Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OMS III > IM Oncology > Flashcards

IM Oncology Flashcards

1
Q

Breast Cancer

Presentation

A

breast cancer is found in asymptomatic women on screening ammography or by the palpation of a mass by the pt or a physician. when breast cncer presents as a plapable mass, it is hard to the touch. it may also be associated with retraction of the nipple bc ligaments int eh breast will withdraw and pull the nipple inward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Breast Cancer

diagnostic tests

A

FNA

core needle biopsy
open biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Breast Cancer is usually

A

painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Breast Cancer

FNA

A

usually the best initial biopsy. the false positive rates are less than 2%. however, bc fna is a small sample the disadvantages are a false negative rate of 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Breast Cancer

core needle biopsy

A

this is a larger sample of the breast. it is more deforming, but you can test for estrogen receptors (ER), progesterone, receptors (PR), and HER 2/neu. the difficulties inclued greater deformity with the procedure and the possibilitiy taht the needle will miss the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Breast Cancer

open biopsy

A

the most accurate diagnostic test, allows for frozen section to be done while the pt is in the operating room followed by immediate resection of cancer followed by sentinel node biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when can you not test for estrogen progestreon or her2/neu

A

on FNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

mammography

A

indicated to screen for breast cancer in the general population starting at age 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

why do a mammo on a person with a palpable mass

A

bc 5-10% of pts have bilateral disease, also to determine if there is multiple or just a single mass.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when is ultrasound the answer with breast lesion

A

clinically indeterminant mass lesions, it tells cysts versus solid lesions

if it is painful

if it varies in size with menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when is PET scan the answer with breast lesion

A

to determine the content of abnormal lymph nodes that are not easily accessible to biopsy, cancer increases uptake on PET scan

like an abnormal hilar lymph node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how do you tell the content of an abnormal inaccessible lesion without biopsy

A

PET scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is BRCA testing the answer to breast lesion

A

BRCA is definitely associated with an increased risk of breast cancer, particularly within families

BRCA is associated with ovarian cancer and pancreatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what do you do if pt is BRCA positive

A

BRCA has not yet been shown to add mortality benefit to usual management. however, some pts opt for bilateral mastectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is sentinel lymph node biopsy the answer to breast lesion

A

Sentinel node biopsy is done routinely in all pts at the time of lumpectomy or mastectomy

a negative sentinel lymph node eliminates the need for axillary lymph node dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When are estrogen and progesterone receptors tested in breast lesion

A

estrogen recptor and prgesterone rectpro testing is routine for all pts

hormone manipulation therapy is done if either test is positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

step 2 will not test on

A

who should get brca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Breast Cancer treatment

surgery

A

lumpectomy with radiation is equal in efficacy to modified radical mastecomty but much less deforming. the addition of radiation to lumpetomy is not a small issue. radiation at the site of the cancer is indispensible in preventing recurrences at the breast. lumpectomy is contraindicated if the cancer is multifocal or radiation is contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

radical mastectomy is

A

always the wrong answer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Breast Cancer treatment

hormonal manipulation

A

all ER or Pr positive pts should receive tamoxifen, faloxifen, or one of the aromatase inhibitors (anastrazole, letrozole, exemestane). aromatase inhibitors seem to have a slight superiority in efficacy. if both are among the answer choices,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

aromatase inihibitors are the answer to

A

the most likely to benefit the pt question

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

aromatase inhibitors are generally for

A

postmenopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

tamoxifen is better in

A

premenopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

tamoxifen ae

A

endometrial cancer and clots (it is a selective ER modifier)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Aromatase inhibitors ae

A

osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Aromatase inhibitors moa

A

inhibit estrogen effect everywhere, even the good effects like on bone density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Trastuzumab

A

all breat cancers should be tested for Her 2/neu. this is an abnormal estrogen receptor

those who are positive should receive anti-Her 2/neu antibodies (trastuzumab)

decreases the risk of recurrent disease and increase survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

adjuvant chemotherapy in breast cancer

A

not prohylactic bc pt already has the disease

it is not treatmen tsinc eth termi implies there are no clearly identified mets

adjuvent meant an additional therapy to clean up presumed microscopic cancer cells too small in amount to be detected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When is adjuvant chemotherapy in breast cancer the answer

A

lesions are larger than 1 cm

positive axillary lymph nodes are found

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

when to use tamoxifen in prophylaxis

A

when multiple first degree relatives have breast cancer, it lowers the risk of breast cancer

31
Q

what lowers mortality with breast cancer

A

mammography

ER/Pr testing, then tamoxifen/raloxifen

aromatase inhibitors

adjuvant chemo

lumpectomy and radiation

modified radical mastectomy

trastuzumab (anti-Her 2/neu)

prophylaxis with tamoxifen (or raloxifene)

32
Q

we do not know whaat to do when what is positive

A

BRCA

33
Q

Prostate Cancer

presentation

A

obstructive symptoms on voiding similar to benign prostatic hypertrophy or a palpable lesion on exam.

34
Q

Prostate Cancer

best initial test and accurate test

A

biopsy and biopsy

35
Q

most prostate cancers are

A

asymptomatic

36
Q

Prostate Cancer

treatment

A

prostatectomy may have a slight benefit over radiation in terms of survival

37
Q

most common complications of prostatectomy

A

ed

urinary incontinence

38
Q

Localized Prostate Cancer treatment

A

it is not known whether prostatectomy, external beam radiation, implantable radioactive pellets, or watchful waiting is uperior in localized prostate cancer

39
Q

what prostate treatment gives ED

A

surgery>radiation

40
Q

Prostate Cancer

Gleason Grading

A

a measure of the aggressiveness or malignant potential of prostate cancer

a high gleason grade suggests a greater benefit of surgical removal of prostate

get it out before it metastasized if the gleason grade is high

41
Q

hormonal manipulation in Prostate Cancer

A

flutamide, GNRH agonists, ketoconazole, and orchiectomy help control the size and progression of mets once they have occurred. they do not prevent recurrences like tamoxifen, they shrink lesions that are already there

42
Q

wrong answers in Prostate Cancer

A

no screening imaging study (us is not a screening test it is used to localize lesions to biopsy when psa is high

lumpectomy

chemo is used only if hormonal therapy doesnt work

no hormonal manipulation prevents recurrences

43
Q

PSA

A

there is no clear mortality benefit

no to be routinely offered to pts

normal psa does not exclude cancer

never do above 75

44
Q

psa corresponds to

A

th volume of cancer

the higher the psa the greater the risk of cancer

45
Q

how many men above age 80 have prostate cancer on autopsy

A

50%

46
Q

what to do if pt asks for psa

A

do the test

47
Q

elevated psa

palpable mass

next step

A

biopsy the mass

48
Q

elevated psa

no palpable mass

next step

A

transrectal us

mass seen (then do a biopsy)

mass not seen (multiple blind biopsies)

49
Q

screen for lung cancer annually with low dose chest CT in those with:

A

30 pack year smoking hx

and

age 55-80

50
Q

Lung cancer

who should be treated with surgery

A

the size of the lesion is not the most important factore in whether or not the lesion if resectable. if the lesion is large, but is surrounded by normal lung and there is enough remaining lung function post resection, then surgery is still possible.

51
Q

Lung cancer

when is surgery not possible

A

bilateral disease or lymph nodes involved on opposite side

malignant pleural effusion

heart, carina, aorta, or vena cava is involved

52
Q

Small cell cancer is considered

A

unresectable bc it is metastatic or spread outside of one lung in 95% of cases

53
Q

Ovarian Cancer

screening test

A

there is none

54
Q

Ovarian Cancer

look for

A

a woman above the age of 50 with increasing abdominal girth but who is still losing weight

BRCA is associated with ovarian cancer

55
Q

Ovarian Cancer

initial test

A

us or Ct

56
Q

Ovarian Cancer

most acccurate diagnostic test

A

biopsy

57
Q

Ovarian Cancer

ca125

A

not for screening, only used in the follow-up of treatment

58
Q

Ovarian Cancer

treatment

A

the only cancer in which removing large amounts of locally metastatic dz will benefit the pt. remove all visible tumor and pelvic organs and give chemo

59
Q

Testicular Cancer

presentation

A

painless lump in the scrotum that does not transilluminate

incraesed with hx of cryptorchidism

60
Q

Testicular Cancer Diagnostic testing

orchiectomy

A

use inguinal orchiectomy, do not cut the scrotum bc it can spread the disease

61
Q

Testicular Cancer Diagnostic testing

needle biopsy

A

always the wrong answer

62
Q

Testicular Cancer Diagnostic testing

markers

A

alpha fetoprotein is secreted by nonseminomatous cancers

HCG is up in all of them

63
Q

Testicular Cancer Diagnostic testing

staging

A

performed with abdominal, pelvis, and chest CT

it mestatasizes throught he lymphatic channels in the retroperitoneum and muves up into the chest

64
Q

Testicular Cancer

treatment

A

after orchiectomy, radiation is used for local disease and chemo is used for widespread dz (seminomas)

65
Q

Testicular Cancer

chemo

A

one of the only cancers where chemo can cure mets even in the brain

66
Q

seminoma

A

sensitive to chemo and radiation

67
Q

non-seminoma

A

sensitive to chemo

68
Q

in cervical cancer pap smear does not lower mortality as much as

A

mammo or colonoscopy

69
Q

managment of advanced cervical cancer

A

hysterectomy

70
Q

Pervention of Cervical cancer

A

HPV vaccine is givent o all women between ages 11 and 26

pap smear is performed starting at age 21. Repeat test every 3 years until the age of 65. of women with fatal cervical cancer 85% have never had a pap smear, if testing HPV can increase to every 5 years

71
Q

Detection of Cervical cancer

low-grade and high grade syplasia on pap smear is followed up with a

A

colposcopy for a biopsy

72
Q

Detection of Cervical cancer

atypical squamos cells of undetermined significance (ASCUS)

A

can be a sign or early, perinvasive cancer or an infection, or may simply be a false positive

73
Q

Detection of Cervical cancer

if ASCUS is present

A

perfomr HPV testing, if HPV is found, colposcopy is performed

74
Q

Detection of Cervical cancer

if hpv is not associated with ASCUS,

A

repeat the pap smear at 6 months

OMS III (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions