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CFPC exam KM > Cancer > Flashcards

Cancer Flashcards

1
Q

What are the types of breast cancer

A

Ductal carcinoma in situ
Lobular carcinoma in situ
Infiltrative ductal carcinoma
Invasive lobular carcinoma
Paget’s
Inflammatory carcinoma

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2
Q

Most common type of breast ca

A

Infiltrative ductal carcinoma

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3
Q

What is paget’s disease

A

ductal ca invades nipple with eczema

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4
Q

What is the most aggressive form of breast ca

A

Inflammatory carcinoma
(peau d’orange sign of advanced disease)

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5
Q

What is the follow up for breast ca

A

Q3-6 months for yr 1-3, q6-12 months for yr 4-5 then q1year

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6
Q

Treatment for stage 0 breast ca

A

BCS +/- radiotherapy and mastectomy

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7
Q

Treatment for stage 1 breast ca

A

BCS + axillary node dissection + radiotherapy, mastectomy +/- chemo

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8
Q

Treatment for stage 2 breast ca

A

BCS + axillary node dissection + radiotherapy + chemo/estrogen receptor negative followed by tamoxifen if ER positive

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9
Q

Treatment for stage 3 breast ca

A

Likely mastectomy + axillary node dissection + radiotherapy + chemo + hormones

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10
Q

Treatment for stage 4 breast ca

A

Likely mastectomy + axillary node dissection + radiotherapy + chemo + hormones

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11
Q

How often to do pap in immunocomprised

A

yearly

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12
Q

How often to do pap in SLE

A

yearly

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13
Q

How often to do pap in total hysterectomy

A

If no hx of dysplasia or HPV then none
If hx of HSIL, AIS or cancer, annual vault smear for lifeS

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14
Q

Signs and symptoms of cervical cancer

A

Abnormal spotting
Bleeding/pain after intercourse
Change in menstrual periods
Discharge
Pain in pelvis/back

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15
Q

Management of CIN 1

A

Observation with repeat in 12 months, can consider excision biopsy

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16
Q

Management of CIN 2 and <25 y/o

A

Colposcopy q6 months up to 24 months before considering treatment

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17
Q

Management of CIN 3 and <25 y/o

A

Excisional procedure, if positive margins repeat colposcopy

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18
Q

Management of CIN 2 or 3 and >/ 25 y/o

A

Excisional procedure, if positive margins repeat colposcopy

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19
Q

Adenocarcinoma in situ

A

Excisional procedure or type 3 transformation zone excision

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20
Q

When/How to screen people with 1 or more first degree relative for colon ca

A

1st line: colonoscopy age 40-50 or 10 years younger than diagnosis age (whichever earlier). Screen q5-10 years.

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21
Q

When/how to screen people with IBD for colon ca

A

Colonoscopy 8-10 years after pan colitis or 12-15 years after left sided colitis done q1-2 years.

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22
Q

When/how to screen people with FAP for colon ca

A

Genetic counselling
Flexible sigmoidoscopy q1years starting age 10-12 years.

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23
Q

When/how to screen people with HNPCC (Lynch syndrome) for colon ca

A

Genetic counselling
Colonoscopy q1-2 years starting age 20 or 10 years earlier than family case.

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24
Q

What is the definition of leukaemia?

A

Uncontrolled proliferation of haematopoietic stem cells in the bone marrow

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25
What are the risk factors for leukaemia?
Down syndrome and neurofibromatosis Ionising radiation Exposure to benzene Household pesticides Obesity
26
What are the acute signs and symptoms of leukaemia in children?
Fever, lethargy, bleeding, MSK, symptoms, enlarged liver/spleen, lymphadenopathy
27
What are the acute signs and symptoms of leukaemia in adults?
Fever, fatigue weight loss anaemia related symptoms, thrombocytopenia related symptoms can have enlarged liver/spleen
28
What is the most common acuteleukaemia in children?
Acute lymphocytic leukaemia
29
What is the most common acute leukaemia and adults?
Acute myelogenous leukaemia
30
What are the signs and symptoms of chronic leukaemia?
Often asymptomatic, less common to have constitutional symptoms, often enlarged liver/spleen
31
What are the initial investigations for leukaemia?
CBC - high white blood cells, acute leukaemias can also have leukopenia usually with anaemia and thrombocytopenia Peripheral smear - michelle, increased haematopoietic precursor cells were marked increase in lymphocytes, which is suggestive of possible leukaemia LFTs creatinine electrolytes, coagulation studies
32
What are the common follow-up investigations for leukaemia?
Bone marrow, aspirate and biopsy Cytogenetics molecular genetics, flow cytometry
33
What is the treatment for leukaemia?
Chemotherapy radiation, monoclonal antibodies, stem cell transplantation
34
What is seen on a peripheral blood smear and bone marrow aspirate in acute myelogenous leukaemia
Blast cells on PBS or BMA Auer rods on peripheral smear
35
What age do most cases of AML occur
Adults, mean age 67
36
Symptoms and signs of AML
Fever, fatigue, weight loss, bleeding, bruising Hepatomegaly
37
What are the subtypes of AML and associated prognosis
Acute promyelocytic and myelomono leukemia - favorable Normal karyotype AML - intermediate AML with complex karyotype - poor
38
Diagnostic work up for AML
CBC, WCC often > 100 x 10^9 More than 20% blasts on marrow or blood smear Serum uric acid, LDH - prognositic relevance Blood group and HLA type - for potential stem cell transplant
39
Surveillance for AML
CBC q1-2 months x 3 years then q3-6 months for 5 years Echo and ECG q2years
40
What is seen on a peripheral blood smear and bone marrow aspirate in acute lymphocytic leukaemia
Blast cells
41
What age do most cases of ALL occur
Children and young adults
42
Signs and symptoms of ALL
Fever, lethargy, bleeding, MSK pain/dysfunction Hepatosplenomegaly and lymphadenopathyS
43
Surveillance for ALL
Annual CBC, Cr, lytes, urea, calcium, magnesium, phosphorus, TSH, urinalysis Echo and ECG q3-5 years if pretreatment abnormalities or signs of heart failure Routine eye/dental
44
What is chronic mylegenous leukemia
Philadelphia chromosome
45
Signs of symptoms of CML
Splenomegaly 20% asymptomatic
46
Investigations for CML
Often WBC > 100 x 10^9
47
Management of CML
Early stage chronic leukemia (no anaemia, thrombocytopenia, <3 nodal involvement) can often be monitored without treatment
48
Surveillance for CML
CBC q3months
49
What is CLL
Clonal expansion of atleast 5000 B lymphocytes in the peripheral blood
50
What age do most cases of CLL occur
Older adults
51
Signs and symptoms of CLL
50% asymptomatic Hepatosplenomegaly and lymphadenopathy
52
What is the management of CLL
Early stage chronic leukemia (no anaemia, thrombocytopenia, <3 nodal involvement) can often be monitored without treatment Monoclonal antibodies, chemo, radiation and transplant
53
Surveillance for CLL
Untreated: Routine visits and CBC Flu shot annualy, pneumo q5years Avoid live vaccines Treated: Refer to cardio Resting and stress echo
54
What is the treatment for non-small cell lung cancer?
Surgical resection for stage 1 to 2, chemo and radiation for stage 3, palliatie for stage 4
55
What is the treatment for small cell lung cancer?
Chemo and radiation
56
Where are the most common prostate cancer is found?
The peripheral zone
57
What are the signs and symptoms of prostate cancer?
Usually asymptomatic May have lower urinary tract symptoms Back pain - mets On DRE, a hard irregular nodule or diffuse dense induration involving one or both lobes
58
What's the management for low risk prostate cancer?
PSA Q3 to 6 months DRE annually Consider biopsy Can choose curative management if personal preference, which would include radical prostatectomy, brachytherapy and radiation
59
The management for intermediate risk prostate cancer?
Radical prostatectomy Brachytherapy Radiation
60
What is management for high risk prostate cancer?
Radiotherapy in androgen deprivation therapy Radical prostatectomy Post prostatectomy radiation radiotherapy
61
Where does prostate cancer metastasise?
Adrenal gland, bone, liver, lung
62
What are the tumour markers for esophageal cancer?
CEA CA 19-9

CFPC exam KM (16 decks)

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