MKSAP HemeOnc VII

Question 1

An _____, such as pembrolizumab, shows benefit in patients with metastatic mismatch repair−deficient colorectal cancer.

Answer 1

immune checkpoint inhibitor

Question 2

EGTR inhibitors such as panitubmumab or cetuximab are inappropriate for patients with mutation in ___, ____, or ____ genes.

Answer 2

KRAS, NRAS, BRAF

Question 3

_____replacement therapy reduces the risk of infections in patients with chronic lymphocytic leukemia with documented hypogammaglobulinemia.

Answer 3

IV IgG

Question 4

The ___ mutational status of tumors should be tested in patients with metastatic disease to determine if they are candidates for treatment with an epidermal growth factor receptor inhibitor, such as cetuximab or panitumumab.

Answer 4

RAS

Question 5

_____is an appropriate option for patients with metastatic non–small cell lung cancer who respond to first-line platinum-based chemotherapy.

Answer 5

Maintenance chemotherapy.

Either the nonplatinum agent used for first-line treatment is continued as a single agent (“continuation maintenance”) or an alternative agent, most commonly docetaxel, is used (“switch maintenance”).

Question 6

Erlotinib is effective only in patient with ____ mutation.

Answer 6

EGFR

Question 7

Early-stage laryngeal cancer is most appropriately treated with ___ because it is highly effective in that area, has low morbidity, and is associated with superior voice quality compared with patients who are treated with surgery.

Answer 7

radiation alone

Question 8

Rectal cancers without full thickness penetration of the bowel wall or involved lymph nodes are stage I and are treated with ____ ONLY.

Answer 8

surgical resection ONLY

Question 9

Neutropenia typically occurs ____ days after administration of chemotherapy

Answer 9

5 to 15

Question 10

When do you give G-CSF?

Answer 10

Day 2 of chemotherapy for primary and secondary prophylaxis of neutropenia (but you don’t give it to patients who are already neutropenic because there is little benefit)

Question 11

High-risk gastrointestinal stromal tumors should be treated with surgery and 3 years of adjuvant ___.

Answer 11

imatinib

Almost all GISTs have an activating mutation in the c-KIT proto-oncogene, leading to constitutive activation of the KIT receptor tyrosine kinase. They are resistant to radiation.

Question 12

Most patients with superior vena cava syndrome do not require emergency intervention, and a tissue biopsy should be obtained. ___ with biopsy has a diagnostic yield of over 90% and is more likely than core biopsies to obtain specimens adequate for determining nodal architecture and histologic subtype if a lymphoma is present.

Answer 12

Mediastinoscopy

Percutaneous intravascular stents can be placed in patients with respiratory distress before tissue biopsy, but only place first if there is respiratory distress.

Question 13

____ is the treatment for patients with locally advanced head and neck cancer after surgery when there are positive surgical margins or evidence of nodal metastases with extracapsular extension.

Answer 13

Combined chemotherapy and radiation

Question 14

Adjuvant ___ for stage II and stage III non–small cell lung cancer provides a survival advantage after surgery.

Answer 14

cisplatin-based chemotherapy (NO RADIATION NEEDED only for Stage III lung cancer with clinically evident mediastinal LAD)

Question 15

Erythrocytosis is a common paraneoplastic syndrome associated with ___. Note: these people will have high Hgb and high EPO whereas PV will have low EPO. Note other causes of secondary elevation in Hgb are lung pathologies like OSA.

Answer 15

kidney cancer

Question 16

Most patients with good performance status can be considered for surgical resection for liver CRC mets unless they have one of three conditions:

Answer 16

1. tumor involvement of the common artery or portal vein or common bile duct
2. more than 70% liver involvement, more than six involved segments, or involvement of all three hepatic veins
3. a predicted inadequate hepatic reserve after resection.

Question 17

Women with isolated axillary lymph-node adenocarcinoma metastases should be presumptively considered to have locoregional breast cancer and should be treated as such. ___ is indicated in this setting and reveals a primary breast mass in 50% to 70% of patients.

Answer 17

Breast MRI

Women with isolated axillary lymph-node adenocarcinoma metastases should be presumptively considered to have locoregional breast cancer and should be treated as such. Meaning that they should get surgery and adjuvant chemo then radiation afterwards (but not as initial management).