High yield ITE

Question 1

Sarcoma imaging - role of PET + MRI

Answer 1

• typically MRI of extremity
• PET not done routinely, useful for high-grade sarcomas to differentiate from benign soft tissue tumors

Question 2

Staging workup of sarcoma of extremities, trunk, and head and neck

Answer 2

MRI

Question 3

NHT with demonstrated MFS benefit for BCR

Answer 3

enzalutamide

Question 3

Staging workup of sarcoma

Answer 3

• MRI of extremity
• CT chest (propensity for lung mets)
• CT abdomen pelvis for certain histologies but not done routinely (round cell, myxodi)

Question 4

More aggressive papillary thyroid cancer variant

Answer 4

Tall cell variant

Question 5

1) phyllodes tumor management 2) Margin requirement

Answer 5

Primary surgery
Review path
Need margins of at least 1 cm

Question 6

Osteoradionecrosis risk factors in head and neck

Answer 6

• oral cavity primary
• smoking
• reirradiation (but only slightly higher)

Question 7

Drugs targeting ROS1

Answer 7

• Crizotinib
• Lorlatinib
  *Entrectinib
• Repotrectinib

Question 8

Serologies positive in LEMS

Answer 8

Voltage gated calcium channel antibody test

Question 9

Paraneoplastic neurologic disorder associated with small cell

Answer 9

LEMS

Question 10

LEMS presentation

Answer 10

• proximal muscle weakness
• ptosis, cranial nerve involvement
• respiratory failure later on
• autonomic dysfunction (dry mouth)

Question 11

Lymphoma that is CD4, CD56, CD123 positive

Answer 11

Blastic plasmacytoid dendritic cell neoplasm

Question 12

Drug approved for blastic plasmacytoid dendritic cell neoplasm

Answer 12

tagraxofusp

Question 13

First line for metastatic ovarian cancer

Answer 13

IF able to resect disease, maximal debulking surgery
IF nonsurgical candidate, neoadjuvant conversion systemic therapy
Carbo/taxol q3 weeks to max 6 cycles (but no real max per Zweizig)

Question 14

CDH1 associated malignancies

Answer 14

• lobular breast cancer
• diffuse gastric cancer

Question 15

CHEK2 associated malignancies

Answer 15

breast cancer (particularly ER-positive breast cancers), male breast cancer, stomach, prostate, kidney, leukemia, plasma cell neoplasms, thyroid cancer, and sarcoma

Question 16

tp53 disease associations

Answer 16

Soft tissue sarcomas

●Osteosarcomas

●Adrenocortical carcinomas

●Central nervous system tumors (mainly glial, choroid plexus, and medulloblastoma)

●Breast cancers in young females (≤30 years)

●Acute leukemias or myelodysplastic syndromes (MDS), often following treatment for one of the above solid tumors

Question 17

HPV oropharyngeal clinical features in terms of size and nodal involvement

Answer 17

HPV tumors are typically smaller but have increased risk of advanced cervical lymphadenopath

Question 18

Prevalence of triple negative myelofibrosis

Answer 18

8-10 percent

Question 19

Risk of progression to overt myeloma with high risk smoldering at 2 years

Answer 19

25%

Question 20

CLL RAI Stage I

Answer 20

lymphocytosis + enlarged lymph nodes

Question 21

CLL RAI Stage II

Answer 21

Lymphocytosis + enlarged liver or spleen with or without lymphadenopathy

Question 22

CLL Rai stage III

Answer 22

Lymphocytosis + anemia (hgb <11) with or without enlarged livers, spleen, or lymph nodes

Question 23

CLL Rai stage IV

Answer 23

lymphocytosis + thrombocytopenia (plt <100K) with or without anemia or enlarged liver, spleen, or lymph nodes

Question 24

CLL RAI Stage 0

Answer 24

Lymphocytosis alone (no cytopenias or lymphadenopathy)

Question 25

11q22.3 is the site of what gene

Answer 25

ATM

Question 26

Loss of which gene is typical of CLL

Answer 26

ATM (disurption of DNA repair pathways is one of the common contributors to CLL pathophysiology)

Question 27

Clinical features of hepatosplenic T cell lymphoma

Answer 27

Young male in 30s + hepatomegaly + no lymphadenopathy + aggressive phenotype

Question 28

Defining cytogenetic abnormality of hepatosplenic t cell lymphoma

Answer 28

Isochromosome 7q