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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
Q

What are the risk factors for leukaemia?

A

Down syndrome and neurofibromatosis
Ionising radiation
Exposure to benzene
Household pesticides
Obesity

26
Q

What are the acute signs and symptoms of leukaemia in children?

A

Fever, lethargy, bleeding, MSK, symptoms, enlarged liver/spleen, lymphadenopathy

27
Q

What are the acute signs and symptoms of leukaemia in adults?

A

Fever, fatigue weight loss anaemia related symptoms, thrombocytopenia related symptoms can have enlarged liver/spleen

28
Q

What is the most common acuteleukaemia in children?

A

Acute lymphocytic leukaemia

29
Q

What is the most common acute leukaemia and adults?

A

Acute myelogenous leukaemia

30
Q

What are the signs and symptoms of chronic leukaemia?

A

Often asymptomatic, less common to have constitutional symptoms, often enlarged liver/spleen

31
Q

What are the initial investigations for leukaemia?

A

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
Q

What are the common follow-up investigations for leukaemia?

A

Bone marrow, aspirate and biopsy
Cytogenetics molecular genetics, flow cytometry

33
Q

What is the treatment for leukaemia?

A

Chemotherapy radiation, monoclonal antibodies, stem cell transplantation

34
Q

What is seen on a peripheral blood smear and bone marrow aspirate in acute myelogenous leukaemia

A

Blast cells on PBS or BMA
Auer rods on peripheral smear

35
Q

What age do most cases of AML occur

A

Adults, mean age 67

36
Q

Symptoms and signs of AML

A

Fever, fatigue, weight loss, bleeding, bruising
Hepatomegaly

37
Q

What are the subtypes of AML and associated prognosis

A

Acute promyelocytic and myelomono leukemia - favorable
Normal karyotype AML - intermediate
AML with complex karyotype - poor

38
Q

Diagnostic work up for AML

A

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
Q

Surveillance for AML

A

CBC q1-2 months x 3 years then q3-6 months for 5 years
Echo and ECG q2years

40
Q

What is seen on a peripheral blood smear and bone marrow aspirate in acute lymphocytic leukaemia

A

Blast cells

41
Q

What age do most cases of ALL occur

A

Children and young adults

42
Q

Signs and symptoms of ALL

A

Fever, lethargy, bleeding, MSK pain/dysfunction

Hepatosplenomegaly and lymphadenopathyS

43
Q

Surveillance for ALL

A

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
Q

What is chronic mylegenous leukemia

A

Philadelphia chromosome

45
Q

Signs of symptoms of CML

A

Splenomegaly
20% asymptomatic

46
Q

Investigations for CML

A

Often WBC > 100 x 10^9

47
Q

Management of CML

A

Early stage chronic leukemia (no anaemia, thrombocytopenia, <3 nodal involvement) can often be monitored without treatment

48
Q

Surveillance for CML

A

CBC q3months

49
Q

What is CLL

A

Clonal expansion of atleast 5000 B lymphocytes in the peripheral blood

50
Q

What age do most cases of CLL occur

A

Older adults

51
Q

Signs and symptoms of CLL

A

50% asymptomatic
Hepatosplenomegaly and lymphadenopathy

52
Q

What is the management of CLL

A

Early stage chronic leukemia (no anaemia, thrombocytopenia, <3 nodal involvement) can often be monitored without treatment

Monoclonal antibodies, chemo, radiation and transplant

53
Q

Surveillance for CLL

A

Untreated:
Routine visits and CBC
Flu shot annualy, pneumo q5years
Avoid live vaccines

Treated:
Refer to cardio
Resting and stress echo

54
Q

What is the treatment for non-small cell lung cancer?

A

Surgical resection for stage 1 to 2, chemo and radiation for stage 3, palliatie for stage 4

55
Q

What is the treatment for small cell lung cancer?

A

Chemo and radiation

56
Q

Where are the most common prostate cancer is found?

A

The peripheral zone

57
Q

What are the signs and symptoms of prostate cancer?

A

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
Q

What’s the management for low risk prostate cancer?

A

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
Q

The management for intermediate risk prostate cancer?

A

Radical prostatectomy
Brachytherapy
Radiation

60
Q

What is management for high risk prostate cancer?

A

Radiotherapy in androgen deprivation therapy
Radical prostatectomy
Post prostatectomy radiation radiotherapy

61
Q

Where does prostate cancer metastasise?

A

Adrenal gland, bone, liver, lung

62
Q

What are the tumour markers for esophageal cancer?

A

CEA
CA 19-9

CFPC exam KM (16 decks)

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