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SBL week 2 > Cancer Diagnosis, Management, and Prevention: Diagnosis part > Flashcards

Cancer Diagnosis, Management, and Prevention: Diagnosis part Flashcards

1
Q

A lump in the breast may be benign or malignant, but what is far more concerning for malignancy?

A

Skin invasion

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2
Q

Because our thoracic, abdominal, and pelvic cavities offer abundant room for tumors to grow without being detected what may be a key clinical presentation?

A

Obstruction

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3
Q

What may be an indication of airway obstruction?

A

Stridor

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4
Q

Lung carcinoma growing in what direction can cause airway obstruction?

What may happen to downstream lung tissue?

A

1) Endobronchial direction

2) Collapse

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5
Q

What causes superior vena cava syndrome?

A

Obstruction of the SVC by lung cancer

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6
Q

What are clinical symptoms of SVC syndrome?

A

1) Venous distension of neck and chest wall

2) Facial and Upper arm edema

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7
Q

What clinical test can exaggerate the facial edema and plethora caused by SVC syndrome?

How is this test performed?

A

1) Pemberton’s sign

2) Arms are raised above the head

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8
Q

Why are spinal cord compressions a true oncologic emergency?

A

May cause permanent paralysis

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9
Q

What do tumors require to grow?

A

Angiogenesis

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10
Q

While a hepatic adenoma is benign, what can make it fatal?

A

Hemorrhages into the liver and bleeds extensively to form a subcapsular hematoma

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11
Q

If a post-menopausal female states that they began menstruating again, what should be number one in your differential diagnosis?

A

Uterine cancer

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12
Q

What is the most common tumor in the kidney?

Why is painless hematuria a common clinical sign with this cancer?

A

1) Renal cell carcinoma

2) It is extremely vascularized and bleeds very easy

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13
Q

Abrupt hemorrhages can lead to rapid enlargement of a tumor or compartment and cause what in patients?

A

Pain

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14
Q

Chronic bleeding from a tumor can lead to?

A

Iron-deficiency anemia

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15
Q

What procedure do you run on a man 40 years or older presenting with iron deficiency anemia?

A

Colonoscopy

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16
Q

What spaces are very easily irritated by tumor cells?

A

Peritoneum and pleural spaces

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17
Q

What clinical sign can ovarian carcinomas cause?

What about for lung carcinomas?

A

1) Malignant ascites

2) Pleural effusions

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18
Q

Palpable and/or visible mass, Obstructive signs/symptoms, and Hemorrhage can all be detected by?

A

History taking

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19
Q

Palpable and/or visible mass, Indications of invasion, Compression, and Effusions can all be detected by?

A

Physical examination

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20
Q

Hemorrhages and Effusions can be detected by?

A

Lab testing

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21
Q

What can all features of malignancy be detected by?

A

Radiography

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22
Q

What cancer marker is used to diagnose ovarian cancer?

A

CA-125

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23
Q

What is the sentinel LN?

A

The first LN hit during lymphatic metastasis

24
Q

What is the typical route of metastasis for sarcomas?

A

Hematogenous

25
Q

What is the typical route of metastasis for carcinomas?

A

Lymphatic but also hematogenous for more advanced carcinomas

26
Q

When breast carcinoma is suspected what should be done to aid in possible detection?

A

Palpating the lymph nodes in the breast, especially the Axillary LNs

27
Q

When lung carcinoma is suspected what should be done to aid in possible detection?

A

Use of radiology for possible hilar and mediastinal lymph node involvement

28
Q

Sentinel node biopsies and LN dissections are used for?

A

Breast carcinomas and melanomas

29
Q

When checking for metastasis in endometrial carcinomas, what should be done?

A

LN dissection due to carcinomas spreading via lymphatics

30
Q

Sarcomas spread to what organs most commonly?

A

Lung and Liver

31
Q

What carcinoma tumor is the exception to the rule because it likes to spread hematogenously?

A

Renal cell carcinoma

32
Q

In a patient with possible cancer, what general symptom may indicate metastasis?

A

Extreme fatigue

33
Q

What symptom may indicate Osseous metastasis?

A

Bone pain/back pain

34
Q

What symptom may indicate Brain metastasis?

A

Headaches, cognitive dysfunction, and neurological signs

35
Q

What symptom may indicate Spinal cord metastasis?

What symptom may indicate Lymph node metastasis?

A

1) Compression

2) Obstruction

36
Q

A Sister Mary Joseph nodule indicates metastasis in what location?

Typically from what cancer?

A

1) Umbilicus

2) Ovarian carcinoma

37
Q

What is a Virchow node?

What is it often associated with, especially in older adults?

A

1) Supraclavicular lymphadenopathy (classically left-sided)

2) Any thoracic or abdominal carcinoma

38
Q

The recurrences of cancer are typically in what form?

A

Metastatic

39
Q

ꞵ2 microglobulin is the cancer marker for?

Calcitonin is the cancer marker for?

A

1) Myeloma

2) Medullary thyroid carcinoma

40
Q

What late metastasis can arise a decade later?

A

1) Lung metastasis from sarcoma

2) Breast carcinoma

41
Q

In a patient with late lung metastasis from sarcoma they may not have even remembered that they had a primary tumor such as?

A

Uterine leiomyosarcoma

42
Q

In a patient with late breast carcinoma metastasis what symptom would they have after breast cancer therapy?

This is due to?

A

1) Back pain

2) Osseous metastases to spine

43
Q

What is paraneoplastic syndrome?

A

1) Tumor that secretes substances such as ACTH

2) Tumor that evokes elaboration of other factors such as cytokines

44
Q

What pertinent lab values would be seen in Humoral hypercalcemia of malignancy?

A

1) High calcium
2) Low phosphorus
3) Low PTH

45
Q

What can cause a hypercalcemic/hypophosphatemic state of Humoral hypercalcemia of malignancy if it isn’t PTH-driven?

What symptom is often seen in these cases?

A

1) Parathyroid hormone-related protein (PTH-rP)

2) Mental status changes

46
Q

PTH-rP mediated hypercalcemia is seen in what type of cancers?

In what sites?

A

1) Squamous carcinomas

2) Lung, breast, GI, GU

47
Q

What pertinent lab values would be seen in Syndrome of Inappropriate ADH secretion (SIADH)?

A

1) High Urine osmolality
2) Low Plasma sodium
3) Low Serum osmolality

48
Q

What is SIADH mediated by?

A

Arginine Vasopressin (AVP)/Antidiuretic Hormone

49
Q

The secretion of ADH/AVP by the tumor, signals renal receptors to?

How does this cause mental status changes seen in SIADH?

A

1) Retain free water rather than excreting it in urine

2) Free water dilutes the serum

50
Q

SIADH is the most common paraneoplastic syndrome in what cancer?

A

Small cell neuroendocrine carcinoma

51
Q

What pertinent lab values would be seen in Cushing’s syndrome?

A

1) High cortisol
2) High ACTH
3) Low serum potassium

52
Q

What symptoms would be seen in Cushing’s syndrome from someone with ectopic ACTH secretion?

A

1) HTN
2) Weight loss
3) Muscle weakness

53
Q

What is the 2nd most common paraneoplastic syndrome in small cell neuroendocrine carcinoma?

A

Cushing’s syndrome

54
Q

What are common symptoms of Eaton-Lambert myasthenic syndrome?

A

1) Dry mouth

2) Weakness in legs

55
Q

Eaton-Lambert myasthenic syndrome is mediated typically by?

How is it diagnosed?

A

1) Antibodies to Voltage-gated Calcium Channels

2) Antibodies and nerve stimulation testing

SBL week 2 (10 decks)

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