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True Learn Studying 2021 > Surgical Oncology Review > Flashcards

Surgical Oncology Review Flashcards

1
Q

What is thought to mediate cancer cachexia

A

Tumor Necrosis Factor alpha

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2
Q

Treatment of choice for undifferentiated spindle cell tumor of the bone

A

neoadjuvant therapy then wide local excision

amputation as last resort

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3
Q

Extremity soft tissue mass suspicious for malignancy should be biopsied how?

A

Core needle biopsy whenever possible

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4
Q

definitive treatment for rhabdomyosarcoma

A

primary excision with sentinel lymph node biopsy if clinically node negative

can offer neoadjuvant or adjuvant chemo if positive

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5
Q

How do taxanes work?

Give example of a taxane

A
  • impair cellular division by inhibiting microtubule disassembly during mitosis
  • Paclitaxel
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6
Q

How does cyclophosphamide work?

A
  • alkylating agent that inhibits DNA synthesis by preventing DNA transcription
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7
Q

What is tumor lysis syndrome?

A

massive death of cells leads to intracellular ions and cellular byproducts to go into systemic circulation

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8
Q

how does tumor lysis syndrome present clinically

A 
Acute renal failure
hyperuricemia 
hyperkalemia
hyperphosphatemia 
hypocalcemia
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9
Q

Pathophysiology of Tumor lysis syndrome

A
  • cells die -> potassium, phosphate, nucleic acids into circulation -> hyperphosphatemia crystalizes calcium (develop hypocalcemia) -> calcium deposits into kidneys -> acute renal failure
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10
Q

Patient presents with 3 months of diarrhea and facial flushing, noted to have 2 cm small bowel mass…what test should you perform to confirm diagnosis?

What is the diagnosis

A

test 5-hydroxyindoleacetic acid (5-HIAA)

Carcinoid syndrome from a carcinoid tumor

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11
Q

Medications for symptom control in carcinoid syndrome?

A

octeotride or lanreotide (somatostatin analog)

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12
Q

how do you treat anal squamous cell carcinoma?

A

Nigro protocol: 5-fluorouracil (5-Fu) with mitomycin C and external beam radiation

APR for salvage

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13
Q

What is the rate of local recurrence/tumor persistence for anal SCC after combined chemoradiation?

A

around 10-30%

those patients will need to have an APR for salvage therapy

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14
Q

imaging characteristics for adrenal carcinoma that would warrant excision

A
  • > 4cm mass above the kidneys
  • central necrosis
  • delayed imaging shows contrast washout
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15
Q

Strongest predictor for prognosis in sarcomas?

A

Histologic grade

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16
Q

what cancers have elevated AFP serum markers

A

germ cell tumors

HCC

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17
Q

margin for melanoma with 1 mm depth

A

1 cm margin

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18
Q

margin for melanoma with 2 mm depth

A

2 cm margin with SLNB

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19
Q

What are Reed-Sternberg Cells

A
  • giant multinucleated cells

- classic cells seen in Hodgkin’s Lymphhoma

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20
Q

Stage I Hodgkin Lymphoma

A
  • lymphoma is only seen in one lymphoid organ
21
Q

Stage 2 Hodgkin Lymphoma

A

Lymphoma is seen in 2 lymphoid tissues either above or below the diaphragm

22
Q

Stage 3 Hodgkin Lymphoma

A

Lymphoma seen in two or more lymphoid tissue above AND below diaphragm (Spleen counts)

23
Q

Stage 4 Hodgkin Lymphoma

A

lymphoma has spread to non lymphoid tissue

24
Q

Ipiliumab

A
  • CTLA-4 inhibitor used in metastatic melanoma
25
Q

Nivolumab

A

PD-1 inhibitor used in metastatic melanoma

26
Q

Interllukin-2

A
  • cytokine that causes increase in immune response by T-cells
27
Q

Vemurafenib

A

used in metastatic melanoma with V600E mutation at BRAF

28
Q

Contraindication for resection in non-small cell lung cancer?

A

Disseminated disease

contralateral lymph node involvement

29
Q

initial surgical treatment for melanoma with inguinal lymphadenopathy?

A
  • resection of melanoma

- superficial inguinal lympahdenopathy

30
Q

high yield anatomy of a superficial inguinal lymphadenectomy

A
  • Saphenous vein at junction of Sartorius and adductor muscles
  • lateral cutaneous femoral nerve under sartorius
  • femoral nerve, vein, and artery in femoral triangle
  • Cloquet’s node in femoral canal
31
Q

Cloquet’s node

A

first deep inguinal lymph node located within the femoral canal

if taken should close residual defect with mesh or sartorius flap

32
Q

when do you perform a deep inguinal lymph node resection?

A

if Cloquet’s node is positive

33
Q

patient with endometriosis s/p medical therapy and laparoscopic ablation with persistent symptoms, what can you offer

A

hysterectomy if they are done with child bearing

34
Q

Cells with a fried egg appearance is most likely what entity?

A

Paget’s disease

35
Q

growing abdominal mass with biopsy showing cytologically bland fibrous neoplasm with local infiltration, what is this?

A

Desmoid tumor

36
Q

What are Desmond tumors associated with?

A

inherited disorders, most notably FAP

37
Q

Primary cancer most likely to metastasize to the adrenal glands?

A

Lung cancer

38
Q

precursor lesion to squamous cell carcinoma of the skin?

A

Actinic Keratosis

39
Q

biopsy of a skin lesion shows atypical keratinocytes that do not invade the dermis, what is this?

A

Actinic Keratosis

40
Q

exposure to aromatic amines increases risk for?

A

transitional cell bladder cancer

41
Q

nitrite consumption increases risk for?

A

gastric cancer

42
Q

most common malignancy of the tongue

A

squamous cell carcinoma

43
Q

most common genetic mutation in anaplastic thyroid cancer?

A

BRAF 600E mutation

44
Q

common SE of doxorubicin

A

cardiomyopathy

45
Q

common SE of cisplatin therapy

A

ototoxicity

46
Q

common SE of Vincristine

A

peripheral neuropathy

47
Q

common SE of bleomycin

A

pulmonary fibrosis

48
Q

tumor marker for yolk sac tumor

A

AFP

True Learn Studying 2021 (27 decks)

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