oncology/hematology

Question 1

post surgery f/u marker for seminoma?

Answer 1

LDH (latate dehydronase)

Question 2

colon cancer screening for patients with family Hx of familiar adenomatous polyposis?

Answer 2

sigmoidoscopy from age 10-15 yrs yearly. sigmoidoscopy every 3 years from age 35yrs.

Question 3

multiple myeloma

bad Px factors?

Answer 3

1. low serum albumin
2. high beta-2 micriglobulin

Question 4

65 yo, malaise, weight loss, fever Leukemia DDx point? CML AML CLL Hodgkin lymphoma

Answer 4

• CML : abdominal fullness, massive splenomegaly, priapiasm, gout
• AML : oral problems (gingivitis, stomatitis), infections, anemia, easy bruising.
• CLL : lymphadenopathy in the axilla, neck, groin
• Hodgkin’s lymphoma : painless cervial lymphadenopathy

Question 5

anemia with increased mean cell volume?

increased MCV

Answer 5

increased MCV =megaloblast

megaloblast anemia is seen in VitB12 deficiency, or folic acid deficienty.

Pernicious anemia, celiac disease, alcholism, gastritis, gastric bypass

Question 6

Breast cancer screening?

Answer 6

1. general population : age 50-74 mammography every 2 years.
2. high risk population : annualy mammo from age 40

• a first degree relative with Breast Ca diagnosed before age 50
• a first degree relative with cancer in both breasts
• two or more relatives with Breast Ca

Question 7

the most common cancer after organ transplantation?

Answer 7

cutaneous squamous cell carcinoma

Question 8

> 50 yrs, white cell count elevation,

spelenomegaly

low platelet, anemia

axillary lymphadenopathy

Dx?

Answer 8

Dx : CLL

Tx : prednisolone for autoimmune thrombocytopenia and anemia , then CTx

Question 9

enlarged, painless, non-erythematous, non-tender lymph node

only in cervical and supraclavicular LN.

night sweats, weight loss, fever, pruritus

Answer 9

Hodgkin lymphoma

Question 10

small bowel cancer, predisposing disease?

small bowel lymphoma

small bowel adenocarcinoma

small bowel hamartoma

Answer 10

small bowel lymphoma : celiac disease

small bowel adenocarcinoma : crohn’s disease

small bowel hamartoma : Peutz-Jeghers syndrome

Question 11

poor prognistic factors for multiple myeloma?

Answer 11

increased beta micoglobulin

decased serum albumin

Question 12

A patient with family Hx of prostate cancer. (father or brother, 1 member)

PSA testing recommendation?

Answer 12

starting from 45 yr, every 2 years.

Question 13

lung mass,

abdominal pain, polyuria, increased thirst, constipation

What kind of cancer?

Answer 13

squamous cell lung cancer, producing PTH, causing hypercalcemia.

Question 14

lung mass,

hyperglycemia, hypertension, hypokalemia, central obesity,

what kind of cancer?

Answer 14

small cell lung cancer, producing ACTH, resulting in Cushing’s syndrome

Question 15

lung mass

nausea, vomiting, fatigue

hypoosmolar hyponatremia

what kind of cancer?

Answer 15

(most of the time)

small cell lung cancer, producing ADH, causing SIADH

Question 16

Vit D deficiency

associated with what cancers?

Answer 16

Breast ductla carcinoma in situ

colon cancer

prostate cancer