flash cancer

Question 1

breast cancer: s/s

Answer 1

MRI: micro-calcifications

Question 2

breast cancer: screening

Answer 2

monthly BSE @ 20+
CBE @ 20-30 (q3 yrs) then 40+ yearly
screening
annual mammogram @ 40 or 5 years before 1st affected relative

Question 3

breast cancer tx

Answer 3

axillary lymph node dissection
sentinel lymph node biopsy
breast conserving therapy
mastectomy (radical, skin sparing, nipple sparing, etc)
radiation therapy, hormone therapy, tamoxifen

Question 4

lung cancer: s/s

Answer 4

30x risk for smoker vs non
CXR changes
FEV1 35-70 = mild to mod impairment
new/changed cough
hoarse, hemoptysis
weight loss
un-resolvinv pneumonia

Question 5

lung cancer baseline test

Answer 5

CXR - most important radiologicla finding = change in characteristic of a lesion

Question 6

superior vena cava syndrome

Answer 6

EMERGENCY! sign of growing lung tumor

Question 7

colon cancer: s/s

Answer 7

depends on L or R - hematochezia or melena, mass etc

Question 8

colon cancer: screening - under 50 vs 50+

Answer 8

average risk, asx, under 50

• colonoscopy
• • f/u based on results: adenomatous = 3 years vs clean = 7-10 years

average risk, asx, 50+

• yearly fecal occult blood test
• flex sig q5; full colonoscopy if + unless less than 1cm

Question 9

IBD + colon cancer significance

Answer 9

UC: 30x increased risk - after 30 yo, 35% risk

Crohn’s + UC: regular surveillance

Question 10

most common symptom of rectal cancer

Answer 10

bleeding (60% pts)

Question 11

rectal cancer s/s

Answer 11

early stage often asx
bleeding (60%)
DRE = size, location

Question 12

cervical cancer s/s + PE

Answer 12

vaginal discharge
bleeding
postcoital spotting

masses/lesions on cervix
cervix greyish color, bleeding, discharge

Question 13

uterine cancer s/s

Answer 13

abnormal bleeding (97%)

premenopausal: prolonged menses, excessive/intermenstrual bleeding
postmenopausal: bleeding after 1 year of last menses

Question 14

uterine cancer key lab

Answer 14

CA-125 diagnostic

Question 15

CA-125

Answer 15

diagnostic lab + for uterine cancer

useful for ovarian as well

Question 16

ovarian cancer s/s

Answer 16

VAGUE constellation

GI distress, abd discomfort, bloating, flatulence, increased pelvic pressure, vaginal bleeding

Question 17

most common GYN malignancy

Answer 17

uterine cancer

Question 18

leading cause of death for all GYN cancers

Answer 18

ovarian cancer

Question 19

ovarian cancer tumor marker labs

Answer 19

CA-125, alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-HCG)

Question 20

testicular cancer s/s

Answer 20

non-tender enlarged testicle

most common in caucasian, young (15 - 34)

Question 21

testicular cancer screening

Answer 21

monthly self-exam puberty - 40, report any new lump/lesion

Question 22

testicular cancer diagnostic tests

Answer 22

CT scan: assess nodal status
CT lung & whole lung tomography for mets eval
IVP: assess kidneys, ureters, bladders
CXR

Question 23

prostate screening

Answer 23

50: DRE & PSA - earlier if 1st degree relative

Question 24

colorectal cancer screening

Answer 24

@ 50

• fecal occult blood: annual
• flex sig q 5 years OR colonoscopy q 10 years

Question 25

uterine (endometrial) cancer screening

Answer 25

@ high risk for hereditary nonpolyposis colon cancer should be offered annual endometrial biopsy beginning @ 35

Question 26

cervical cancer screenings

Answer 26

begin 3 yrs after vaginal intercourse OR at least by 21

annual Pap OR q2 for newer liquid-based

@ 30 if 3 normal paps, screening 2-3 years

70+ with normal paps can stop, also if hysterectomy w/o removal of cervix

Question 27

adriamycin significant AE

Answer 27

cardiotoxic