Onc - Solid Tumors

Question 0

When to use an ultrasound for breast masses?

Answer 0

#Painful
#Varies in size or pain with menstruation

Question 1

Breast cancer – best initial test? Most accurate test?

Answer 1

FNA biopsy; open biopsy

Question 2

When to use a PET scan?

Answer 2

Determine content of the lymph nodes that are not easily accessible to biopsy

Question 3

Importance of the negative sentinel node?

Answer 3

Eliminates the need for axillary lymph node dissection

Question 4

ER or PR positive breast cancer patients should receive?

Answer 4

Tamoxifen, raloxifene, anastrozole, letrozole, exemestane)

Question 5

Adverse effects of tamoxifen?

Adverse effects of aromatase inhibitors?

Answer 5

Endometrial cancer and clots

Osteoporosis

Question 6

Went to adjuvant chemotherapy in breast cancer?

Answer 6

#Lesions larger than 1 cm
#Positive axillary lymph nodes

Question 7

Patient with suspected prostate cancer – best initial test? Most accurate test?

Answer 7

Biopsy is best initial and most accurate

Question 8

Erectile dysfunction is more common after surgery or radiation?

Answer 8

Surgery

Question 9

Gleason grading is a measure of?

Hormonal medications for prostate cancer?

Answer 9

Malignant potential

#flutamide
#GnRH agonist
#Ketoconazole
#Orchiectomy

Question 10

Management that is NOT beneficial in prostate cancer?

Answer 10

#Chemotherapy
#Hormonal drugs to prevent recurrences
#Screening imaging tests
#Lumpectomy

Question 11

Age at which PSA is never done?

Answer 11

75+

Question 12

Elevated PSA and palpable mass – next step?

Answer 12

Transrectal ultrasound –

#if mass, biopsy
#If no mass, multiple blind biopsies

Question 13

In the lung cancer patients – surgery is not possible if,

Answer 13

#Bilateral disease
#Malignant effusion
#Heart, Carina, aorta or vena cava involved
#Small cell cancer

Question 14

Typical presentation of ovarian cancer? Best initial test? Most accurate test?

Answer 14

Woman over 50 who presents with increasing abdominal girth but losing weight

Ultrasound or CT scan

Biopsy

Question 15

Only cancer in which removing large amounts of locally metastatic disease has a benefit? Then treat with?

Answer 15

Ovarian cancer; chemotherapy

Question 16

Patient presents with painless lump in the scrotum that does not transluminate – diagnostic testing?

Answer 16

Inguinal orchiectomy

Question 17

Serum markers in testicular cancer?

Answer 17

#Alpha-fetoprotein in nonseminomatous tumors
#HCG in all

Question 18

Testicular cancer metastasizes through? Into?

Answer 18

Lymphatic Channels in the retroperitoneum

The chest

Question 19

Management of testicular cancer?

Answer 19

Orchiectomy followed by:
#Radiation if local disease
#Chemotherapy for widespread disease (one of the malignancies where metastasis can be cured with chemotherapy)

Question 20

Management of cervical cancer?

Answer 20

Hysterectomy

Question 21

Perform Pap smear when? Repeat how often? Until? Interval if you get Pap and HPV testing?

Answer 21

Age 21; every three years until age 65

Five-year interval with both

Question 22

Pap smear shoes atypical squamous cell of undetermined significance - next step? Then?

Answer 22

HPV testing;

#if HPV is found, colposcopy 
# if no HPV, repeat Pap smear at six months