Oncology Flashcards
Screening
Breast mammogram at 35, then 40, then yearly
Prostate-men over 50-DRE, PSA, US of prostate
Colon- all adults 50 and older need flexible sigmoid after 3 normal at 3 year intervals can stop surveillance
Bladder- urine test
Endometrial- pap smear eval uterine bleeding post menopausal women
Breast
Three common masses:
Fibroadenoma-15-35 years, multiple tumors round rubbery, discrete, moveable, non tender, 1-5 cm,
Fibrocystic breast changes- 30-50 years, rare for HRT patients, pain or tenderness before menses, fluctuations in size and rapid appearance or disappearance common, can be bilateral or multiple
Cancer- non painful lump, firm, hard mass, poor margins; nipple discharge, pain, nipple erosion, retraction, enlargement or itching and redness, hardness, enlargement or shrinking of breast, axillary swelling
Pagets carcinoma
Infiltrating duct disease well differentiated or a distal in situ
Ducts of nipple epithelium are infiltrated but nipple changes are minimal
Tumor may not be palpable
First symptoms is often itching or burning of the nipple with supervision erosion or ulcer
Inflammatory breast carcinoma
Most malignant form of breast cancer
Rapid growing sometimes painful mass that enlarges the breast
Overlying skin may be erythematous edematous and warm
No distinct mass
Non invasive breast cancer
Ductal in situ and lobular in situ
Ductal- unilateral, non treatment results in invasive cancer, total mastectomy with XRT
Lobular-invasive cancer risk, close observation with possible mastectomy
Breast cancer in men
Rare
60 years and older
Prognosis poor
Blood born metastasis
Painless lump with discharge; retraction, erosion or ulceration, ill defined non tender mass
Colon and rectal cancer
Large bowel is major in elderly
Weakness, anemia or blood in stool
Lesions seen in right colon-obstruction less likely
Left sided lesion present with change in bowel habits or bleeding
Lung cancer
50-70 years
Most caused by smoking
Also second hand smoke; asbestos exposure, XRT, COPD, pollution, genetics
Epidermoid tumors and small cell undifferentiated tumor associated with smoking
Alveolar cell and large cell less certain for smoking
Metastasis common
Cough; with Sputumn, anorexia, weight loss; SOB, hemoptysis, wheezing, fever, hoarseness, dysphagia, chest pain, fatigue; bone pain, neurologic deficits
Small cell tends to be aggressive
Horners syndrome
Miosis, ptosis; loss of sweating on affected side, facial flushing; recession of globe of eye into socket
Due to tumor invasion on sympathetic trunk
Pancoast tumor
Caused by rumor that is located on the pulmonary apex
Involves adjacent structure such as chest wall, lymphatics, ribs, vertrbrae, vessels and nerves
Causes shoulder pain, arm pain with paralysis
Prostate cancer
Voiding symptoms, hematuria, anemia, weakness, weight loss, bone pain
PSA
Gleason score- 2-10, so being aggressive
Lymphoma
Non Hodgkin and hodgkins
Hodgkins-rare; age 16-34 and over 55, RF: age, males, FmHX. Pesticides, HIV, EBV immunosuppressant drugs
Non hodgkins-herbicide and insecticide
Which of the following is not a risk factor for bladder cancer
Long term use of ASA
Leukemia
Common over 60 years
CLL most seen
Melanoma
Types
Superficial spreading
Modular
Lentigo maligna
Acral lentiginous
ABCDE
Which of the following is most likely presentation to be seen in a patients with colorectal cancer?
Few symptoms
Symptoms of lung cancer by a primary tumor include all of the following except
Stridor
Clinical signs and symptoms of multiple myeloma are
Back pains renal impairment, hypercalcemia
The initial treatment of renal failure in patients with multiple myeloma is
Treatment of underlying disease
Obesity is a risk factor for which of the following cancers
Renal, endometrial, and esophageal adenocarcinoma
Small cell cancer frequently metastasizes to the
Brain
The cause of dyspnea in patients with lung cancer is
Obstruction of airway and or restriction of lung expansion
A 35 year old women presents either cervical lymphadenopathy and symptoms of fever, weight loss and night sweats. A biopsy of the supraclavicular lymph nodes revealed a nodular sclerosing Hodgkin’s lymphoma staging PRT CT shows bulky mediastinal lymphadenopathy and she has a baseline ESR of 50 what favorable prognosis feature does this patient have for early stage Hodgkin lymphoma?
Less than age 50
The most commonly used identified benign breast disease is
Fibrocystic changes
