Onc Flashcards
DCIS tx?
Breast conserving therapy, wide excision (lumpectomy) followed by Breast radiation
Estrogen positive DCIS tx?
Breast conserving therapy, wide excision (lumpectomy) followed by Breast radiation + tamoxifen
Breast tumors involving the skin, Chest wall, or more than one quad of the breast, inflammatory breast cancer, Contraindications to radiation tx?
Mastectomy
Sentinel lymph node biopsy positive, axillary lymph nodes clinically involved with breast cancer tx?
Axillary lymph node dissection
Tumor greater than 5 cm, positive surgical margins, Skin or chest wall involvement, Inflammatory breast cancer, greater than four positive axillary nodes. Tx?
Chest wall radiation therapy after mastectomy
Aromatase inhibitors (anastrazole, letrozole, exemestane) side fx?
Arthralgia, bone pain, Hld, Osteoporosis
Tamoxifen side fx?
Endometrial cancer, VTE disease
Anthracyclines (doxorubicin, epirubicin) side fx?
Cardiomyopathy, acute leukemia
Trastuzumab side fx?
Cardiomyopathy, Especially If used with an anthracycline
Bisphosphonates side fx?
Osteonecrosis of the jaw
Denosumab side fx?
Hypocalcemia and Osteonecrosis of the Jaw
Post renal transplant lymphoma is most often associated with which organism?
Epstein Barr Virus (EBV)
Peripheral blood showing smudge cells is most specifically associated with what condition?
Chronic Lymphocytic Leukemia (CLL)
Breast cancer along with sarcomas,leukemia, lymphoma, brain tumors and adrenal cancer defines which syndrome?
Li-Fraumeni Syndrome
Sweet’s Syndrome (fever and painful rash on the arms, legs, trunk, face, or neck. It’s also known as acute febrile neutrophilic dermatosis) can be associated with what type of malignancy?
AML, Can occur with the use of NSAIDs, G, CSF medications, trimethoprim-sulfamethoxazole, or pregnancy.
Trastuzumab is used for what positive marker in patients with breast cancer?
HER2/neu positive
Treatment of MALT requires eradication of what organism?
Heliobacter Pylori (H. pylori)
What are the CD markers for a Reed Sternberg cell in Hodgkin’s lymphoma?
CD15 and CD30
Rapid fire assoc: Lytic (“punched out”) bone lesions on x-ray
Multiple myeloma
Rapid fire assoc: Mucin-filled cell with peripheral nucleus “Signet ring”
gastric carcinoma
Rapid fire txt: Breast cancer in postmenopausal women
Aromatase inhibitors (anastrozole)
Rapid fire txt: Chronic myelogenous leukemia
Imatinib
Rapid fire txt: Acute promyelocytic leukemia (M3)
All-trans retinoic acid
t(8;14)- translocation of c-myc and heavy-chain Ig
Burkitt lymphoma
t(14;18)- translocation of BCL-2 and heavy-chain Ig
Follicular lymphoma
t(15;17)- translocation of retinoic acid receptor (RARA gene)
AML (M3)- Acute promyelocytic leukemia. Treat with all-trans retinoic acid
t(11;14)- translocation of cyclin D1
Mantle cell lymphoma. Txt w/RCHOP
Bacteria associated with gastritis, peptic ulcer disease, and gastric malignancies (eg, adenocarcinoma, MALToma)?
H. pylori
Breast cancer (most common/important association)?
Invasive ductal carcinoma
Breast tumor (benign, young woman)?
Fibroadenoma
Philadelphia chromosome t(9;22) (BCR-ABL) associated with what cancer?
CML (may sometimes be associated with ALL/AML)
Rapid fire assoc:”Soap bubble” in femur or tibia on x-ray
Giant cell tumor of the bone (generally benign)
Rapid fire assoc:Raised periosteum (creating a “Codman triangle”)
Aggressive bone lesion (eg, osteosarcoma, Ewing sarcoma, osteomyelitis)
Rapid fire assoc:”Onion skin” periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
Rapid fire assoc:Psammoma bodies (4)
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
Rapid fire assoc:Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
What is the treatment of M3form of AML?
All-Trans Retinoic Acid(ATRA)
What is the syndrome that contains the triad of ptosis, miosis, and anhidrosis?
Horner’s Syndrome (assoc w/pancoast tumor From squamous cell carcinoma)
What is the most common subtype of thyroid cancer?
Papillary thyroid cancer(papillary carcinoma)
What group of testicular cancer is not sensitive to radiation therapy?
Non-seminomas (eg. teratoma, embryonal carcinoma, choriocarcinoma, yolk sac tumor)
Which type of anemia is a common complication of chronic lymphocytic leukemia?
Warm agglutinin autoimmune hemolytic anemia
CLL Txt?
Ibrutinib (Bruton kinase inhibitor), alkylating agents (chlorambucil, cyclophosphamide, bendamustine), purine nucleoside analogs (fludarabine, cladribine, pentostatin), Monoclonal antibodies (Rituximab)
Which type of cancer is least likely to metastasize to the brain and usually produces blastic bone lesions?
Prostate cancer
Which type of lung cancer can give a paraneoplastic syndrome of gynecomastia?
Large cell carcinoma
Dark purple skin/mouth nodules in a patient with AIDS
Kaposi sarcoma, associated with HHV-8
Rapid fire assoc: Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
Rapid fire assoc: Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
Which marker is often associated with ovarian cancer?
CA 125
Which marker is often associated with pancreatic cancer?
CA 19-9
Rapid fire assoc: Giant B lymphocytes with bilobed nuclei with prominent inclusions (“owl’s eye”)
Reed-Sternberg cells (Hodgkin lymphoma)
Rapid fire assoc: Glomerulus -like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
Rapid fire assoc: Disarrayed granulosa cells arranged around collections or eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
Rapid fire assoc: Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
To which class of medications do tamoxifen and raloxifene belong?
SERMs, Selective estrogen receptor modulators.
CSF analysis in CNS lymphoma shows what cell population?
Monoclonal B cell population.
What rash is associated with glucagonoma?
Necrolytic migratory Erythema (NME)
The diagnosis of Glucagonoma is suggested with Glucagon levels above what?
> 1000 pg/mL
What chemotherapeutic agent Is used with metastatic hepatocellular carcinoma?
Sorafenib or regorafenib
What are the three possible interventions for localized hepatocellular carcinoma?
Surgical resection, liver transplantation, radiation.
What is the Chemotherapeutic regimen for colon cancer?
FOLFOX, 5-fluorouracil, leucovorin, folinic acid, Oxaliplatin.