Oncology, Preventative Medicine Flashcards
Which diagnostic breast test is the best initial test for a lump? Which test can test for ER, PR and HER 2/neu receptors? Which is the most accurate test?
- FNA small sample so high false negative results. 2. Core biopsy bigger sample more deforming. 3. Open biopsy done in the OR gives frozen section and can be followed immediate resection of cancer.
When will you do US as a diagnostic choice for breast mass?
In young pts < 35 do FNA and US. Also tells the difference btw fluid and cystic lesions.
What to diagnostic test helps you determine the content of abnormal lymph nodes that are no easily accessible?
PET Scan.
Who should receive Tamoxifen prophylatically?
Pts of first degree relatives of breast cancer who are positive for ER and PR receptos.
Describe the use of Flutamide, GNRH agnoist, Ketocanazole and orchiectomy in Prostate Cancer.
They help shrink the lesion when pt has already developed prostate cancer. They do not decrease recucrences like Tamoxifen (Prophylatic) in breast cancer.
Women above 50 with increasing abdominal girth and positive for BRCA. Best initial Test? Most accurate Test? Rx?
US or CT abdomen to check for possible endometrial or ovarian cancer. Biopsy. Remove all visible tumors and pelvic organs then give adjuvant chemo.
Painless lump in the scrotum that does NOT Transilluminate. Diganostic test? Common wrong answer? Rx?
Testicular Carcinoma. Remove whole testicle with inguinal orchiectomy. Wrong Answer: Needle biopsy is wrong because you can seed cancer. Then do CT abdomen, Chest and Pelvis is done for metastasis to determine treatment type. Radical orchietecomy with Radiation for local disease and Chemo for Widespread dx (only cancer where chemo for widespread dz is beneficial.)
When does screening for breast cancer using mammography Begin and End?
50-70
At what age do you stop pap smears?
Age 65 OR Post Hysterectomy.
At what age do you stop recommending PSA for men?
Age 75
When do you start screening for Colon cancer in the general population?
Age 50 then every 10 years with colonoscopy. Sigmoidoscopy is every 5 years.
When to start screening men and women for LDL? Give the recommendation for LDL: 1. 0-1 Risk 2. 2 Risk 3. CAD 4. CAD + DM Type 2
Screen Men 35, Women 45. 0-1 Risk: Diet at LDL > 160 Drugs at LDL >190 2 or more Risk: Diet at LDL > 130 Drugs at LDL >160. CAD Drugs at LDL>100 DM: Drugs at LDL > 70
Recommendations for Pneumovax ?
One dose > age 65. Every 5 years for immunocompromised, renal, lung, liver, heart disease.
Age to start screening for Osteoporosis? When to give Bisphosphentes? What to give postmenapausal women?
Age 65 Dexa Scan. We stop PAP smears and Start Dexa Scans. < 2.5 SD then give Bisphosphenates. Post-menopausal should be on daily Calcium and Vitamin D.
Age and Sex to Screen for AAA?
Age 65 male smokers.
