oopherectomy

SBL (21 decks)

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