oncology

Question 1

breast cancer screening [age/freq]

Answer 1

45-54/annual mammogram
55+/every 2 years, or annually

Question 2

cervical cancer screening [age/freq]

Answer 2

26-65/ cervical cell analysis:
* PAP Q 3 years
* HPV DNA test Q 5 years
* or both Q5 years

Question 3

colorectal cancer screening [age/freq]

Answer 3

45+
Stool tests: FIT/FOBT yearly, MT-sDNA Q3Y
Visual exam: colon/rectal colonoscopy Q10Y and PRN confirm dx, flexible sigmoidoscopy Q5Y

Question 4

lung cancer screening [age/freq]

Answer 4

Annual low dose CT scan of chest if 2 criteria met:
1. 20+ year smoking hx
2. Still smoking/quit within last 15 years

Question 5

prostate cancer screening

Answer 5

individualized decision
PSA blood test
DRE (digital rectal exam optional)

Question 6

CAUTION warning sign

Answer 6

Chance in bowel/bladder habits
A sore that does not heal (Abcess)
Unusual bleeding or discharge
Thickening or lump (breast/elsewhere)
Indigestion or difficulty swallowing
Obvious change in wart or mole (ABCDE)
Nagging cough or hoarseness

Question 7

Cancer # staging system

Answer 7

1 = early stage
5 = advanced disease

Question 8

TNM staging system

Answer 8

T = primary tumor size/location
N = lymph node involvement
M = mets evidence

Question 9

Evaluating cancer

Answer 9

Biopsy
Imaging
Biomarker
others (genetics, CBC,CMP, H&P)

Question 10

Carcinoma

Answer 10

epithelial cells that line internal/external body surfaces

Question 11

Leukemia

Answer 11

Bone marrow - affects leukocytes

Question 12

Lymphoma

Answer 12

Begins in lymphatic system cells

Question 13

Multiple myeloma

Answer 13

arise from PLASMA CELLS of bone marrow

Question 14

Sarcoma

Answer 14

connective tissue or supportive tissue (bone, cartilage, muscle)

Question 15

neoadjuvant therapy

Answer 15

before surgery to shrink tumor

Question 16

adjuvant therapy

Answer 16

after primary tx, eradicate residuals + prevent reoccurrence

Question 17

M phase chemo drugs

Answer 17

Taxanes
Vinca alkaloids

Question 18

G2 phase chemo drugs

Answer 18

Etoposide
Bleomycin

Question 19

G1 phase chemo drugs

Answer 19

pegaspargase

Question 20

S phase chemo drugs

Answer 20

“AT the s phase, the DNA replicATes”
Antimetabolites (MTX, 5-FU)
Topoisomerase 1 inhibitors (irinotecan, topotecan)

Question 21

non-cell cycle specific chemo drugs

Answer 21

“All Awesome Pharmacists”
Alkylating agents
Anthracyclines
Platinum compounds

Question 22

Mosteller equation

Answer 22

BSA = SQRT (cm x kg /3600)

Question 23

Du Bois equation

Answer 23

BSA = 0.007184 x cm^0.725 x kg^0.425

Question 24

Calvert formula

Answer 24

carboplatin dosing
need AUC (range 2-8 mg/ml*min)
GFR max 125
CrCl ok if GFR not available to estimate GFR
TOTAL carbo dose (mg) = target AUC x (GFR + 25)

Question 25

list the alkylating agents

non-specific

Answer 25

Cyclophosphamide, Ifosfamide
Busulfan
Carmustine

MOA: cross link DNA strands = stop protein synthes

Question 26

Platinum based

nonspecific

Answer 26

Cisplatin
Carboplatin
Oxaliplatin

MOA: cross link DNA strands = stop protein synthes

Question 27

Anthracyclines

nonspecific

Answer 27

Doxorubicin, “-rubicin”
Mitoxantrone (blue)
LIFETIME MAX - cardiotoxicity

MOA: MULT - intercalate DNA, inhibit TOPO2, create ROS damage cells

Question 28

Total lifetime cummulative dose for anthracyclines

Answer 28

450-550 mg/m^2