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CK Heme Onc > Onc 4 > Flashcards

Onc 4 Flashcards

1
Q

symptoms of inhibiting parasympathetic

A 
dry
red
hot
mad
bloated
blind
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2
Q

tumor marker:

PSA

A

prostate

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3
Q

tumor marker:

AFP

A

HCC

yolk sac

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4
Q

tumor marker:

CA 125

A

ovarian

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5
Q

tumor marker:

alk phosph

A

biliary

bone

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6
Q

tumor marker:

CEA

A

colon

pancreatic

stomach

breast

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7
Q

tumor marker:

bHCG

A

choriocarcinoma

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8
Q

tumor marker:

S100

A

melanoma

astrocytoma

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9
Q

treatment for:

giardia,entameoba, trichomonas

A

metro

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10
Q

treatment for:

vivax/ovale

A

chloroquine

primaquine

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11
Q

treatment for:

flukes, tapeworms

A

praziquantel

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12
Q

treatment for:

worms

A

bendazoles

pyrantel pamoate

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13
Q

chemo:

nitrogen mustard, alkylates DNA

A

cyclophosphamide

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14
Q

chemo:

mechanism similar to antivirals acyclovir and foscarnet

A

cytarabine

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15
Q

chemo:

free radical induced DNA breakage

A

blemycin

-rubacin

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16
Q

Rx for choriocarcinoma

A

methotrexate

vincristin/blastin

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17
Q

Rx for AML

A

cytarabine

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18
Q

Rx for CML

A

imatinib

busulfan

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19
Q

MOA of tituximab

A

monoclonal antibody vs CD20

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20
Q

SE of imatinib

A

fluid retention

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21
Q

SE of trastuzumab

A

cardiotoxicity

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22
Q

MOA of bortezomib

A

proteasome inhibitor

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23
Q

Rx for MM

A

bortezomib

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24
Q

Rx for hairy cell leukemia

A

cladribine

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25
Q

what drugs cause nephrotoxicity and ototoxicity

A

-platins

vancomycin

aminoglycosides

loops

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26
Q

how do you prevent nephrotoxicity caused by

-platins

A

amifostine

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27
Q

MOA of -platins

A

cross link DNA

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28
Q

what drugs work on the M phase

A

vincristin/blastin

-taxols

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29
Q

SE of vincristine

A

neurotoxicity

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30
Q

SE of vinblastin

A

BM suppression

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31
Q

how do you prevent cardiotoxicity caused by

-rubacin

A

dexrazoxane

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32
Q

MOA of dexrazoxane

A

iron chelating agent

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33
Q

how does -rubacin cause cardiotoxicity

A

cardiac fibrosis

-dilated cardiomyopathy

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34
Q

Rx for testicular cancer

A

etoposide

bleomycin

cisplatin

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35
Q

MOA of busulfan

A

alkylates DNA

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36
Q

MOA of cyclophosphamide

A

covalently X link DNA at the guanine N-7

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37
Q

what is required for cyclophosphamide to work

A

biactivation by liver

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38
Q

what causes the heorrhagic cystitis by cyclophosphamides

A

toxic metabolites

-Acrolein

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39
Q

SE of cyclophosphamide

A

hemorrhagic cystitis

transitional cell carcinoma of the bladder

SIADH

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40
Q

MOA of bleomycin

A

induces free radicals which break DNA strand

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41
Q

MOA -rubacin

A

generates free radicals which intercalate DNA

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42
Q

MOA of dactinomycin

A

intercalates DNA

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43
Q

MOA of cytarabine

A

inhibits DNA polymerase

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44
Q

5FU can be used to Rx

A

actinic keratosis

basal cell carcinoma

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45
Q

Rx for 5FU toxicity

A

thymidine

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46
Q

Rx for MTX toxicity

A

leucovorin

-folinic acid

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47
Q

what drugs inhibit DHF reductase

A

MTX

TMP

pyrimethamine

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48
Q

what drugs work in G2

A

bleomycin

etoposide

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49
Q

what drugs work in the S phase

A

MTX

6MP/TG

5FU

cytarabine

etoposide

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50
Q

a/w anterior mediastinal mass

A

thymoma
teratoma
thyroid neoplasm
terrible lymphoma

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51
Q

Rx for chemotherapy induced nausea

A

ondasetron

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52
Q

Rx for cancer associated anorexia

A

progestins

  • megestrol acetate
  • medroxyprogesterone acetate
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53
Q

features of tumor lysis syndrome

A

cell breakdown which releases Urate, P and K

P binds to Ca which causes hypocalcemia

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54
Q

how can breast cancer present

A

skin changes
palpable mass
nipple retraction
nipple discharge

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55
Q

best initial test for breast cancer

A

FNA

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56
Q

most accurate test for breast cancer

A

open biopsy

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57
Q

which breast cancer test allows to test for ER, PR and HER 2

A

core needle biopsy

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58
Q

what is the most important factor for prognosis and Rx of breast cancer

A

HER 2

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59
Q

which receptors are a/w worst breast cancer prognosis

A

HER 2

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60
Q

which receptors are a/w better breast cancer prognosis

A

ER and PR

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61
Q

screening for breast cancer

A

mammography starting at 50 yo but not required after 75

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62
Q

what cancer is a/w pagets disease of the breast

A

adenocarcinoma

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63
Q

how does pagets disease present

A

rash on nipple with ulcerating eczematous appearance

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64
Q

what is seen on biopsy of pagets disease of the breast

A

large cells with clear halo

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65
Q

next step in suspected fibrocystic disease of the breast

A

aspiration

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66
Q

what is seen on aspiration of fibrocystic disease of the breast

A

clear fluid

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67
Q

what should be done in all females with a suspicious breast mass who are undergoing FNA and why

A

mammography

could be bilateral

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68
Q

when should an US be done done in breast mass

A

painful

varies in size or pain with menstruation

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69
Q

when is PET scan indicated for breast mass

A

determine the content of abnormal lymph nodes

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70
Q

what does a positive BRCA mean

A

increased risk for breast and ovarian cancer

nothing else

71
Q

what is the sentinel node

A

first node to be identified near the operative field in identified breast cancer

72
Q

what is the significance of a negative sentinel node in breast cancer

A

no need for axillary lymph node dissection

73
Q

Rx for breast cancer

A

if meet criteria
-lumpectomy with radiation

ER or PR positive should recieve

  • aromatase -
  • tamoxifen
  • raloxifene
74
Q

why is radiation done in breast cancer

A

prevents recurrence

75
Q

criteria for surgery in breast cancer

A

primary tumor is resected
no other site of cancer
no comorbidities
complete resection is possible

76
Q

SE of tamoxifen

A

endometrial cancer (uterine sarcoma)

clots

77
Q

SE of aromatase inhibitors

A

osteoporosis

78
Q

what are the aromatase inhibitors

A

anastrazole

letrozole

exemestane

79
Q

what is the benefit of recieving trastuzumab

A

decreases risk of recurrence

80
Q

who should recieve trastuzumab

A

those positive for HER 2

multiple first degree relatives have breast cancer

81
Q

SE of trastuzumab

A

cardiotoxicity

82
Q

what test should be done before starting trastuzumab

A

echocardiogram

83
Q

when is adjuvant chemotherapy used in breast cancer Rx

A

lesions larger than 1 cm

positive axillary lymph nodes

84
Q

where in the prostate does prostate cancer occur

A

peripheral zone

85
Q

best initial test for prostate cancer

A

biopsy

86
Q

most accurate test for prostate cancer

A

biopsy

87
Q

how does prostate cancer present

A

obstructive symptoms when voiding

palpable lesion
-nodular or irregular

88
Q

complications of prostatectomy

A

erectile dysfunction

urine incontinence

89
Q

how are BPH and prostate cancer presentation different

A

BPH

  • center
  • smooth

prostate cancer

  • peripheral
  • nodular/irregular
90
Q

what should all px with BPH be checked for

A

hydronephrosis

-if present place foley

91
Q

what is the goal of hormonal manipulation in prostate cancer

A

shrink lesions that are already present

92
Q

what is used to shrink prostate cancers

A

flutamide
leuprolide
ketoconazole
orchidectomy

93
Q

next best step in a px with prostate cancer with suspected lumbar metastasis

A

glucocorticoids to preserve neurologic functions

94
Q

what can an increased PSA be a/w

A

BPH
prostatitis
prostate cancer

95
Q

what PSA level is most a/w prostate cancer

A

> 4

96
Q

when is surgery not indicated in lung cancer

A

bilateral disease
malignant pleural effusion
heart, carina, aorta or vena cava are involved
small cell cancer

97
Q

what are some risk factors for ovarian cancer

A

BRCA + (multiple first degree relatives)

estrogen replacement

98
Q

what should be done in a px with positive BRCA and family history of ovarian cancer

A

pelvic US or CA-125

99
Q

how does ovrian cancer present

A

woman above 50 with wieght loss and increased abdominal girth

100
Q

best initial test for ovarian cancer

A

US or CT

101
Q

most accurate test for ovarian cancer

A

biopsy

102
Q

what is protective against ovarian cancer

A

increased pregnancies

OCP

103
Q

Rx for ovarian cancer

A

remove all visible tumor and pelvic organs and give chemo

104
Q

next step in a px with a painless lump in the scrotum

A

transluminate or US

105
Q

diagnostic test for testicular cancer

A

inguinal orchiectomy

106
Q

next step in a px with a painless lump in the scrotum and US shows suspicious mass

A

inguinal orchiectomy

107
Q

testicular cancer a/w:

increased B-hCG

A

seminoma

108
Q

testicular cancer a/w:

increased AFP

A

yolk sac (endodermal sinus)

109
Q

testicular cancer a/w:

increased AFP and B-hCG

A

embryonal
choriocarcinoma
teratoma

110
Q

how is testicular cancer staged

A

CT or the

  • abdomen
  • pelvis
  • chest
111
Q

how does testicular cancer metastasize

A

retroperitoneum and up into chest

112
Q

Rx for testicular cancer

A

orchiectomy with

  • radiation if local
  • chemo if widespread
113
Q

management for advanced cervical cancer

A

hysterectomy

114
Q

when is HPV vaccine indicated

A

woman between ages 11-26

-try to do before initiating sex

115
Q

HPV serotype a/w cancer

A

16 and 18

116
Q

HPV serotype a/w warts

A

6 and 11

117
Q

when are pap smears indicated

A

21 - 30 every 2 years

30-65 every 3 years

118
Q

what increases the risk of cervical cancer

A

smoking

119
Q

what cancer is lynch syndrome a/w

A

endometrial cancer

120
Q

how is a solitary brain lesion managed

A

surgical resection

then whole brain radiotherapy

121
Q

best initial test for squamous cell carcinoma of the head or neck

A

panendoscopy followed by biopsy

122
Q

next best step if bone tumor is suspected

A

refer to orthopedic surgeon

123
Q

SE of megestrol acetate and medroxyprogesterone acetate

A

DVT

124
Q

what meds are a/w cochleardysfunction

A

platins

aminoglycosides

loops

125
Q

Dx

bloody discharge from nipples

A

intraductal papilloma

126
Q

Dx

bilateral breast pain and lumps that vary with periods

A

fibrocystic change

127
Q

Dx

painless, firm mobile mass that does not change with periods

A

fibroadenoma

128
Q

what is seen on CT of craniopharyngioma

A

cystic calcification of parasellar lesions

129
Q

type of cancer therapy:

Rx before standard

A

neoadjuvant

130
Q

type of cancer therapy:

radiation before prostatectomy

A

neoadjuvant

131
Q

type of cancer therapy:

Rx is standard therapy fails

A

salvage

132
Q

type of cancer therapy:

Rx given in addition to standard

A

adjuvant

133
Q

type of cancer therapy:

radiation at the same time as prostatectomy

A

adjuvant

134
Q

type of cancer therapy:

initial dose to kill tumor cells and put px into remission

A

induction

135
Q

type of cancer therapy:

given after induction

A

consolidation

136
Q

type of cancer therapy:

multidrug regiemn to reduce tumor

A

consolidation

137
Q

type of cancer therapy:

given after induction and consolidation

A

maintenance

138
Q

type of cancer therapy:

kills residual cells and keeps px in remission

A

maintenance

139
Q

type of cancer therapy:

daily antiandrogen therapy in prostate cancer

A

maintenance

140
Q

which cancer screening lowers mortality the most

A

mammography after 50 yo

141
Q

what should be given to women with multiple first degree relatives with breast cancer

A

SERMs

  • tamoxifen
  • raloxifene
142
Q

next best step if colonoscopy shows polyps

A

colonoscopy in 3-5 years

143
Q

screen for colon cancer

A

colonoscopy at 50 yo every 10 years

start 10 years earlier than family member if they had cancer

144
Q

what meds can help quit smoking

A

bupropion and TCA

145
Q

what is the single most beneficial disease prevention method of any type

A

stop smoking

146
Q

when is lipid screening indicated

A

men above 35
women above 45

any one with

  • DM
  • HTN
  • CAD
  • aortic disease
  • carotid disease
  • peripheral vascular disease
147
Q

screening for HTN

A

indicated to all px over 18 yo at every visit

148
Q

therapy for hyperlipidemia

A

0-1 risk factors
>160 life style changes
>190 meds

2 or more risk factors
>130 life style changes
>160 meds

149
Q

screening for DM

A

fasting blood glucose in px with

  • HTN
  • hyperlipidemia
150
Q

what are the 2 most beneficial vaccines in adults

A

influenza

pneumococcus

151
Q

when is the tetanus diptheria toxoid indicated

A

severe dirty wounds

those who recieved booster >5 years ago

152
Q

when is tetanus immune globulin indicated

A

severe dirty wound

unclear or incomplete immunization

153
Q

when is Tdap given

A

once every 10 years after age of 18

154
Q

who can recieve the intranasal influenza vaccine

A

healthy, non pregnant adults

155
Q

indications for influenza vaccine

A

everyone yearly (including pregnant women)

156
Q

indications for pneumococcal vaccine

A

everyone above 65 (must be given 5 years later if done prior to 65 because of chronic disease)

cochlear implant

CSF leaks

alcoholics

157
Q

what vaccines have an egg allergy

A

influenza

yellow fever

158
Q

when is varicella zoster vaccine indicated

A

all children

all px over 60

159
Q

why is zoster vaccine given to px over 60

A

prevents shingles

160
Q

who benefits most from hepatitis A and B vaccine

A

chronic liver disease

161
Q

when is hepatitis A and B vaccine indicated

A 
children
chronic liver disease
men who have sex with men
multiple sexual partners
household contacts with hepatitis
IVDA
162
Q

what should be done in an unvaccinated px who is exposed to hepatitis

A

give vaccine and HBIG

163
Q

when is meningococcal vaccine indicated

A

age 11

asplenia

terminal compliment deficiency

military recruits

dorms

travelers for asia, africa, arabia

164
Q

what is the strongest indication for meningococcal vaccine

A

asplenia

165
Q

screening for osteoporosis

A

DEXA scan for every woman >65 yo

166
Q

Dx

DEXA T-score = 1.5-2.5

A

osteopenia

167
Q

Dx

DEXA T-score = >2.5

A

osteoporosis

168
Q

who has the highest risk factor for osteoporosis

A

postmenopausal women

169
Q

screening for AAA

A

US all men over 65 with smoking history

170
Q

MC infection in AAA

A

salmonella or staph

171
Q

when is AAA repaired

A

> 5 centimeters

172
Q

MC complication of AAA repair

A

bowel ischemia

173
Q

how can bowel ischemia from AAA repair be avoided

A

check sigmoid perfussion after aortic graft placement

174
Q

screening for chlamydia

A

sexually active females

CK Heme Onc (13 decks)

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