Diseases and Treatments

Question 1

Autoimmune Diseases

Answer 1

-Rhumatoid Arthritis (joints)
-Systemic Lupus Erythematosus (vasculitis)
-Chron’s Disease(small bowel/colon)
-Diffuse Toxic Goiter(thyroid)
-Psoriasis (skin)
Aplastic anemia(blood cell lines)

Question 2

Diffuse Toxic Goiter

Answer 2

Graves Disease: Autoimmune

• enlargement of the thyroid
• T and B cells produce antibodies to teh TSH receptor
• stimulates uptake of iodine, groth of thyroid folicles, and production of thyroid hormone(hyperthyroidism)
• 30/100,000 ppl/yr US
• typically female 20-40 y/o

Question 3

Hyperthyroidism

Answer 3

Symptoms:

• weight loss with normal appetite
• nervousness/irritability/sleepiness
• heat intolerance/sweating
• tremors
• diarrhea
• menstrual abnormalities
• palpitations(irregular heartbeat)

Question 4

Exophthalmos

Answer 4

buggy eyes

• complication of Diffuse Toxic Goiter
• from hypertrophy of connective tissue behind eyes
• may not go away with treatment

Question 5

Diffuse Toxic Goiter: Treatment

Answer 5

• surgery not common ONLY for very large thyroids, cancer, or pregnancy
• Drugs(propylthiouracil) and beta blockers
• ablation with radioactive iodine

Question 6

4 Characteristics of Cancer

Answer 6

1) Dedifferentiation- Cancer cells resemble and fxn more like immature precursors
2) Neovascularity- tumor can independently develop its own blood supply
3) Invasiveness- can extend into adjacent organs
4) Metastasis- can spread to distant organs via lymph channles

Question 7

Induction of Cancer

Answer 7

• mutations on promoter or inhibitor genes may lead to unregulated growth and dedifferentiation
• cancer usually comes from a single cell

Question 8

Carcinoma

Answer 8

Cancer of epithelial tissue

• adenocarcinoma: glandular structure (breast, prostate, pancreas)
• Squamous cell carcinoma (lung=bronchogenic, skin, head, neck)

Question 9

Scarcoma

Answer 9

Cancer of Bone and soft tissue

• Osteogenic sarcoma (bone)
• Chondrosarcoma (cartilage)
• Ewing sarcoma (perivascular cells in bone)

Question 10

Lymphoma

Answer 10

Cancer of Lymphatic Tissue

• Hodgkins Lymphoma
• Non-Hodgkins lymphoma

Question 11

Glioma

Answer 11

Brain Tissue(not neurons)

• Astrocytoma (aka glioblastoma)
• Ependymoblastoma
• Schwannoma

Question 12

Neuorendocrine Tumor

Answer 12

Arrises in embryonic neuroectodermal derivative

• Neuroblastoma
• Insulinoma
• Carcinoid tumors

Question 13

Staging

Answer 13

Skipped no cards on

Question 14

“Summary Staging”

Answer 14

Used by NCI SEER (Surveillance, Epidemiology, and End Results)
Stages: in situ, localized, regional, distant, unknown

Question 15

Cancer Staging

Answer 15

• Physical exam
• Diagnostic Imaging
• Lab Tests
• Pathology Reports
• Surgical Reports

Question 16

RECIST

Answer 16

Response Evaluation Criteria In Solid Tumors

• imaging based method for quantifying changes of solid tumor in response to RT or chemo
• complete response, partial response, stable disease, or progressive disease

Question 17

Beast Cancer: Treatment

Answer 17

Surgery:
-Lumpectomy
-Partial/Total mastectomy +/- lymph node dissection
-Halstead Radical Mastecomy (obsolete) 
RT:
-External Beam
-Brachy
Chemo:
-cytotoxic drugs if metastatic
-estrogen receptor blockers

Question 18

Sentinel Lymph Node Localization

Answer 18

• inject around tumor
• radio tracer and blue dye move through the lymph channels into the first lymph node in the tumor drainage
• that is probably infected

Question 19

Cervical Cancer: Treatment

Answer 19

• Surgery
• Brachy
• External Beam

Question 20

dysplasia

Answer 20

cells that look funny

Question 21

Radioisotopes used in Brachytherapy

Answer 21

Cs-137:
-662 keV, T 1/2=30 yrs

Ir-192:
295-588 keV, T 1/2= 74 days

Question 22

Lung Cancer Treatments

Answer 22

Surgery:
-wedge resection- take out 1 segment
-lobectomy- take out 1 lobe
-pneumonectomy- take out 1 lung
External Beam
Chemo
-if matastatic

Question 23

Prostate Cancer: Sympotoms

Answer 23

• frequency of urination
• difficulty to urinate
• blood prostate specific antigen is high
• Bone scan may show metastatic disease

Question 24

Prostate Cancer: Treatment

Answer 24

• Transurethral Resection of the Prostate(TURP)
• Cryosurgery(freeze it)
• External Beam RT
• Brachytherapy

Question 25

Prostate LDR Bracytherapy

Answer 25

seeds:
-Iodine-125 or palladium-103

insert seeds with needles with ultrasound guidence

Question 26

Glioblastoma multiforme

Answer 26

• Type of brain tumor

- high grade astrocytoma

Question 27

Brain Tumors: Treatment

Answer 27

• limited resection
• chemo
• External Beam/radiosurgery
• brachy- inserted into resection cavity

Question 28

Thyroid Carcinoma: Statistics

Answer 28

• 3/100,000 ppl per year
• 2:1 Females to males
• 80% papillary type, rest follicular or medullary
• medullary does not take up radioactive iodine

Question 29

Thyroid Carcinoma: Diagnosis

Answer 29

• usually asymptomatic except for a painless neck mass
• Cold nodule on Tc-99m pertechnetate scintigraphy
• non-cystic mass on ultrasound
• fine needle aspiration of nodule

Question 30

Thyroid Carcinoma: Treatment

Answer 30

• surgical removal of thyroid and dissection of local lymph nodes
• total body diagnostic I-131 scan after withdrawal of thyroid hormone to detect metastatic disease
• I-131 sodium iodine, 150-200 millicuries administered orally to ablate remaining thyroid metastases

Question 31

Hodgkins Disease(Lymphoma)

Answer 31

• typically seen in young adults
• 2:1 F to M ratio
• characterized by superficial cervical, axillary or inguinal lymphadenopathy(enlarged lymph glands)
• treated with external beam
• good prognosis

Question 32

Non-Hodgkins Lymphoma: Statistics

Answer 32

• 200/100,000 per year in US
• 7-8x more common than Hodgkins
• ~60 y/o at diagnosis
• Diffuse disease involving lymph nodes and bone marrow
• B and T cell types

Question 33

Non-Hodgkins Lymphoma: Symoptoms

Answer 33

• weight loss
• night sweats
• lethargy
• pruritis ( diffuse itching)
• lymphadenopathy (swollen lymph nodes usually in neck, axillae or groin)

Question 34

Non-Hodgkins Lymphoma: Diagnosis

Answer 34

• Gallium-67 citrate scintigraphy
• CT and MR
• Lymph node and bone marrow biopsy
• PET with Fluorodeoxyglucose

Question 35

Non-Hodgkins Lymphoma: Treatment

Answer 35

• external beam Rt of mantle field and/or pelvic lymph nodes
• chemo
• immunotherapy with monoclonal antibodies against B-cells (MAB)
• Radioimmunotherapy: I-131 MAB or Yittrium-90 MAB

Question 36

Intraocular Melanoma: Treatmnet

Answer 36

• enucleation- surgical removal of eye

- epsicleral plaque therapy