Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Forget Nots > Oncology/Skin > Flashcards

Oncology/Skin Flashcards

1
Q

What else can trastuzamab be used to treat besides breast?

A

Her-2 overexpressing stomach or esophagogastric adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dabrafenib can be used for what cancer?

A

Melanoma. Unresectable or metastatic melanoma BRAF V600

daBRAFenib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cetuximab can be used for what cancer?

mechanism?

A

EGFR expressing metastatic colon cancer

If the tumor is KRAS (+) then no benefit for cetuximab

Also for squamous cell head and neck cancer

Erlotinib also EGFR. Used for non small cell lung CA, pancreatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Erlotinib is used for what cancer?

A

tarceva

Metastatic non-small cell lung cancer with EGFR mutations

locally advanced or unresectable pancreatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the “halo” sign?

A

US Finding for papillary thyroid CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the accordion sign?

A

Pseudomembranous colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Radiation. When giving 5000 cGy, which one is more potent? 500 for 10 days or 250 for 20 days?

A

Higher dose, shorter time is more potent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Median survival when peritoneal carcinomatosis is left untreated?

With chemo?

A

~7mo.

~12mo. With chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the steps for HIPEC. what temperature? For how long? What agent?

A

Laparotomy
Debulk all tumors to < 2mm, strip the diaphragm
Mitomycin C heated to 42C, 90 minutes
Make anastomosis if needed then closeq

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Usual chemo regimen for breast CA?

A

Adriamycin, cytoxan +/- taxotere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is merkel cell tumor?

What is the treatment? Do you have to do sentinel node?

A

Neuroendocrine tumor of the skin

Wide excision with 1-2cm margin + sentinel node biopsy + adj RADIATION to the tumor bed (esp for tumor size > 10mm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sarcomas spread hematomgeously. Which types are exceptions to this and spread via nodes?

A

Synovial sarcoma
Epithelioid sarcoma
Angiosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

For sarcomas when do you do incisional vs excisional biopsy?

A

<3cm: excisional bx

>3cm: core needle biopsy first then incisional bx if inconclusive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most important prognostic factor for sarcoma?

A

Grade, even moreso than size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What’s the T staging for sarcoma?

A

There’s only 2 T staging for sarcomas.

T1: <5cm
T2: >5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Preferrable margin for sarcoma WLE

A

2cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

After resection of GIST, how long does the gleevec therapy last?

A

Prolonged 3yr therapy increases 5yr survival by ~10%, reduced recurrence by ~20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Von hippel lindau

A

VHL gene

Renal cell
Hemangioblastomas
Retina
Pheo
CNS tumor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Li fraumeni

A

P53

Breast
Sarcoma
Brain
Leukemia
Pancreatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CDH1

A

Diffuse gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which cell cycle phase is most susceptible to radiation?

A

M phase and G2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cetuximab targets what? What kinds of cancer is it used for?

A

EGFR

colon, head & neck

Also EGFR expressing metastatic colon cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Other than PTLD, what other cancer does EBV cause?

What is kaposi sarcoma caused by?

A

A subset of gastric cancer is caused by EBV

kaposi is caused by human herpes virus 8 HHV8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Merkel cell tumor. Immunohistochemistry stain for CK20 is positive or negative?

What about TFF-1?

How is this different from small cell lung cancer?

A

CK20(+) cytokeratin
TFF-1(-) thyroid transcription factor

Small cell lung cancer: both positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

They give you a melanoma and asks how to biopsy but doesn’t give you punch as an option. What to do? Does it depend on the size?

A

Excisional biopsy with 1-2 mm margin

For lesions > 2cm may do partial incisional biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Nec fasc. What is the most common organism? Overall?

What is the most common monomicrobial nec fasc?

A

Overall: polymicrobial

Most common monomicrobial: strep A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How do you classify nec fasc

A

First: clostridium vs non-clistridium nec fasc

Then non-clistridium nec fasc has 4 types
I: polymicrobial (mixed anaerobes and aerobes)
II: group A strep
III: vibrio (marine bacteria)
IV: fungal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Skin lesion pathology: “microscopic tentacles that extend laterally from the lesion “ or “spindle cells”

What is it? Treatment?

A

Dematofibrosarcoma

En Bloc excision with a wide 2cm margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

During a deep inguinal node dissection, where do you divide the inguinal ligament?

Where does the dissection start?

How do you close?

A

Over the femoral canal. Place the finger in the femoral canal to protect the femoral vessels

Starts at the common iliac vessels and extend caudally

Femoral canal is closed by suturing the inguinal ligament to the lacunar ligament. Then you can use a mesh or a sartorius flap to cover the defect to prevent hernias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Ehler danlos.

Which type collagen defect?

18yo comes into your office with this. What screening do you recommend?

A

Type III

CT angio for aortic root aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Flesh colored nodule on the back/arm. First step in diagnosis? Excisional biopsy?

A

Core needle first. If inconclusive then excisional bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a natal cleft?

How is the disease here classified?

What’s a navicular area?

A

Buttcrack

Type I: asymptomatic
Type II: acute disease
Type III: limited to navicular area
Type IV: extend beyond navicular area
Type V: recurrent disease

Navicular area: areas you can’t see you when you push the buttcheeks together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What’s stage V pressure ulcer?

A

There is no stage V.

Stage IV: you see bone and muscle
Stage III: subQ fat
Stage II: partial skin breakdown
Stage I: erythema

34
Q

Actinic keratosis is a risk factor for developing what kind of cancer?

A

Squamous cell

35
Q

Lentigo maligna predominantly affects what area?

A

Head & neck

36
Q

What is the most important reason for meshing up the skin graft?

Does it impact imbibition?

A

Surface area. Decreases the amt needed for harvest

Doesn’t really affect imbibition

37
Q

CK20(+) TTF-1(-) treatment? It’s 15mm

A

It’s merkel cell carcinoma. Basically neuroendocrine tumor of the skin

CT neck, CAP

WLE with 2cm margin
Sentinel node
Adjuvant radiation (can be skipped if size < 10mm)

38
Q

Why is sebaceous cyst a misnomer?

What is the pathogenesis of this? What gets blocked and what gets trapped in the cyst?

What is the most common location?

A

It’s epidermal cyst. It doesn’t contain sebum. It contains keratin

Hair follicle gets blocked. Epidermal cells gets implanted into the dermis. Keratin gets trapped, not sebum

Face, neck, scalp, back

39
Q

Is Moh’s surgery okay for melanoma?

A

Yes but only for in situ disease. Start with 5mm margin

40
Q

Full thickness skin graft. Keep the fat or get rid of it?

What is a usual donor site

Designed into what shape? Rectangular?

How to close donor site?

A

Make sure to remove fat to prevent fat necrosis

Retroauricular or superior eyebrow region

Other: subclailvicular, infraabdominal fold

Elliptical shape

Close donor site primarily. If unable split thickness skin graft can be used

41
Q

Most common short term complication of inguinal node dissection?

A

Infection. 1-2%

42
Q

Follow-up after melanoma

Stage IA
Everything else

When do you do CBC/LFT/LDH/PET?

A

Stage IA: history and physical every 3-12 months

Everything else: history and physical every 3-6 months for 3 years, then every 4-12 months for 2 years

Labs and imaging only if suspicion based on hnp

43
Q

4 tumors that you can resect the liver met and can get a cure

A

Colon
Melanoma (primary from the eye. Typically only goes to liver)
Carcinoid/neuroendocrine
Ovarian

44
Q

Which tumor metastasizes to the pancreas?

A

Renal cell

45
Q

What genes are associated with lynch syndrome?

A

MLH1, MSH2, MSH6, PMS2

Microsatellite instability

46
Q

What is the most common malignancy encountered during pregnancy?

Does pregnancy affect survival of this disease?

A

Melanoma

Pregnancy does not affect melanoma survival

47
Q

Mechanism of action of ipilimumab?

A

anti-CTLA4

48
Q

What drug can be used for BRAF(+) melanoma?

What % of melanoma are BRAF(+)?

A

Dabrafenib

About half

49
Q

Treatment for subungal/digit melanoma?

A

Used to be amputation of the proximal joint but now digit sparing WLE. No survival benefit

Only if margin (+) amputate the joint

50
Q

Dematofibrosarcoma protuberans

  • cells stain for what antibody?
  • treatment?
  • sensitive to radiation ?
  • what medical therapy?
A
  • spindle cells stain for CD34
  • WLE with 2cm margin. Sentinel node not needed because they don’t usually go through the nodes. Go to the lungs
  • yes, sensitive to radiation
  • imatinib (Gleevec bcr-abl tyrosine kinase inhibitor)
51
Q

Does groin dissection for melanoma improve survival?

What is the rate of post-inguinal dissection lymphedema?

A

It improves disease free survival

But it does not improve melanoma specific survival.

Aka it decreases nodal relapse but overall survival is the same

MSLT-II. 24% lymphedema rate

52
Q

Keloids and hypertrophic scars have excess type I or type III collagen?

A

Excess type I

53
Q

What are the medical treatment options for hidradenitis suppurativa?

A

Zinc gluconate
Steroids

Crftriaxone, rifampin, moxifloxacin for weeks

If they fail, dapsone and or cyclosporine

Then adalinumab (humira. binds to TNF-a)

54
Q

Diagnosis and treatment for:

Fluctuance under the nail bed

Erythema, pain, and edema of the fingertip pulo

A

Fluctuance under the nail bed:
Paronychia. Rx: remove the nail plate

Erythema, pain, and edema of the fingertip pulp:
Felon. Rx: incision and drainage

55
Q

What is an early sign of nec fasc of LE?

A

Severe pain on passive motion

56
Q

Think of the cancer for:

  • BCR/abl
  • erb-B2
  • c-Kit
  • K-ras
  • B-raf
A
  • BCR/abl: proto oncogene for CML
  • erb-B2: breast proto onco. This is HER2
  • c-Kit: proto onco for GIST
  • K-ras: proto onco for CRS/pancreas
  • B-raf: melanoma
57
Q

For gastric cancer which pts get neoadj?

A

MAGIC trial: resectable T2 or greater lesions

T1: mucosa, submucosa
T2: muscularis propria
T3: serosa
T4: adjacent structures

actually the same as the esophagus. for esophagus, T4a: attaches to resectable things like pericardium, pleura, diaphragm, T4b: attaches to unresectable things like the vertebrae, aorta, trachea

58
Q

Annular pancreas:

Duodenoduodenostomy vs DJ vs GJ. When to use what?

A

In neonates DD

Adults: DJ/GJ

59
Q

Melanoma metastasis to where have better prognosis?

A

Skin and lung

60
Q

What tumor is CK-20(+) TFF-1 (+)?

A

Small cell carcinoma of the lung

61
Q

For cytoreductive debulking for ovarian cancer, residual tumor diameter of what size is considered “optimal debulking”?

A

<1cm

62
Q

what drug is Anti CD-20 ?

Used to treat what?

A

Rituximab.

CML, rheumatoid, MS

PTLD in txp

63
Q

Hereditary diffuse gastric cancer (DGC)

inheritance pattern?

Mutation in what gene?

What prophylactic surgery should be done at what age?

Anything else to do for women?

A

Autosomal dominant

CDH1 gene: codes for E-cadherin (found 30-50% of the time)

E-cadherin in breast is ADH. ALH = (-) e-cadherin

Prophylactic gastrectomy between 18-40

For women screen like BRCA1/2. Us and mri

64
Q

What virus is related to kaposi sarcoma?

A

Human herpes virus 8. HHV-8

65
Q

What cancer is EBV related to?

A

Burkitt, hodgkin, PTLD, gastric cancers, nasopharyngeal

66
Q

Which cancer? Malignant degeneration if epithelial cells with differentiation toward keratin formation

A

SCC

67
Q

Which cancer? Areas of tumor islands rising from the epidermis with peripheral palisading if nuclei and stromal retraction

A

Basal cell

68
Q

What is the most common malignancy associated with DVT/PE?

A

lung cancer followed by pancreatic

69
Q

Which poses a higher risk for DVT/PE?

prolonged hospitalization and immobility vs cancer?

A

Prolong hospitalization and immobility higher risk for DVT than cancer

70
Q

PRSS1 is related to what?

A

Hereditary pancreatitis. It’s diagnostic for it

71
Q

Renal cell carcinomas are associated with what paraneoplastic syndromes?

Most common site of metastasis for RCC?

Major risk factor?

A

PTH related protein
ACTH
renin
Erythrocytosis

most common met to lung

Smoking is the major risk factor

72
Q

What is doxorubicin’s Moa?

A

Inhibition of DNA synthesis by inhibition if toooisomerase II

Cardiotoxicity

73
Q

What genetic alteration is associated with improved prognosis for pancreatic neuroendocrine tumor?

A

Hypermethylation of hMLH1

This leads to microsatellite instability and is associated with improved prognosis

74
Q

Sarcoma abuts but does not invade the artery. What to do?

A

Excision with adjacent vascular adventitia

75
Q

Margin for marjolin’s ulcer?

A

5-20mm

76
Q

Pembrolizumab

Target? Therapy for what?

A

PD-1

melanoma

77
Q

STK11?

A

Peutz Jeghers

Autosomal dominant

78
Q

What do the BRCA1 and BRCA2 proteins actually do?

A

BRCA1: complexes with RNA polymerase in the transcription process

BRCA2: binds directly to DNA to repair damage

79
Q

What are the two biggest risk factors for cholangiocarcinoma?

A

Primary sclerosing cholangitis

Fibropolucystic liver disease

80
Q

retroperitoneal liposarcoma:

A

true. recurrence is most likely to be local
false. debulking doesn’t improve survival. even the primary tumor. thus, subtotal resection should be limited to relieving intestinal obstruction when deemed appropriate

81
Q

dermatofibrosarcoma vs. merkel cell:

  • margin?
  • sentinel node?
  • radiation?
  • medical therapy?
A

dermatofibrosarcoma protuberans:

  • 2cm margin
  • NO SLN
  • YES RADIATE
  • Imatinib can be used for locally advanced and metastatic disease.

Merkel cell:

  • 1-2cm margin
  • YES SLN
  • YES RADIATE (esp for tumor size > 10mm)
82
Q

Adjuvant therapy for resectable cholangiocarcinoma?

A

Capecitabine > gemcita + cisplatin.

Forget Nots (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions