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MKSAP KEY POINTS > Heme/Onc KPs2 > Flashcards

Heme/Onc KPs2 Flashcards

1
Q

pembrolizumab MoA? Approved for?

A

PD-1 inhibitor.

treatment of mismatch-repair deficient tumors (tumors with high microsatellite instability), regardless of the tissue of origin.

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2
Q

Who are candidates for brest cancer prophylaxis?

What are the prophylaxis options?

A

> 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

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3
Q

Women with BRCA1/2 mutations should undergo breast cancer screening when?

A

MRI beginning at age 25 years and mammography beginning at age 30 years

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4
Q

In patients with estrogen receptor–positive DCIS, this decreases the risk of local recurrence of both DCIS and invasive cancer? Caveat?

A

adjuvant tamoxifen

no survival benefit

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5
Q

in postmenopausal women younger than 60 years with DCIS, treat with?

A

anastrozole > tamoxifen

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6
Q

Mastectomy is recommended for?

A

extra-breast involvement, 2+ breast quadrants, inflammatory breast cancer

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7
Q

How to stage inflammatory breast cancer? Treatment?

A

CT and bone scan

chemotherapy, followed by surgery, and then radiation

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8
Q

Therapy-related hot flushes in breast cancer survivors may be improved with?

A

SSRIs, SNRIs

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9
Q

All women with ovarian cancer are eligible for?

A

BRCA1/2 testing

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10
Q

How to stage ovarian cancer?

A

surgical exploration

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11
Q

Follow-up for treated ovarain cancer? This has no role

A

CA-125 monitoring;

no role for continued imaging

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12
Q

Test NOT helping for colon cancer staging?

A

PET

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13
Q

Treatment of stage III colon cancer?

A

adjuvant 5-FU + surgery

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14
Q

All patients with metastatic colorectal cancer should undergo tumor genotyping to identify mutations in?

Why?

A

K-ras and N-ras.

anti–epidermal growth factor receptor antibodies, cetuximab and panitumumab, are inactive in the 50% of tumors that harbor mutations.

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15
Q

Anal cancer is often curable with?

A

radiation therapy and concurrent chemotherapy with mitomycin plus 5-fluorouracil

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16
Q

Anal cancer - natural course after treatment? Implication?

A

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

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17
Q

Treatment of metastatic gastroesophageal cancer?

A

Palliative with cisplant+trastuzaumab if HER-2

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18
Q

General treatment of neuroendocrine tumors?

A

because so indoluent. can effectively be managed with expectant observation and serial imaging

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19
Q

Patients with metastatic gastrointestinal stromal tumors are treated with lifelong?

A

Imatinib

20
Q

Class of lung cancer characterized by various paraneoplastic syndromes?

A

NSCLC

21
Q

Limited-stage small cell lung cancer is defined as?

A

confined to a single hemithorax (could include supraclavicalar lymph nodes)

22
Q

Extensive-stage small cell lung cancer is treated with?

A

Platinum-containing doublet

23
Q

How do Human papillomavirus tumors from squamous cell carcinoma of the head and neck?

A

exclusively within the oropharynx, develop in younger individuals, and are associated with a significantly improved prognosis.

24
Q

Active surveillance, with the use of serum prostate-specific antigen measurement, digital rectal examination, and repeat prostate biopsy, is appropriate only for men with?

A

very low–risk or low-risk prostate cancer who have a life expectancy of at least 10 years

25
Q

Active prostate cancer after surgery is defined as? After radiation?

A

Any identifiable level of prostate specific antigen

a progressive increase in the serum PSA level

26
Q

In patients with prostate cancer, these reduce the incidence of skeletal-related events?

A

zoledronic acid and denosumab

27
Q

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?

A

androgen deprivation therapy

28
Q

dentification of new-onset hematuria in patients older than 40 years mandates ?

A

Cystoscopy

29
Q

WHen can lymph nodes be followed with serial exams alone (no imaging/labs)?

A

small, soft, freely moveable lymph nodes that are limited to one or two adjacent sites

30
Q

Do not use this test to diagnose lymphoma?

A

FNA

31
Q

only curative therapy for follicular lymphoma?

A

allo-HCT

32
Q

Treatment of MALT lymphoma not responsive to H pylori abx?

A

surgical removal, involved-field radiation therapy + rituximab

33
Q

Diagnosis of chronic lymphocytic leukemia is confirmed by?

prognosis is determined by ?

A

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.

34
Q

When can CLL be observed without therapy?

A

if asymptomatic and stage 0 to II

35
Q

Drug for CLL?

A

Ibrutinib

36
Q

Hairy cell leukemia presents wtih?

A

splenomegaly without lymphadenopathy

37
Q

Early-stage cutaneous T-cell non-Hodgkin lymphoma is treated with?

If advanced?

A

topical glucocorticoids, retinoids, and psoralen and ultraviolet light with interferon alfa.

chemotherapy, purine analogs, histone deacetylase inhibitors, and monoclonal antibodies.

38
Q

Patients with cancer of unknown primary site and isolated cervical lymphadenopathy should undergo?

A

triple endoscopic examination (upper endoscopy, bronchoscopy, and laryngoscopy)

39
Q

Women with adenocarcinoma limited to lymph nodes in one or both axillae have what type of cancer until proven otherwise? Get this test?

A

breast - breast MRI

40
Q

oung men with poorly differentiated carcinoma that is relatively symmetrical around the midline - likely is?

A

Germ cell tumor

41
Q

Drug for metastatic melanoma?

For patients with metastatic melanoma and a V600 BRAF mutation?

A

ipilimumab

Targeted therapy (BRAF inhibitor like Vemurafenib)

42
Q

In patients with pleural effusion - max fluid to drain?

A

1500 cc

43
Q

Spontaneous tumor lysis syndrome occurs commonly in patients with?

A

Leukemia and Burkitt lymphoma

44
Q

everyone on Aromatase ibhibitors should also be on?

A

calcium and vitamin D supplements to avoid osteopenia fractures

45
Q

women treated early in life with mantle radiation therapy are likley to develop what other cancers?

A

Breast cancer (radiation induced)

MKSAP KEY POINTS (19 decks)

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