Fiser ABSITE Ch. 11 Oncology Flashcards Preview

Surgery > Fiser ABSITE Ch. 11 Oncology > Flashcards

Flashcards in Fiser ABSITE Ch. 11 Oncology Deck (86):
1

Most common CA in women

breast CA

2

Most common cause of CA related death in women

lung CA

3

Most common CA in men

Lung CA

4

Most common cause for CA related death in men

lung CA

5

Used to identify metastases, detects fluorodeoxyglucose molecules

PET scan

6

___ need MHC complex to attack tumor, while ___ cells can independently attack tumor cells

T cells, Natural killer cells

7

What is the tumor marker for colon CA and what is the half-life?

CEA, 18 days

8

What is the tumor marker for liver CA and what is the half life?

AFP, 5 days

9

What is the tumor marker for pancreatic CA?

CA 19-9

10

What is the tumor marker for ovarian CA?

CA 125

11

What is the tumor marker for testicular CA, choriocarcinoma?

Beta HCG

12

What is the tumor marker for prostate CA and what is the half-life?

PSA (thought to be the tumor marker with the highest sensitivity), 18 days

13

What is the tumor marker for small cell lung CA and neuroblastoma?

NSE (neuron specific enolase)

14

Time between exposure and formation of clinically detectable tumor

Latency period

15

What two cancers are associated with the Epstein-Barr virus?

Burkitt's Lymphoma and nasopharyngeal CA

16

What infectious agent is associated with gastric CA?

Helicobacter pylori

17

What infectious agent is associated with hepatocellular carcinoma?

Hep B and C

18

What infectious agent is associated with Kaposi's sarcoma and primary effusion lymphoma?

HHV-8

19

What infectious agent is associated with splenic lymphoma?

Hep C

20

What infectious agent is associated with adult T-cell leukemia/lymphoma

Human T-cell leukemia virus-1

21

What is the most vulerable stage of the cell cycle for XRT?

M phase

22

How is most damage done to DNA with XRT?

formation of oxygen radicals

23

In XRT, higher-energy radiation has a ___ effect (maximal ionizing potential not reached until deeper structures)

skin-preserving

24

Fractionate doses in XRT allow for:
___ of normal cells
___ of tumor
___ of tumor cells in cell cycle

repair
reoxygenation
redistribution

25

Name 2 very radiosensitive tumors

seminomas, lymphomas

26

Name 2 very radioresistant tumors

epithelial, sarcomas

27

Why are large tumors less responsive to XRT?

lack of oxygen in tumor

28

Lymphocytes as well as what 3 organs have increased sensitivity to XRT?

kidneys, liver, lungs

29

What is the difference in cell killing ability in cell cycle-specific agents (5FU, MTX) and cell cycle-nonspecific agents?

cell cycle-specific agents exhibit plateau in cell-killing ability while cell cycle-nonspecific agents have a linear response to cell killing

30

What chemotherapy agent decreases short-term (5 year) of breast CA but carries a 1% risk of blood clots and a 0.1% endometrial CA.

Tamoxifen (blocks estrogen receptor)

31

What chemotherapy agent promotes microtubule formation and stabilization that cannot be broken down; cells are ruptured

Taxol (Paclitaxel)

32

What 2 chemotherapy agents can cause pulmonary fibrosis?

Bleomycin and busulfan

33

Name 3 side effects of cisplatin (platinum alkylating agent).

nephrotoxic, neurotoxic, ototoxic

34

Name the primary side effect of carboplatin (platinum alkylating agent).

myelo suppression (carBoplatin = bone)

35

Primary side effect of Vincristine (microtubule inhibitor).

peripheral neuropathy

36

Primary side effect of Vinblastine (microtubule inhibitor).

myelo suppresion (vinBlastine = bone)

37

What is the active metabolite of cyclophosphamide?

acrolein

38

Name 3 side effects of cyclophosphamide?

gonadal dysfunction, SIADH, hemorrhagic cystitis

39

What drug can help with hemorrhagic cystitis associated with cyclophosphamide?

Mesna

40

What is the antihelminthic drug thought to stimulate the immune system against CA?

Levamisole

41

What is the MOA of methotrexate

inhibits dihydrofolate reductase which inhibits purine and DNA synthesis

42

What are two side effects of methotrexate?

renal toxicity, radiation recall (inflammatory reaction after radiation therapy, usually a rash with blistering)

43

What can be used to reverse the effects of methotrexate

Leucovorin rescue (folinic acid)

44

What is the mechanism of action of 5-Fluorouracil?

inhibits thymidylate synthesis, which inhibits purine and DNA synthesis,

45

What drug increases the effectiveness of 5FU

leucovorin

46

What is the mechanism of doxorubicin and what is it toxic to?

DNA intercalator, O2 radical formation;
heart toxicity secondary to O2 radicals at > 500 mg/m2

47

Etoposide inhibits ___

topoismerase (which normally unwinds DNA)

48

What can be used for neutrophil recover after chemo?

granulocyte colony-stimulating factor (GCSF)

49

What are the side effects of GCSF?

Sweet's syndrome (acute febrile neutropenic dermatitis)

50

What are two indications for resection of normal thyroid to prevent CA

RET proto-oncogene or MENIN gene with family history of MEN or thyroid CA

51

Li-Fraumeni syndrome defect is in __ gene; pts get childhood sarcomas, breast CA, brain tumors, leukemia, adrenal CA

p53

52

What is the proto-oncogene associated with medullary CA of the thyroid?

Ret

53

What function is the APC gene involved with?

cell adhesion and cytoskeleton function

54

What 3 cancers is coal tar associated with?

larynx, skin, bronchial

55

What cancer is Beta-naphthylamine assoiciated with?

urinary tract CA

56

What cancer is benzen associated with?

leukemia

57

What cancer is asbestos associated with?

mesothelioma

58

What 4 cancers are associated with a suspicious supraclavicular node?

neck, breast, lung, stomach (Virchow's), pancreas

59

What 3 cancers are associated with a suspicious axillary node?

lymphoma (#1), breast, melanoma

60

What cancer is associated with a suspicious periumbilical node?

pancreas (Sister Mary Joseph's node)

61

What 2 cancers are associated with ovarian metastases?

stomach (Krukenberg tumor), colon

62

What 2 cancers are associated with bone metastases?

breast (#1), prostate

63

What 2 cancers are associated with skin metastases?

breast melanoma

64

What is the number one cancer associated with small bowel metastases?

melanoma

65

"Name the type of therapy:
sole treatment; often used for advanced disease or when no other treatment exists"

Induction

66

"Name the type of therapy:
chemotherapy given 1st, followed by another (secondary) therapy"

Primary (neoadjuvant)

67

"Name the type of therapy:
combined with another modality; given after other therapy is used"

Adjuvant

68

"Name the type of therapy:
for tumors that fail to respond to initial chemotherapy"

Salvage

69

Does colon CA go to bone?

not usually

70

Colon metastasis to the liver, if successfully resected what is the 5 year survival rate?

25%

71

What are the 2 most successfully cure metastases with surgery?

colon CA to liver, sarcoma to the lung
(but survival still low overall for these)

72

Name the main tumor for which surgical debulking improves chemotherapy (not seen in other tumors)

Ovarian CA

73

Name the 2 solid tumors curable with chemotherapy only

Hodgkin's disease, non-Hodgkin's lymphoma

74

What are most lymphomas?

B cell

75

Name 2 HIV-related malignancies

Kaposi's sarcoma, NHL

76

Tumor suppressor gene: Chrom 13, cell cycle

Rb

77

Tumor suppressor gene: Chrom 17, cell cycle

p53

78

Tumor suppressor gene: Chrom 5

APC

79

Tumor suppressor gene: Chrom 18, cell adhesion

DCC

80

Tumor suppressor gene: Apoptosis

bcl and p53

81

Tumor suppressor gene: Breast CA

BRCA

82

Proto-oncogene: G-protein defect

ras

83

Proto-oncogene: Tyrosine kinase defect

src

84

Proto-oncogene: PDGF receptor defect

sis

85

Proto-oncogene: EGF receptor defect

erb B

86

Proto-oncogene: Transcription factors

myc