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Surgery > Chapter 15 > Flashcards

Chapter 15 Flashcards

1
Q

What is the second most common cause of death?

What is first?

A

Malignant CA

Heart dz

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2
Q

What are the top three common causes of CA for men?

A

Prostate
Lung
Colorectal

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3
Q

What are the top three common causes of CA for women?

A

Breast
Lung
Colorectal

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4
Q

Oncogenes

A

Mutated forms of normal cellular genes generally conferring uninhibited cell growth

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5
Q

Mechanisms of oncogenes

A

Point mutation (Ras family), chromosomal translocation (CML 9 and 22), gene amplification (N-myc oncogene in neuroblastoma)

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6
Q

Tumor suppressor gene

A

Result in loss of function (TSG p53)

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7
Q

Physical carcionogens

A

Radiation is carcinogen
Ionizing radiation- leukemia
UV light- nonmelanocytic skin cancers

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8
Q

Chemical carcinogens

A

Tobacco (lung cancer)
Asbestos
Benzene
Aromatic amines

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9
Q

Dietary carcinogens

A

Alcohol (oropharynx, esophagus, liver)
Salt (Nasopharyngeal, gastric)
Animal fats (breast, colon)

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10
Q

Viral carcinogens

A

HCV (hepatocellular carcinoma)

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11
Q

Growth characteristics of tumor phenotype

A

Typically not seen until ~1 cm (30 doubling from a single cell)
Only 10 additional doublings are required to reach a lethal size of 1 kg
Depends on 3 factors:
-Tumor growth fraction
-Duration of the cell cycle
-Balance between cell proliferation and death

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12
Q

Angiogenesis

A

Delivery of nutrients and growth factors is required to sustain tumor growth
Without neovascularization, tumors fail to grow beyond a few milimeters

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13
Q

What occurs during tumor development in angiogenesis

A

An angiogenic switch occurs, favoring proangiogenic factors
This may result from an increase in proangiogenic factors such as VEGF or basic fibroblast growth factor (BFGF) or from a decrease in anti-angiogenic factors such as thrombospondin-1 (TSP-1)
Leads to neovascularization
Leads to tumor growth and metastasis

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14
Q

How is angiogenesis treated?

A

Treated with angiogenesis inhibitor- bevacizumab (binds to VGEF)

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15
Q

Invasion and metastasis

A

Ability to cross the basement membrane

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16
Q

Carcinoma in situ

A

The whole layer is bad

17
Q

Associated cancer with cryptorchidism

Prophylactic sugery

A

Testicular

Ochiopexy

18
Q

Associated cancer with FAP

Prophylactic surgery

A

Colon

Colectomy

19
Q

Associated cancer with HNPCC/Lynch syndrome

Prophylactic surgery

A

Colon

Colectomy

20
Q

Associated cancer with ulcerative colitis

Prophylactic surgery

A

Colon

Colectomy

21
Q

Associated cancer with MEN type 2 and 3

Prophylactic surgery

A

Medullary cancer of the thyroid

Thyroidectomy

22
Q

Associated cancer with familial breast cancer

Prophylactic surgery

A

Breast

Mastectomy

23
Q

Associated cancer with familial ovarian cancer

Prophylactic surgery

A

Ovary

Oophrectomy

24
Q

Neoadjuvant therapy

A

Systemic or radiation therapy prior to definitive surgery

25
Q

Principles of chemo

A

Induction or primary chemo- administered as primary tx for metastatic dz
Adjuvant chemo- given after another tx modality (surgical resection)

26
Q

Principles of radiation therapy

A 
Direct and indirect toxic effects on tumor cells (breaks DNA)
Internal radiotherapy (brachytherapy)- source is placed within or adjacent to target tissue
External beam radiotherapy (teletherapy)- high energy electomagnetic beam
27
Q

Indications for busulfan

A

CML

Myeloproliferative d/o

28
Q

Toxicities for busulfan

A

Myelosuppression
Pulmonary fibrosis
Gonadal dysfunction
Marrow failue

29
Q

Indications for cisplatin

A 
Carcinomas of:
Ovaries
Testis
Cervix
Head an neck
Bladder
Lung (small and NSCLC)
Esophagus
Lymphomas
30
Q

Indications for 5-FU

A 
Carcinomas of:
Breast
Cervix
Head and neck
GI tract
Nonmelanoma skin cancer
31
Q

Toxicities for 5-FU

A 
Mucositis
Diarrhea
Myelosuppression
Dermatitis
Hepatotoxicity (intra-arterial therapy)
Nausea and vomiting
32
Q

Indications for methotrexate

A 
Carcinomas of:
Breast
Head and neck
Esophagus
Choriocarcinoma
Leptomeningeal Carcinomatosis
Osteogenic sarcoma
33
Q

Toxicities for methotrexate

A 
Myelosuppression
Stomatitis
Diarrhea
Intestinal bleeding and perf
Arachnoiditis
Hepatic dysfunction
Cirrhosis
Radiating recall
Pneumotitis
Renal dysfunction
34
Q

Indication for fludarabine

A

B0 cell chronic lymphocytic leukemia

35
Q

Toxicities for fludarabine

A 
Myelosuppression
Tumor lysis syndrome
Weakness
Neurotoxicity
Edema
Pneumonitis
N/V
Anorexia
Bleeding
Stomatitis
Diarrhea

Surgery (30 decks)

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