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Hematology/Oncology > Exam > Flashcards

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1
Q

Oncology

A

Branch of medicine that studies tumors

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2
Q

Hematology

A

Branch of medicine that studies blood

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3
Q

Cancer

A

Disease in which abnormal cells divide without control and are able to invade other tissues - these cancer cells can spread to other parts of the body through the blood and lymph

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4
Q

Carcinoma

A

Cancer that begins in the skin or in the tissues that line or cover internal organs

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5
Q

Sarcoma

A

Cancer that begins in the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue

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6
Q

Leukemia

A

Cancer that starts in the blood-forming tissue such as the bone marrow

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7
Q

Lymphoma and Myeloma

A

Cancers that begin in the cells of the immune system

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8
Q

Central Nervous System Cancers

A

Cancers that begin in the tissues of the brain or spinal cord

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9
Q

Neoplasm

A

New growth - abnormal mass of cells that grows more or less progressively at the expense of the host (may be benign or malignant)

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10
Q

Etiology of Neoplastic Cells

A 
Altered nuclear and cellular structure
Chromosomal Abnormalities
Genetic Mutations
Biochemical Abnormalities
Inappropriate Cell Products
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11
Q

Malignant Neoplasms

A 
Differentiation
Anaplasia (often)
Unencapsulated
Unrestrained Growth
Invasion of Adjacent Tissues
Failure of Programmed Cell Death
Metastasis to distant sites possible
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12
Q

How do Metastasis Happen?

A

Lymphatic Invasion
Blood-Born Transport
Seeding of Body Cavities, Organs, and Skeleton
Angiogenesis

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13
Q

Cancer is the _______ leading cause of death in the United States

A

Second

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14
Q

Cancer accounts for nearly 1 out of every ____ deaths

A

4

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15
Q

There are _________ deaths from cancer per day

A

1600

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16
Q

Over ______ newly diagnosed cancers predicted in 2013

A

1.6 million

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17
Q

What is the most important risk factor for Cancer?

A

Tobacco

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18
Q

About 30% of Cancer Deaths are due to these five behavioral and dietary risks:

A 
High BMI
Low Fruit and Veggies
Lack of Physical Activity
Tobacco Use
Alcohol Use
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19
Q

3 most common Cancers in Men

A

1, Prostate

  1. Lung
  2. Colorectal
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20
Q

3 highest mortality Cancers in Men

A
  1. Lung
  2. Prostate
  3. Colorectal
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21
Q

3 most common cancers in Women

A
  1. Breast
  2. Lung
  3. Colorectal
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22
Q

3 highest mortality Cancers in Women

A
  1. Lung
  2. Breast
  3. Colorectal
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23
Q

What is the 5-year survival rate for Glioblastoma?

A

4%

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24
Q

What is the 5-year survival rate for Breast Cancer?

A

98.6%

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25
Q

National Cancer Act of 1971

A

Nixon - $$ to enlarge NIH and NCI “to advance the national effort against cancer”

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26
Q

Cancer death rate has decreased by only ____ since 1950

A

5%

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27
Q

Incidence Rate of Cancer in Oregon is ______ per 100,000

A

434

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28
Q

Mortality Rate from Cancer in Oregon is _______ per 100,000

A

175

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29
Q

Cancer is the Leading Cause of Death in Oregon (T/F)

A

TRUE

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30
Q

Tumor-node-metastatis (TNM) method of staging uses ____ measurements

A

3

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31
Q

T Score

A

Size and extent of invasion of primary TUMOR

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32
Q

N Score

A

Number and location of histologically involved lymph NODES

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33
Q

M Score

A

Presence or absence of distant METASTASES

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34
Q

Tis =

A

in situ tumor

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35
Q

T1-T4 =

A

usually based on size, invasion of adjacent structures

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36
Q

Tx =

A

primary tumor cannot be assessed

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37
Q

Nx =

A

lymph nodes cannot be assessed

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38
Q

N1-3 =

A

based on levels of lymph nodes

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39
Q

Mx =

A

presence of mets cannot be assessed

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40
Q

M0 =

A

no metastases

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41
Q

M1 =

A

presence of metastases

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42
Q

Stage I =

A

T1-T2 N1 or T3 N0

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43
Q

Stage II =

A

T1-T2 N1 or T3 N0

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44
Q

Stage III =

A

T1-3 with N1-3

45
Q

Stage IV =

46
Q

70 on the Karnofsky Performance Status

A

Cares for self, unable to carry on normal activity or to do active work - usually the cut-off for whether a person can handle chemotherapy or being entered into a clinical trial

47
Q

Exploding cells release __________

48
Q

MCV

A

How big is it?

49
Q

MCH and MCHC

A

How dark is it?

50
Q

RDW

A

What is the distribution/spread of the size of RBC

51
Q

Normal RDW

A

most of the cells are the same

52
Q

Wide RDW

A

Varying sized cells are present - this may be a mixed anemia or thalassemia

53
Q

Microcytic =

A

Small (<80)

54
Q

Macrocytic =

A

Big (>100)

55
Q

Normocytic =

A

Normal (80-99)

56
Q

Anisocytosis =

A

Mixed large cells and small cells

57
Q

MCV Values are higher in newborns or adults?

A

Newborns and Infants

58
Q

Mean Corpuscular Hemoglobin Concentration (MCHC)

A

Proportion of each cell taken up by hemoglobin

59
Q

Mean Corpuscular Hemoglobin (MCH)

A

Measures the amount of hemoglobin present in one RBC

60
Q

Hypochromic

A

Low MCH/MCHC = iron deficiency

61
Q

Normochromic

A

normal MCH/MCHC

62
Q

Microcytic Anemia

63
Q

Microcytic Anemia causes

A

Iron Deficiency
Chronic Disease
Lead Poisoning
Less Common: Thalassemia, Sideroblastic, Hemoglobinopathies

64
Q

Macrocytic Anemia

65
Q

Causes of Macrocytic Anemia

A

Folic Acid Deficiency, Vitamin B12 Anemia

66
Q

Metabolic Intermediaries for Folate

A

Homocysteine (HC)

67
Q

Metabolic Intermediaries for Vit B12

A

Methylmalonic Acid (MMA)

68
Q

Normocytic Anemia

A

Normal MCV

69
Q

Causes of Normocytic Anemia

A

Bleeding

Chronic Disease

70
Q

In anemia, Retic Count should be HIGH/LOW?

71
Q

If Retic Count is not high, the probelm is in….

A

the making/marrow
Either Not enough stuff to make the cell (iron, vitamins, etc.) OR the bone marrow cannot make it (lymphoma, aplastic anemia)

72
Q

What should you ask of someone who has a high MCV?

A

Ask about alcohol, B12, Folate, TSH

73
Q

What should you check for someone with a low MCV?

A

Ferritin and other iron studies

74
Q

What to check if Hb, Hct is low:

A

MCV, RDW and check other CBC components

Order Retic Count, Liver, and Renal Tests

75
Q

Cervical Cancer most often metastasizes to

A

Peritoneum

76
Q

Breast Cancer most often metastasizes to

A
  1. Bones

2. Lungs

77
Q

Colon Cancer most often metastasizes to

78
Q

Lung Cancer most often metastasizes to

79
Q

Prostate Cancer most often metastasizes to

80
Q

Testicular Cancer most often metastasizes to

81
Q

Thrombocytopenia

A

Low platelets

82
Q

Low platelets (>50K) symptoms

A

Easy bleeding/bruising
hematuria
Petechial Rash

83
Q

Very Low Platelets (5,10, 20K) symptoms

A 
Spontaneous Bleed
High risk-brain/GI Bleed
Confusion
HA
Hematochezia
Hematemasis
84
Q

Which cancer causing viral infections are responsible for up to 20% of cancer deaths in low and middle income countries?

85
Q

About ______ of all cancer deaths in 2008 occurred in low and middle income countries

86
Q

Top Country for Cancer Mortality

87
Q

Steps in Histologic Diagnosis

A
  1. Tumor obtained through biopsy or surgery and evaluated by pathologist
  2. Type of cancer is determined
  3. Therapy cannot proceed until this step is completed
88
Q

Two major classifications of Hematologic Malignancies

A
  1. Myeloid

2. Lymphoid

89
Q

In anemia, the retic count should be (HIGH/LOW)

90
Q

If the Retic count is low, it means the problem is in the

A

making/marrow

91
Q

Increased Transferrin (TIBC) is related to which anemia?

A

Iron Deficient Anemia

92
Q

Teletherapy

A

Beams of radiation aimed at a tumor

93
Q

Brachytherapy

A

Encapsulated radiation implants

94
Q

Systemic Therapy

A

Radionucleotides delivered systemically

95
Q

49 y/o female presents with SOB and hemoptysis. A bulky lung mass is found and biopsy shows a small cell carcinoma. Due to SVC syndrome, therapy is started urgently with cisplatin/etoposide. 24 hours later, she has mental status changes and refractory oliguria

A

Acute Tumor Lysis Syndrome

96
Q

What lab finding will you see with Acute Tumor Lysis Syndrome?

A 
Hyperuricemia
Hyperkalemia
Hyperphospohatemia
Hypocalcemia
Axotemia
97
Q

What types of tumors are most likely to have Acute Tumor Lysis Syndrome when treated?

A

High-grade lymphomas
Leukemia
Bulky tumors
Usually seen after first round of chemo

98
Q

62 y/o male with history of squamous cell carcinoma of tonsillar pillar, treated 18 months prior with combined chemo/XRT presents with 2 weeks of worsening fatigue, anorexia, polyuria, with occasional incontinence, constipation, and muscle weakness…

A

Hypercalcemia

99
Q

Hypercalcemia Symptoms

A

Fatigue, anorexia, nausea, constipation, polyuria, polydypsia, weakness, lethargy, apathy, seizures, coma

100
Q

81 y/o with multiple medical problems presents with 3 months of mid-thoracid back pain, increasing over 1 week. He has no history of cancer and no constitutional symptoms. The pain increased with movement and with lying flat. He denies weakness, paresthesias, or autonomic dysfunction.

A

Spinal Cord Compression

101
Q

Previously health 48 y/o man presents with syncope. he desribes 6 months of blurred vision and several weeks of presyncope with exertion. He notes progressive facial swelling and redness

A

Superior Vena Cava Syndrome

102
Q

Superior Vena Cava Syndrome is most common with

A

Bronchogenic Carcinoma and Lymphoma

103
Q

Symptoms of SVC Syndrome

A

Dyspnea, chest pain, cough, dysphagia, headache, seizure, altered consciousness, swlling neck/face/arms, venous distention, cyanosis, facial plethora, vocal cord paralysis, Horner’s syndrome

104
Q

A 20 y/o man with AML develops an asymptomatic fever of 38.1 8 days after first cycle of consolidation chemotherapy. He arrives to the ER with a normal exam EXCEPT temp 38.2, RR 24, HR 132, and BP 70/30.

A

Neutropenic Fever

105
Q

29 y/o woman presents with progressive fatigue, dyspnea, blurred vision, and near syncope. She has marked pallor, fever, diffuse nontender lymphadenopathy and pre-retiinal hemorrhages.

A

Hyperleukocytosis with Leukostasis

106
Q

Primary Prevention

A

Remove risk factors

107
Q

Secondary Prevention

A

Early detection and treatment

108
Q

Tertiary Prevention

A

Reduce Complications

Hematology/Oncology (2 decks)

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