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Differential Dx > Cancer Screening > Flashcards

Cancer Screening Flashcards

1
Q

_______ and ________ are the two biggest red flags for cancer

A

advancing age and previous history of cancer

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2
Q

inadequate surgical margin, skip metastases, tumor thrombus, and lymph node metastasis all could cause _______

A

cancer recurrence

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3
Q

survivors of childhood cancers are at higher risks for ________

A

secondary cancer, organ dysfunction, reduced growth/development, decreased fertility, early death.

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4
Q

________ involves regular screening for early detection of cancer and the prevention of progression of known premalignant lesions

A

secondary prevention

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5
Q

_______ is a method for detecting disease or body dysfunction before an individual would normally seek medical care

A

Screening

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6
Q

__% of cancers can be linked to environmental factors

A

80-90%

include: age over 50, ethnicity, family history (1st gen), environment/lifestyle factors

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7
Q

incidence of cancer _____ after 25 years of age and increases every __ years until mid 80’s

A

doubles; 5 years

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8
Q

______ ethnicity has a 10% increase rate of cancer

A

African American

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9
Q

______ is the primary cause of cervical cancer

A

HPV

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10
Q

reactions from carcinogens from occupations or environment can lay dormant up to __ years

A

30

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11
Q

Leading cause of skin cancer is _______

A

UV rays and tanning beds

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12
Q

_______ is the development of molecular signatures for the effects of specific hazardous chemical agents

A

toxicogenomics - defects may occur in one or more genes

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13
Q

______ is a malignant tumor that comprises epithelial tissue and accounts for 85% of all cancers affecting the skin, large intestine, stomach, breast, lungs.

A

carcinoma - they spread by invading local tissues and by metastasis

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14
Q

_______ is a fleshy growth and refers to a large variety of tumors arising in the connective tissue

A

Sarcoma - affects bone, cartilage, muscle, fibrous tissue, fat, and synovium

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15
Q

Neoplasms are divided into 3 categories: ____, _____, ______

A

benign, invasive, and metastatic

-metastatic can spread as late as 15-20 years after initial diagnosis. Most early metastasis die in transit. patterns of blood flow, regional venous drainage, and lymphatic channels determine the distribution of most metastasis

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16
Q

Besides metastasis, cancer can also be transported through _______

A

mechanical transport - likely through lymph or circulatory

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17
Q

5 most common sites of cancer metastasis are bone, lymph nodes, lung, liver, brain and affect which systems?

A

integumentary, pulmonary, neurologic, MS, hepatic

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18
Q

early warning signs of malignancy are ______

A

rapid unintended weight loss, unusual vitals, bleeding from ulcerations, lumps, lesions, enlarged lymph nodes (T), proximal muscle weakness (may be secondary to hypercalcemia), night pain

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19
Q

What type of reflexes can indicate malignancy?

A

hyperreflexive or hyporeflexive (if large tumor completely blocks)

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20
Q

metastases to the skin often come directly from ______ or ______

A

breast cancer or upper respiratory tract cancer

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21
Q

skin cancers are the most common types of cancer and are usually classified as ________

A

non-melanoma (further classified as basal cell or squamous cell)

  • most common cause is UV rays or tanning bed.
  • is increased risk after solid organ transplantation and tend to be more aggressive
22
Q

ABCD

A

A-asymmetry
B-border irregularity
C-color variegation
D-diameter of 6 mm >

23
Q

______ involves bottom layer of epidermis and occurs in hair areas with slow growing lesions in sun exposed areas

A

Basal cell carcinoma

-present pearly papule with small crater, scaly, red, outlined plaque, scar-like tumor, tough

24
Q

_______ involves the top epidermis on areas exposed to skin appeaing as small, red, hard nodules with smooth or warty surface

A

Squamous cell carcinoma

-metastasis uncommon

25
Q

______ is the most serious form of skin cancer and can appear anywhere on body with asymmetric, irregular shape

A

Malignant Melanoma

-early symptoms are ABCDE

26
Q

________ are the most common of all metastatic tumors

A

pulmonary

  • because vena cava goes everywhere. pleural pain and dyspnea are two most common symptoms.
  • lung cancer is the most common cancer to metastasize to brain causing neuro symptoms
27
Q

S/S of brain tumor

A
  • can be asymptomatic
  • extremity weakness, ataxia, HA, personality change, seizures, papillary edema
  • if compressing SC, it will present as SCI
28
Q

S/S of LBP, sciatica, saddle anesthesia, bowel/bladder changes, LE weakness, sexual dysfunction, decreased rectal tone, decreased perineal reflexes, diminished LE reflexes all suggest ______

A

Cauda Equina Syndrome

29
Q

when tumors produce S/S at distance from tumor as remote effects, its called _______ and can be first sign of malignancy

A

paraneoplastic syndromes

  • common ones are to brain, endocrine/fluid/electrolyte abnormalities, CNS
  • often is implicated with immune issues such as Rheumatic disorders (common from breast or lung cancers)
30
Q

Tumor cells commonly metastasize to which parts of bone?

A
  • marrow of axial skeleton, proximal ends of long bones, pelvis, ribs
  • bone pain is usually deep, intractable, poorly localized described as burning or aching
  • worse at night unrelieved by change in position, reproduced b heel strike
  • back pain may be result of vertebral metastasis
31
Q

______ metastasis are among the most ominous signs of advanced cancer because it filters blood from stomach, colon, pancreas

A

Liver

  • may see bilateral CTS
  • may also see asterixis
32
Q

mild-to-moderate superficial pain is ________ response whereas severe/visceral pain is _________

A
  • sympathetic

- parasympathetic

33
Q

Why is bone pain so bad with cancer?

A

-the pain threshold is reduced through sensitization of free nerve endings. there is a more rich supply of nerves and tension or pressure on the sensitive periosteum or endosteum.

34
Q

5 causes of cancer pain are:

A
  • bone destruction
  • visceral obstruction
  • nerve compression
  • skin/tissue distention
  • tissue inflammation/infection/necrosis
35
Q

What are some common S/E of cancer treatment?

A

-bone marrow suppression, leukopenia, anemia, fatigue, cardiopulmonary dysfunction, radiation recall, bone demineralization

36
Q

_______ is often used to describe mental fogginess experience by some people during the course of chemotherapy

A

chemobrain

37
Q

Persistent swelling or lump in muscle, pain, pathologic fracture, local swelling, and warmth overlying skin suggests _________

A

soft tissue sarcoma

-relatively rare. in kids. often goes unnoticed until some other injury

38
Q

Pain/swelling in body part, loss of motion, tender lump, pathologic fracture, occasional weight loss, malaise, fatigue suggest ______

A

osteosarcoma

  • ages 10-25
  • 80-90% in long bones
39
Q

Increasing pain/swelling decreasing in movement, fever, fatigue, weight loss, bowel/bladder disturbance suggest _________

A

Ewing Sarcoma

-ages 5-16

40
Q

Palpable mass, back/pelvis/thigh pain, sciatica, bladder symptoms, unilateral edema suggest _______

A

chondrosarcoma

  • most common malignant cartilage tumor, older 40
  • usually slow-growing
41
Q

bone pain worse at night, pain relieved by aspirin, warmth and tenderness over involved site suggest _______

A

Osteoid Osteoma

-50% in femur

42
Q

increased intracranial pressure, HA, vomiting, visual changes, mentation, personality change, drowsy, weakness, bladder dysfunction, hyperreflexia, ataxia, positive Babinski, clonus, vertigo all suggest ______

A

brain tumor

  • more likely over 40
  • 80% intracranially
43
Q

Infection, fever, abnormal bleeding, easy bruising or petechie, epistaxis, hematuria, rectal bledding, weakness, fatigue, enlarged lymph nodes, bone/joint pain, weight loss, loss of appetite, splenomegaly all suggest ________

A

Leukemia

-develops in bone marrow with abnormal multiplication of WBCs

44
Q

recurrent bacterial infections, anemia with weakness/fatigue, bleeding tendencies, bone paion, spontaneous fracture, osteoporosis, hypercalcemia, kidney stones, renal insufficiency, CTS, back pain with radicular symptoms, SC compression suggest _________

A

multiple myeloma

  • 50-70 years
  • bone disease is the most common complication; drainage of Calcium and Phosphorus from damaged bones eventually lead to renal stones
45
Q

Painless enlarged lymph nodes, pruritus, fever, night sweats, anorexia, weight loss, anemia, fatigue, malaise, jaundice, edema, nonproductive ough, dyspnea, chest pain, nerve root pain, paraplegia, cyanosis suggest ________

A

Hodgkin’s Disease

  • is a chronic, progressive, neoplastic disorder of lymphatic tissue with unknown mechanism
  • any change in size, shape, tenderness, consistency is a red flag
  • obstruction of bile ducts as result of liver damage causes bilirubin to accumulate
46
Q

Enlarged lymph nodes, fever, night sweats, weight loss, bleeding, infection, red skin suggest __________

A

Non-Hodgkin’s Lymphoma

  • 40-60 years
  • HIV increases risk
47
Q

Painless enlarged mass, subcutaneous nodules, constitutional symptoms (fever, night sweats, weight loss), MS lesions (lytic bone, pain, swelling) suggest ________

A

AIDS-NHL

-95% of all HIV-associated malignancy are NHL or Kaposi’s sarcoma

48
Q

Immediate Referral if…

A
  • recent lumps/nodules found
  • palpable mass in breast
  • recurrent cancer
  • suspicious node changes
  • idiopathic weakness w/ DTR changes
  • unexplained breathing
  • sign of metastasis
  • man w/ pelvic, groin, SI, LBP w/ sciatic and Hx of prostate cancer
49
Q

clues to cancer screening

long slide

A
  • older than 50, Hx of cancer
  • woman w/ chest, breast, axillary, shoulder pain of unknown origin
  • back, pelvic, groin, hip pain w/ mass
  • prolonged or excessive menstrual bleeding
  • recent weight loss, MS symptoms better by eating/drinking, reproducible by heel strike, constant pain, intense pain at night
  • disproportionate relief from aspirin, growing mass, changes in node variation.
50
Q

Cancer Red Flags

A
  • pain on WB unrelieved by rest of position, no response to treatment, unremitting night pain, history of cancer
  • also skin changes, any masses, node changes.

Differential Dx (12 decks)

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