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Senior - Oncology > Spicy > Flashcards

Spicy Flashcards

1
Q

MC CA in males?

A

Prostate

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2
Q

MC CA in females?

A

Breast

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3
Q

Top three CA’s for men

A
  1. Prostate
  2. Lung and bronchus
  3. Colon and rectum
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4
Q

Top three CA’s for women

A
  1. Breast
  2. Lung and bronchus
  3. Colon and rectum
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5
Q

Most lethal CA for men and women?

A

Lung and bronchus

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6
Q

Pathogens and which CA they correlate to

A

HPV - cervical, anal, laryngeal

EBV - nasopharygneal, B-cell lymphomas, oeal hairy leukoplakia

H. pylori - gastric, MALT lymphoma

Schistoma - bladder

HHV-8 - Kaposi sarcoma

HIV - lymphoma

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7
Q

Screening for colorectal CA ages 50 to 75 (average risk):

A

Fecal immunochemical every year

OR

Flex sig every 5 years

OR

Colonoscopy every 10 years (GOLD STANDARD)

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8
Q

Colorectal CA screening adults over age 76:

A

Nah

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9
Q

FHx FDR for CRC Dx’d > 60yrs OR two or more SDR - screening guidelines:

A

No change - begin screening at 50 , and do every 5 years instead of every 10

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10
Q

FHx FDR for CRC Dx’d < 60yrs OR 2 or more FDR- screening guidelines:

A

Begin at 40, or 10 years younger than the age of Dx for affected relative (whichever comes first) and screen every 5 years instead of every ten

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11
Q

CRC screening for blacks or non-alcoholic fatty liver dz?

A

Consider starting at age 45

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12
Q

Cervical CA screening guidelines - age 21-65

A

Pap q3 yrs

Once you’re 30, can do co-testing q5 yrs instead of pt wants

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13
Q

Cervical CA screening < 21 yrs?

A

Nope

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14
Q

Women over 65 who’ve taken care of themselves in the past (good routine medical care) and are not high risk, OR have has hysterectomy with removal of cervix - cervical CA screening guidelines ?

A

Do not screen

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15
Q

Stages of CA

A 
0 - carcinoma in situ
1 - localized
2 - early locally advanced
3 - late locally advanced
4 - metastasized
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16
Q

Adjuvant vs neoadjuvant chemo:

A

Adjuvant - after surg

Neo - before surg

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17
Q

Tumor markers ands their associated tumor cells:

A

Alpha fetoprotein (AFP) - hepatocellular, testicular

CA-125 - Ovarian

Carcinoembryonic antigen (CEA) - colon

CA 19-9 - pancreatic

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18
Q

Which CA is most likely to be associated with paraneoplastic syndromes?

A

Small-cell lung CA

Cushing, SIADH, hypercalcemia, etc…

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19
Q

JAK-2 mutation, think:

A

Polycythemia vera (PCV)

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20
Q

Which myeloproliferative disorder has the lowest risk of progression to AML?

A

Essential thrombocytosis

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21
Q

What is the specific chromosomal abnormality associated with chronic myelogenous leukemia (CML)?

A

Philadelphia chromosome translocation between 9 (abl) and 22 (bcr) -> (bcr/abl) which possess tyrosine kinase activity

Leads to unregulated production of myeloid cells

22
Q

How do tyrosine kinase inhibitors work in treating CML?

A

They induce apoptosis in cells expressing BRC-ABL

1st line treatment

23
Q

What medication is really good (98%) at achieving control of the chronic phase of CML?

A

Imatinib

If it’s Imatinib-resistant, use Dasatinib

24
Q

Difference between acute and chronic bone marrow blasts percentages?

A

Acute - > 20% blasts

Chronic - < 20% blasts

25
Which acute leukemia is associated with DIC?
M3 AML Acute promyelocytic leukemia
26
If you see lymphoblasts on smear, think:
Acute lymphoblastic leukemia
27
If you see myeloblasts on smear, think:
Acute myelogenous leukemia
28
Which leukemia is a relative emergency?
AML
29
What does remission look like?
``` Normal peripheral blood, normal bone marrow (decreased blast to no blast), normal clinical status (disappearance of all signs and sxs) ```
30
Richter’s syndrome?
Transformation from CLL Aggressive, diffuse large B cell lymphoma Kills you quick Picture stable CLL patient that goes to shit quickly
31
See Reed-Sternberg? Think:
Hodgkin’s Lymphoma | Owl cells
32
NHL - elevated LDH?
Reflects tumor cell proliferation and burden Corresponds with overall prognosis
33
What is R-CHOP or R-CVP?
I have no idea, but it’s related to treatment of NHL (maybe it’s a type of chemo)
34
What disease can make your lymph nodes hurt if you drink booze?
Hodgkin’s Lymphoma
35
AE of Bleomycin/radiation?
Risk of pulmonary toxicity leading to fibrosis and death Txt for classical HL
36
MGUS
Like a milder MM - at anytime it could progress to MM
37
Most notable features of MM?
Bone pain - back, hips, ribs Pathologic fx’s (femoral neck, vertebrae)
38
Imaging for MM
Skeletal survey, NOT bone scan, to visualize LYTIC lesions of MM MRI and CT/PET = demonstrates extent of disease ONCE DX’d
39
3 things required for MM Dx
1. M-protein 2. Bone marrow aspirate > 10% plasma cells 3. End-organ damage from plasma cells (at least one of the CRAB things)
40
CRAB
MM C - hyperCalcemia R - renal injury A - anemia B - lytic Bone lesion
41
Big differences between MM and Waldenstrom Macroglobulinemia
No bone pain with WM No kidney dz with WM
42
MCC of elevated CA:
Primary hyperparathyroidism (outpatient) Malignancy (inpatient)
43
MC CA’s associated with high Ca++
Lung (squamous cell) Breast MM
44
What is HHM?
Humoral hypercalcemia of malignancy Mediated by secretion of PTHrP which causes increased bone resorption Most common cause of hypercalcemia in CA patient
45
Other than HHM, causes of high Ca++ in CA?
Activation of osteoclast by cytokines released from CA cells (20%)(breast/MM) 1,25-OH2 Vit D secretion by CA cells (lymphomas, granulomatous disease)
46
In HHM, the tumor itself secretes:
PTHrP (it acts like PTH, increases CA++ reabsorption)
47
Imaging of choice for known CA patient with new onset back pain?
MRI (emergently if neuro changes) IMMEDIATE steroids while you’re waiting for the MRI
48
Absolute neutrophil count
ANC = WBC (total) x neutrophil (%) *don’t need to memorize for exam but a good pimp question for Phase 2
49
Criteria for febrile neutropenia?
Fever >100.4 for >1hr OR a single temp >101.0 in the setting of ANC < 1500
50
SVC Syndrome is MC’ly associated with:
Lung CA
51
When does tumor lysis syndrome most commonly occur?
When treating heme malignancies or any rapidly proliferating tumor that is sensitive to chemo
52
The big four things to look out for with tumor lysis syndrome?
Hyperuricemia Hyperphosphatemia Hypocalcemia Hyperkalemia

Senior - Oncology (5 decks)

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