Cancer

Question 1

List of proto-oncogenes

Answer 1

1. HER2/Neu 2. Ret 3. Ras 4. Myc

Question 2

List of tumor suppressor genes

Answer 2

1. BRCA 2. APC 3. Rb 4. p53 5. MEN1

Question 3

Systemic therapies for Colorectal Cancer (non-metastatic)

Answer 3

1. FOLFOX (Folfiniic Acid, 5-FU, Oxaliplatin) 2. CAPEOX

Question 4

Systemic therapies for metastatic colorectal cancer

Answer 4

1. FOLFIRI 2. FOLFOXIRI +/- Avastin (TK inhibitor VEGF) +/- Cetuximab (TK inhibitor EGFR)

Question 5

Systemic therapies for non metastatic biliary tract cancers

Answer 5

1.Gemcitabine 2. Capecitabine (Bilcap)

Question 6

Systemic therapies for metastatic biliary tract cancers

Answer 6

1. Gemcitabine + Cisplatin

Question 7

Systemic therapies for Pancreas cancer

Answer 7

1. Gemcitibine + Capecitabine 2. Gemcitabine + Albumin bound Paclitaxel (Abraxane) 3. FOLFIRINOX

Question 8

Systemic therapies for Gastric cancer

Answer 8

1. Epirubicin (unwind the strand) + Cisplatin (hurt the strand w crosslinks)+ 5-FU (ECF) 2. 5FU + Oxaliplatin (hurt the strand w crosslinks) + Docetaxol (microtubules) (FLOT) 3. FOLFOX 4. Trastuzumab (metastatic )

Question 9

Systemic therapies for HCC

Answer 9

Sorafenib (TK inhibitor VEGFR, PDGFR) (metastatic)

Question 10

Systemic therapies for Breast Cancer

Answer 10

1. Trastuzumab (TK inhibitor Her2/Neu) 2. Pertuzumab (TK inhibitor Her2) 3. Docetaxol/Paclitaxel (microtubules) + Carboplatin (hurt the strand w crosslinks) 4. Adriamycin (Doxorubicin) (unwind the strand) + Cyclophosphamide (hurt the strand w crosslinks)

Question 11

Systemic therapies for melanoma

Answer 11

1. Pembrolizumab (anti PD-1) 2. Nivolumab (anti PD-1) 3. Ipilimumab (anti CTLA-4) 4. Dabrafenib (BRAF inhibitor) + Trametinib (MEK inhibitor) 5. IL2 6. Interferon Alpha

Question 12

Systemic therapies for GIST

Answer 12

1. Imatinib (TK inhibitor C-kit) 2. Sunitinib (TK inhibitor BCR-ABL, SRC)

Question 13

systemic therapies for metastatic neuroendocrine tumor

Answer 13

1. Everolimus (mTOR inhibitor)

Question 14

FAP (Gene + Cancers)

Answer 14

APC 1. GI polyposis

Question 15

HNPCC (Lynch)

Answer 15

MMR (mismatch repair) (MLH1, MSH2, MSH6, PMS2) 1. Colon 2. Endometrial 3. Stomach 4. Ovarian 5. Hepatobiliary 6. CNS

Question 16

Juvenile polyposis

Answer 16

SMAD4 1. < 100 colon polyps

Question 17

Peutz-Jeghers

Answer 17

STK11 1. GI polyposis 2. Pancreas 3. Breast 4. Gastric 5. Ovarian 6. Testicular

Question 18

Li-Fraumeni

Answer 18

p53 1. Breast 2. Sarcoma 3. Brain 4. Leukemia 5. Medulloblastoma 6. Adrenocortical

Question 19

Cowden

Answer 19

PTEN 1. Breast 2. Endometrial 3. Thyroid

Question 20

Hereditary Breast/Ovarian

Answer 20

BRCA 1/2 1. Breast 2. Ovarian 3. Endometrial 4. Fallopian 5. Pancreas 6. Colorectal

Question 21

MAP (MUTY-H associated polyposis)

Answer 21

MUTY-H 1. Colon polyposis

Question 22

Hereditary diffuse Gastric cancer

Answer 22

CDH1 1. Lobular breast 2. Gastric

Question 23

Carney Stratakis

Answer 23

SDHD 1. GIST 2. Pheo 3. Pulmonary chondroma

Question 24

Von Hippel-Lindau

Answer 24

VHL 1. Retinal/cerebellar hemangioblastoma 2. RCC 3. Pheo 4. PanNET

Question 25

MEN1

Answer 25

MEN1 1. Parathyroid 2. Pancreatic islet 3. Pituitary

Question 26

MEN2A/B

Answer 26

RET A. MTC, pheo, parathyroid B. MTC, pheo, neuroma

Question 27

Work up for CUP (cancer of unknown primary) exclusive of head/neck mass of unknown primary

Answer 27

1. History and physical exam
2. CT C/A/P
3. If liver lesions
   
   1. Endoscopy
4. If mediastinal lesions
   
   1. AFP/BHCG if male w concern for testicular
   2. CA 125 for female w concern for ovarian
5. If male > 50, PSA with concern for prostate

Question 28

Treatment for CUP

Answer 28

if inguinal, then node dissection and RT/chemo

if axillary, male should to LN dissection and RT/chemo, if female, gets more complex.

Question 29

chylous ascites lab results

Answer 29

high in TG, high in leukocytes with lymphocyte predominance.