Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin med FINAL- sem 2 > Cancers > Flashcards

Cancers Flashcards

1
Q

endometrial cancer- most common type

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

endometrial cancer- risk factors

A 
Increasing age >45
Late menopause
Early menarche
Nulliparity/ infertility 
Unopposed estrogen OCPs
Lynch syndrome
Tamoxifen- breast cancer

In general: more periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

endometrial cancer- what is protective?

A

combined estrogen and progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

endometrial cancer- signs and symptoms

A 
bleeding 
discharge
spotting 
cramps and pain 
POST MENOPAUSAL bleeing on exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

endometrial cancer screening

A

not advised if asymptomatic - there is a high % of W that are symptomatic in early stage (confined to uterus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

endometrial cancer- lynch syndrome risk reducing tx

A

lifetime risk of 54%

hysterectomy- risk reducing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

endometrial cancer- diagnosis

A

bx= GOLD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

endometrial cancer- labs and imaging

A

pap smear
pelvic us- if you see thickening or stripe >4mm–> biopsy
D&C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

endometrial cancer- gene

A

CA125

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

endometrial cancer- treatment

A

total hysterectomy + salingo-oophorectomy

RT, chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Transition zone

A

where columnar endocervical cells transform into squamous epithelial
- junction of endocervix & ectocervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cervical cancer- can obstruct what and lead to what?

A

obstruct ureters and lead to renal death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

cervical cancer- risk factors

A 
HPV- 16&18 & other STIs
- HPV present for avg of 15yrs to become cancer
Early onset of intercourse 
Multiple sex partners- partners w multiple partners
Smoking 
OCPs >5yrs 
Multiple vaginal births- >3
Immunosuppresion
DES exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

cervical cancer- classification

A

CIS= full thickness but encapsulated

Cancer- beyond cervix to uterus to pelvic walls/vagina to lympth nodes, to bladder/ rectum to distant sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

cervical cancer- signs and symptoms

A

bleeding
post coidal bleeding
discharge
pelvic or lower back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

cervical cancer- screening method

A

pap smear- not diagnostic test - regardless of sexual hx and HPV vaccination status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

cervical cancer- screening age 21-29

A

cytology q 3yrs or

hrHPV starting at 25 q 5yrs in avg risk pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

cervical cancer- screening age 30-65

A

cytology q 3yrs or
hrHPV q 5yrs or
contesting q 5 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

cervical cancer- screening age >65

A

none after - in last 10 yrs

  • 3 (-) in a row cytology
  • 2… contesting
  • 2… hrHPV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

cervical cancer other labs and imaging

A

colposcopy- if there are no visual lesions but high suspicion or abnormal cytology

bx- anything friable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

cervical cancer- treatment- CIN 2 or 3

A

LEEP- loop electrosurgical excision procedure- excise tissue of interest
- increases risk of scarring or stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

cervical cancer- treatment- CIN 3 or CIS

A

Cone biopsy- goes deeper

  • used if larger neoplasia
  • more likely to lead to incompetent cervix than LEEP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

cervical cancer other treatments besides leep or cone bx?

A

radical hysterectomy plus pelvic lymphadenectomy, rad, chemo or combo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

why is there no screening for cervical cancer if <21?

A

Increased risk of preterm birth, low birthweight and PPROM- preterm premature rupture of membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
cervical cancer- follow up
high risk of recurrence high risk- q 3m to year 5 low risk- q 6 m to year 5
26
breast cancer- risk factors
``` hx of ovarian, endometrial or breast cancer BRCA 1 & 2 radiation between ages 10-30 nulliparity delayed childbearing early menarche late menopause estrogen ``` in general- more menses- estrogen exposures
27
breast cancer- MC type
ductal carcinoma
28
breast cancer- signs and symptoms
hard (firm), immobile (fixed), single dominant mass- feels like a marble thickening, dimpling of skin- peau d'orange
29
breast cancer- screening method
mammograph- soft tissue mass, speculated, high density
30
breast cancer screening- <40
not recommended for avg risk individuals
31
breast cancer screening- 40-49
q 2yrs | consider pts input
32
breast cancer screening- 50-74
q 2yrs
33
breast cancer screening- >75
q 2yrs if life expectancy >10yrs
34
breast cancer screening methods if high risk
also MRI and breast US
35
breast cancer- breast US
hypoechogenic- more dense calcifications shadowing speculated
36
breast cancer treatment
Lumpetomy w sentinel bx preferred w early-stage cancer OR Mastectomy- Both same outcomes Radiation therapy Adjuvant chemo or hormonal therapy Palliative (if widely metastatic)
37
breast cancer- ACS screening
annually starting at 40 q 2 yrs starting at age 55 if high risk start at 30 yearly
38
breast cancer fine vs core needle
``` Fine needle (localized, if too large) Core needle bx (preferred- size of a pencil- take whole thing out) ```
39
what should you do once cancer is confirmed?
Do hormone testing ER PR HER2
40
Parget disease of the breast- palpable mass vs none
Palpable mass- usually invasive infiltrating ductal carcinoma No palpable mass- usually DCIS or noninvasive breast cancer Eczematous or ulcerated lesion of the nipple May be pruritic, burning, or painful
41
Paget disease of the breast- symptoms
Eczematous or ulcerated lesion of the nipple | May be pruritic, burning, or painful
42
Parget disease of the breast- treatment
mastectomy
43
Lobular carcinoma- dx
Lucky find! | found early, no spread, no invasion
44
Lobular carcinoma treatment
excise lesion- can become invasive- risk of developing breast cancer chemoprevention
45
Invasive carcinoma- mc area
upper outer quadrant
46
Invasive carcinoma signs and symptoms
``` Fixed, Firm nodule Non-tender but can have breast pain Dimpling of skin Retraction of nipple Breast size changes- nl but sudden change Skin thickening- peau d'orange Eczematous changes Axillary node enlargement Arm edema= lymphatic blockage Palpable supraclavicular/ infraclavicular nodes ```
47
Breast cancer in men- risk factor
increased incidence in M w prostate cancer
48
Breast cancer in men- signs and symptoms
Painless lump beneath areola Nipple discharge Retraction Ulceration
49
Ovarian cancer- risk factors
Age (avg age 63) BRCA Lynch syndrome Infertility- release more eggs (ovulation) Nulliparity- release more eggs Others- endometriosis, PCOS, postmenopausal hormone therapy, obesity, smoking, asbestos More periods- releasing more eggs
50
Ovarian cancer- protective factors
``` Multiparity Breastfeeding Oral contraceptives Salpingo-oophorectomy Tubal ligation Hysterectomy ``` Less periods
51
Ovarian cancer- MC type
epithelial carcinoma
52
Ovarian cancer- signs and symptoms
Asymptomatic until advanced disease (distant metastases) Subacute presentation - adenxal mass - pelvic/ abdominal symptoms (bloating, urinary urgency or frequency, etc.)
53
Ovarian cancer- screening
none, rapidly progressive- poor prognosis
54
Ovarian cancer- diagnosis
full surgical removal vs bx
55
Ovarian cancer- imaging
CT abdomen/ pelvis and or pelvic US
56
Ovarian cancer- gene
CA-125
57
Vulvar cancer is
superficial
58
Vulvar cancer risk factors
``` Vulvar or cervical intraepithelial neoplasia (VIN) Prior hx of cervical cancer Smoking Vulvar lichen sclerosus Immunodeficiency syndromes HPV infection- 16, 33, 18 ```
59
Vulvar cancer- MC type
squamous cell carcinoma
60
Vulvar cancer - signs and symptoms
``` Abnl finding on the labia majora= MC Local discomfort Unifocal vulvar plaque, ulcer or mass- cauliflower lesion - can be fleshy, nodular, or warty Pruritus Bleeding (including rectal) Pain- Dysuria or Dyschezia Enlarged lymph node in groin Lower extremity edema ```
61
Vulvar cancer- diagnosis
bx anything abnl
62
penile cancer- risk factors
``` HPV HIV Age 60 Phimosis- uncircumcised Smoking ```
63
penile cancer- MC type
squamous cell carcinoma
64
penile cancer- signs and symptoms
Lump, mass or ulceration on penis- most commonly on glans Inguinal lymphadenopathy Infection- erythema, swelling, drainage
65
penile cancer- diagnosis
bx
66
penile cancer- treatment - abx
If infection suspected | OR for excision of lesion
67
penile cancer treatment- low risk of recurrence
Low risk of recurrence (Tis, Ta glans and T1a/T1b glans & shaft) - Partial penectomy - goal 1-2 cm of (-) margins - radiation - laser ablation, glans resurfacing (Tis) - mohs micrographic surgery - topical tx- fluorouracil, imiquimod
68
penile cancer- high risk or recurrence treatment
High risk of recurrence (bulky, T2-T4) | - Penectomy
69
penile cancer- treatment if sx refusal
interstitial brachytherapy (radioactive seeds)
70
bladder cancer - MC type
urothelial (transitional cell) carcinoma
71
bladder cancer - signs and symptoms
``` Gross hematuria - microscopic >3 RBC/hpf - in kids blood in urine= US - @ beginning = urethra source - Terminal= bladder neck - Throughout= kidney, ureter, bladder Voiding symptoms - frequency, urgency, hesitancy Pain Usually always symptomatic ```
72
bladder cancer- imaging
Cystoscopy Cytology CT abdomen and pelvis Imaging of upper tract collecting system
73
bladder cancer - how to determine invasive vs noninvasive
if tumor visualized on office cystoscopy and/or (+) cytology- go to OR- exam under anesthesia TURBT- go deep enough to get muscle, not deep enough to penetrate - Pathologic evaluation will help differential muscle invasive vs non-invasive
74
bladder cancer- treatment- non-invasive
Non-invasive- - low risk: 1 dose of intravesical chemo - interm: extended course - high: extended +/- systemic chemo, consider cystectomy
75
bladder cancer- treatment- invasive
Muscle invasive- | - radical cystectomy
76
bladder cancer treatment- metastatic
Metastatic disease | - platinum based- chemo
77
prostate cancer- psa abnl level... when is it falsely low?
Abnl >4ng/ml Falsely low if take 5-alpha reductase inhibitors (Proscar and Avodart) for BPH - double the #
78
prostate cancer- why is PSA debatable?
go through colon to get bx- get septic and can die
79
prostate cancer- DRE exam
DRE- normal= symmetric and smooth ``` If elevated PSA or abnl DRE- repeat PSA or Prostate biopsy- TRUS - 12 cores taken - (+) = consider tx - (-) = observation, if still high or rising- 18-24 core biopsy ``` Enema prep & 2d abx prophylaxix
80
prostate cancer- treatment is based on what?
Tx based on many things like: - histologic grade (gleason score) - -- 2 most prevalent tissue types from biopsy- added together (range from 6-10) - PSA level - etc. slide 22
81
prostate cancer- treatment- localized, very low risk
- PSA <10, normal DRE, GS <6, <3 (+) cores | - Active surveillance
82
prostate cancer- treatment- low risk
- PSA <10, normal DRE, GS <6, >3 (+) cores | - surveillance, radiation, radical prostatectomy
83
prostate cancer- treatment- localized interm risk
- PSA >10, GS >7, larger, and/or in both lobes | - RT, radical prostatectomy
84
prostate cancer- treatment- localized high risk
- PSA >20, GS 8+ | - RT, radical prostatectomy
85
prostate cancer- treatment- stage IV
- lymph node involvement/distant mets | - RT +/- ADT (chemotherapy)
86
prostate cancer- after treatment
- serial PSA for recurrence | - serial CT- depending on risk level
87
Testicular cancer- mc population?
adolescents and young adults 15-35
88
Testicular cancer- risk factors
Cryptochidism Fhx Prior personal hx Intra-tubular germ cell neoplasia (ITGCN)
89
Testicular cancer- germ cell tumors vs stromal tumors
Germ cell tumors: AFP- bHCG - seminoma- originate from seminiferous tubules - non-seminoma- originate from sperm/ova cells Stromal tumors: inhibin - Leydig cell tumors (testosterone) - Sertoli cell tumors (estradiol)
90
Testicular cancer seminoma- description
- local (limited to testicle) - usually no elevated b-hCG and never AFP - sensitive to radiation tx
91
Testicular cancer non-seminoma- description
- present w distant metastatic disease - elevated b-hCG & AFP - less sensitive to radiation tx
92
Testicular cancer- signs and symptoms
Painless, unilateral mass in scrotum | Back and flank pain
93
Testicular cancer- treatment
Inguinal surgery- radical orchiectomy is indicated if (+) markers or concern on frozen section - Exception- pt w massive pulmonary metastatic disease w fatal potential If markers are (-), <2cm mass, and suspected benign disease or a stromal tumor - testicular sparing surgery (TSS) may be reasonable - have pathology available for immediate frozen section analysis Chemotherapy and RT based on clinical/pathologic staging
94
Testicular cancer- staging imaging
- pre op CXR before orchiectomy to R/O massive pulmonary mets - consideration of pre-op CT chest/abd/pelvis
95
Testicular cancer imaging and labs
``` Scrotal US Serum tumor markers - bHCG, AFP, LDH - if (-) concern for stromal tumor - based on levels AFTER orchiectomy ```
96
Testicular cancer- what is something usually recommended?
sperm banking
97
Renal cell carcinoma in children is called?
Wilm's tumor and nephroblastoma
98
Renal cell carcinoma- risk factors
Tabacco smoking Leather tanners, shoe workers, asbestos workers Obesity, HTN Long-term dialysis develop acquired polycystic kidney disease --> RCC
99
Renal cell carcinoma- cause
Majority sporadically | Pseudo-hypoxia--> angiogenesis
100
Renal cell carcinoma- signs and symptoms
Slow growing Occult most of its course TRIAD- flank pain, hematuria, palpable abdominal mass Hematuria Systemic- fatigue, weight loss, hypercalcemia, hepatic dysfunction
101
Renal cell carcinoma- labs and imaging
Labs- CBC, BMP, LFTs, alkaline phosphatase, urinalysis Radiographic studies- cross sectional imaging - CT or MRI of abd/pel - CT chest once confirmed RCC- to look for metastatic disease
102
Renal cell carcinoma treatment- localized (I-III)
surgical excision is curative - 20-30% relapse within 2-3yrs - metastases to lung common
103
Renal cell carcinoma- metastatic (IV) treatment
nephrectomy + metastasectomy OR cytoreductive RN (if unresectable proceed to first line systemic therapy)
104
Renal cell carcinoma- why is conventional chemo rarely used?
Intrinsic resistance
105
Anal cancer- risk factors
``` Similar to genital malignancy: HPV- lower incidence if vaccinated HIV Multiple partners Receptive anal intercourse Smoking ```
106
Anal cancer- MC type
squamous cell carcinoma colon cancer- adenocarcinoma
107
Anal cancer- signs and symptoms
Rectal bleeding Anorectal pain Sensation of mass/fullness- pressure that turns to pain
108
Anal cancer- screening
Colonoscopy- age 45
109
Anal cancer- in women
Need thorough GYN evaluation due to higher incidence of cervical cancer if dx w anal cancer
110
Anal cancer- DRE and imaging
``` DRE- most are felt Inguinal lymph node eval Bx CT chest, abdomen and pelvis +/- PET scan Anoscopy HIV testing ```
111
Anal cancer- treatment
Primary treatment: - combo therapy of rad and chemo - may achieve cure wo surgery - preserve anal sphincter - restage and proceed w sx resection if needed: - APR= removal of anus- colostomy required - local incision If metastatic: - RT and chemo focus
112
Perianal cancer location
skin/hair containing surface
113
Perianal cancer treatment
Similar to anal cancer | Can consider local excision

Clin med FINAL- sem 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions