Colon cancer, GI cancer , prostate, testicular

Question 1

dx of CRC ?
Stage of CRC ?
markers of CRC ?

Answer 1

colo + bx
ct chest abdo pelvis
CEA

Question 2

is radiation popular in CRC

Answer 2

no

Question 3

crc management
- stage 1, 2,3,4

Answer 3

-stage 1-2 : surgery ( ajdv chemo for some stage 2 )
-stage 3 : surgery + adjv chemo
-stage 4: systemic therapy ( potentially curable)

Question 4

curable stage 4 means what ?

Answer 4

oligometastatic ( liver/lungs), usually <4 mets
- metastectomy and chemotherapy

Question 5

CRC
- year 1 to 3 how do you do surveillance

Answer 5

• h&P q6 months
• CEA PRN
• CT abdopelvchest year 1 and year 3
• colonoscopy 1 year post resection and if all normal q5years

Question 6

CRCR year 4-5 , what to do as surveillance

Answer 6

H&P PRN
CEA PRN
CT CAP PRN

Question 7

leser trelat sign
- what is it ?
-common in ?

Answer 7

• seborrheic keratosis
• gastric and lung cancer

Question 8

squamous cell risk factors

Answer 8

etoh
caustic injury
smoking

Question 9

adenocarcinoma rsk factors

Answer 9

gerd
barrets
smoking
obesity

Question 10

prostate fave meta spot ?

Answer 10

bone

Question 11

paraneo syndrome w/ prostate Ca = ?

Answer 11

paraneoplastic coagulopathy ( DIC) , usually postop or in metastatic context

Question 12

type of prostate cancer metastatic ?

Answer 12

sclerotic bone lesions only

Question 13

what do you absolutely need for prostate cancer staging ?

Answer 13

bone scan
ct C-A-P

Question 14

lytic or sclerotic l;esions in prostate cancer ?

Answer 14

sclerotic

Question 15

sclerotic bone lesion makes you think of ?

Answer 15

prostate cancer

Question 16

early prostate cancer ( or localized ) - how can you treat it ?

what’s new nopw

Answer 16

surveillance
prostatectomy
radiation ( brachytherapy/ext beam)

now you can give give anti androgen pill and cyp 17 inhibitor in early/localized

Question 17

if metastatic, what regimen for prostate cancer

Answer 17

1. androgen deprivation therapy ( ADT)
2. CYP17i, antiandrogen +/-chemo

Question 18

type of test cancer and subtype

Answer 18

germ cell
seminoma vs non semino

Question 19

test cancer markers

Answer 19

LDH
AFP
BHCG

Question 20

AFP in which type of test cancer

Answer 20

non seminoma

Question 21

management of test cancer
- local
- meta

Answer 21

localized : orchiectomy
meta : chemo (bleomycin)

Question 22

why no biopsy test cancer

Answer 22

bcs needle biopsy = tumor seeding

Question 23

non seminoma test cancer, is it good or bad ?

Answer 23

worse survival
higher recurrence

Question 24

2 solid cancers that can be cured even if meta

Answer 24

colon
testicular

Question 25

stage 4 meta exists in test cancer ?

Answer 25

no only stage 3

Question 26

bleomycin toxicity suspecte din who ?

Answer 26

someone with pulmonary fibrosis w/ hx of test cancer tx

Question 27

if you have metastasis to the omentum, type of cancer suspecting ?

Answer 27

upper GI cancer

Question 28

R supraclav node met from ?

Answer 28

Lung Esophagus

Question 29

L supraclav node met (virchow's node)

Answer 29

Abdominal malignancies (via the thoracic duct) - Gastric - gallbladder - pancreas, kidneys, testicles, ovaries, prostate - Ipsilateral breast & lung

Question 30

umbilical node ( Sister Mary Joseph Node) aka intrabddominal/pelvic mass

Answer 30

GI : gastric, colon, pancreas Gyne: ovarian, endometrial Unknown primary

Question 31

osteoblastic/sclerotic bone metas from

Answer 31

prostate SCLC hodgkin Carcinoid

Question 32

osteolytic bone mets frm ?

Answer 32

MM NSCLL RCC thyroid melanoma Non hodgkin

Question 33

hodkgin which type of bone mets ?

Answer 33

osteoblastic/sclerotic

Question 34

non hodgkin which bone mets

Answer 34

osteolytic

Question 35

sclc which bone mets

Answer 35

osteoblastic/sclerotic

Question 36

nsclc which bone mets

Answer 36

osteolytic

Question 37

mixed bone mets ( osteoblastic-sclerotic VS osteolytic)

Answer 37

Breast, GI, Squamous cell carcinomas (NSCLC, H&N, Cervical ca)

Question 38

thyroid cancer, which bone mets

Answer 38

osteolytic

Question 39

Adenoca + woman + axillary adnp - treat as ?

Answer 39

BC

Question 40

adenoCA, woman, peritoneal carcinomatos, Ca 125 - tx ?

Answer 40

as ovarian cancer

Question 41

adenoCa, high PSA, bone mets - tx ?

Answer 41

prostate ca

Question 42

SCC- cervical adenopathy - tx as ?

Answer 42

h&C ca

Question 43

SCC- inguinal adnp, man - tx as ?

Answer 43

anal cancer w/ lower endoscopy to be done

Question 44

scc - woman - inguinal adnp - tx as ? investigation

Answer 44

- cervical vs anal - pap smear, tvus , endoscopy

Question 45

poorly differentiated carcinoma - youg man, midline tumor, high HCG/AFP - tx as ?

Answer 45

treat as testicular primary

Question 46

classic triad in RCC ?

Answer 46

palpable mass hematuria flank pain

Question 47

possible constellattion in RCC

Answer 47

* Hypercalcemia * Hypertension * Polycythemia * Cushing’s * Galactorrhea * Amyloidosis * Coagulopathy/ Thrombosis * Stauffer’s Syndrome

Question 48

what's stauffer syndrome

Answer 48

non metastatic hepatic dysfunction from RCC