USMLE Deck2 Flashcards
Most common cancer in men
Prostate > lung > colon
Most common cancer in women
Breast > Lung > Colorectal > uterine
Most common cancer mortality in men
Lung > prostate > colorectal > pancreas
Most common cancer mortality in women
Lung > breast > colon > oancreas
abl
tyrosine kinase; CML
c-myc
Transcription factor; Burkitt’s t(8;14)
bcl-2
anti-apoptosis; follicular and undifferentiatiod lymphomas t(14;18)
erb-B2
Tyrosine Kinase (HER2/neu) targeted by trastizumab; breast, ovarian and gastric
ras
GTPase; K-ras->colon, lung pancreas; H-ras->bladder, kidney tumors; N-ras->melanomas, hematologic
L-myc
Transcription factor; Lung
N-myc
Transcription factor; neuroblastoma
ret
Tyrosine Kinase (neurotrophic growth factor); MEN IIA and IIB; papillary thyroid carcinoma
c-Kit
Cytokine receptor; GI stromal tumor
Rb
blocks G1->S by binding E2F; retinoblastoma
p53
glocks G1->S; most cancers
BRCA
DNA Repair; breast and ovarian
p16
Melanoma
APC
Associated with FAP, Colorectal cancer
WT1
Wilm’s tumor
DPC
Deleted in Pancreatic cancer
DCC
Deleted in colon cancer
HNCC
inactivation of DNA mismatch repair (microsatellite alterations)
Cyclin D
Mantle cell lymphoma t(11;14)
CDK4
Melanoma
PDGF-beta
Astrocytoma
TGF-alpha
Astrocytoma and hepatocellular carcinoma
HER2/neu
Growth factor receptor; breast tissue
Drugs with low therapeutic index
Lithium, digoxin, warfarin, phenobarbital
Cigarette smoke associated cancers
Lung (squamous and small cell), Oral (squamous laryngeal and squamous esophageal), Pancreatic, bladder, and renal cell
aflatoxin
mutation in p53, aspergillus in food -> hepatocellular carcinoma
Nitrosamines
gastric cancer
vinyl chloride
angiosarcoma of the liver
CCl4
liver disease
asbestos
mesothelioma and bronchogenic carcinoma (more commonly)
Naphthalene dyes
In moth balls -> transitional cell bladder cancer (along with smoking)
Alkylating agents
Leukemia
Arsenic
alloys, pesticides, squamous cell carrcinoma angiosarcoma
Li Fraumeni syndrom
AD inherited mutation in p53; have many cancer especially sarcomas, adrenal, neural etc.
DNA REPAIR DISEASES
HNPCC, Xeroderma pigmentosum (excision repair defect-unusaully sensitive to sunlight because can’t repair T-T dimers), Ataxia-telangiectasia (ataxia, telangiectasia, increased risk of lymphoma and leukemi)
Assoc. w what neoplasm: Down syndrome
ALL, AML
Assoc. w what neoplasm: Xeroderma pigmentosum; albinism
melanoma, basal cell carcinoma, squamous cell carcinomas of skin
Assoc. w what neoplasm: Atrophi gastritis, pernicious anemia, postsurgical gastric remnants
Gastric Adenocarcinoma
Assoc. w what neoplasm: Tuberous Sclerosis
Angiomyolipoma, rhabdomyoma, astrocytoma
Assoc. w what neoplasm: Actinic Keratosis
Skin squamous cell
Assoc. w what neoplasm: Barrett’s esophagus
Esophageal adenocarcinoma
Assoc. w what neoplasm: Plummer Vinson syndrome
Esophageal squamous carcinoma
Assoc. w what neoplasm: cirrhosis
hepatocellular carcinoma
Assoc. w what neoplasm: ulcerative colitis
colonic adenocarcinoma
Assoc. w what neoplasm: paget’s bone
Osteosarcoma and fibrosarcoma
Assoc. w what neoplasm: immunodeficiency
Lymphomas
Assoc. w what neoplasm: AIDS
Non-Hodgkin’s lymphomas, Kaposi
Assoc. w what neoplasm: Autoimmune disease
Lymphoma (such as in hashimoto’s thyroiditis)
Assoc. w what neoplasm: Acanthosis nigricans
Visceral malignancy (gastric, lung, uterus)
Assoc. w what neoplasm: Dysplastic nevus
Malignant melanoma
Assoc. w what neoplasm: Radiation
Sarcoma, papillary thyroid cancer, leukemia
Drugs contraindicated in sulfa allergy patients
celecoxib, loops (furosemide), thiazide, acetazolamide, probenecid, sulfonamides
Anaplastic cell features
High nucleus:cytoplasmic ratio; prominent nucleoli; clumping chromatin; mitotic figures
Most common sites to metastatic liver
Colon, stomach, pancreas, breast, lung
Mets to brain
Lung, breast, skin (melanoma), kidney, GI
Bone mets
Prostate, renal cell, tyroid, lung, testes, lung, lymphoma, breast
Paraneoplastc: Small cell lung
ACTH or ACTH-like; ADH; Lambert-eaton
Paraneoplastc: Intracranial
ADH
Paraneoplastc: squamous cell lung
PTHrP (hypercalcemia), TGF-beta, TNF, IL-1
Paraneoplastc: Renal cell, hemangioblastoma, hepatocellular, pheochromocytoma
Epo -> polycythemia
Paraneoplastc: Thymoma
Lambert Eaton
Paraneoplastc: Leukemias and lymphomas
Hyperuricemia and gout
Psammoma bodies
Papillary adenocarcinoma of thyroid, serous papillary cystadenocarcinoma of ovary, meningioma, malignant mesothelioma
PSA
Prostate cancer, or other prostate pathologies
CEA (carcinoembryonic antigen
colon cancer, pancreatic cancer
AFP (alpha fetoprotein)
Hepatocellular or Yolk sac tumor
CA-125
Marker for ovarian cancer
S-100
melanoma, schwanomma, glial tumor
Alk phos
METs to bone, paget’s disease of bone
Bombesin
Adrenal neuroblastoma, lung, and gastric cancer
TRAP
Hairy cell leukemia
CA 19-9
Pancreatic adenocarcinoma
inhibits complement C9 binding
CD55 and CD59
NK Cell receptors
CD16
Endotoxin receptor on macrophages
CD14
Cancer associated with obesity
Esophagus adenocarcinoma, renal cell carcinoma, endometrial, gallbladder cancers, thyroid and colon cancer
Nephrotoxic/ototoxic drugs
Vancomycin, Aminoglycosides, Loop diuretics, Cisplatin
Drugs that interfere with microtubules
Vincristine, vinblastine, paclitaxel, -bendazoles, griseofulvin, colchicine
Volume of distribution
Vd = D/C (amount of drug/plasma concentrat)
Clearance
CL = Rate of elimination/plasma concentration = [0.7xVd]/(t1/2)] = Vd x K
LD
CpxVd/F (Cp = target plasma concentration)
Maintenance Dose MD
MD = Cp x CL/F (CL = clearance, F = bioavailability)
Half life
t(1/2) = 0.7xVd/(CL); after 4 half-lves 94% has been eliminated, 3 half-lives 88% has been eliminated, 2 half lives 75% has been eliminated and 1 half life has eliminated
Therapeutic index TI
TI = LD50/ED50 so a higher TI results in a safer drug; Drugs with low TI: Warfarin, Digoxin, Lithium and Seizure drugs
P450 Inhibitors
Macrolides, Amiodarone, Grapefruit juice, Isociazid, Cimetidine, Ritonavir, Acute alcohol, Ciprofloxacin, Ketoconazole, Sulfonamides
P450 Inducers
Quinidine, Barbiturates, St. John’s wort, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, Chronic alcohol
Disulfiram-like reaction drugs
Metronidazole, some Cephalosporins, Procarbazine, 1st generation sulfonylureas
Sulfa Drugs
Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotics, Sulfasalazine, Sulfonylureas
Drugs that undergo Zero-order metabolism
Phenytoin, Ethanol, Aspirin
-azole
antifungal
-cycline
protein synthesis inhibitor, tetracycline
-navir
Protease inhibitor
-triptan
5-HT1B/1Dagonists (migraine)
-ane
Inhalation general anesthetic (ie. Halothane)
-caine
Local anesthetic
-operidol
Neuroleptic
-azine
Neuroleptic, antiemetic
-barbital
Barbiturate
-zolam
Benzodiazepine
-azepam
Benzodiazepine
-etine
SSRI (ie Fluoxetine)
-ipramine
TCA
-triptyline
TCA
-olol
Beta antagoinist
-terol
beta-2 antagonist
-zosin
alpha-1 antagonist
-oxin
Cardiac glycoside
-pril
ACE-I
-afil
Erectile Dysfunction
- tropin
pituitary hormone
-tidine
H-2 antagonist (Cimetidine)