Oncology Flashcards
1
Q
Alkylating Agent: Cyclophaphamide
A
Alopecia, bone marrow toxicity, gonadal failure;
2
Q
Alkylating Agent: Cisplatin
A
Ototoxicity, nephrotoxicity, neuropathy -> give amifostine (antidote)
3
Q
Alkylating Agent: Busulfan
A
Pulmonary fibrosis
4
Q
Alkylating Agent: Nitrosureas
A
Neurotoxicity
5
Q
Alkylating Agent: Oxaliplatin
A
Neurotoxicity
6
Q
Alkylating Agent: Procarbazine
A
Disulfiram-like reaction
7
Q
Antitumor Antibiotic: Bleomycin
A
Pulmonary fibrosis
8
Q
Antitumor Antibiotic: Dactinomycin/Actinomycin D
A
Myelosuppresion
9
Q
Antitumor Antibiotic: Doxorubicin/Adriamycin
A
Cardiotoxicity -> give dexrazoxane (antidote)
10
Q
Antimetabolite: Methotrexate
A
Inhibits dihydrofolate reductase
11
Q
Antimetabolite: 5-FU
A
Inhibits thymidylate synthase
12
Q
Antimetabolite: Azathioprine and 6-Mercaptopurine
A
Purine analogue
13
Q
Antimetabolite: Cytarabine
A
Pyrimidine analogue
14
Q
Antimetabolite: Hydroxyurea
A
Inhibits ribonucleotide reductase
15
Q
Microtubule Inhibitor: Taxanes
A
Hyperstabilize polymerized microtubules preventing their breakdown during anaphase
16
Q
Microtubule Inhibitor: Vinblastine and Vincristine
A
Attach to B tubulin and inhibit polymerization
17
Q
Topoisomerase Inhibitor: Etoposide, Teniposide
A
Inhibit topoisomerase II
18
Q
Topoisomerase Inhibitor: Ironotecan, Topotecan
A
Inhibit topoisomerase I
19
Q
Hypercalcemia
A
PTHrP: squamous cell carcinoma (lung, head & neck, skin, breast, GU, GI)
20
Q
SIADH
A
Small cell carcinoma of the lung, carcinoid tumors, GI, GU, ovarian cancer
21
Q
Cushing’s syndrome
A
Ectopic ACTH: small cell lung cancer, carcinoid, pancreatic islet cell tumors
22
Q
Hypoglycemia from IGF-2 excess
A
Mesenchymal tumors, hepatocellular and adrenal carcinomas
23
Q
Erythrocytosis
A
Renal and hepatocellular cancer, cerebellar hemangioblastomas
24
Q
Trousseau’s Sndrome (migratory thrombophlebitis)
A
Pancreatic cancer
25
Myasthenia gravis, pure red cell aplasia
Thymoma
26
Lambert-Eaton myasthenic syndrome (LEMS)
Small cell carcinoma of the lung
27
Xeroderma pigmentosa
Lack of an endonuclease for thymidine dimer repair -> increased susceptibility to skin cancers of all types
28
Basal cell carcinomas
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
29
Face/head and neck area
Most common site of basal cell carcinoma
30
Classical or nodular type
Most common type of basal cell carcinoma
31
Squamous cell carcinoma
Dome-shaped, elevated, hard infiltrating lesion (deeply nodular), may eventually develop an ulcer, occurs on sun-exposed areas
32
Bowen's disease
In situ form of squamous cell carcinoma
33
Chronic long term sun exposure
Major risk factor for squamous cell carcinoma of the skin
34
Actinic keratosis
Known precursor lesion of squamous cell carcinoma of the skin
35
Superficial spreading
Most common type of melanoma
36
Asymmetry
Characteristics of a malignant lesion melanoma (versus benign nevus
37
Depth of invasion (Breslow thickness)
Single greatest determinant of metastasis of melanoma
38
Personal history of melanoma
Single greatest risk factor for melanoma
39
Acral-lentiginous melanoma
Most common type of melanoma in dark-skinned individuals and Asians
40
Regional lymph node metastasis
Single most important prognostic factor for melanoma
41
Early excision
Most important determinant of outcome in melanoma
42
Wheal
Primary lesion erythematous edematous evanescent rash
43
Lichenification
Thickening of skin with accentuation of skin fold markings
44
Erosion
Loss of epidermis without loss of dermis
45
Ulcer
Loss of both epidermis and dermis
46
Lungs
Most common site of metastasis of soft tissue sarcomas
47
Chemotherapy
Mainstay of the treatment for Ewing's sarcoma, PNET, and rhabdomyosarcoma
48
Plasma cell tumors
Most common malignant tumor of bone
49
Osteosarcoma
Account for majority of bone sarcomas, predominant in young males, usually occurring on the metaphysis of long bones, distal femur, proximal tibia, and humerus
50
Moth-eaten appearance
Radiographic hallmarks of osteosarcoma
51
Response to chemotherapy
Most important prognostic factor for long-term survival in osteosarcoma
52
Vertebrae
Site most commonly involved in bone metastasis
53
Urinary bladder
Most common site of malignancy in the urinary tract
54
Urinary bladder
Most common source of gross hematuria
55
Painless hematuria
Most common presentation of bladder, renal pelvis, and ureteric cancer
56
BCG
Vaccine component used as intravesicular therapy in bladder cancer
57
Smoking
Most common environmental risk factor for bladder and renal cell carcinoma
58
Clear cell carcinoma
Most common hisopathologic type of renal carcinoma
59
Hematuria
Classic triad of renal cell carcinoma
60
Peripheral zone
Site where most prostate cancers develop
61
5-alpha reductase inhibitors (finasteride/dutasteride)
Predominant therapy to reduce future risk of prostate cancer
62
Free PSA <10%, PSA density >0.15ng/ml/cm^3
PSA levels suggestive of cancer requiring biopsy
63
Transrectal ultrasound-guided needle biopsy
Test to establish prostate cancer diagnosis
64
Gleason scoring
Scoring used to measure histologic aggressiveness of the dominant and secondary glandular histology of prostate cancers
65
Pancreatic head
Most common location of pancreatic cancer
66
Smoking
Most common environmental risk factor for pancreatic cancer
67
Hepatomegaly
Most common physical sign in hepatocellular carcinoma (HCC)
68
Non-cirrhotic or Child-Pugh A cirrhosis
Candidates for resection in HCC
69
Single lesion <=5cm or <=3 nodules each <=3cm, no gross vascular invasion
Criteria for orthotopic liver transplant (Milan criteria)
70
Fibrolamellar HCC
Variant of HCC associated with younger females, elevated blood neurotensin levels, no cirrhosis
71
Hemangioma
Most common benign liver tumor among women
72
Adenoma
Benign liver mass associated with contraceptive use, with low potential for malignant change and risk of bleeding
73
Focal nodular hyperplasia
Benign liver mass with characteristic central scar, hypovascular on arterial phase and hypervascular on delayed phase CT
74
Triphasic CT scan
Most useful diagnostic tool in differentiating between benign and malignant liver masses
75
Cholangiocarcinoma
Mucin-producing adenocarcinomas that arise from the bile ducts, majority of which are located in the hilar or central area
76
Klatskin tumors
Nodular tumors arising at the bifurcation of the common bile duct
77
Ampullary carcinoma
Adenocarcinoma arising within 2 cm of the distal end of the common bile duct
78
Courvoisier's sign
Palpable gallbladder associated with obstructive biliary malignancy
79
Pylorus preserving pancreaticoduodenectomy (modified Whipple's procedure)
Standard surgical procedure for pancreatic head and uncinate tumors
80
Villous sessile adenomatous polyps, >2.5 cm in size
Characteristics of colonic polyps most associated with malignancy
81
FAP (familiar adenomatous polyposis)
Familial autosomal dominant condition with multiple polyps (polyposis coli)
82
Gardner's syndrome
Multiple polyps in the small and large intestines with osteomas, fibromas, and congential hypertrophy of the retinal pigment epithelium
83
Turcot's syndrome
Multiple polyps in the large intestine with brain tumors
84
Peutz-Jeghers syndrome
Multiple small and large intestinal polyps (hamartomatous/juvenile), mucocutaneous pigmentation, tumors of the ovary, breast and pancreas
85
Hereditary nonpolyposis colon cancer (Lynch syndrome)
Hereditary autosomal dominant predisposition to colon, ovarian and endometrial cancers caused by defects in DNA mismatch repair
86
Aspirin and NSAIDs
Most effective class of agents to reduce the risk of colon adenomas and carcinomas
87
Right-sided colon cancers
Usually non-obstructive, discovered late, with iron-deficiency anemia
88
Left-sided colon cancers
Usually with obstructive symptoms and apple-core or napkin ring deformity on barium studies
89
Rectosigmoid cancers
Hematochezia, tenesmus, narrowing of stool caliber
90
Within the first 4 years
Period of time when most recurrencies after surgical resection of large bowel cancer occur
91
Minimum of 12 lymph nodes
Number of sampled lymph nodes necessary to accurately define tumor stage during surgery
92
Liver
Most frequent visceral site of metastasis for colon cancer
93
5-fluorouracil (5-FU)
Backbone chemotherapeutic agent for colon cancer and acts as a radiosensitizer for treatment of rectal cancer
94
Diarrhea
Major side effect of irinotecan used in FOLFIRI regiman for colon cancer
95
Dose-dependent sensory neuropathy
Common side effect of oxaliplatin used in FOLFOX regimen for colon cancer
96
Squamous cell carcinoma
Esophageal cancer related to smoking and alcohol, arising in the middle 1/3
97
Adenocarcinoma
Esophageal cancer related to acid reflux and Barrett's esophagus arising in the distal 1/3
98
Progressive dysphagia and weight loss
Initial symptoms of esophageal cancer in majority of patients
99
>60% of esophageal circumference is infiltrated
Threshold of dysphagia
100
Diffuse type
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
Intestinal type
Type of gastric carcinoma frequently ulcerative and involving the antrum and lesser curvature, often initiated by H. pylori
102
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
Implicated risk factors for gastric cancer
103
Krukenberg tumor
Gastric cancer metastatic to the ovar
104
Sister Mary Joseph nodes
Gastric cancer metastatic to the periumbilical region
105
Blumer's nodes
Gastric cancer metastatic to the peritoneal cul-de-sac
106
Virchow's nodes
Gastric cancer metastatic to the supraclavicular lymph nodes
107
Liver
Most common site for hematogenous spread of gastric cancer
108
Complete surgical removal of the tumor with resection of adjacent lymph nodes
Only chance of cure for gastric cancer
109
Stomach
Most frequent site of extra-nodal lymphoma
110
Eradication of H. pylori
Primary treatment of gastric lymphoma
111
Age of menarche
Three dates in a woman's life with major impact on breast cancer risk
112
Days 5-7 of the menstrual cycle
Best time for breast examination
113
Tumor stage
Most important prognostic variable in breast cancer
114
Selective estrogen receptor modulators (SERM)
Hormonal treatment for breast cancer which increases the risk of endometrial cancer
115
Oral contraceptive pills
Treatment that increases breast cancer risk but decreases ovarian and endometrial cancer risk
116
Trastuzumab
Monoclonal antibody directed against the erb/her2-neu receptor used for breast cancers
117
Lobular neoplasia
Premalignant lsion that suggests elevated risk of breast cancer
118
Smoking
Primary cause of lung cancer worldwide
119
Small cell and squamous cell lung cancer
Types of lung cancer implicated with smoking which tend to present centrally
120
Adenocarcinoma of the lung
Most prevalent type of lung cancer among women, young adults and non-smokers presenting peripherally
121
Bronchioalveolar carcinoma
Subtype of lung adenocarcinoma that grows along the alveoli without invasion (lepidic growth), may present with classic ground glass appearance on CT
122
Pancoast syndrome or superior sulcus tumor
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
Hypercalcemia from extopic PTH/PTH-related protein production
Most common life-threatening metabolic complication of malignancy associated with squamous cell cancer of the lung
124
SIADH, Cushing's Syndrome, Lambert Eaton Syndrome
Paraneoplastic syndromes associated with small cell lung cancer
125
Chemotherapy
Treatment of choice for small cell lung cancer
126
Surgical resection
Treatment of choice for early (stage 1 or 2) non-small cell lung cancer
127
Lungs
Location of majority of hamartomas
128
Alyklating agents and benzene
AML
129
Aromatic dyes and Schistosoma hematobium
Bladder cancer
130
Asbestos, arsenic
Lung cancer, mesothelioma
131
Epstein-Barr virus
Burkitt's lymphoma, nasopharyngeal cancer
132
Diethylstilbestrol (DES)
Vaginal clear cell cancer (in daughters exposed to it during fetal development)
133
HIV
Lymphoma, Kaposi's sarcoma (HHV-8 Virus)
134
Human Papilloma Virus (HPV)
Cervical cancer, head and neck cancer
135
HTLV-1
Adult T-cell leukemia
136
UV radiation (sunlight)
Skin
137
Vinyl chloride
Liver angiosarcoma
138
Smoking
Bladder, lung, esophageal, kidney, head and neck and pancreatic cancers
139
H. pylori
Gastric adenocarcinoma and MALT lymphoma
140
HBV, HCV, aflatoxin-1, ethanol
Hepatocellular carcinoma
141
APC
Colon cancer (FAP)
142
BRCA1, BRCA2
Breast and ovarian cancer
143
DCC
Colon cancer
144
MEN1
MEN 1
145
NF1, NF2
Neurofibromatosis 1 and 2
146
p53 (guardian of the genome)
Li-Fraumeni Syndrome
147
Rb
Retinoblastoma, osteosarcoma
148
VHL
Von Hippel Lindau Syndrome
149
WT1, WT2
Wilm's Tumor
150
BRAF
Melanoma, lung, colorectal cancer
151
BCR-ABL
CML, ALL
152
BCL-2
Follicular lymphoma
153
C-myc
Burkitt's lymphoma
154
L-myc
Lung and bladder cancer
155
N-myc
Neuroblastoma, lung cancer
156
RAS
Colon, lung, pancreatic cancer
157
RET
Multiple endocrine neoplasia (MEN) 2A and 2B
158
hCG (human chorionic gonadotropin)
Trophoblastic disease, gonadal germ cell tumor, choriocarcinoma
159
Calcitonin
Medullary thyroid cancer
160
Catecholamines
Pheochromocytoma
161
AFP (alpha fetoprotein)
Hepatocellular, gonadadal germ cell tumor, yolk sac or endodermal sinus tumor
162
CEA (carcinoembryonic antigen)
Colon, pancreatic, breast, lung and ovarian cancer
163
Prostatic acid phosphatase, prostate specific antigen (PSA)
Prostate cancer
164
Neuron-specific enolase
Small cell lung cancer, neuroblastoma
165
Lactate dehydrogenase (LDH)
Lymphoma, Ewing's sarcoma, dysgerminoma
166
Monoclonal immunoglobulins
Myeloma
167
CA-125
Ovarian cancer, lymphoma
168
CA 19-9
Colon, pancreatic, and breast cancer
169
S-100
Cancers of neural crest origin (melanomas, schwannomas, Langerhans cell histiocytosis)
170
Sigmoidoscopy
Adults >=50 years old; screen every 5 years
171
FOBT (fecal occult blood testing)
Adults >=50 years old; screen every year
172
Colonoscopy
Adults >=50 years old; screen every 10 years
173
Pap smear
Begin 3 years after first intercourse or by age 21
174
Mammography
Women >=40 years old: screen annually (ACS)
175
DRE and PSA
Men >=50 years old: screen annually
176
Age
Most significant risk factor for cancer overall
177
Lung cancer
Most common cancer worldwide
178
Breast cancer
Second most common cancer worldwide
179
Lung cancer
Most common cause of cancer death
180
Tumor suppressor genes
Genes involved in restraining cell growth and requiring both alleles to be mutated for tumorigenesis
181
Oncogenes
Genes involved in cellular growth wherein mutation of one allele may lead to tumorigenesis
182
Surgery
Most effective means of treating cancer
183
Teletherapy
Delivery of radiation therapy from a distance
184
Brachytherapy
Encapsulated sealed sources of radiation implanted directly or adjacent to tumor
185
Systemic radiation therapy
Radionuclides targeted to the site of the tumor
186
Alcohol and smoking
Most significant risk factor for head and neck cancer
187
Chemoradiotherapy
Most commonly used treatment for head and neck cancers
188
Serotonin receptor antagonists (i.e. ondansetron)
Most effective drugs against highly emetogenic agents
