Exam Flashcards
(108 cards)
1
Q
Oncology
A
Branch of medicine that studies tumors
2
Q
Hematology
A
Branch of medicine that studies blood
3
Q
Cancer
A
Disease in which abnormal cells divide without control and are able to invade other tissues - these cancer cells can spread to other parts of the body through the blood and lymph
4
Q
Carcinoma
A
Cancer that begins in the skin or in the tissues that line or cover internal organs
5
Q
Sarcoma
A
Cancer that begins in the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue
6
Q
Leukemia
A
Cancer that starts in the blood-forming tissue such as the bone marrow
7
Q
Lymphoma and Myeloma
A
Cancers that begin in the cells of the immune system
8
Q
Central Nervous System Cancers
A
Cancers that begin in the tissues of the brain or spinal cord
9
Q
Neoplasm
A
New growth - abnormal mass of cells that grows more or less progressively at the expense of the host (may be benign or malignant)
10
Q
Etiology of Neoplastic Cells
A
Altered nuclear and cellular structure Chromosomal Abnormalities Genetic Mutations Biochemical Abnormalities Inappropriate Cell Products
11
Q
Malignant Neoplasms
A
Differentiation Anaplasia (often) Unencapsulated Unrestrained Growth Invasion of Adjacent Tissues Failure of Programmed Cell Death Metastasis to distant sites possible
12
Q
How do Metastasis Happen?
A
Lymphatic Invasion
Blood-Born Transport
Seeding of Body Cavities, Organs, and Skeleton
Angiogenesis
13
Q
Cancer is the _______ leading cause of death in the United States
A
Second
14
Q
Cancer accounts for nearly 1 out of every ____ deaths
A
4
15
Q
There are _________ deaths from cancer per day
A
1600
16
Q
Over ______ newly diagnosed cancers predicted in 2013
A
1.6 million
17
Q
What is the most important risk factor for Cancer?
A
Tobacco
18
Q
About 30% of Cancer Deaths are due to these five behavioral and dietary risks:
A
High BMI Low Fruit and Veggies Lack of Physical Activity Tobacco Use Alcohol Use
19
Q
3 most common Cancers in Men
A
1, Prostate
- Lung
- Colorectal
20
Q
3 highest mortality Cancers in Men
A
- Lung
- Prostate
- Colorectal
21
Q
3 most common cancers in Women
A
- Breast
- Lung
- Colorectal
22
Q
3 highest mortality Cancers in Women
A
- Lung
- Breast
- Colorectal
23
Q
What is the 5-year survival rate for Glioblastoma?
A
4%
24
Q
What is the 5-year survival rate for Breast Cancer?
A
98.6%
25
National Cancer Act of 1971
Nixon - $$ to enlarge NIH and NCI "to advance the national effort against cancer"
26
Cancer death rate has decreased by only ____ since 1950
5%
27
Incidence Rate of Cancer in Oregon is ______ per 100,000
434
28
Mortality Rate from Cancer in Oregon is _______ per 100,000
175
29
Cancer is the Leading Cause of Death in Oregon (T/F)
TRUE
30
Tumor-node-metastatis (TNM) method of staging uses ____ measurements
3
31
T Score
Size and extent of invasion of primary TUMOR
32
N Score
Number and location of histologically involved lymph NODES
33
M Score
Presence or absence of distant METASTASES
34
Tis =
in situ tumor
35
T1-T4 =
usually based on size, invasion of adjacent structures
36
Tx =
primary tumor cannot be assessed
37
Nx =
lymph nodes cannot be assessed
38
N1-3 =
based on levels of lymph nodes
39
Mx =
presence of mets cannot be assessed
40
M0 =
no metastases
41
M1 =
presence of metastases
42
Stage I =
T1-T2 N1 or T3 N0
43
Stage II =
T1-T2 N1 or T3 N0
44
Stage III =
T1-3 with N1-3
45
Stage IV =
M1
46
70 on the Karnofsky Performance Status
Cares for self, unable to carry on normal activity or to do active work - usually the cut-off for whether a person can handle chemotherapy or being entered into a clinical trial
47
Exploding cells release __________
biliruben
48
MCV
How big is it?
49
MCH and MCHC
How dark is it?
50
RDW
What is the distribution/spread of the size of RBC
51
Normal RDW
most of the cells are the same
52
Wide RDW
Varying sized cells are present - this may be a mixed anemia or thalassemia
53
Microcytic =
Small (<80)
54
Macrocytic =
Big (>100)
55
Normocytic =
Normal (80-99)
56
Anisocytosis =
Mixed large cells and small cells
57
MCV Values are higher in newborns or adults?
Newborns and Infants
58
Mean Corpuscular Hemoglobin Concentration (MCHC)
Proportion of each cell taken up by hemoglobin
59
Mean Corpuscular Hemoglobin (MCH)
Measures the amount of hemoglobin present in one RBC
60
Hypochromic
Low MCH/MCHC = iron deficiency
61
Normochromic
normal MCH/MCHC
62
Microcytic Anemia
Low MCV
63
Microcytic Anemia causes
Iron Deficiency
Chronic Disease
Lead Poisoning
Less Common: Thalassemia, Sideroblastic, Hemoglobinopathies
64
Macrocytic Anemia
High MCV
65
Causes of Macrocytic Anemia
Folic Acid Deficiency, Vitamin B12 Anemia
66
Metabolic Intermediaries for Folate
Homocysteine (HC)
67
Metabolic Intermediaries for Vit B12
Methylmalonic Acid (MMA)
68
Normocytic Anemia
Normal MCV
69
Causes of Normocytic Anemia
Bleeding
| Chronic Disease
70
In anemia, Retic Count should be HIGH/LOW?
HIGH!
71
If Retic Count is not high, the probelm is in....
the making/marrow
Either Not enough stuff to make the cell (iron, vitamins, etc.) OR the bone marrow cannot make it (lymphoma, aplastic anemia)
72
What should you ask of someone who has a high MCV?
Ask about alcohol, B12, Folate, TSH
73
What should you check for someone with a low MCV?
Ferritin and other iron studies
74
What to check if Hb, Hct is low:
MCV, RDW and check other CBC components
| Order Retic Count, Liver, and Renal Tests
75
Cervical Cancer most often metastasizes to
Peritoneum
76
Breast Cancer most often metastasizes to
1. Bones
| 2. Lungs
77
Colon Cancer most often metastasizes to
Liver
78
Lung Cancer most often metastasizes to
Brain
79
Prostate Cancer most often metastasizes to
Bones
80
Testicular Cancer most often metastasizes to
Lungs
81
Thrombocytopenia
Low platelets
82
Low platelets (>50K) symptoms
Easy bleeding/bruising
hematuria
Petechial Rash
83
Very Low Platelets (5,10, 20K) symptoms
```
Spontaneous Bleed
High risk-brain/GI Bleed
Confusion
HA
Hematochezia
Hematemasis
```
84
Which cancer causing viral infections are responsible for up to 20% of cancer deaths in low and middle income countries?
HBV/HCV
85
About ______ of all cancer deaths in 2008 occurred in low and middle income countries
70%
86
Top Country for Cancer Mortality
Mongolia
87
Steps in Histologic Diagnosis
1. Tumor obtained through biopsy or surgery and evaluated by pathologist
2. Type of cancer is determined
3. Therapy cannot proceed until this step is completed
88
Two major classifications of Hematologic Malignancies
1. Myeloid
| 2. Lymphoid
89
In anemia, the retic count should be (HIGH/LOW)
HIGH
90
If the Retic count is low, it means the problem is in the
making/marrow
91
Increased Transferrin (TIBC) is related to which anemia?
Iron Deficient Anemia
92
Teletherapy
Beams of radiation aimed at a tumor
93
Brachytherapy
Encapsulated radiation implants
94
Systemic Therapy
Radionucleotides delivered systemically
95
49 y/o female presents with SOB and hemoptysis. A bulky lung mass is found and biopsy shows a small cell carcinoma. Due to SVC syndrome, therapy is started urgently with cisplatin/etoposide. 24 hours later, she has mental status changes and refractory oliguria
Acute Tumor Lysis Syndrome
96
What lab finding will you see with Acute Tumor Lysis Syndrome?
```
Hyperuricemia
Hyperkalemia
Hyperphospohatemia
Hypocalcemia
Axotemia
```
97
What types of tumors are most likely to have Acute Tumor Lysis Syndrome when treated?
High-grade lymphomas
Leukemia
Bulky tumors
Usually seen after first round of chemo
98
62 y/o male with history of squamous cell carcinoma of tonsillar pillar, treated 18 months prior with combined chemo/XRT presents with 2 weeks of worsening fatigue, anorexia, polyuria, with occasional incontinence, constipation, and muscle weakness...
Hypercalcemia
99
Hypercalcemia Symptoms
Fatigue, anorexia, nausea, constipation, polyuria, polydypsia, weakness, lethargy, apathy, seizures, coma
100
81 y/o with multiple medical problems presents with 3 months of mid-thoracid back pain, increasing over 1 week. He has no history of cancer and no constitutional symptoms. The pain increased with movement and with lying flat. He denies weakness, paresthesias, or autonomic dysfunction.
Spinal Cord Compression
101
Previously health 48 y/o man presents with syncope. he desribes 6 months of blurred vision and several weeks of presyncope with exertion. He notes progressive facial swelling and redness
Superior Vena Cava Syndrome
102
Superior Vena Cava Syndrome is most common with
Bronchogenic Carcinoma and Lymphoma
103
Symptoms of SVC Syndrome
Dyspnea, chest pain, cough, dysphagia, headache, seizure, altered consciousness, swlling neck/face/arms, venous distention, cyanosis, facial plethora, vocal cord paralysis, Horner's syndrome
104
A 20 y/o man with AML develops an asymptomatic fever of 38.1 8 days after first cycle of consolidation chemotherapy. He arrives to the ER with a normal exam EXCEPT temp 38.2, RR 24, HR 132, and BP 70/30.
Neutropenic Fever
105
29 y/o woman presents with progressive fatigue, dyspnea, blurred vision, and near syncope. She has marked pallor, fever, diffuse nontender lymphadenopathy and pre-retiinal hemorrhages.
Hyperleukocytosis with Leukostasis
106
Primary Prevention
Remove risk factors
107
Secondary Prevention
Early detection and treatment
108
Tertiary Prevention
Reduce Complications
