Oncology- adults Flashcards

Question

Acute lymphatic leukemia (ALL)- dx

Answer 1

BMB/A- >20% blasts- cytogenetics/ immunophenotyping

Answer 2

CBC- pancytopenia

Answer 3

<60yo- combo chemo and + Philadelphia chromosome- add tyrosine kinase inhibitor >60yo- tyrosine kinase inhibitor + prednisone after remission- CNS prophylaxis --> chemo or BMT

Answer 4

Worse- adults

Answer 5

Clonal malignancy of B lymphocytes M>W Increasing age White

Answer 6

``` Asymptomatic Lymphocytosis Lymphadenopathy Recurrent infections HSM 8 symptoms Leukemia cutis ```

Answer 7

Flow cytometry

Answer 8

CBC w diff and peripheral smear- lymphocytosis- smudge cells

Answer 9

Early- observe Stage 1-2- local radiation Stage >2- chemo

Answer 10

Early- 10yr III, IV- 2 yr Cannot be cured

Answer 11

Clonal proliferation of myeloid precursors w dec ability to differentiate into mature cells Chemo Ionizing radiation Chemical exposure 60yo

Answer 12

``` Fatigue Weakness Gingival bleeding Ecchymosis Epistasis Anemia Thrombocytopenia Pallor ```

Answer 13

BMB >20% blasts | Presence- Auer rods, myeloperoxidase or markers on phenotyping

Answer 14

CBC w diff and peripheral smear- blasts

Answer 15

Induction therapy--> consolidation (chemo or BMT)

Answer 16

65% remission- depends on age

Answer 17

young- middle aged adults M>F Ionizing radiation

Answer 18

``` Asymptomatic- found in lab work Fatigue Abdominal fullness Anorexia Weight loss Low-grade fever Excess sweating (worse than blast crisis) ```

Answer 19

BMB- Philadelphia chromosome

Answer 20

CBC- leukocytosis | PCR- BCR- ABL gene

Answer 21

Chronic- Gleevec Accelerated- Allo Blast crisis- induction chemo --> Allo

Answer 22

Chronic- 25yr Accelerated- 5 yr Blast- 1 yr

Answer 23

Biomodal peak- 20-65yr M>F EBV Immunodeficient

Answer 24

Painless localized peripheral lymphadenopathy- cervical Mediastinal mass B symptoms Post partying

Answer 25

Lymph node biopsy Reed Sternberg cells PET/CT and BM- staging

Answer 26

Combo chemo ABBVD + radiation Refractory- auto

Answer 27

``` Inc age HIV Toxin eposure Autoimmune EBV Obesity White ```

Answer 28

``` Indolent - painless lymphadenopathy HSM Cytopenia Aggressive - rapidly growing mass Fever Night sweats Weight loss ```

Answer 29

Biopsy- nodes | BM- staging

Answer 30

LDH- inc | Uric acid- inc

Answer 31

Indolent- radiation | Intermediate- high grade- chemo, immunotherapy, BMT

Answer 32

HIV - worse Indolent- long survival Aggressive- 50%

Answer 33

``` M>W Childhood head/neck radiation Family hx MEN type II - Papillary - Follicular - Medullary - Anaplastic ```

Answer 34

Painless neck swelling Palpable single, firm nodule Asymptomatic

Answer 35

U/S--> FNA

Answer 36

``` Surgery Radioactive iodine (RAI) ``` Need thyroid replacement for life Anaplastic - no effective tx- palliative care- Chemo + radiation for those who want to try

Answer 37

P, F, M- good | A- very bad

Answer 38

``` Inc age BRCA Nulliparity Early menarche Late menopause Delayed childbearing Radiation exposure Long-term estrogen use ```

Answer 39

Single, nontender, firm immobile mass - upper outer quadrant Asymptomatic Rare- nipple discharge, retraction, peau deorange, eczematous change (Paget discharge), pain, axillary lymphadenopathy

Answer 40

Stereotactic | Excisional core needle biopsy

Answer 41

Mammogram- check estrogen and progesterone receptor

Answer 42

``` Lumpectomy w/ Sentenal lymph node biopsy Mastectomy Radiation + Chemo Hormone receptors - Arimidex, tamoxifen, raloxifene Her-2 - Herceptin ```

Answer 43

Early- great | ER/PR pos- better

Answer 44

``` M>F >55yo Smoking American Indian/ Alaska Hereditary HTN Obesity Polycystic kidney disorder ```

Answer 45

``` TRIAD- hematuria, flank pain, palpable mass Asymptomatic Incidental diagnosed Weight loss Paraneoplastic symptoms ```

Answer 46

Nephrectomy or partial- obtain tissue

Answer 47

Abdominal CT | U/S

Answer 48

Partial/radical nephrectomy Advanced- immunotherapy and meds Inhibiting VEGF Chemo unhelpful

Answer 49

``` Leading cause of cancer deaths Smoking Radiation therapy Pulmonary fibrosis Environmental toxins ```

Answer 50

``` Cough Hemoptysis Chest pain Dyspnea Weight loss ```

Answer 51

Histologic confirm - sputum cytology - bronchoscopy - pleural fluid examination - biopsy

Answer 52

NSCLC- surgery—> chemo +/- radiation | SCLC- chemo, radiation

Answer 53

Poor, 5y 15%

Answer 54

Oat cell - central - Mets early - aggressive

Answer 55

SCC Adenocarcinoma Large cell carcinoma - slow growing

Answer 56

``` >70 Infection- high risk HPV HSV Immunosuppression Smoking ```

Answer 57

``` Pruritus Visible lesion Pain Bleeding Ulceration ```

Answer 58

Biopsy- - 5% acetic acid solution - visualize - acetowhite lesion biopsy

Answer 59

Excision- wide and local Topical 5-FU Early- laser therapy Radical- partial or complete vulvectomy +/- SLNB/ lymphadenectomy +/- chemo/radiation

Answer 60

Good 1-2 75-90% 4- 16%

Answer 61

``` HPV- type 16 & 18 Multiple sexual partners Smoking Early age of 1st sexual intercourse Early childbearing Low socioeconomic status STI hx AA>Hispanic>white ```

Answer 62

Asymptomatic- found on screening | Advanced- vaginal bleeding or discharge

Answer 63

Pap —> abnormal: - repeart - colposcopy + biopsy

Answer 64

``` Loop electro surgical excision procedure (LEEP) Ablation Conization Hysterectomy Pelvic lymphadenopathy Radiation Chemo ```

Answer 65

Early- >90% | IV- <15%

Answer 66

``` Unopposed estrogen therapy Obesity Age PCOS Early menarche, late menopause Nulliparity Family hx Tamoxifen, Lynch syndrome DM White>Black PROTECTIVE:: Combo OCPs and smoking ```

Answer 67

Abdominal uterine bleeding Post menopausal women Abnormal vaginal discharge Abnormal cervical cytology

Answer 68

Endometrial biopsy | D&C

Answer 69

Transvaginal u/s- determine thickness and prevent need for biopsy

Answer 70

Hysterectomy + bilateral salphingo-oophorectomy (BSO) May need chemo + radiation Progress in therapy- preserve fertility

Answer 71

Good- usually present w early stage

Answer 72

``` UV light Fair skin Family hx Radiation hx M>F Inc age ```

Answer 73

85% on head and neck- NOSE Nodular- pearly papule w telangiectasia0- central ulceration Superficial- circumscribed, scaling lesion w raised pearly white border Morpheaform- flat or slightly raised yellow/white lesion, scar like w waxy surface

Answer 74

Shave or punch

Answer 75

``` Mohs Excision/suturing Radiotherapy Curettage/electrodessication Intralesional infereon 5-FU ```

Answer 76

Good | Slow growing- no Mets

Answer 77

``` UV light Smoking Immunosuppression Chronic ulcer M>F Inc age ```

Answer 78

Sun-exposed areas - head/neck Actinic keratosis Scaly patch, plaque or nodule Ulceration w/ irregular borders - bleed or crust

Answer 79

Shave, punch, or excisional biopsy

Answer 80

Depends on depth 5-FU, imiquimod, electrodessication, curettage, excision, Mohs, radiation, chemo

Answer 81

Good | 5y > 90%

Answer 82

UV light exposure Caucasian Large number of moles Inc age

Answer 83

Skin lesion- recent changes in appearance

Answer 84

Excision w margins Sentinel lymph node excision- staging Mets- interferon alpha, immune therapy, chemo

Answer 85

Tumor thickness dependent- Breslow stage

Answer 86

Superficial spreading Nodular melanoma Lentigo maligna Acral lentiginous

Answer 87

``` Cirrhosis M HCV, HBV Obesity Asian, Hispanic >55yo DM ```

Answer 88

Asymptomatic- sx of chronic liver dx Abdominal pain, new decompensation of cirrhosis, paraneoplastic syndrome, hepatic bruit- signs of progression Skin lesion- recent changes in appearance

Answer 89

U/S | Biopsy- if image not conclusive- risk of tumor seeding

Answer 90

CT/MRI | AFP

Answer 91

``` Surgical resection- live function preserved Liver transplant- advanced cirrhosis Ablation Alcohol injection Cryotherapy Tranarterial chemoablation Chemotherapy Radiation - if surgery not an option ```

Answer 92

Poor | 5y 5-70%

Answer 93

``` >50yo Lynch syndrome Diet high in meat/fat, low veggies Family hx Inflammatory bowel disease ```

Answer 94

``` Asymptomatic- found on screening Blood in stool- frank or occult Change in bowel habits Unexplained IDA Abdominal pain Hematochezia Melena ```

Answer 95

Colonoscopy | FOBT screening- Amy alert

Answer 96

C/A/P CT | CEA- monitoring

Answer 97

Surgery + chemo | Radiation- if rectal cancer

Answer 98

5 y stage 1 >90% | 5 y stage 4 5-75%

Answer 99

Tenesmus, urgency, recurrent hematochezia

Answer 100

``` Age Tabacco Chronic pancreatitis Alcohol Family hx Obesity Diabetes ```

Answer 101

``` Abdominal pain- gnawing, epigastric Nausea Weight loss Courvoisier sign- palpable gallbladder Anorexia Fatigue Jaundice Steatorrhea Dark urine ```

Answer 102

LFTs Lipase Abdominal U/S or CT - double duct sign- dilation of pancreatic and hepatic duct

Answer 103

Whipple- w/o metastatic dx Chemo+/- radiation- after & w/o resectable tumor Pallative care- advanced

Answer 104

Very poor- almost all die

Answer 105

Black High fat diet Family hx Inc age

Answer 106

Early- asymptomatic Late- hematuria, hematospermia, obstructive urinary sx, bone pain, asymmetric induration or nodules on DRE Inc PSA

Answer 107

Biopsy- transrectal

Answer 108

Low grade- watchful waiting Higher stages- radical prostatectomy, brachytherapy, radiation Metastatic- above + castration (physical and/or chemical) + bisphosphonate

Answer 109

Gleason score

Answer 110

Proliferation of plasma cells producing monoclonal antibodies BM or plasmacytoma

Answer 111

``` Bone pain Anemia- roulexaux Hypercalcemia Fatigue/weakness Weight loss Inc creatinine Prone to recurrent infection- encapsulated organisms ```

Answer 112

Biopsy plasmacytoma | BMA/B >10% plasma cells

Answer 113

SPEP- M spike Bence-Jones- UPEP X ray- lytic lesions MRI/CT/PET- bone scan not helpful

Answer 114

Induction therapy- high dose chemo + autoBMT | Bisphosphonates- dec pathologic fracture

Answer 115

Most relapse | Maintenance chemo to prevent this

Answer 116

C- hypercalcemia R- renal disease A- anemia B- bone disease

Answer 117

``` Family hx BRCA Lynch II Infertility PCOS Endometriosis Smoking HRT 60 Caucasian ```

Answer 118

``` Abdominal fullness/bloating Nausea Early satiety Pelvic/abdominal pain Adrenal mass on pelvic exam Changes in urinary or bowl patterns ```

Answer 119

Unilateral | Salpingo-oophorectomy

Answer 120

``` Pelvic U/S CA-125 CXR CT Genetic counseling ```

Answer 121

Pathy shows Ca- hysterectomy, contralateral salpingo-oophorectomy, omentectomy and pelvic node sampling THEN chemo

Answer 122

Poor | 75% reoccur in 1-4 yrs

Answer 123

M 15-35yo Cryptorchidism- testes didn't drop Caucasian

Answer 124

Painless mass or swelling in testis | Heaviness or ache in lower abdomen, pain

Answer 125

Scrotal U/S

Answer 126

Tumor markers- AFP, beta-hCG | LDH

Answer 127

Inguinal orchiectomy + surveillance- stage 1 | Plus RPLND, radiation, and platinum- based chemo- stage 2+

Answer 128

M>F Smoking Animal fat- rich diets Most- transitional cell carcinoma

Answer 129

Painless hematuria- gross or microscopic | Frequency/urgency/dysuria- pain from spread- locally or metastatic

Answer 130

Cystoscopy- biopsy

Answer 131

UA Cystoscopy IVP- contrast agent to see dark/light spaces CT

Answer 132

Transurethral resection of bladder (TURBT)- non-muscle invasive Cystectomy- muscle invasive

Answer 133

Varied- depends on stage