Heme/Onc KPs2 Flashcards
pembrolizumab MoA? Approved for?
PD-1 inhibitor.
treatment of mismatch-repair deficient tumors (tumors with high microsatellite instability), regardless of the tissue of origin.
Who are candidates for brest cancer prophylaxis?
What are the prophylaxis options?
> 35, 5year risk of 1.7% with lobular carcinoma in situ or atypical ductal hyperplasia
tamoxifen prior to menopause and with tamoxifen, raloxifene, or exemestane after menopause
Women with BRCA1/2 mutations should undergo breast cancer screening when?
MRI beginning at age 25 years and mammography beginning at age 30 years
In patients with estrogen receptor–positive DCIS, this decreases the risk of local recurrence of both DCIS and invasive cancer? Caveat?
adjuvant tamoxifen
no survival benefit
in postmenopausal women younger than 60 years with DCIS, treat with?
anastrozole > tamoxifen
Mastectomy is recommended for?
extra-breast involvement, 2+ breast quadrants, inflammatory breast cancer
How to stage inflammatory breast cancer? Treatment?
CT and bone scan
chemotherapy, followed by surgery, and then radiation
Therapy-related hot flushes in breast cancer survivors may be improved with?
SSRIs, SNRIs
All women with ovarian cancer are eligible for?
BRCA1/2 testing
How to stage ovarian cancer?
surgical exploration
Follow-up for treated ovarain cancer? This has no role
CA-125 monitoring;
no role for continued imaging
Test NOT helping for colon cancer staging?
PET
Treatment of stage III colon cancer?
adjuvant 5-FU + surgery
All patients with metastatic colorectal cancer should undergo tumor genotyping to identify mutations in?
Why?
K-ras and N-ras.
anti–epidermal growth factor receptor antibodies, cetuximab and panitumumab, are inactive in the 50% of tumors that harbor mutations.
Anal cancer is often curable with?
radiation therapy and concurrent chemotherapy with mitomycin plus 5-fluorouracil
Anal cancer - natural course after treatment? Implication?
continue to regress for 6 months to 1 year following completion of radiation therapy
treatment failure should not be declared unless unequivocal growth or metastases are documented
Treatment of metastatic gastroesophageal cancer?
Palliative with cisplant+trastuzaumab if HER-2
General treatment of neuroendocrine tumors?
because so indoluent. can effectively be managed with expectant observation and serial imaging
Patients with metastatic gastrointestinal stromal tumors are treated with lifelong?
Imatinib
Class of lung cancer characterized by various paraneoplastic syndromes?
NSCLC
Limited-stage small cell lung cancer is defined as?
confined to a single hemithorax (could include supraclavicalar lymph nodes)
Extensive-stage small cell lung cancer is treated with?
Platinum-containing doublet
How do Human papillomavirus tumors from squamous cell carcinoma of the head and neck?
exclusively within the oropharynx, develop in younger individuals, and are associated with a significantly improved prognosis.
Active surveillance, with the use of serum prostate-specific antigen measurement, digital rectal examination, and repeat prostate biopsy, is appropriate only for men with?
very low–risk or low-risk prostate cancer who have a life expectancy of at least 10 years
Active prostate cancer after surgery is defined as? After radiation?
Any identifiable level of prostate specific antigen
a progressive increase in the serum PSA level
In patients with prostate cancer, these reduce the incidence of skeletal-related events?
zoledronic acid and denosumab
Patients with a biochemical recurrence of prostate cancer (a rising serum prostate-specific antigen level and no evidence of local disease progression) are treated with?
androgen deprivation therapy
dentification of new-onset hematuria in patients older than 40 years mandates ?
Cystoscopy
WHen can lymph nodes be followed with serial exams alone (no imaging/labs)?
small, soft, freely moveable lymph nodes that are limited to one or two adjacent sites
Do not use this test to diagnose lymphoma?
FNA
only curative therapy for follicular lymphoma?
allo-HCT
Treatment of MALT lymphoma not responsive to H pylori abx?
surgical removal, involved-field radiation therapy + rituximab
Diagnosis of chronic lymphocytic leukemia is confirmed by?
prognosis is determined by ?
flow cytometry indicating co-expression of cell surface antigens CD5 and CD23
gene mutation status (immune globulin variable heavy-chain mutation) and fluorescence in situ hybridization or array-based karyotyping.
When can CLL be observed without therapy?
if asymptomatic and stage 0 to II
Drug for CLL?
Ibrutinib
Hairy cell leukemia presents wtih?
splenomegaly without lymphadenopathy
Early-stage cutaneous T-cell non-Hodgkin lymphoma is treated with?
If advanced?
topical glucocorticoids, retinoids, and psoralen and ultraviolet light with interferon alfa.
chemotherapy, purine analogs, histone deacetylase inhibitors, and monoclonal antibodies.
Patients with cancer of unknown primary site and isolated cervical lymphadenopathy should undergo?
triple endoscopic examination (upper endoscopy, bronchoscopy, and laryngoscopy)
Women with adenocarcinoma limited to lymph nodes in one or both axillae have what type of cancer until proven otherwise? Get this test?
breast - breast MRI
oung men with poorly differentiated carcinoma that is relatively symmetrical around the midline - likely is?
Germ cell tumor
Drug for metastatic melanoma?
For patients with metastatic melanoma and a V600 BRAF mutation?
ipilimumab
Targeted therapy (BRAF inhibitor like Vemurafenib)
In patients with pleural effusion - max fluid to drain?
1500 cc
Spontaneous tumor lysis syndrome occurs commonly in patients with?
Leukemia and Burkitt lymphoma
everyone on Aromatase ibhibitors should also be on?
calcium and vitamin D supplements to avoid osteopenia fractures
women treated early in life with mantle radiation therapy are likley to develop what other cancers?
Breast cancer (radiation induced)
