Onc

Question 1

Screening cervical cancer starts at age

Answer 1

21

Question 2

Mammography screening starts at age

Answer 2

Age 40
Q1-2 years
Yearly at 50

Question 3

Colorectal cancer screening

Answer 3

Age 50
Stop at age 85
FmHx of FAP (APC?) = begin a puberty
HNPCC = begin at age 21, Q1-2 years
Small adenoma = 3-5 years after polypectomy (< 3 years if > 1 cm)

Question 4

Neutropenic fever

Answer 4

Neutrophil < 1000 and single fever > 100.9

Start emperic therapy

Question 5

Breast cancer screening ages

Answer 5

Start mammogram age 40

Stop at age 75

Question 6

Breast lump < Age 30

Answer 6

US

> 30 diagnostic mammography

Question 7

BI-RADS

Answer 7

0 incomplete
1 negative
2 benign
3 probably benign
4 suspicious
5 highly suspicious
6 proven malignancy

Question 8

Eczematous breast lesion

Answer 8

Paget disease

Question 9

Unilateral watery or serous nipple discharge

Answer 9

ductal carcinoma

Question 10

Bloody nipple discharge

Answer 10

intraductal papilloma

Question 11

Only drug approved for chemoprevention in Premenopausal women

Answer 11

Tamoxifen = SERM

• Increased VTE, stroke, endometrial cancer (can’t use TVUS to determine thickness, need to do biopsy)
• SE= vasomotor symptoms

**Use aromatase inhibitors (anastrazole) only in post-menopausal women (less thrombosis, EMCA, and vaginal bleeding compared to tamoxifen), or in pre-menopausal women with risk factors

Question 12

BRCA mutations account for what amount of Ovarian Cancer?

Answer 12

20-25%

4% of breast cancer

Question 13

BRCA 1 on what chromosome?

Answer 13

Chromosome 17

Question 14

BRCA 2 on what chromosome?

Answer 14

Chromsome 13

Question 15

Risk reducing BSO reduces risk of cancer by what percent in BRCA1 patient?

Answer 15

85%-95%

*Perform at age 40 or when done childbearing

Question 16

Risk of malignancy with complex hyperplasia with atypia?

Answer 16

30%

Question 17

Types of endometrial cancer

Answer 17

Type 1 = from unopposed estrogen

Type 2 = 20%, clear cell, papillary serous, some grade 3 endometrioid, this, elderly women (poor prognosis)

Question 18

Low grade endometrial CA in pts that desire fertility?

Answer 18

Treat with high-dose progestin (76% response rate)

Poor surgical candidates = Mirena or Megace

Question 19

Thickness of EMS on US that require biopsy in post menopausal women?

Answer 19

> 4 mm

Question 20

Rapid enlargement of uterus concerning for….

Answer 20

sarcoma

Question 21

What ovaria tumor produces estrogen?

Answer 21

Granulosa cell tumors = inhibin A and B
Produce estrogen
Call-exner bodies on pathology
Need to do endo biopsy, will have thickened endometrium

Question 22

Most common germ cell ovarian tumor?

Answer 22

Dysgerminoma

Question 23

CA-125

Answer 23

epithelial carcinoma

Question 24

CEA

Answer 24

Mucinous epithelial tumor

Question 25

High risk HPV supbtypes

Answer 25

16, 18, 31, 33, 35

Question 26

HPV vaccine

Answer 26

3 shots (0,2, 6 months)
Contraindicated during pregnancy

Question 27

Risk of GTN following a complete mole?

Answer 27

15-20%

Question 28

Most common cause of PMB?

Answer 28

Atrophic Endometrium

Depending on age and risk factors 1-14% will have endometrial cancer

Question 29

What HPV strain has the highest carcinogenic potential?

Answer 29

HPV 16