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Oncology > MKSAP Oncology > Flashcards

MKSAP Oncology Flashcards

1
Q

What is the treatment for metastatic cholangiocarcinoma?

A

Gemcitabine-Cisplatin

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2
Q

What are two chemo agents that can cause HTN and AKI due to thrombotic microangiopathy?

A

Bevacizumab, Gemcitabine

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3
Q

What is the initial chemotherapy for leptomeningeal metastases from leukemia and lymphoma?

A

Methotrexate and cytarabine

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4
Q

What are two main side effects of tyrosine kinase inhibitors?

A

Fluid retention, QTc prolongation

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5
Q

What is the treatment for AML in younger adults vs. older adults (4 options)?

A
  1. Anthracycline + Cytarabine

2. Hydroxyurea, low dose cytarabine, decitabine, or azacitidine

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6
Q

Between NPM1-mutated AML and FLT3-ITD AML, which has a favorable outcome and which has a poor outcome?

A

NPM1 has favorable outcome

FLT3 has poor outcome; consider midostaurin with 7+3, and transplant in first remission

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7
Q

What is the chemo regimen for ALL? Is CNS prophylaxis and/or maintenance treatment needed?

A

DVAP - Daunorubicin, vincristine, asparaginase, prednisone

CNS ppx is required, and maintenance with daily PO mercaptopurine and weekly methotrexate

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8
Q

What are the differences between SPEP, UPEP, free serum light chains, and serum/urine immunofixation?

A

Monoclonal protein can be a complete immunoglobulin with a heavy chain (IgG, IgA, IgD, or IgM) complexed with a light chain (kappa or lambda), or free light chains without a heavy chain component
SPEP & UPEP can quantify the presence of a monoclonal protein but cannot identify the subtype of immunoglobuiln, and may miss small M proteins
Serum FLC testing detects light chains that are not bound to heavy chains, and can quantify them
Serum/urine immunofixation can subtype the immunoglobulin and differentiate monoclonal vs. polyclonal spike

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9
Q

What are the 3 criteria for MGUS?

A

Monoclonal protein (M protein) <3 g/dL or urinary monoclonal FLCs <500 mg/24 hours
Clonal plasma cells comprising <10% of bone marrow cellularity
Absence of end-organ damage signs/sx

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10
Q

What are the 3 criteria for patients w/ smoldering multiple myeloma at imminent risk of progression in next 2 years, meaning they require immediate treatment?

A

> 60% plasma cells in bone marrow, more than one focal lesion on bone MRI, or serum FLC ratio <0.01 or >100

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11
Q

What is the criteria for smoldering multiple myleoma? What should be used to assess for bony lesions?

A

Monoclonal protein >3 g/dL, urine free light chains >500 mg/24 hours, 10-59% plasma cells in bone marrow, and no CRAB criteria (end organ damage)
Need whole body MRI (bone scan does not detect lytic lesions)

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12
Q

What are some induction chemotherapy regimens for multiple myeloma?

A

RVD (revlimid or lenalidomide), Velcade (Bortezomib), Dexamethasone
VCD - Velcade, Cyclophosphamide, Dexamethasone
VTD - Velcade, Thalidomide, Dexamethasone
Alkylating agent Melphalan or cyclophosphamide are alternatives for non transplant candidates

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13
Q

What is the main side effect of lenalidomide and pomalidomide? Bortezomib (name 2)? Thalidomide?

A
  1. VTE
  2. Peripheral neuropathy, herpes zoster reactivation, LV dysfunction
  3. Peripheral neuropathy, VTE
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14
Q

What are aprepitant and netupitant used for?

A

Neurokinin 1 receptor blockers used for chemotherapy related nausea/vomiting

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15
Q

What are some side effects of 5-fluorouracil and capecitabine? Name 3.

A

Hand-foot syndrome
Coronary spasm and ischemia during administration
Neutropenia

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16
Q

What are some chemotherapy agents that are associated w/ pulmonary toxicity? Name 3.

A

Bleomycin, Nitrosureas (carmustine, lamustine, sumstine), Gemcitabine - these have the strongest association
Rituximab, Trastuzumab, Cetuximab, Erlotinib

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17
Q

What are 2 chemo agents that can cause significant tubular toxicity? What are 2 chemo agents that can cause hemorrhagic cystitis? What are 2 chemo agents that can cause HUS?

A
  1. Cisplatin, Ifosfamide
  2. Cyclophosphamide, Ifosfamide
  3. Mitomycin, Gemcitabine
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18
Q

What chemo agent causes a transient hypersensitivity to the cold forcing patients to avoid drinking, eating, or touching cold items for several days after infusions?

A

Oxaliplatin

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19
Q

What are 2 chemo agents that are associated w/ cerebellar toxicity?

A

5-fluorouracil

High dose cytosine arabinoside

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20
Q

What are 2 chemo agents associated with reversible encephalopathy syndrome - presents w/ HA, visual changes, delirium, and seizures?

A

Bevacizumab, Sunitinib

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21
Q

What cardiac side effects are the following associated with? Nilotinib, Ponatinib, Dasatinib?

A

Nilotinib & Ponatinib - coronary insufficiency

Dasatinib - pulmonary HTN

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22
Q

When should screening breast MRI start in women who have received radiation to the mediastinum?

A

25 y.o. or 8 years after completion of radiation therapy, whichever occurs last

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23
Q

Which cytogenetic patterns in AML are high risk vs. favorable risk in the following: t(8;21), inv(16), t(15;17), -5, -7, -5q, 3q?

A

Favorable: t(8;21), inv(16), t(15;17)

High risk: -5, -7, -5q, 3q

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24
Q

What is differentiation syndrome (name 3 findings) and how is it treated?

A

Fever, pulmonary infiltrates, hypoxemia, and occasionally hyperleukocytosis; can have pericardial or pleural effusion
Seen with ATRA for APML treatment
Tx: dexamethasone

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25
Q

What are some chemotherapy agents that increase risk for VTE? Name 4.

A

Thalidomide, Lenalidomide, Bevacizumab, Sunitinib, Sorafenib, Cisplatin, Erlotinib

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26
Q

What 3 genes should be tested in colorectal cancer? If this mutation is present what 2 chemo agents cannot be used, and what is their major side effect?

A

KRAS, NRAS, BRAF genes
Cetuximab, Panitumumab (EGFR inhibitors)
Major side effect is acneiform rash (painful, pruritic)

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27
Q

What is the MOA of ipilimumab? What is the MOA of nivolumab and pembrolizumab?

A
  1. Anti-CTLA-4

2. Anti-PD-1

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28
Q

What imaging/test/procedure should be performed for isolated inguinal lymphadenopathy?

A

Anoscopy

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29
Q

What are the 3 mutations found in melanoma?

A

BRAF (50%)

MEK or NRAS (20%)

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30
Q

What are the treatment regimens in melanoma?

A

Surgery
BRAF inhibitors - Vemurafenib, Dabrafenib
MEK inhibitors - Trametinib, Cobimetinib
Combine above for patients w/ BRAF mutations
Ipilimumab (anti-CTLA-4) + Nivolumab or Pembrolizumab (anti-PD-1) despite BRAF status

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31
Q

What is the MOA for tamoxifen and raloxifene? What are some side effects? Name 4. Which one has lower vascular risk?

A
  1. Selective estrogen receptor modulator (SERM)
  2. Vasomotor symptoms, cataracts, vascular events (stroke, TIA, DVT/PE), endometrial cancer, uterine sarcoma; reduction in osteoporotic fractures
  3. Raloxifene has 25% lower risk of vascular events
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32
Q

What is the MOA for anastrozole and exemestane? What are some side effects? Name 5.

A

Aromatase inhibitor
Vasomotor symptoms, arthralgia, joint stiffness, bone pain, headache, insomnia, osteoporosis
Anastrozole has above + carpal tunnel syndrome, dry eyes, HTN

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33
Q

When should breast cancer screening start for women w/ BRCA mutations? When should a prophylactic BSO be performed?

A
  1. Age 25 with breast MRI, age 30 with mammography
  2. BSO should be performed between ages 35-40 for BRCA1 carriers, age 40-45 for BRCA2 carriers (since they develop ovarian cancer 8-10 years later)
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34
Q

At what stages of breast cancer should you perform imaging studies for staging?

A

Stage III and beyond

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35
Q

When can breast conservation therapy (wide excision followed by radiation) be used? When is axillary dissection required?

A
  1. Cancers <5 cm, without skin involvement, and with clear margins after excision
  2. Clinically involved axillary nodes, 3 or more positive sentinel nodes, and/or if patient will be receiving chemotherapy or anti-estrogen therapy in addition to whole breast radiation
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36
Q

Who should receive adjuvant endocrine therapy for breast cancer and for how long?

A

Hormone receptor positive patients
Tamoxifen is preferred in pre-menopausal women for at least 5 years, but 10 years is recommended; ovarian suppression w/ surgical oophorectomy or pelvic irradiation for premenopausal women also receiving chemotherapy (high risk)
Aromatase inhibitors are preferred in post menopausal women for a total of 10 years

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37
Q

What is the 21 gene recurrence score and when is it used?

A

Multigene assay that predicts recurrence of hormone receptor positive, HER2 negative invasive breast cancers with anti-estrogen therapy alone - determines need for adjuvant chemotherapy

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38
Q

When should triple negative breast cancers get adjuvant chemotherapy? What are the most common chemotherapies used?

A
  1. > 5 mm in size or with positive lymph nodes

2. Anthracyclines, cyclophosphamide, and taxanes (paclitaxel, docetaxel)

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39
Q

When should HER2 positive cancers receive adjuvant chemotherapy? What HER2 targeted treatment should be used?

A
  1. > 5 mm in size and/or lymph node positive
  2. Trastuzumab and Pertuzumab (combined if >2 cm in size and/or node positive); if <3 cm in size and node negative, can treat w/ trastuzumab + paclitaxel for less toxicity
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40
Q

What medications should be avoided w/ tamoxifen?

A

Medications with strong CYP2D6 inhibition such as bupropion or fluoxetine, as they may decrease tamoxifen activation

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41
Q

In metastatic breast cancer, what can be combined with anti-estrogens to improve response rate to hormonal therapy?

A

Palbociclib (CDK4/6 inhibitor) or Everolimus (mTOR inhibitor)
Those who develop metastatic breast cancer during adjuvant therapy w/ aromatase inhibitor, first line is palbociclib + fulvestrant (inhibits estrogen receptor function)
Those who develop metastatic breast cancer after having completed adjuvant therapy w/ aromatase inhibitor, palbociclib + aromatase inhibitor is first line

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42
Q

What is the treatment regimen for HER2 positive metastatic breast cancer?

A

Trastuzumab and Pertuzumab + Docetaxel

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43
Q

What are single agent chemotherapy options used in metastatic breast cancer? Name 4.

A

Taxanes, Capecitabine, Gemcitabine, Liposomal doxorubicin, Eribulin, Ixabepilone

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44
Q

What are treatment options for BRCA carriers with metastatic breast cancer?

A

Olaparib, Talazoparib (Poly (ADP-ribose) polymerase (PARP) inhibitors)

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45
Q

What is used in multiple myeloma to prevent skeletal events?

A

Zoledronic acid or Pamidronate

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46
Q

What is the maintenance treatment for patients with BRCA mutations and advanced ovarian cancer previously treated w/ 3 lines of chemotherapy?

A

Olaparib

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47
Q

What are the treatment options for ovarian cancer?

A

Carboplatin + Paclitaxel
Surgery
Intraperitoneal chemotherapy if stage III and above (spread to abdomen)

48
Q

What is the treatment for stage III cervical cancer (extend to pelvic wall and/or involves lower third of vagina and/or causes hydronephrosis)? Those w/ distant metastases?

A
  1. Radiation with concurrent platinum-based chemotherapy (cisplatin)
  2. Same as above + bevacizumab
49
Q

Stage I rectal cancer is managed with surgery. What is the management for stage II (full thickness tumors) and above rectal cancer?

A

Radiation, chemotherapy, and surgery
5-FU or oral capecitabine is given with radiation
FOLFOX (FOLinic acid or leucovorin, 5-FU, OXaliplatin) is given for the chemo-only portion of treatment

50
Q

What is the management for stage II colon cancer? Stage III and above?

A 
Stage II w/o high risk features -> surgery
Stage II w/ high risk features (poorly differentiated, T4 primary tumor [invasion into adjacent structures or through peritoneum], lymphovascular invasion, elevated post-op CEA, perforation/obstruction) -> adjuvant 5-FU or capecitabine
Stage III (lymph node metastasis)-> FOLFOX or CAPOX (CAPecitabine and OXaliplatin)
51
Q

What are some 3 chemotherapy regimens used for metastatic colon cancer? What agent can be used to increase the efficacy of the regimen, and what are some side effects of this?

A

FOLFOX, CAPOX, FOLFIRI (Folinic acid, 5-FU, irinotecan)
Bevacizumab to potentiate other chemotherapies; side effects include HTN, interference with wound healing (needs to be discontinued 6-8 weeks before surgery and withheld for at least a month after surgery), VTE (including MI and cerebrovascular accidents), GI perforations, reversible encephalopathy syndrome

52
Q

What must be present in metastatic colon cancer in order to use pembrolizumab or nivolumab?

A

dMMR mutation (mismatch repair) or MSI (microsatellite instability); some of these patients have Lynch syndrome

53
Q

What are treatment options for anal cancer?

A

Mitomycin + 5-FU or capecitabine
Radiation
Avoid surgery

54
Q

What is the treatment for non-metastatic pancreatic cancer? Metastatic pancreatic cancer?

A
  1. Gemcitabine + Capecitabine

2. Oxaliplatin, Irinotecan, 5-FU, Leucovorin (FOLFIRINOX), or Nab-Paclitaxel + Gemcitabine

55
Q

Which type of gastrointestinal tumor warrants PET-CT for pre-operative staging?

A

Gastroesophageal cancer

56
Q

What protein receptor should all gastroesophageal cancers be tested for?

A

HER2 overexpression - can use Trastuzumab

57
Q

What mutation is found in GIST tumors? What is the treatment for this cancer?

A
  1. c-kit
  2. Surgery for localized, low risk tumors; adjuvant Imatinib for higher risk tumors (occur outside of stomach, large size, and higher mitotic index), or patients w/ unresectable or metastatic disease
58
Q

Neuroendocrine tumors are typically indolent. What is the treatment for pancreatic NETs when tx is needed?

A

Temozolamide + Capecitabine, or Sunitinib, or Everolimus

59
Q

What is the main chemotherapy agent used in NSCLC? What are the 4 most commonly used chemo partners?

A
  1. Cisplatin

2. Pemetrexed, Gemcitabine, Docetaxel, Vinorelbine

60
Q

What mutations should be screened for in metastatic NSCLC? What are the treatment options if these are present?

A

EGFR, ALK, ROS1, PD-L1
EGFR -> Erlotinib
ALK or ROS1 -> Crizotinib
PD-L1 -> Pembrolizumab

61
Q

In addition to cisplatin which chemo agent is preferred in metastatic adenocarcinoma? What is an agent that can be given in combination? Should there be maintenance chemotherapy?

A
  1. Pemetrexed in adenocarcinoma
  2. Bevacizumab - improves survival
  3. Yes - continue pemetrexed; alternatively can use docetaxel
62
Q

What is the management for small cell lung cancer?

A

Cisplatin based chemo, typically + etoposide; can also use gemcitabine
Radiation
Prophylactic cranial irradiation
*No need for molecular profiling

63
Q

Which type of lung cancer presents in the peripheral lung parenchyma as a solitary nodule or mass? In the central airways, and may have post-obstructive PNA or lobar collapse? Peripheral mass w/ prominent necrosis? In the central airways with extensive lymphadenopathy and distant metastasis?

A
  1. Adenocarcinoma
  2. Squamous cell carcinoma
  3. Large cell carcinoma
  4. Small cell carcinoma
64
Q

What tumor stain is used in evaluation of head/neck cancer? Which imaging studies?

A
  1. p16 for HPV

2. MRI > CT; PET-CT

65
Q

What is the main chemo agent is used in advanced head and neck cancer? What is it combined w/ in distant metastasis? What can be used if it continues to progress?

A

Cisplatin; use Cetuximab if CKD
If distant metastasis or unresectable persistent local disease can use with 5-FU and Cetuximab
Pembrozliumab and Nivolumab can be used if progression after platinum based chemotherapy

66
Q

What is the management for intermediate or higher risk localized prostate cancer? High risk or very high risk?

A

Radiation + GnRH agonist (Leuprolide) vs. Surgery

Above + Docetaxel

67
Q

What is the mainstay of therapy for metastatic prostate cancer?

A
  1. Androgen deprivation therapy - orchiectomy, GnRH agonist therapy (+/- anti-androgen), GnRH antagonist therapy
    * First use anti-androgen like Bicalutamide or Flutamide, b/c GnRH agonist therapy temporarily increases testosterone levels and can worsen metastasis
68
Q

What are treatment options for patients w/ metastatic prostate cancer that respond to ADT? Do not respond?

A
  1. ADT responders = castrate sensitive cancer; Docetaxel x 6 cycles
  2. Castrate resistant -> Docetaxel + Prednisone, Abiraterone (antiandrogen) + Prednisone, Enzalutamide (antiandrogen), Radium-223 (for symptomatic bone metastases), secondary hormone therapy; bisphosphonates if bone metastasis
69
Q

How do you diagnose testicular cancer? What is the preferred chemotherapy agent for treatment?

A
  1. Inguinal orchiectomy (after tumor markers are checked)

2. Cisplatin

70
Q

What are some paraneoplastic syndromes seen in RCC? Name 5.

A

Thrombocytosis, Erythrocytosis, Hypercalcemia, AA amyloidosis, Polymyalgia rheumatica, Stauffer syndrome (hepatic dysfunction in absence of liver metastasis), anemia

71
Q

What are some chemotherapy agents that can be used in RCC? Name 5.

A

Anti-PD1: Pembrolizumab, Nivolumab
VEGF inhibitors: Bevacizumab
VEGF tyrosine kinase inhibitors: Sunitinib, Sorafenib, Pazopanib, Axitinib
mTOR inhbitors: Everolimus, Temsirolimus

72
Q

What is the management for non-muscle invasive bladder cancer? Muscle invasive cancer? Metastatic disease?

A
  1. TURBT + intravesical chemotherapy w/ BCG or mitomycin
  2. Cystectomy +/- cisplatin
  3. Cisplatin; after further progression can use Atezolizumab (PD-L1 antagonist)
73
Q

What type of lymphoma is hepatitis C associated with? Human herpesvirus 8?

A
  1. Splenic marginal zone lymphoma

2. Kaposi sarcoma, primary effusion lymphoma, multicentric castleman disease

74
Q

What is the most common indolent B-cell lymphoma? What gene translocation is present? What is the treatment?

A
  1. Follicular lymphoma - accounts for 30% of NHL
  2. t(14;18), overexpression of bcl2
  3. Radiation for localized disease; R-CHOP, R-CVP, or Rituximab + Bendamustine for stage III or IV
75
Q

Which heme malignancy presents w/ increased lymphocytes, and expression of CD19, 20, 23, and CD5?

A

CLL

76
Q

What are the 2 first line therapies for hairy cell leukemia? What can be used in relapse?

A
  1. Cladribine, Pentostatin

2. Rituximab, Vemurafenib (BRAF inhibitor)

77
Q

What genes are overexpressed in double hit lymphoma? What is the treatment?

A

myc, bcl2, or bcl6

R-EPOCH

78
Q

Which type of lymphoma arises from thymic B cells, presents in younger patients (typically female), and w/ bulky disease?

A

Primary mediastinal large cell lymphoma

79
Q

What lymphoma is associated with t(11;14) translocation and overexpression of cyclin D1? What are the treatment options?

A
  1. Mantle cell lymphoma

2. Rituximab + Lenalidomide or Bendamustine (least aggressive) -> R-CHOP (most aggressive)

80
Q

What CD is found in anaplastic large cell lymphoma? What gene translocations/protein expression are important for prognostic reasons?

A
  1. CD30
  2. t(2;5) or variant ALK; ALK positive patients are typically younger and have more favorable prognosis, can be treated w/ crizotinib
81
Q

What are the 4 types of classical Hodgkin lymphoma? What is the treatment for Hodgkin lymphoma? What are tx options for relapsed or refractory disease?

A
  1. Nodular sclerosis, lymphocyte rich, mixed cellularity, lymphocyte depleted
  2. ABVD - doxorubicin, bleomycin, vinblastine, dacarbazine
  3. Brentuximab (anti-CD30), Pembrolizumab, Nivolumab
82
Q

What is the treatment for nodular lymphocyte predominant hodgkin lymphoma, which is associated w/ high rate of late relapse?

A

Radiation for early stage disease

Rituximab +/- chemotherapy for advanced or relapsed disease

83
Q

What is the management for a young man w/ poorly differentiated carcinoma characterized by centrally located bulky RP or mediastinal LAD?

A

Chemotherapy for germ cell tumor - cisplatin and etoposide

84
Q

What are some paraneoplastic syndromes associated with small cell lung cancer? Name 4.

A

SIADH, hypercortisolism (via ACTH), Lambert-Eaton syndrome, cortical cerebellar degeneration, limbic encephalitis, peripheral neuropathy

85
Q

Which type of lung cancer is associated w/ hypercalcemia?

A

Squamous cell carcinoma

86
Q

In patients with extensive disease and poor performance status, which should be offered chemotherapy? SCLC vs. NSCLC?

A

Those w/ SCLC should be offered chemo b/c it can improve sx and increase survival

87
Q

What tumor markers should be checked in testicular cancer? Which one is never elevated in a pure seminoma?

A

AFP, b-hCG, LDH

AFP is never elevated in a pure seminoma

88
Q

What mutation is associated w/ papillary thyroid carcinoma? Medullary thyroid carcinoma?

A
  1. BRAF gene mutation

2. RET proto-oncogene

89
Q

What are the 4 type of thyroid cancers, starting with most common to least common? Which thyroid cancer can not be treated w/ radioiodine after surgery?

A

Papillary -> follicular -> medullary -> anaplastic

Medullary b/c C cells do not take up radioiodine

90
Q

What are are the first line therapies for CLL?

A

Ibrutinib (BTK inhibitor) +/- Rituximab
Venetoclax (anti bcl2) +/- Obinutuzumab (anti-CD20)

Alternatives include cyclophosphamide, chlorambucil, bendamustine, fludarabine, cladribine, pentostatin, lenalidomide

91
Q

What is the management for a woman with axillary lymphadenopathy and normal breast mammogram/MRI?

A

Treat as stage II breast cancer

92
Q

What type of heme malignancy typically presents w/ cytopenia and splenomegaly, without LAD, and has the following surface markers: CD20, CD11c, CD25, CD103?

A

Hairy cell leukemia

93
Q

What is the management for men w/ early stage prostate cancer w/ limited life expectancy or significant co-morbidities?

A

Observation

94
Q

How do you diagnose suspected primary CNS lymphoma that is biopsy-inaccessible? If radiation is part of the treatment regimen, what type of radiation is used?

A
  1. Slit lamp exam and vitreous fluid collection w/ cytologic analysis
  2. Whole brain irradiation
95
Q

What is the management for women w/ high risk hormone receptor positive breast cancer that remain pre-menopausal after chemotherapy?

A 
Ovarian suppression (leuprolide) + aromatase inhibitor
Next option is ovarian suppression + tamoxifen
96
Q

Which malignancies is right supraclavicular lymphadenopathy associated with? Left supraclavicular LAD?

A

Right -> cancer in thorax (lungs, mediastinum, esophagus)

Left -> abdominal, lymphoma

97
Q

What are the 3 criteria for high risk prostate cancer?

A

PSA >20 ng/mL, gleason score 8-10, or evidence of extraprostatic extension of the cancer

98
Q

What is the management for SVC syndrome?

A

Mediastinoscopy to obtain tissue

Can place intravascular stent for patients in respiratory distress

99
Q

What is the management for a residual mass after treatment of bulky DLBCL?

A

Observation with serial CT scanning if diagnostic testing shows low likelihood of active disease (PET CT w/ no metabolic activity of mass)

100
Q

What is the preferred management for early stage laryngeal cancer? Early stage oral cancer?

A
  1. Radiation
  2. Surgery
    However either can be considered
101
Q

What is the management for melanoma with single metastasis to the brain? What is the management for lung cancer w/ brain metastases?

A

Surgical resection for both

102
Q

What are some chemo agents that lead to HTN? Name 3.

A

Bevacizumab, Sorafenib, Sunitinib

103
Q

What are some chemo agents that can lead to LV dysfunction? Name 5.

A

Cyclophosphamide, anthracyclines, taxanes, doxorubicin, trastuzumab, sunitinib, bortezomib, ifosfamide

104
Q

What are some chemo agents that can lead to bradycardia? Name 2.

A

Thalidomide, paclitaxel

105
Q

What are the contraindications to surgical resection of metastatic liver lesions? Name 4.

A

Involvement of the common artery or portal vein or common bile duct, >70% liver involvement, more than 6 involved segments, involvement of all 3 hepatic veins, predicted inadequate hepatic reserve after resection

106
Q

Who needs MRI for breast cancer screening? Name 5 groups.

A

BRCA mutation, first degree relative of BRCA carrier but are untested, strong fam hx of breast cancer w/ lifetime breast cancer risk >20-25%, radiation to chest between ages 10-30, hx of other rare familial breast cancer syndromes

107
Q

What are the indications for G-CSF?

A

Persistent neutropenic fever despite abx treatment, severe neutropenia (ANC <100) expected to last >7 days
Prophylaxis in patients w/ previous episode of neutropenic fever, or with chemotherapy regimens w/ high risk of neutropenia

108
Q

Which type of cancer has brain metastases that have higher risk of ICH and patients cannot get anti-coagulation? Name 4

A

Melanoma, thyroid cancer, renal cell carcinoma, and choriocarcinoma

109
Q

How do you prevent skeletal related events in bone metastases?

A

Denosumab (preferred)

IV bisphosphonates - Zoledronic acid (cannot use in GFR <35), Pamidronate

110
Q

Which patients w/ NSCLC benefit from post-op radiation?

A

Those w/ positive surgical margins

111
Q

What are some side effects of asparaginase? Name 3.

A

Hypersensitivity, pancreatitis, thrombosis, hemorrhage

112
Q

For how long should tamoxifen be held prior to surgery that his moderate or high risk of VTE?

A

2-4 weeks

113
Q

What effect does smoking and early menopause have on endometrial cancer?

A

Both reduce the risk

114
Q

What are some cardiac effects of cisplatin? Name 2.

A

SVT, myocardial ischemia, cardiomyopathy

115
Q

What is the management for locoregional gastroesophageal cancer?

A

Neoadjuvant chemotherapy +/- radiation therapy, and surgery

Oncology (1 decks)

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