Neoplasms

Question 1

What is the most common type of breast cancer?

Answer 1

Invasive ductal carcinoma is the most common. 70-80%. Tend to mets to axillary lymphatic system.

Question 2

What is Paget’s disease of the breast?

Answer 2

Chronic eczematous, itching, scaling rash of the nipple & areola.
+/- Bloody discharge & lump

Question 3

What is Inflammatory breast cancer?

Answer 3

fast & aggressive infiltration of the lymph nodes and skin. No lumps associated

Question 4

Inflammatory breast cancer presentation?

Answer 4

red swollen, warm, itchy breast with nipple retraction and breast skin dimpling (due to block of the lymph vessels) = prognosis.

Question 5

What is peau d’ orange and what is it associated with?

Answer 5

skin dimpling similar to orange peel due to lymphatic blockage associated with inflammatory breast cancer.

Question 6

What is triple-negative?

Answer 6

Her 2 negative, Estrogen (ER) negative and Progesterone (PR negative)

Question 7

What is the initial imaging modality to evaluate breast masses in women under 40 ?

Answer 7

Ultrasound because younger women’s breasts tend to be denser and harder to read with mammography

Question 8

What is the initial imaging modality to evaluate breast masses in women over 40 ?

Answer 8

Mammography

Question 9

What are the MC distant site of mets for breast cancer? HINT 2B’s & 2L’s

Answer 9

Brain & Bone
Liver & lungs

Question 10

What are the biopsy options for the evaluation of a breast mass?

Answer 10

Fine needle aspiration
Core biopsy
Open biopsy

Question 11

What medications are used for estrogen + receptors in the breast?

Answer 11

Premenopausal: tamoxifen
Postmenopausal: aromatase inhibitors (letrozole, anastrozole, exemestane)

Question 12

What medications are used for human epidermal growth factor receptor 2 (HERs) positive receptors in the breast?

Answer 12

Monoclonal therapy: trastuzumab

Question 13

What are the USPTF guidelines for mammograms?

Answer 13

Every 2 years starting at the age of 40 -74 OR 40 y/o if increased risk factors

Question 14

When should clinical breast exams be conducted?

Answer 14

every 3 years in women age 20-40 then annually after age 40.

Question 15

How does endometrial cancer typically manifest?

Answer 15

women present with abnormal or postmenopausal uterine bleeding

Question 16

What would transvaginal u/s show in a pt with endometrial cancer?

Answer 16

thickened endometrial stripe >4mm.

post-menopausal women should have an endometrial stripe <4mm

Question 17

What is the most common type of endometrial cancer

Answer 17

adenocarcinoma: represents 80% of all diagnosed endometrial cancers and is associated with excess estrogen.

Question 18

What is the most common type of vulvar cancer?

Answer 18

Squamous cell carcinom

Question 19

Vulvar cancer is most common in?

Answer 19

older women

Question 20

What are the presentations of vulvar lesion?

Answer 20

firm; white, red, or skin-colored; nodules, papules, or plaques; and have varying degrees of erosion or ulceration.

Question 21

How is vulvar cancer diagnosed?

Answer 21

colposcopy + Bx

Question 22

What are the risk factors for vulvar cancer?

Answer 22

human papillomavirus (16 &18)
prior vulvar or cervical intraepithelial neoplasia,
prior history of cervical cancer, cigarette smoking, and immunodeficiency syndromes.

Question 23

Breast cancers that are HER2 receptor-positive should be treated with?

Answer 23

trastuzumab, a monoclonal antibody to the HER2 receptor after surgical excision

Question 24

What is the physical appearance of paget disease of the vulva?

Answer 24

well-demarcated, slightly raised, erythematous vulvar lesion with an eczematoid appearance.

Question 25

A pruritic vulvar lesion that does not resolve within 6 weeks of eczema therapy is suspious for?

Answer 25

Paget disease of the vulva & should be Bx

Question 26

What is the most common symptom of Paget disease of the vulva?

Answer 26

Itching

Question 27

Elevated hCG levels can cause nausea and vomiting, hyperthyroidism, and bilateral theca lutein cysts in ?

Answer 27

Gestational trophoblastic disease
Hcg mimics thyroid-stimulating hormone and luteinizing hormone.

Question 28

characteristic pathology of Choriocarcinoma

Answer 28

sheets of trophoblastic tissue consisting of syncytiotrophoblasts and cytotrophoblasts without villi

Question 29

What is the most common type vaginal cancer?

Answer 29

Squamous cell carcinoma
-> risk are the same for cervical cancer

Question 30

What is the name of the drug that causes adenocarcinoma in women?

Answer 30

Diethylstilbestrol