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Fall > Doctor Exam 2 > Flashcards

Doctor Exam 2 Flashcards

1
Q

Epidemiology of carcinoma of the nasopharynx

A
  • Uncommon in US, more common in China and Chinese ethnicities
  • Can happen in young people
  • M:F 3:1
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2
Q

Etiology of carcinoma of the nasopharynx

A
  • Carcinogens
  • Genetics
  • EBV
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3
Q

Defn of Nasopharynx

A

Transition zone between the nasal cavity and the oropharynx

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4
Q

Patterns of spread for carcinoma of the nasopharynx

A

Up to base of skull, down along the pharyngeal walls, nasal cavity

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5
Q

carcinoma of the nasopharynx travels through

A

directly of through involvement of the retropharyngeal LN

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6
Q

Carcinoma of the nasopharynx distant mets?

A

LN, Lung, bone and liver

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7
Q

Symptoms of carcinoma of the nasopharynx

A

Painless neck mass, nasal obstruction, ear infection, sore throat, neurological deficits,

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8
Q

Work up for carcinoma of the nasopharynx

A

Fibroptic exam, CT and MR, Chest scan, PET scan

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9
Q

Histology of carcinoma of the nasopharynx

A

Most common is squamous cell carcinoma

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10
Q

Standard treatment for carcinoma of the nasopharynx?

A

Radiation therapy w/wo chemotherapy

Treat LN level 2-5

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11
Q

Prescription dose for carcinoma of the nasopharynx

A

Initial volume to 40 Gy, Off-cord to 54, Boost to ~70

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12
Q

Carcinoma of the nasopharynx 5 yr survival?

A

60-70%

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13
Q

Epidemiology of Carcinoma of the Oropharynx

A
  • 8000 cases/year
  • M:F 4:1
  • Usually seen in older patients but increase incidence in young people with HPV
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14
Q

Etiology of Carcinoma of the Oropharynx

A

Tobacco, alcohol, p53 mutation

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15
Q

Symptoms of Carcinoma of the Oropharynx

A

Otalgia, painless neck mass*, dysphagia, trismus, face numbness

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16
Q

Patterns of spread of Carcinoma of the Oropharynx

A

Typically a neck mass w/unknown origin, LYMPH NODES

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17
Q

work-up of Carcinoma of the Oropharynx

A

Direct laryngoscopy, CT, MR, PET, Dental eval

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18
Q

Histology of Carcinoma of the Oropharynx

A

Most common is squamous cell carcinoma

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19
Q

Treatment of Carcinoma of the Oropharynx

A

Early stage: Surgery and RT*

Late Stage: organ preservation with RT and maybe chemo

20
Q

margin for tumor of Carcinoma of the Oropharynx

A

2 cm

21
Q

Earl stage 5 yr survival of Carcinoma of the Oropharynx

A

70-80%

22
Q

Epidemiology of carcinoma of the hypopharynx

A

Male, 60s or older, common recurrence, poor prognosis,

23
Q

Etiology carcinoma of the hypopharynx

A

Tobacco, alcohol, iron deficiency

24
Q

Most common tumor loc for carcinoma of the hypopharynx

A

pyriform sinus

25
Q

symptoms of the carcinoma of the hypopharynx

A

Dysphagia, otalgia, painless neck mass, airway obstruction, hoarseness,

26
Q

work up for the carcinoma of the hypopharynx

A

Direct laryngoscopy, CT, MR, PET

27
Q

Treatment for carcinoma of the hypopharynx

A

Early stage: surgery plus or minus radiation

Late stage: Organ preservation w/ RT

28
Q

radiation treatment for carcinoma of the hypopharynx

A

2 cm margin of primary tumor, bilateral cervical nodes, retropharyngeal nodes, supraclav nodes

29
Q

Epidemiology of carcinoma of the larynx

A

9500 cases, 70 years old, more males, good prognosis

30
Q

Etiology of carcinoma of the larynx

A

Smoking*, alcohol, occupational, prior radiation

31
Q

Patterns of spread

A

Not as common to go to LN, Most glottis cancers arise from the free margin of the true vocal cord. Spreads to supraglottic and subglottic regions. Mets is uncommon but if it does, goes to lung and liver

32
Q

Symptoms for carcinoma of the larynx

A

Hoarseness, vocal change

33
Q

work-up for carcinoma of the larynx

A

Direct laryngoscopy, CT, chest x-ray, PET, fiberoptic, pulmonary function test

34
Q

histology of carcinoma of the larynx

A

squamous cell carcinoma

35
Q

early treatment of carcinoma of the larynx

A

early stage: tripping (remove w/o damaging the vocal cords) + RT
late stage: total laryngectomy, maybe RT
**Typically 3D planning

36
Q

radiation prescription for carcinoma of the larynx

A

40 to all, 50-54 off cord, boost to 70

37
Q

Epidemiology of breast cancer

A

more white women diagnosed, black women present with more advanced stages, 1/8 women will have, 1% of breast cancer patients are male

38
Q

Estimated new breast cancer statistics?

A

about 250,000

39
Q

Estimated deaths from breast cancer

A

about 40,000

40
Q

Risk factors for breast cancer?

A

age, over weight, 1st degree relative, genetic mutations, Estrogen exposure, dense breast tissue,

41
Q

Most common s/sx for breast cancer?

A

95% present with a non palpable, asymptomatic mass seen on a screening exam

42
Q

Detection and diagnosis for average risk women for breast cancer?

A

40+ annual mammogram, self exam

20-39 clinical breast exam every 3 years, monthly self breast exam

43
Q

detection and diagnosis for high risk

A

mammogram beginning at 30, annual breast MRI, genetic counseling, clinical exam yearly

44
Q

Histology of breast cancer

A

20% non invasive
75-80% invasive
1-3% inflammatory

45
Q

DCIS

A

WBI b/c it can move along the ducts

without treatment, about 30% will progress to invasive cancer

Fall (6 decks)

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