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USMLE Step 3 Master the board > Oncology > Flashcards

Oncology Flashcards

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USMLE® Step 1 flashcards
1
Q

breast cancer screening with mammography begins at what age?

A

50

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2
Q

breast cancer screening with mammography is not routinely indicated at what age?

A

75

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3
Q

if a mammogram shows an abnormality, next step?

A

biopsy

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4
Q

what is the “sentinel node” in a sentinel node biopsy?

A

the FIRST node where the tracer goes

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5
Q

if sentinel node is FREE of cancer, then?

A

axillary node dissection is NOT necessary

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6
Q

if sentinel node HAS cancer, then?

A

axillary lymph node dissection

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7
Q

should BRCA genetic testing routinely be done?

A

NO

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8
Q

BRCA is associated with?

A

increased risk of familial breast cancer and ovarian cancer

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9
Q

best INITIAL treatment for breast cancer

A

lumpectomy WITH radiation

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10
Q

when should primary preventive treatment of breast cancer be given, at what age, and what should be given?

A
  • multiple first-degree relatives with breast cancer
  • age 40
  • tamoxifen
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11
Q

treatment for estrogen receptor + or progesterone receptor + breast cancer

A

tamoxifen, or raloxifene

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12
Q

adverse effects of tamoxifen (3)

A
  1. DVT
  2. hot flashes
  3. endometrial cancer
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13
Q

MOA of aromatase inhibitors (anastrozole, letrozole, exemestane)

A

pure estrogen antagonists

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14
Q

adverse effect of aromatase inhibitors (anastrozole, letrozole, exemestane)

A

osteoporosis

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15
Q

when should adjuvant chemotherapy be given in breast cancer?

A
  • cancer in axilla
  • cancer larger than 1cm
  • patient is still menstruating
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16
Q

trastuzumab MOA

A

monoclonal Ab against HER-2/NEU

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17
Q

when do you use trastuzumab?

A

metastatic breast cancer

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18
Q

colon cancer treatment

A

surgical resection and 5-FU

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19
Q

colon cancer screening: routine

A
  • colonoscopy starting at age 50

- every 10 years

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20
Q

colon cancer screening: single family member with colon cancer

A
  • colonoscopy at age 40 or 10 years EARLIER than age at which family member was diagnosed
  • every 10 years
21
Q

colon cancer screening: HNPCC (3 family members, 2 generations, or one premature (less than 50 yoa))

A
  • colonoscopy at age 25

- every 1-2 years

22
Q

colon cancer screening: FAP

A
  • sigmoidoscopy at age 12

- every 1-2 years

23
Q

colon cancer screening: juvenile polyposis, Peutz-Jeghers, Turcot syndrome, Gardner syndrome

A
  • no additional screening

- same as routine screening guidelines: start at age 50, every 10 years

24
Q

which patients should be screened for lung cancer?

A
  • more than 30 pack-years smoking history
  • between ages 55-75
  • chest CT scan at age 55
25
Q

when and what is the treatment for lung cancer?

A
  • if disease is LOCALIZED ENOUGH

- surgery

26
Q

when is surgery not an option for lung cancer? (5 scenarios)

A
  1. B/L disease
  2. metastases
  3. malignant pleural effusion
  4. involvement of aorta, vena cava, or heart
  5. lesions w/i 1-2cm of carina
27
Q

is small-cell lung cancer resectable, and why?

A

NO, bc 1 of these features is present in more than 95% of cases

  1. B/L disease
  2. metastases
  3. malignant pleural effusion
  4. involvement of aorta, vena cava, or heart
  5. lesions w/i 1-2cm of carina
28
Q

is size alone a reason lung cancer is not resectable?

A

no, as long as it’s peripheral, and without metastases

29
Q

when do you start cervical cancer screening?

A
  • age 21
  • repeat every 3 years until age 29
  • then do Pap WITH HPV every 5 years
30
Q

abnormal Pap smear with low-grade or high-grade dysplasia; next step in management

A

COLPoscopy and biopsy

31
Q

if Pap smear shows atypical squamous cells of undetermined significance (ASCUS); next step in management

A

test for HPV

32
Q

if patient is HPV POSITIVE; next step in management

A

COLPoscopy, or repeat Pap in 6-12 months

33
Q

when do you stop screening for cervical cancer?

A

greater than 65 yoa

34
Q

should screening be performed for prostate cancer?

A

NO, not recommended

35
Q

besides SPREAD OF DISEASE, most important PROGNOSTIC factor for prostate cancer

A

Gleason score

higher score, more aggressive cancer

36
Q

LOCALIZED prostate cancer treatment

A

SURGERY, AND either external radiation, or implanted radioactive pellets

37
Q

METASTATIC prostate cancer treatment

A

ANDROGEN blockade (flutamide), AND GnRH agonist (leuprolide, or goserelin)

38
Q
  • woman greater than 50 yoa
  • increasing abdominal girth
  • weight loss
A

ovarian cancer

39
Q

marker of progression and response to therapy in ovarian cancer

A

CA-125 (carcinoma Ag)

40
Q

treatment for ovarian cancer

A

surgical debulking, then chemotherapy

41
Q
  • man under 35 yoa

- painLESS scrotal lump

A

testicular cancer

42
Q

diagnostic test for suspected testicular cancer

A

inguinal orchiectomy

do NOT do a needle biopsy

43
Q

95% of all testicular cancers are

A

GERM CELL TUMORS (seminoma and nonseminoma)

44
Q

AFP is secreted ONLY by this type of testicular cancer

A

NONSEMINOMA

45
Q

what should be measured in testicular cancer?

A
  • AFP
  • LDH
  • B-HCG
46
Q

how do you stage testicular cancer?

A

CT scan of abd/pelvis

47
Q

treatment for testicular cancer after orchiectomy: LOCAL disease

A

radiation

48
Q

treatment for testicular cancer after orchiectomy: WIDESPREAD disease

A

chemotherapy

USMLE Step 3 Master the board (33 decks)

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