Oncology

Question 1

Who needs a mammogram? How often?

Answer 1

50-75 q2

Question 2

Who should be BRCA tested? What is BRCA associated with?

Answer 2

Test women with family history.

BRCA increased risk of familial breast cancer & Ovarian cancer

Question 3

When should tamoxifen be used for breast cancer treatment?

Answer 3

If the cancer is ER or PR positive.(usually in women who are post menopausal)

Question 4

What are the 3 major side effects of Tamoxifen?

Answer 4

DVT, Hot flashes, Endometrial cancer

Question 5

When would you use aromatase inhibitors for breast cancer? side effects?

Answer 5

when you need to block estrogen(estrogen dependent BC).

major side effect: osteoporosis(block estrogen at bone too)

Question 6

When is Adjuvant chemotherapy appropriate for breast cancer?

Answer 6

when cancer is in the axilla, When cancer is larger than 1cm, when the patient is still menstrating(its not likey these cancers will be driven by E/P so chemo is more ideal)

Question 7

When would you use Trastuzumab & Pertuzumab for breast cancer? major side effect?

Answer 7

monoclonal ab to HER2/neu + BC. used full with metastatic disease, used in combo.

**trastuzumab is cardiotoxic

Question 8

How is colon cancer treated?

Answer 8

surgical resection + chemo(5FU) if stage 2-3.

Question 9

Colon cancer screening: routine?

Answer 9

colonoscopy 50q10 or FOBT 50q1`

Question 10

Colon cancer screening: w/family history of CRC

Answer 10

40q10 or 10 years before the age of the family member who got CRC

Question 11

Colon cancer screening: HNPCC, 3 family members, 2 generation, 1 premature?

Answer 11

Colonoscopy 25q1/2

Question 12

Colon cancer screening: FAP, Gardner’s Syndrome, Peutz-Jeghers or Turcot’s Syndrome?

Answer 12

Sigmoidoscopy 12q1/2

Question 13

Colon cancer screening: Juvenile polyposis?

Answer 13

no additional screening! follow routine screening(50q10)

Question 14

Anticoagulation and colonoscopy..when do you stop NOACs? Warfarin?

Answer 14

NOACs = stopped the day before and restarted the day after.

Warfarin = stopped 3-5days before

Question 15

What size does lung cancer need to be to do an EXCISIONAL biopsy?

Answer 15

> 1cm

Question 16

Who needs screening for lung cancer?

Answer 16

30 pack year smoker 55-75 q1 chest CT who has not quit in the past 15 years.

Question 17

Pembrolizumab & Nivolumab

What are they? when are they used?

Answer 17

Programmed Death Inhibitors used when NON-SMALL CELL lung cancer is PD positive

Question 18

Screening for Cervical Cancer?

Answer 18

21-65q3 or 21q3 then 29-65q5+HPV testing

Question 19

Who gets Gardasil?

Answer 19

13-26

Question 20

What is the Gleason score?

Answer 20

measure of histology of prostate cancer. higher the score = worse the cancer

Question 21

Treatment of localized prostate cancer?

Answer 21

surgery, external radiation or implanted radioactive pellets

Question 22

Treatment of metastatic prostate cancer?

Answer 22

Androgen Blockade(Flutamide(T-receptor antagonist, Leuprolide or goserelin(GnRH agonist))

Question 23

Whats Finasteride for?

Answer 23

5a-reductase inhibitor, used to treat BPH and male pattern hair loss.

Question 24

Whats Abiraterone for?

Answer 24

17 hydroxylase inhibitor that stops production of all androgen’s in the body = decreases the progression of metastatic prostate cancer and decreased risk of death by 1/3

Question 25

Treatment of Ovarian Cancer?

Answer 25

surgery + chemotherapy

Question 26

how do you monitor return of cervical cancer?

Answer 26

measure CA125

Question 27

—— can improve the alopecia of chemotherapy.

Answer 27

scalp hypothermia

Question 28

what population do you suspect testicular cancer?

Answer 28

male <35 with painless scrotal lump(95% are germ cell tumors)

Question 29

How do you dx testicular cancer?

Answer 29

inguinal orchiectomy! **DO NOT BX! will seed T.T

Question 30

How is testicular cancer treated?

Answer 30

local: radiation
mets: chemo