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Internal Medicine Mnemonics > Oncology > Flashcards

Oncology Flashcards

1
Q

Alkylating Agent: Cyclophaphamide

A

Alopecia, bone marrow toxicity, gonadal failure;

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2
Q

Alkylating Agent: Cisplatin

A

Ototoxicity, nephrotoxicity, neuropathy -> give amifostine (antidote)

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3
Q

Alkylating Agent: Busulfan

A

Pulmonary fibrosis

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4
Q

Alkylating Agent: Nitrosureas

A

Neurotoxicity

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5
Q

Alkylating Agent: Oxaliplatin

A

Neurotoxicity

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6
Q

Alkylating Agent: Procarbazine

A

Disulfiram-like reaction

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7
Q

Antitumor Antibiotic: Bleomycin

A

Pulmonary fibrosis

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8
Q

Antitumor Antibiotic: Dactinomycin/Actinomycin D

A

Myelosuppresion

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9
Q

Antitumor Antibiotic: Doxorubicin/Adriamycin

A

Cardiotoxicity -> give dexrazoxane (antidote)

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10
Q

Antimetabolite: Methotrexate

A

Inhibits dihydrofolate reductase

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11
Q

Antimetabolite: 5-FU

A

Inhibits thymidylate synthase

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12
Q

Antimetabolite: Azathioprine and 6-Mercaptopurine

A

Purine analogue

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13
Q

Antimetabolite: Cytarabine

A

Pyrimidine analogue

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14
Q

Antimetabolite: Hydroxyurea

A

Inhibits ribonucleotide reductase

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15
Q

Microtubule Inhibitor: Taxanes

A

Hyperstabilize polymerized microtubules preventing their breakdown during anaphase

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16
Q

Microtubule Inhibitor: Vinblastine and Vincristine

A

Attach to B tubulin and inhibit polymerization

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17
Q

Topoisomerase Inhibitor: Etoposide, Teniposide

A

Inhibit topoisomerase II

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18
Q

Topoisomerase Inhibitor: Ironotecan, Topotecan

A

Inhibit topoisomerase I

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19
Q

Hypercalcemia

A

PTHrP: squamous cell carcinoma (lung, head & neck, skin, breast, GU, GI)

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20
Q

SIADH

A

Small cell carcinoma of the lung, carcinoid tumors, GI, GU, ovarian cancer

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21
Q

Cushing’s syndrome

A

Ectopic ACTH: small cell lung cancer, carcinoid, pancreatic islet cell tumors

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22
Q

Hypoglycemia from IGF-2 excess

A

Mesenchymal tumors, hepatocellular and adrenal carcinomas

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23
Q

Erythrocytosis

A

Renal and hepatocellular cancer, cerebellar hemangioblastomas

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24
Q

Trousseau’s Sndrome (migratory thrombophlebitis)

A

Pancreatic cancer

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25
Q

Myasthenia gravis, pure red cell aplasia

A

Thymoma

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26
Q

Lambert-Eaton myasthenic syndrome (LEMS)

A

Small cell carcinoma of the lung

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27
Q

Xeroderma pigmentosa

A

Lack of an endonuclease for thymidine dimer repair -> increased susceptibility to skin cancers of all types

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28
Q

Basal cell carcinomas

A

One or few small waxy, semitranslucent nodules forming around a central depression that may be ulcerated, crusted or bleeding, edge is rolled or pearly with rodent ulcer, rare metastasizes

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29
Q

Face/head and neck area

A

Most common site of basal cell carcinoma

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30
Q

Classical or nodular type

A

Most common type of basal cell carcinoma

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31
Q

Squamous cell carcinoma

A

Dome-shaped, elevated, hard infiltrating lesion (deeply nodular), may eventually develop an ulcer, occurs on sun-exposed areas

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32
Q

Bowen’s disease

A

In situ form of squamous cell carcinoma

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33
Q

Chronic long term sun exposure

A

Major risk factor for squamous cell carcinoma of the skin

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34
Q

Actinic keratosis

A

Known precursor lesion of squamous cell carcinoma of the skin

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35
Q

Superficial spreading

A

Most common type of melanoma

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36
Q

Asymmetry

A

Characteristics of a malignant lesion melanoma (versus benign nevus

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37
Q

Depth of invasion (Breslow thickness)

A

Single greatest determinant of metastasis of melanoma

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38
Q

Personal history of melanoma

A

Single greatest risk factor for melanoma

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39
Q

Acral-lentiginous melanoma

A

Most common type of melanoma in dark-skinned individuals and Asians

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40
Q

Regional lymph node metastasis

A

Single most important prognostic factor for melanoma

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41
Q

Early excision

A

Most important determinant of outcome in melanoma

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42
Q

Wheal

A

Primary lesion erythematous edematous evanescent rash

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43
Q

Lichenification

A

Thickening of skin with accentuation of skin fold markings

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44
Q

Erosion

A

Loss of epidermis without loss of dermis

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45
Q

Ulcer

A

Loss of both epidermis and dermis

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46
Q

Lungs

A

Most common site of metastasis of soft tissue sarcomas

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47
Q

Chemotherapy

A

Mainstay of the treatment for Ewing’s sarcoma, PNET, and rhabdomyosarcoma

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48
Q

Plasma cell tumors

A

Most common malignant tumor of bone

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49
Q

Osteosarcoma

A

Account for majority of bone sarcomas, predominant in young males, usually occurring on the metaphysis of long bones, distal femur, proximal tibia, and humerus

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50
Q

Moth-eaten appearance

A

Radiographic hallmarks of osteosarcoma

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51
Q

Response to chemotherapy

A

Most important prognostic factor for long-term survival in osteosarcoma

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52
Q

Vertebrae

A

Site most commonly involved in bone metastasis

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53
Q

Urinary bladder

A

Most common site of malignancy in the urinary tract

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54
Q

Urinary bladder

A

Most common source of gross hematuria

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55
Q

Painless hematuria

A

Most common presentation of bladder, renal pelvis, and ureteric cancer

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56
Q

BCG

A

Vaccine component used as intravesicular therapy in bladder cancer

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57
Q

Smoking

A

Most common environmental risk factor for bladder and renal cell carcinoma

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58
Q

Clear cell carcinoma

A

Most common hisopathologic type of renal carcinoma

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59
Q

Hematuria

A

Classic triad of renal cell carcinoma

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60
Q

Peripheral zone

A

Site where most prostate cancers develop

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61
Q

5-alpha reductase inhibitors (finasteride/dutasteride)

A

Predominant therapy to reduce future risk of prostate cancer

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62
Q

Free PSA <10%, PSA density >0.15ng/ml/cm^3

A

PSA levels suggestive of cancer requiring biopsy

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63
Q

Transrectal ultrasound-guided needle biopsy

A

Test to establish prostate cancer diagnosis

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64
Q

Gleason scoring

A

Scoring used to measure histologic aggressiveness of the dominant and secondary glandular histology of prostate cancers

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65
Q

Pancreatic head

A

Most common location of pancreatic cancer

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66
Q

Smoking

A

Most common environmental risk factor for pancreatic cancer

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67
Q

Hepatomegaly

A

Most common physical sign in hepatocellular carcinoma (HCC)

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68
Q

Non-cirrhotic or Child-Pugh A cirrhosis

A

Candidates for resection in HCC

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69
Q

Single lesion <=5cm or <=3 nodules each <=3cm, no gross vascular invasion

A

Criteria for orthotopic liver transplant (Milan criteria)

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70
Q

Fibrolamellar HCC

A

Variant of HCC associated with younger females, elevated blood neurotensin levels, no cirrhosis

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71
Q

Hemangioma

A

Most common benign liver tumor among women

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72
Q

Adenoma

A

Benign liver mass associated with contraceptive use, with low potential for malignant change and risk of bleeding

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73
Q

Focal nodular hyperplasia

A

Benign liver mass with characteristic central scar, hypovascular on arterial phase and hypervascular on delayed phase CT

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74
Q

Triphasic CT scan

A

Most useful diagnostic tool in differentiating between benign and malignant liver masses

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75
Q

Cholangiocarcinoma

A

Mucin-producing adenocarcinomas that arise from the bile ducts, majority of which are located in the hilar or central area

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76
Q

Klatskin tumors

A

Nodular tumors arising at the bifurcation of the common bile duct

77
Q

Ampullary carcinoma

A

Adenocarcinoma arising within 2 cm of the distal end of the common bile duct

78
Q

Courvoisier’s sign

A

Palpable gallbladder associated with obstructive biliary malignancy

79
Q

Pylorus preserving pancreaticoduodenectomy (modified Whipple’s procedure)

A

Standard surgical procedure for pancreatic head and uncinate tumors

80
Q

Villous sessile adenomatous polyps, >2.5 cm in size

A

Characteristics of colonic polyps most associated with malignancy

81
Q

FAP (familiar adenomatous polyposis)

A

Familial autosomal dominant condition with multiple polyps (polyposis coli)

82
Q

Gardner’s syndrome

A

Multiple polyps in the small and large intestines with osteomas, fibromas, and congential hypertrophy of the retinal pigment epithelium

83
Q

Turcot’s syndrome

A

Multiple polyps in the large intestine with brain tumors

84
Q

Peutz-Jeghers syndrome

A

Multiple small and large intestinal polyps (hamartomatous/juvenile), mucocutaneous pigmentation, tumors of the ovary, breast and pancreas

85
Q

Hereditary nonpolyposis colon cancer (Lynch syndrome)

A

Hereditary autosomal dominant predisposition to colon, ovarian and endometrial cancers caused by defects in DNA mismatch repair

86
Q

Aspirin and NSAIDs

A

Most effective class of agents to reduce the risk of colon adenomas and carcinomas

87
Q

Right-sided colon cancers

A

Usually non-obstructive, discovered late, with iron-deficiency anemia

88
Q

Left-sided colon cancers

A

Usually with obstructive symptoms and apple-core or napkin ring deformity on barium studies

89
Q

Rectosigmoid cancers

A

Hematochezia, tenesmus, narrowing of stool caliber

90
Q

Within the first 4 years

A

Period of time when most recurrencies after surgical resection of large bowel cancer occur

91
Q

Minimum of 12 lymph nodes

A

Number of sampled lymph nodes necessary to accurately define tumor stage during surgery

92
Q

Liver

A

Most frequent visceral site of metastasis for colon cancer

93
Q

5-fluorouracil (5-FU)

A

Backbone chemotherapeutic agent for colon cancer and acts as a radiosensitizer for treatment of rectal cancer

94
Q

Diarrhea

A

Major side effect of irinotecan used in FOLFIRI regiman for colon cancer

95
Q

Dose-dependent sensory neuropathy

A

Common side effect of oxaliplatin used in FOLFOX regimen for colon cancer

96
Q

Squamous cell carcinoma

A

Esophageal cancer related to smoking and alcohol, arising in the middle 1/3

97
Q

Adenocarcinoma

A

Esophageal cancer related to acid reflux and Barrett’s esophagus arising in the distal 1/3

98
Q

Progressive dysphagia and weight loss

A

Initial symptoms of esophageal cancer in majority of patients

99
Q

> 60% of esophageal circumference is infiltrated

A

Threshold of dysphagia

100
Q

Diffuse type

A

Type of gastric carcinoma with loss of cell cohesion developing throughout the stomach resulting to loss of distensibility (linitis plastica or leather bottle appearance)

101
Q

Intestinal type

A

Type of gastric carcinoma frequently ulcerative and involving the antrum and lesser curvature, often initiated by H. pylori

102
Q

Low socio-economic class, H. pylori infection, ingestion of high concentrations of nitrates in preserved foods, Menetrier’s disease (hypertrophy of rugal folds), blood group A

A

Implicated risk factors for gastric cancer

103
Q

Krukenberg tumor

A

Gastric cancer metastatic to the ovar

104
Q

Sister Mary Joseph nodes

A

Gastric cancer metastatic to the periumbilical region

105
Q

Blumer’s nodes

A

Gastric cancer metastatic to the peritoneal cul-de-sac

106
Q

Virchow’s nodes

A

Gastric cancer metastatic to the supraclavicular lymph nodes

107
Q

Liver

A

Most common site for hematogenous spread of gastric cancer

108
Q

Complete surgical removal of the tumor with resection of adjacent lymph nodes

A

Only chance of cure for gastric cancer

109
Q

Stomach

A

Most frequent site of extra-nodal lymphoma

110
Q

Eradication of H. pylori

A

Primary treatment of gastric lymphoma

111
Q

Age of menarche

A

Three dates in a woman’s life with major impact on breast cancer risk

112
Q

Days 5-7 of the menstrual cycle

A

Best time for breast examination

113
Q

Tumor stage

A

Most important prognostic variable in breast cancer

114
Q

Selective estrogen receptor modulators (SERM)

A

Hormonal treatment for breast cancer which increases the risk of endometrial cancer

115
Q

Oral contraceptive pills

A

Treatment that increases breast cancer risk but decreases ovarian and endometrial cancer risk

116
Q

Trastuzumab

A

Monoclonal antibody directed against the erb/her2-neu receptor used for breast cancers

117
Q

Lobular neoplasia

A

Premalignant lsion that suggests elevated risk of breast cancer

118
Q

Smoking

A

Primary cause of lung cancer worldwide

119
Q

Small cell and squamous cell lung cancer

A

Types of lung cancer implicated with smoking which tend to present centrally

120
Q

Adenocarcinoma of the lung

A

Most prevalent type of lung cancer among women, young adults and non-smokers presenting peripherally

121
Q

Bronchioalveolar carcinoma

A

Subtype of lung adenocarcinoma that grows along the alveoli without invasion (lepidic growth), may present with classic ground glass appearance on CT

122
Q

Pancoast syndrome or superior sulcus tumor

A

Results from local extension of tumor growing in the apex involving C8 and TI-T2 nerve roots with shoulder pain radiating to the ulnar distribution and Horner’s syndrome

123
Q

Hypercalcemia from extopic PTH/PTH-related protein production

A

Most common life-threatening metabolic complication of malignancy associated with squamous cell cancer of the lung

124
Q

SIADH, Cushing’s Syndrome, Lambert Eaton Syndrome

A

Paraneoplastic syndromes associated with small cell lung cancer

125
Q

Chemotherapy

A

Treatment of choice for small cell lung cancer

126
Q

Surgical resection

A

Treatment of choice for early (stage 1 or 2) non-small cell lung cancer

127
Q

Lungs

A

Location of majority of hamartomas

128
Q

Alyklating agents and benzene

A

AML

129
Q

Aromatic dyes and Schistosoma hematobium

A

Bladder cancer

130
Q

Asbestos, arsenic

A

Lung cancer, mesothelioma

131
Q

Epstein-Barr virus

A

Burkitt’s lymphoma, nasopharyngeal cancer

132
Q

Diethylstilbestrol (DES)

A

Vaginal clear cell cancer (in daughters exposed to it during fetal development)

133
Q

HIV

A

Lymphoma, Kaposi’s sarcoma (HHV-8 Virus)

134
Q

Human Papilloma Virus (HPV)

A

Cervical cancer, head and neck cancer

135
Q

HTLV-1

A

Adult T-cell leukemia

136
Q

UV radiation (sunlight)

A

Skin

137
Q

Vinyl chloride

A

Liver angiosarcoma

138
Q

Smoking

A

Bladder, lung, esophageal, kidney, head and neck and pancreatic cancers

139
Q

H. pylori

A

Gastric adenocarcinoma and MALT lymphoma

140
Q

HBV, HCV, aflatoxin-1, ethanol

A

Hepatocellular carcinoma

141
Q

APC

A

Colon cancer (FAP)

142
Q

BRCA1, BRCA2

A

Breast and ovarian cancer

143
Q

DCC

A

Colon cancer

144
Q

MEN1

A

MEN 1

145
Q

NF1, NF2

A

Neurofibromatosis 1 and 2

146
Q

p53 (guardian of the genome)

A

Li-Fraumeni Syndrome

147
Q

Rb

A

Retinoblastoma, osteosarcoma

148
Q

VHL

A

Von Hippel Lindau Syndrome

149
Q

WT1, WT2

A

Wilm’s Tumor

150
Q

BRAF

A

Melanoma, lung, colorectal cancer

151
Q

BCR-ABL

A

CML, ALL

152
Q

BCL-2

A

Follicular lymphoma

153
Q

C-myc

A

Burkitt’s lymphoma

154
Q

L-myc

A

Lung and bladder cancer

155
Q

N-myc

A

Neuroblastoma, lung cancer

156
Q

RAS

A

Colon, lung, pancreatic cancer

157
Q

RET

A

Multiple endocrine neoplasia (MEN) 2A and 2B

158
Q

hCG (human chorionic gonadotropin)

A

Trophoblastic disease, gonadal germ cell tumor, choriocarcinoma

159
Q

Calcitonin

A

Medullary thyroid cancer

160
Q

Catecholamines

A

Pheochromocytoma

161
Q

AFP (alpha fetoprotein)

A

Hepatocellular, gonadadal germ cell tumor, yolk sac or endodermal sinus tumor

162
Q

CEA (carcinoembryonic antigen)

A

Colon, pancreatic, breast, lung and ovarian cancer

163
Q

Prostatic acid phosphatase, prostate specific antigen (PSA)

A

Prostate cancer

164
Q

Neuron-specific enolase

A

Small cell lung cancer, neuroblastoma

165
Q

Lactate dehydrogenase (LDH)

A

Lymphoma, Ewing’s sarcoma, dysgerminoma

166
Q

Monoclonal immunoglobulins

A

Myeloma

167
Q

CA-125

A

Ovarian cancer, lymphoma

168
Q

CA 19-9

A

Colon, pancreatic, and breast cancer

169
Q

S-100

A

Cancers of neural crest origin (melanomas, schwannomas, Langerhans cell histiocytosis)

170
Q

Sigmoidoscopy

A

Adults >=50 years old; screen every 5 years

171
Q

FOBT (fecal occult blood testing)

A

Adults >=50 years old; screen every year

172
Q

Colonoscopy

A

Adults >=50 years old; screen every 10 years

173
Q

Pap smear

A

Begin 3 years after first intercourse or by age 21

174
Q

Mammography

A

Women >=40 years old: screen annually (ACS)

175
Q

DRE and PSA

A

Men >=50 years old: screen annually

176
Q

Age

A

Most significant risk factor for cancer overall

177
Q

Lung cancer

A

Most common cancer worldwide

178
Q

Breast cancer

A

Second most common cancer worldwide

179
Q

Lung cancer

A

Most common cause of cancer death

180
Q

Tumor suppressor genes

A

Genes involved in restraining cell growth and requiring both alleles to be mutated for tumorigenesis

181
Q

Oncogenes

A

Genes involved in cellular growth wherein mutation of one allele may lead to tumorigenesis

182
Q

Surgery

A

Most effective means of treating cancer

183
Q

Teletherapy

A

Delivery of radiation therapy from a distance

184
Q

Brachytherapy

A

Encapsulated sealed sources of radiation implanted directly or adjacent to tumor

185
Q

Systemic radiation therapy

A

Radionuclides targeted to the site of the tumor

186
Q

Alcohol and smoking

A

Most significant risk factor for head and neck cancer

187
Q

Chemoradiotherapy

A

Most commonly used treatment for head and neck cancers

188
Q

Serotonin receptor antagonists (i.e. ondansetron)

A

Most effective drugs against highly emetogenic agents

Internal Medicine Mnemonics (8 decks)

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