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HemOnc > Oncology--Pedo > Flashcards

Oncology--Pedo Flashcards

1
Q

gold standard for cancer Dx

A

tissue sample–bx–no non-invasive means

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2
Q

Most common cancer men vs women (3 each)

A

Men: 1. prostate 2. lung 3. colorectal
women: 1. breast 2. lung 3. colorectal

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3
Q

when approaching the literature about cancer be mindful of

A

the dirrerence btwn the INCIDENCE and DEATH RATE from that cancer

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4
Q

any new growth of tissue–benign or malignant

A

neoplasm

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5
Q

an abnormal tissue mass– benign or malignant

A

tumor

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6
Q

benign def

A

growth not recurrent, progressive, or invasive in nature–not dangerous

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7
Q

if person treated for cancer and still cancer-free after 5 years they are _______

A

“cured” – used to quantify survival rates, meaningless for some cancers

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8
Q

malignant aka & def

A

Cancer,

a neoplasm that grows uncontrollably and is locally invasive or spreads to other sites

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9
Q

classification of cancer as benign or malignant based on (4)

A
  1. rate of neoplasm growth
  2. propensity of surrounding tissue invasion
  3. local area spread
  4. propensity for metastatic spread
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10
Q

very aggressive cancer cell

A

blastoma (used to imply a tumor of primitive, incompletely differentiated cells)

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11
Q

lung cancer:

  1. rates
  2. death rates
A
  • 2nd highest cancer for men/women

- 1st highest cancer for men/women

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12
Q

tumor names based on

A

histology of the tumor–cell derivative and “look” of cell

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13
Q

biggest cancers in children

A

hematologic (leukemia, lymphocytic)

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14
Q

cancers of connective tissue (bone, cart, fat, nerve)

A

sarcoma

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15
Q

malignant growth derived from “true” epithelium

A

carcinoma

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16
Q
  1. MALIGNANT epithelial carcinoma arising from glandular structures or that contain secretory structures sim to glands
  2. BENIGN epithelial tumor w/ secretary (glandular) structures (pituitary, adrenal)
A
  1. adenocarcinoma

2. adenoma

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17
Q

NET aka + def

A

neuroendocrine tumor,

tumor of endocrine or neural tissues

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18
Q

cancer confined to its site of origin

A

cancer in situ CIS (sometimes referred to as “pre-cancerous”)

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19
Q

Dysplasia + rating (3)

A

tissue w/ an abnormal size, shape, organization of mature cells.
Rated: mild, moderate, severe dysplasia (likely to become cancer)

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20
Q

extreme loss of muscle and body mass associated w/ many dz states esp. end stage cancer

A

cachexia

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21
Q
  • critical discriminating feature btwn neoplasia and hyperplasia
A

the “clonal” origin–cancers originate from a single cell!

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22
Q

neoplasia vs. hyperplasia

A

neoplasias are uncoordinated and lack normal regulatory control over the normal events of mitosis seen in non-cancerous cells

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23
Q

telomerase

A

an enzyme that prevents or repairs the shortening of telomeres

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24
Q

a gene which has the ability to cause autonomous cell growth and differentiation (cancer)

A

oncogene – an uncontrolled oncogene directly affects cellular growth in a positive manner.

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25
Q

a normal gene which may become an oncogene due to mutation

A

proto-oncogene

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26
Q

tumor-suppressor genes

A

control cell division (cell birth) or cell death–essentially they restrain cell growth–lost in cancer

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27
Q

gene the provides genome stability by preventing the accumulation of mutations

A

caretaker genes–affect the ability of the cell to maintain the integrity of its genome. Missing these = ^ cancer

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28
Q

gate keeper genes…

A

encode a system of checks and balances that monitor cell division and death. I.e. when tissue damage occurs, products of gate keeper genes ensure that balance of cell growth over cellular death remains in check.

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29
Q

genes that foster stromal environment conducive to cell proliveration

A

landscaper genes–target of future chemo drugs

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30
Q

Normally, these (3) cells “read” the HMC1 of cancer cells and eliminate them

A
  1. CD4 and CD8 lymphocytes

2. NKCs

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31
Q

Cancer techniques for avoiding elimination (2)

A
  1. missing antigenic surface tumor antigens

2. inadequate immune surveillance (immunosuppression or immundeficiency)

32
Q

oncogenes strongly associated w/ BREAST, OVARIAN, prostate, pancreatic, and colon cancers. (2)

A
  1. *BRCA-1 (angelina jolie)

2. BRCA-2

33
Q

40% of retinoblastoma inherited in ______ _______ manner

A

autosomal dominant

34
Q

estrogen or testosterones may activate cell division in cells w/ malignant potential phonotypes and lead to (5)

A
  1. breast
  2. ovary
  3. endometrium
  4. prostate
  5. testis
35
Q

Common environmental exposure factors implicated in cancer (6)

A
  1. benzene (petrolium derived)
  2. asbestos
  3. ionizing radiation
  4. UV light (tanning beds)
  5. polycyclic hydrocarbons (cigs)
  6. industrial agents (arsenic, funficides, etc)
36
Q

Newly discovered gene associated w/ breast cancer

A

PALB-2

37
Q

Viruses associated w/ cancer (6)

A
  1. Chronic Viral Hepatitis B or C
  2. HPV
  3. Herpes virus-8
  4. EBV (Burkett’s Lymphoma)
  5. HIV (Kaposi’s sarcoma)
  6. CMV
38
Q

Food and drugs related to cancer risk (6)

A
  1. *DES (Diethylstilbestrol) (synthetic estrogen) (clear-cell carcenoma of vagina in daughters)
  2. nitrates, nitrites
  3. high fat diet
  4. lack of fruits and vegies (less antioxidants)
  5. alcohol + cigs synergistically carcinogenic
  6. anticancer agents
39
Q

Clinical manifestations of cancer (5)

A
    1. pain (“worse at night”)
      1. abnormal masses (primary tumor or enlarged lymph node)
    1. Unintended weight loss (tumor caloric burden, cytokines)
      1. bleeding (seen and unseen)
      2. PAINLESS jaundice (yellowing of sclera w/out hep)
      3. indigestion or difficulty swallowing
      4. non-healing sore
40
Q

leading causes of lung cancer in US (2)

A
  1. smoking

2. radon exposure

41
Q

paraneoplastic syndromes def

A

a grouping of clinical manifestation of cancer resulting from a tumor’s presence in the body–but NOT due to MASS EFFECT

42
Q

paraneoplastic syndrome example symptoms()

A
  1. fever
  2. anorexia
  3. fatigue
  4. hypertrophic osteoarthropathy (clubbing, arthritis)
  5. SIADH
  6. hypoK+, hyper/hypoNa+, hyperphosphatemia
  7. HYPERCALCEMIA
  8. Cushing syndrome
  9. paraneoplastic sensory neuropathy
  10. myasthenia gravis
43
Q

substances that are produced by cancer or by other cells of the body in response to cancer or certain benign conditions

A

tumor markers

44
Q

tumor markers are usually _________, but more recently, paters of ______ ______ are being used

A 
proteins,
gene expression (changes to DNA)
45
Q

Common tumor markers (6)

A
  1. Alphafetroprotein (AFP)
  2. carcinoembryonic antigen (CEA)
  3. CA-125
  4. Prostate specific antigen (PSA)
  5. Estrogen receptor (ER)
  6. HER2/neu
46
Q

tumor marker used to help Dx liver cancer

A

Alphafetroprotein

47
Q

tumor marker used to check whether colorectal cancer has spread

A

carcinoembryonic antigen

48
Q

tumor marker associated w/ prostate cancer

A

prostate specific antigen

49
Q

estrogen receptor (tumor marker) used to

A

determine whether tx w/ hormonal therapy is appropriate

50
Q

tumor marker used to determine whether tx w/ TRASTUZUMAB is appropriate

A

HER2/neu

51
Q

when a dx of cancer is made the next step is

A

to “Stage” the cancer

52
Q

staging will determine (2)

A
  1. a treatment pathway

2. prognosis

53
Q

Roman numeral cancer staging 0-IV

A 
0: in situ carcinoma
I: small and localized
II: locally advanced
III: higher degree of local advancement
IV: metastasis
54
Q

uses of tumor markers (5)

A
  1. cancer presence? (CAN”T DX CANCER W/ MARKERS)
  2. response to tx
  3. recurrence
  4. prognostic
  5. DIRECTED CHEMO
55
Q

T/F We can make a dx of cancer w/ tumor markers

A

F

56
Q

TNM staging system (KNOW box on page 12 of notes)

A

Tumor size
Nodal involvement?
Metastisis?

57
Q

Generally, the ______ and _______ the tumor, the more likely lymph node involvement or metastisis

A

larger and older

58
Q

staging system for cancers w/out central location (leukemia, myeloma, and lymphoma)

A

ann arbor staging system

59
Q

histological grading for aggressiveness of tumor based on appearance

A

Gleason score

60
Q

more _______ cancer cells tend to be more aggresive

A

primative (i.e. blasts) (more differentiated cells less aggresive)

61
Q

(3) broad categories of oncologic emergency

A
  1. pressure or obstruction from space occupying lesion
  2. metabolic or hormal problems (paraneoplastic syn)
  3. Tx-related complications
62
Q

structural/ obstructive oncologic emergencies (7)

A
  1. Superior Vena Cava Syndrome
  2. Intestinal obstruction
  3. Malignant Spinal Cord Compression MSCC
  4. Pericardial Effusion/Tamponade
  5. Urinary Obstruction
  6. Malignant Biliary Obstruction
  7. Increased Intracranial Pressure
63
Q

Dz process resulting in impairment of venous return from the head, neck, and upper extremities. +presenting features (6) + X-ray findings

A 
Superior vena cava syndrome,
1. puffy EYES, head, neck
2. dyspnea
3. cough
4. dilated neck veins
5. increased collateral veins covering ant chest wall
6. cyanosis
X-Ray: widening of R superior mediastinum
64
Q

Dz process resulting in Pain (colicky in nature) + presenting features (4)

A

Intestinal obstruction,

  1. ascites
  2. visible peristalsis
  3. *high-pitched bowel sounds
  4. tumor mass
65
Q

Oncological emergency presenting w/ LOCALIZED back pain and a history of cancer

A

Malignant Spinal Cord Compression MSCC

66
Q

Dz process presenting w/ low back pain, low sensation over buttocks, SADDLE SIGN (perineal numbness), rectal/ bladder dysfunction, leg weakness

A

Cauda equine syndrome

67
Q

oncological emergency presenting w/ flank pain, recurrent UTI, persistent proteinuria/hematuria, dydronephrosis

A

Urinary obstruction (prostate or gyno malignancies)

68
Q

liver or pancreatic cancers may lead to

A

malignant biliary obstruction

69
Q

Oncological emergency presenting w/ headache, nausea, vomiting, AMS, seizures, and focal neuro changes

A

Increased intracranial pressure

70
Q

Metabolic oncological emergencies (2)

A
  1. Hypercalcemia (Tumor production of PTHrP)

2. SIADH (hyponatremia may be asymp or severe)

71
Q

most common metabolic paraneoplastic syndrome symp

A

hypercalcemia

72
Q

hyperkalemia, hyperphosphatemia, and hypocalcemia may result from

A

massive destruction of a large # of rapidly proliferating neoplastic cells –> may lead to death or renal failure (CHEMO)

73
Q

(3) cancer treatment categories

A
  1. curative (may have to move to control)
  2. control
  3. palliative
74
Q

Radiation and Chemotherapy targets rapidly proliferating cell indiscriminately thus leading to (3)

A
  1. myelosupression (bone marrow suppression)
  2. Mucositis (mouth, throat, vag, rectal)
  3. taste or smell changes
75
Q

Hormone therapy used for some responsive cancers, primarilly (2) – Tx example (1)

A
  1. breast
  2. prostate
    - -Tamoxifen
76
Q

______ __ ______ late complication of bone marrow and stem cell transplantation

A

Graft vs. Host Dz

HemOnc (7 decks)

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