Ovarian and Bladder Cancer Flashcards

1
Q

What are some important predisposing factors for epithelial ovarian Carcinoma?

A

Family Hx

BRCA 1/2

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2
Q

Your patient is over 35 years old and has epithelial ovarian carcinoma. What is a good treatment method?

A

Prophylactic Oophorectomy

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3
Q

What factor in the blood stream can be used to monitor epithelial ovarian carcinoma?

A

CA-125

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4
Q

What is the staging method for epithelial Ovarian Carcinoma?

A

Stage 1 = only in the ovaries
Stage 2 = Ovaries and Pelvis
Stage 3 = Ovaries, Pelvis, and lymph nodes
Stage 4 = mets to bone/lung/liver (pleural effusion)

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5
Q

What is the typical chemotherapeutic treatment for epithelial ovarian carcinoma?

A

High volume intra-peritoneal cisplatin instillation.

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6
Q

What is the Chemotherapeutic regimen for Stage 1&2 epithelial ovarian carcinoma?

A

Carbo/Cisplatin IP and Cyclophosphamide and/or doxorubicin IV

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7
Q

What is the chemotherapeutic regimen for Stage 3&4 epithelial Ovarian Carcinoma?

A

Carboplatin/cisplatin IP and Paclitaxel

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8
Q

What is the presenting symptom of bladder carcinoma most likely to be?

A

Painless hematuria

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9
Q

What is the treatment for Bladder carcinoma (generally speaking)?

A

Transurethral resection

Chemo is put in the bladder

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10
Q

What is the MOA of Carboplatin/Cisplatin?

A

Creates DNA intrastrand crosslinks

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11
Q

What are the adverse effects associated with Carboplatin?

A

Allergic rxn
Dose related myelosuppression, anemia
elevated hepatic enzymes
Elevated BUN/Cr

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12
Q

What are the adverse effects associated with Cisplatin?

A

Allergic rxn
Dose related NEPHROTOXICITY
Ototoxicity

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13
Q

What is the MOA of Cyclophosphamide?

A

cyclophosphamide alkylates DNA.

it is also a prodrug

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14
Q

What are the adverse effects associated with cyclophosphamide?

A

Hemorrhagic cystitis (mesna)
Anemia
Amenorrhea/infertility
Pulmonary fibrosis

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15
Q

What is the MOA of Doxorubicin?

A

Intercalates within DNA
Generates free radicals
inhibits Topo 2

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16
Q

What are the adverse effects associated with Doxorubicin?

A

CARDIOTOXICITY (dose limiting)
Liver disease
Extravasational necrosis

17
Q

What should you give with doxorubicin to help with the cardiotoxicity?

A

Dexrazoxone

18
Q

What is the MOA of Paclitaxel?

A

Paclitaxel is a microtubule stabilizer

19
Q

What adverse effects are associated with paclitaxel?

A

Hypersensitivity
Peripheral neuropathy
Arthralgia/myalgia

20
Q

What is the MOA of BCG?

A

Binds to urothelium and activates APCs thus inducing immune activation. lasts for months, is used post TUR.

21
Q

What is the MOA of Mitomycin C?

A

Mono/bi - functional alkylator

22
Q

What adverse effects are associated with Mitomycin C?

A

Pneumonitis
pancytopenia
Chemical cystitis
Dermatitis (when urine contacts skin)

23
Q

What is the MOA of Thiotepa?

A

DNA alkylation via aziridine groups and intrastrand cross-linkage.

24
Q

What adverse effects are assoicated with Thiotepa?

A
Pancytopenia
Dysuria
urine retention 
Chemical cystitis
Renal dysfunction