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Clinical medicine A > Lecture 9: Principles of Onco Part 1 (enoch) > Flashcards

Lecture 9: Principles of Onco Part 1 (enoch) Flashcards

1
Q

How many deaths is cancer responsible for in the US?

A

1 in 4 deaths ):

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2
Q

What # cause of death is cancer in the US?

A

1 is Tobacco

Second leading cause.

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3
Q

What are the 4 MC cancers?

A

Breast
Colon
Lung
Prostate

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4
Q

What are the top 3 MC cancers for males? Females?

A

Males:
Prostate
Lung/bronchus
Colorectal

Females:
Breast
Lung/bronchus
Colorectal

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5
Q

What is the MC cancer to cause death in our age group?

A

Leukemia

Breast

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6
Q

What factors affect a person’s chance of developing cancer?

A

Exposure to certain environmental factors (diet, hormones)

Genetic makeup
Age/gender

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7
Q

What is cancer prevention concerned with?

A

Identification and manipulation of biologic, environmental, social, and genetic factors.

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8
Q

What is primary prevention?

A

Health lifestyle, designed to avoid ALL carcinogens.

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9
Q

What is the biggest factor in cancer susceptibility?

A

Environment!!

Genes play a minor role and are only for a few select cancers.

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10
Q

What is the most common PREVENTABLE cause of cancer death in the US?

A

Smoking tobacco

80% of lung cancers are associated with smoking tobacco.

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11
Q

What is adequate physical activity good at preventing cancer-wise?

A

Reduced risk of colon and breast cancer.

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12
Q

At what BMI does cancer risk seem to start increasing significantly?

A

25

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13
Q

What kind of diets are associated with increased risk of breast, colon, prostate, and endometrium?

A

Diets high in fat.

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14
Q

Eating what in your diet is associated with a reduced risk of colonic polyps and colonc cancer?

A

Dietary fiber!

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15
Q

What does alcohol increase the risk of cancer-wise?

A

Mouth
Esophagus
Liver
Throat

Breast
Larynx
Stomach

MELT Bacon Lettuce Sandwiches in tequila

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16
Q

What cancer is EBV most associated with?

A

Burkitt’s lymphoma
Nasal T cell lymphoma

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17
Q

What cancer is estrogen most associated with?

A

Endometrium
Liver
Breast

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18
Q

What cancer is ethyl alcohol most associated with?

A

Liver
Esophagus
Head and Neck

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19
Q

What cancer is H. pylori most associated with?

A

Gastric cancer
Gastric MALT lymphoma

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20
Q

What cancer is Hep B or C most associated with?

A

Liver

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21
Q

What cancer is UV sunlight most associated with?

A

Skin cancer

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22
Q

What cancer is tobacco most associated with?

A

Cancer of the upper aerodigestive tract
Bladder

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23
Q

What is secondary prevention concerned with?

A

Early detection and treatment.

Identifying people who are most at risk and implementing screening assessments for them.

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24
Q

What 4 things describe a screening test’s capability?

A

Sensitivity: # of people who test true positive in the screening.
Specificity: # of people who are true negatives in the screening.
PPV: # of people who are positive that have disease.
NPV: # of people who are negative that lack disease.

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25
What cancers do we generally screen for routinely?
Breast Cervical Colon Prostate Lung (if at risk)
26
When are annual mammograms indicated?
Age 40
27
What is not recommended per USPSTF and ACS?
Clinical breast exams Self breast exams
28
When does colorectal cancer screening begin?
Age 45
29
When does cervical cancer screening begin?
21
30
What is the mnemonic for warning signs of cancer?
CAUTION Change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in breasts, testes, etc. Indigestion or difficulty swallowing Obvious change in size/color of a mole Nagging cough or hoarseness
31
What are some classical findings of cancer?
Nighsweats Unexplained weight loss or loss of appetite Persistent low-grade fever Chronic pain Persistent fatigue
32
What must be done to diagnose someone with cancer 100%?
An invasive tissue biopsy. Non-invasive diagnostic tests are only suggestive.
33
What are the two components to diagnosing cancer?
Staging it Monitoring it
34
What is staging?
Determining the extent of a disease, prognosis, and best treatment plan.
35
How common is depression in cancer pts?
25% incidence rate
36
What are some options we can treat with if a cancer pt becomes depressed?
SSRIs Sertraline Paroxetine TCAs
37
What are the two types of staging?
Clinical staging Pathologic staging
38
What is clinical staging?
PE Radiographs Isotopic scans CT scans
39
What is pathologic staging?
Palpation Resection of lymph nodes Inspection and biopsy. Generally the info you obtain during a surgical procedure.
40
What is the first step in managing a cancer pt?
Determining the extent of the disease, aka staging it.
41
What is the common way to stage a cancer?
TNM Tumor Node Metastasis
42
What is each component of TNM associated with?
Tumor is to check the size of the main tumor and if it has spread nearby. Node is whether it has spread to regional lymph nodes. Metastasis is whether it has spread beyond its region to other organs.
43
What kind of cancers cannot be staged by something like TNM?
Hematopoietic cancers, like leukemia or lymphoma.
44
What is physiologic reserve?
A patient's likelihood of being able to cope with the physiologic stresses of cancer treatment.
45
What are some markers for physiologic reserve?
Age Karnofsky performance status Eastern cooperative oncology group performance status (ECOG)
46
How is Karnofsky performance status graded?
0-100, 100 being normal. Has to do with ability to take care of oneself physically.
47
How is ECOG status graded?
Grade 0-5. Grade 5 is dead. Grade 4 is bedbound
48
What are the two goals of a treatment plan for cancer?
Curative Palliative
49
What is the difference between remission and relapse?
Remission is lack of S/S of cancer. Relapse is a return of S/S. Treating a relapse is called salvage therapy.
50
What is palliative care?
Improving quality of life. Managing symptoms No goal of curing the disease.
51
What are tumor markers mainly used for?
Determining a patient's RESPONSE to treatment.
52
What cancer is HCG associated with?
Gestational trophoblastic disease, gonadal germ cell tumor. Also in pregnancy.
53
What cancer is calcitonin associated with?
Medullary cancer of the thyroid
54
What cancer is alpha-fetoprotein associated with?
Hepatocellular carcinoma Gonadal germ cell tumor.
55
What cancer is carcinoembryonic antigen (CEA) associated with?
Adenocarcinomas of the colon, pancreas, lung, beast ovary Also in pancreatitis, hepatitis, IBD, and smokers
56
What cancer is LDH associated with?
Lymphoma Ewing's sarcoma Also in Hepatitis, hemolytic anemia, and many others.
57
What cancer is PSA associated with?
Prostate Also in prostatitis and BPH
58
What is cancer is CA-125 associated with?
Ovarian cancer Lymphomas Also in menstruation, peritonitis, and pregnancy.
59
What cancer is CA 19-9 associated with?
COLON Pancreatic Breast Also in pancreatitis and ulcerative colitis.
60
What tumor markers can be present in pregnancy?
HCG CA-125
61
What tumor markers are specifically tumor-associated proteins?
PSA CA-125 CA 19-9
62
What tumor marker is mainly for colon cancer?
CA 19-9
63
What is the biggest risk factor for cancer that we CANNOT modify?
Age
64
What is the most common cancer to cause death?
Lung cancer
65
What are the oncofetal antigens that are used as tumor markers?
Alpha fetoprotein CEA
66
What enzyme is used as a tumor marker?
LDH

Clinical medicine A (32 decks)

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