Suspected cancer evaluation

Question 1

Algorithm for suspected pancreatic cancer

Answer 1

Question 2

Why is U/S of abdomen not greatest way to screen for pancreatic cancer?

Answer 2

can miss masses if bowel overlying pancreas or for masses <3 cm small and depends on skill of operator

Question 3

Best test for pancreatic cancer screen

Answer 3

helical CT abd/pelvis and if mass seen get a EUS w/ FNA

Question 4

with primary biliary cholangitis what do you see on labs?

Answer 4

elevated alkaline phosphatase and cholestatic jaundice but no extrahepatic biliary duct dilation or gallbladder enlargement.

Question 5

WHat do you see on liver biopsy for primary biliary cholangitis?

Answer 5

See inflammation confined to portal and periportal areas and bridging fibrosis and or cirrhosis

Question 6

Risk factors for pancreatic cancer

Answer 6

heavy tobacco use, weight loss, abdominal pain, juandice and no gall stones on ultrasound.

Question 7

If there’s a new soft tissue mass in the extremity what is the best next step?

Answer 7

needs to get a core needle biopsy so cancer grade can be obtained.

any soft tissue mass >5cm or 2 inches in maximal demension should be biopsied.

Need a high index of suspicion to increase changes of limb salvage therapy and decrease risk for local reoccurrence.

Can get MRI to characterise the mass.

Question 8

After diagnosis of soft tissue sarcoma what is needed to be done next?

Answer 8

need chest imaging.

Treatment is usually surgical resection and if this is not possible needs to get neoadjuvant radiation therapy.

Question 9

Sarcoma treatment is

Answer 9

resection.

Question 10

metastatic sarcoma is

Answer 10

palliative but involves chemotherapy, radiation (or can be without radiation) and surgery.

Meant to reduce tumor burden but this often reoccurs.