Oncology Flashcards
Direct acting carcinogens
Initiators
Modify DNA
Initiators
Need metabolic conversion to form active carcinogen
Procarcinogen
Cause cellular proliferation of mutated cells
Promotors
Nitrosamines
Gastric Cancer
Smoking
Lung Cancer
Pancreatic Cancer
Polycyclic hydrocarbons
Bronchogenic Carcinoma
Asbestos
Mesothelioma
Chromium
Bronchogenic carcinoma
Nickel
Bronchogenic carcinoma
Arsenic
Angiosarcoma of the liver
Vinyl Chloride
Angiosarcoma of the liver
Aromatic amine
Hepatocellular Carcinoma
Azo dyes
Hepatocellular Carcinoma
Alkalating agent
Leukemia
Benzene
Leukemia
Napthylamine
Bladder cancer
Screening for potential carcinogen
Ames test
Most common UV
UVA
Most dangerous UV
UVC
Most carcinogenic UV
UVB
Produced by UVB that causes transcriptional errors and mutation
Pyrimidine dimers
Inc risk of skin cancer due to defect in DNA repair
Xeroderma pigmentosum (PIX)
Cross linking and chain breaks
Ionizing radiation
Most sensitive to ionizing radiation
Mitosis or G2
Human T-cell leukemia virus (HTLV1)
Leukemia/lymphoma
Hep B virus
Hepatocellular carcinoma
EBV
Nasopharyngeal carcinoma
HPV 16,18
Cervical cancer
Herpes virus 8
Kaposi sarcoma
Most neoplasm arise
Epithelium
Prevents damaged DNA from entering S phase
p53
Requires appropriate signal to permit entry to S phase
Rb gene
Both genes must be inactivated for oncogenesis
Two hit hypothesis
Familial retinoblastoma
Rb on chr 13
Li Fraumeni Syndrome
p53 on ch 17
Anti apoptosis
bcl-2
Over expressed bcl -2
Follicular lymphoma
Gene for cellular proliferation
C-myc
Ca assoc with C-myc
Burkitt’s lymphoma t(8:14)
Childhood tumor
Neuroectoderm
Cushing triad
Systemic HTN
Bradycardia
Irregular respiration
Most common symptom of CNS tumor
Headache
Obliteration of disc margins
Absent central vein pulsation
Papilledema
Primitive neuroectodermal tumor
Medulloblastoma
Most common site of medulloblastoma
Cerebellar vermis
Pedia, infratentorial, ataxia
Medulloblastoma
Origin of medulloblastoma
Neuroblasts
Homer wright rosettes
Medulloblastoma
Neuroblastoma
Most common primary brain tumor
Glioblastoma Multiforme
Astrocytoma WHO grade I
Pilocytic astrocytoma
Astrocytoma WHO grade IV
Glioblastoma Multiforme
Astrocytoma WHO grade II
Diffuse astrocytoma
Astrocytoma WHO grade III
Anaplastic astrocytoma
Most aggressive primary brain tumor
Glioblastoma Multiforme
Spread of tumor across corpus callosum
Butterfly pattern
Butterfly pattern
Glioblastoma Multiforme
Glial cells with areas of necrotizing tissue surrounded by anaplastic cells
Glioblastoma Multiforme
Pallisading formation
Glioblastoma Multiforme
Increased mitotic activity
Microvascular proliferation
Necrosis
Glioblastoma Multiforme
Glial fibrillation acidic protein (GFAP) positive
Glioblastoma Multiforme
Irregular hypodense lesion with a peripheral ring like zone on CT
Glioblastoma Multiforme
Study of choice for Glioblastoma Multiforme
MRI
Treatment for Glioblastoma Multiforme
Surgical resection
Radiotherapy
Chemotherapy
Preferred chemotherapeutic drug for Glioblastoma Multiforme
Timozolamide
Line central canal of spinal cord and ventricles
Ependymal cells
Most common site of Ependymoma
Roof and floor of 4th ventricle
Hormone secreted by Pineal gland
Melatonin
Limited upward gaze
Accommodative spasms
Light near dissociation of pupils
Parinaud Syndrome
Vertical gaze palsy
Increased intracranial pressure
Pineal tumor
Fried egg appearance
Oligodendroglioma
Chicken wire blood vessels
Oligodendroglioma
Most common site of Oligodendroglioma
Frontal lobe
Intracranial tumor with calcification
Oligodendroglioma
Neonate with brain calcification
Toxoplasmosis
Most benign brain tumor
Pituitary adenoma
Most common functioning Pituitary adenoma
Prolactinoma
Microadenomas
Macroadenomas
> 1cm
Most common affected structure of pituitary adenoma
Optic chiasm
Most common presentation of optic chiasm involvement
Bitemporal hemianopsia
Amenorrhea
Galactorrhea
Prolactinoma
Drug of choice for Prolactinoma
Bromocriptine
Extra-axial calcified cystic tumor derived from Rathke’s pouch
Craniopharyngioma
Origin of anterior pituitary
Rathke’s pouch
Cyst with machine oil-like fluid
Craniopharyngioma
Prechiasmal
Optic atrophy
Retrochiasmal
Hydrocephalus
Headache
Endocrinopathy
Intrasellacraniopharyngioma
Origin of Meningioma
Meningothelial cells
Benign adult tumor with DURAL attachment
Meningioma
Dural tail sign
Meningioma
Whorls of calcium
Psammoma bodies
Psammoma bodies
Papillary thyroid Ca
Meningioma
Serous Cystadenoma of the Ovary
Common in HIV and AIDS
Primary CNS Lymphoma
Most common site of CNS Lymphoma
Deep periventricular region
Perivascular reticulin loops
Primary CNS Lymphoma
Round well demarcated lesions with extensive zone of edema
Brain metastasis
Drug for brain edema due to tumors
Dexamethasone
Systemic Ca that metastasize to the brain
Lots of Bad Stuff Kills Glia
Lung Breast Skin Kidney GIT
Single most important test in evaluation of thyroid mass
FNAB
Most common malignancy of the endocrine system
Thyroid carcinoma
Most common thyroid cancer
Papillary thyroid carcinoma
Ground glass nuclei
Orphan annie eyes
Psamomma bodies
Orphan annie eyes
Papillary thyroid carcinoma
Iodine deficient regions
Higher mortality
Follicular thyroid carcinoma
Hurthle cell
Follicular thyroid carcinoma
Hypothyroid
Autoimmune
Hashimoto’s Thyroiditis
Hyperthyroid
Autoimmune
Grave’s disease
Hashimoto’s thyroiditis
Rapidly enlarging
Sensitive to radiation
Thyroid Lymphoma
Most common thyroid lymphoma
Diffuse large cell lymphoma
Marker for recurrent Medullary thyroid carcinoma
Calcitonin
RET mutation
Medullary thyroid carcinoma
Most common site of breast cancers
Upper outer quadrant
Screening mammography
50 years old
Breast cancer with worst prognosis
Inflammatory breast cancer
Invasion of dermal lymphatics
Peau d’ orange
Screening for at risk of breast cancer
35 years old
Cookie cutter spaces
Non Comedo DCIS
Major circulating androgen
Testosterone
BPH
Transition zone
Prostate cancer
Peripheral zone
Enzyme present in prostatic secretion
Acid phosphatase
Most common malignancy in women
Breast cancer
Prostate cancer screening
50 years old
PSA
DRE
Prostate cancer screening for at risk population
45 years old
Malignant hepatoma
Hepatocellular carcinoma
Most common primary malignancy of the liver
Hepatocellular carcinoma
Most common malignancy of the liver
Metastasis
Aflatoxin B1
Hepatocellular carcinoma
Most common symptom of Hepatocellular carcinoma
Abdominal pain
Most common sign of Hepatocellular carcinoma
Hepatomegaly
Hepatic vein thrombosis
Budd-Chiari Syndrome
Mucin producing adenocarcinoma
Cholangiocarcinoma
Most common site of Cholangiocarcinoma
Hilar or central
Clonorchis sinensis or Chinese liver fluke
Cholangiocarcinoma
Tumor at the hepatic duct junction
Klatskin tumor
Most common liver tumor of childhood
Hepatoblastoma
Treatment of hepatoblastoma
Chemotherapy
Resection
Serologic assays for Hepatocellular carcinoma
Alpha-feto protein (AFP)
Des-gamma-carboxy prothrombin (DCP)
More specific Tumor marker for Hepatocellular carcinoma
AFP L3
Dye retained in the tumor used for diagnostic CT
Ethiodol
Gold standard for pathologic diagnosis of Hepatocellular carcinoma
Core liver biopsy
Child-Turcotte-Pugh Score (BAIAE)
Bilirubin Albumin INR Ascites Encephalopathy
Salt and pepper chromatin
Pheochromocytoma
Most abundant cell in Pheochromocytoma
Chromaffin cells
Secreted by chromaffin cells
Catecholamines (Epi, NorE)
Catecholamine metabolite
VMA
Neuroendocrine tumor of the adrenal medulla
Pheochromocytoma
Extra adrenal source
Organs of Zuckerkandl
Dominant sign in Pheochromocytoma
Hypertension
Cornerstone for diagnosis of Pheochromocytoma
Catecholamine excess
Most sensitive for the diagnosis of Pheochromocytoma
Metanephrine
Drug of choice for Pheochromocytoma
Phenoxybenzamine
Gene alteration in colon cancer
APC gene
Premalignant colonic lesion
Villous adenoma
Most common colonic lesion
Tubular adenoma
Streptococcus bogus bacteremia
Colon cancer
Prophylaxis for Colon cancer
Aspirin
NSAIDs
Most common site of colon cancer
Sigmoid
Right sided colon cancer
Anemia
Most commonly perforated part of the colon
Cecum
Radiologic finding of colon ca
Apple core or napkin ring
Chemotherapeutic drug of choice for Colon Cancer
5-FU
Monoclonal antibody used for colon cancer
Irinotectan
Drug of choice for choriocarcinoma
Methotrexate
Inhibits thymidilate synthase
5-FU
Inhibits dihyrofolate reductase
Methotrexate
Decrease toxicity of methotrexate
Increase effect of 5-FU
Leucovorin
Gold standard for diagnosis of gastric cancer
Endoscopy
E-cadherin gene
Diffuse type Gastric cancer
Diffuse infiltrative Gastric cancer
Linitis Plastica
Most common symptom of gastric cancer
Weight loss
Most common site of metastasis of gastric cancer
Liver
Control GI peristalsis
Interstitial cells of Cajal
Gastric GIST
Paraganglioma
Pulmonary chondroma
Carney’s triad
C-kit
GIST
Enterochromaffin cells
Carcinoid
Secreted by enterochromaffin cells
Serotonin
Metabolite of Serotonin
5-HIAA (Hydroxy-Indole acetic acid)
Oat Cell Lung Ca
ACTH
ADH
Small Cell Carcinoma of the Lungs
PTH
Most common cancer of non smokers, young, and women
Adenocarcinoma
Lung cancer
RAS
Adenocarcinoma of non smokers
Tyrosine kinase domain
Non small cell carcinoma
EGFR
Over expression means poor prognosis
VEGF
Cough
Hemoptysis
Central growth
Pleuritic pain
Peripheral
Local extension of tumor from lung apex involving C8, T1-2
Pancoast tumor
Pancoast tumor
Horner’s Syndrome
Coin lesion
Hamartoma
Most common intraocular malignancy of childhood
Retinoblastoma
Retinoblastoma
Embryonic neural retina
RB1 gene
Retinoblastoma
Flexner wintersteiner rosettes
Retinoblastoma