MKSAP STOCK2 Flashcards

1
Q

A treament regimen for adenocarcinoma of unknown primary below the diaphragm should target this type of cancer

A

Gastrointestinal primary

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2
Q

What is the appropriate post-operative surveillance colonoscopy for patients with stage III colon CA?

A

Every 3-5 years following a normal study at 1 year

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3
Q

What is the prognostic scoring system for patients with diffuse large B cell lymphoma?

A

Revised International Prognostic Index (r-IPI) score

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4
Q

What drug therapy is indicated for all patients with multiple myeloma to prevent or to treat bone disease?

A

Bisphosphonate therapy (zoledronic acid > pamidronate)

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5
Q

What type of stage I testicular cancer is most often cured by surgical resection alone?

A

Seminoma

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6
Q

What is the initial mgmt in patients with suspected malignant superior vena cava syndrome?

A

Biopsy for histoligic diagnosis

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7
Q

What preoperative imaging is needed to stage newly diagnosed colon CA?

A

Contrast-Enhanced CT of C/A/P

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8
Q

Indicated mgmt following surgical resection of nonmetastatic renal cell carcinoma?

A

Clinical observation

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9
Q

What is the first test in the diagnosis of a low pretest probability of DVT?

A

D dimer

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10
Q

What are three laboratory findings consistent with coagulopathy of liver disease?

A

Prolonged prothrombin time; Prolonged activated partial prothromboplastin time, and INCREASED factor VIII level (from WP bodies in endothelium)

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11
Q

Treatment of locally advanced cervical cancer

A

Chemoradiation (not surgery)

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12
Q

What tissue testing is indicated for patients with newly diagnosed head and neck cancers?

A

p16 tissue testing (IHC stain for HPV)

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13
Q

What is the treatment of high risk myelodysplastic syndrome?

A

Allogeneic Hematopoetic Stem Cell Transplant

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14
Q

What is the timing of bilateral prophylactic salpingo-oopherectomy for BRCA1 carriers?

A

By age 35 years and after child-bearing is complete

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15
Q

Two goals of posttreatment surveillance following therapy for head and neck cancer

A

Identify local recurrence; Identify distant second primary cancer

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16
Q

Genetic mutation commonly associated with polycythemia vera

A

JAK2 V617F activating mutation

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17
Q

What agent for acute treatment of tumor lysis syndrome catalyzes breakdown of uric acid? Testing needed before giving (theoretically)?

A

Rasburicase; G6PD level

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18
Q

What is a diagnosis for acute respiratory distress, elevated BNP, and elevated central venous pressure within 6 hours of transfusion?

A

Transfusion associated circulatory overload

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19
Q

What is the initial treatment of intracranial hypertension associated with central nervous system lymphoma?

A

High dose systemic glucocorticoids

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20
Q

What are two essential steps in managing heparin-induced thrombocytopenia?

A

Stop heparin; Start nonheparin anticoagulant (Lepirudin, ARGATROBAN, danaparoid)

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21
Q

What is the initial treatment of metastatic ER+ breast cancer limited to the bone?

A

Aromatase inhibitor (letrozole, exemestane)

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22
Q

What are three CONTRAindications to outpatient therapy for acute pulmonary embolism in a hemodynamically stable patient?

A

Need for supplemental oxygen; need for IV pain meds; presence of “significant” comorbid conditions

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23
Q

Recommended adjuvant therapy for SCC of head and neck with positive surgical margins following resection

A

Chemoradiation

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24
Q

What is the INITIAL treatment of malignancy-associated hypercalcemia?

A

NS infusion- liberal

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25
Q

What is a monoclonal antibody used to treat Waldenstroms Macroglobulinemia?

A

Rituximab (recall it is lymphoplasmacytic LYMPHOMA)

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26
Q

What is the treatment of solitary colon cancer metastasis to liver or lung

A

Surgicla resection

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27
Q

What tissue testing is indicated in patients with metastatic gastric cancer

A

HER2 tumor status

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28
Q

What is the first step in mgmt of suspected transfusion-transmitted bacterial infection?

A

Stop transfusion! Then broad spec abx

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29
Q

Immunosuppressed patients at greater risk for this lymphoma

A

Non-Hodgkin Type lymphomas

30
Q

Therapy for mycosis fungoides limited to the skin

A

Topical glucocorticoids

31
Q

What genotype testing is indicated in patients with metastatic colorectal cancer?

A

K-ras and N-ras

32
Q

What is the intial diagnostic study for ALL patients with confirmed amyloidosis?

A

Amyloid typing (I think this is the microdissection that goes to Mayo)

33
Q

Two measures of performance status commonly used to guide therapy in patients with metastatic cancer

A

Karnofsky Score and ECOG score (Zubrod score)

34
Q

What are two adjuvant treatment options for stage III colon cancer?

A

FOLFOX (folinic acid = leucovorin, 5 FU, oxaliplatin); CAPOX- capecitabine and oxaliplatin

35
Q

What are 7 treatment related complications following therapy for testicular cancer?

A

CV disease, Metabolic Syndrome, Kidney dz, Peripheral neuropathy, Chronic Pulmonary toxicity, Secondary malignancy, and sexual dysfunction

36
Q

Genetic testing for metastatic melanoma

A

BRAF V600E mutation analysis

37
Q

What are 3 possible indications for neoadjuvant chemotherapy for patients with localized breast CA?

A

HER2-amplified breast CA; Triple negative breast CA; large cancers in women who want breast-conserving tx

38
Q

What are 3 conditions that are associated with iron malabsorption

A

Celiac disease, achlorhydria, and H. pylori infection (also bariatric surgery)

39
Q

This intervention provides survival benefit in patients with early-stage ovarian CA

A

Exploratory surgery with intact removal of adnexal mass

40
Q

Recommended screening for ovarian cancer in women of average risk

A

No screening

41
Q

What is the target hemoglobin level for patients with sickle cell disease undergoing low to moderate risk surgery?

A

10 (TAPS study)

42
Q

Syndrome characterized by rheumatoid arthritis, splenomegaly, and neutropenia?

A

Felty’s Syndrome

43
Q

This is the initial treatment for patients with rectal cancer that invades into but not fully through the rectal wall without evidence of lymph node mets

A

Surgical resection (This is Stage I)

44
Q

What are three risk factors for progression of Monoclonal Gammopathy of Undetermined Significance to Multiple Myeloma?

A

Non IgG M protein; M protein of at least 1.5 g/dl; and abnormal serum free light chain ratio

45
Q

What hormonal contraceptive option has the lowest risk for venous thromboembolism?

A

Progestin-releasing intrauterine device

46
Q

What is the most common musculoskeletal adverse effect in patients taking an aromatase inhibitor?

A

Arthralgia (Aromatase Inhibitor-Induced Arthralgia Syndrome)

47
Q

What is the treatment of ipilimumab-induced toxicity

A

DC ipilimumab and start systemic high-dose glucocorticoid tx

48
Q

This is a term for chemotherapy that is given to a patient with an unresectable tumor to shrink it to a resectable size

A

Conversion Chemotherapy

49
Q

What is the immediate treatment of multiple myeloma associated spinal cord compression?

A

IV high dose glucocorticoids

50
Q

What is the recommended treatment for a patient with asymptomatic, nonbulky follicular lymphoma?

A

Clinical observation; but if stage I-IIA can do ISRT

51
Q

What is the management of recurrent superficial bladder cancer following treatmetn with TURBT (transurethral resection of bladder tumor) or intravesical BCG?

A

Cystectomy

52
Q

What are two indications to perform a SLNB in patients with newly diagnosed melanoma?

A

1-4 mm thickness; <1 mm thick but with HIGH RISK FEATURES - ulceration, > 1 mitosis/mm2, and lymphovascular invasion (LVI)

53
Q

What is the general time frame to stop new oral anticoagulants (NOAC) before surgery?

A

24-36 hours before a surgery with standard risk of bleeding

54
Q

What is the treatment of warm autoimmune hemolytic anemia?

A

Systemic Glucocorticoids

55
Q

What is the mgmt of low risk myelodysplastic syndrome?

A

Clinical observation

56
Q

Genetic mutation commonly associated with essential thrombocythemia

A

JAK2 V617F activating mutation

57
Q

What is the diagnosis for a decrease in hemoglobin level, reticulocytosis, and elevated LDH several days following a transfusion?

A

Delayed Hyperhemolytic transfusion reaction

58
Q

What is the most effective chemoprophylaxis in postmenopausal women with newly diagnosed atypical ductal hyperplasia?

A

Exemestane (Aromatase Inhibitor)

59
Q

What are the two criteria for discontinuing heparin when initiating anticoagulant treatment for VTE with the combo of heparin and warfarin (i.e. bridging)

A

Heparin and Warfarin have overlapped for >5 days; INR is >2 for 24 hours

60
Q

Therapy for gastric MALT lymphoma associated with H. pylori infection?

A

Treat the H. pylori

61
Q

What is the diagnosis for episodic hemolysis in response to oxidant stressors?

A

Glucose-6-phosphate dehydrogenase deficiency

62
Q

What are three indications for BRCA 1/2 testing in women with newly diagnosed breast cancer?

A

Patient under 45; Breast CA diagnsed at any age with one or more first, second, or third degree relatives dx with ovarian CA; Triple neg breast CA diagnosed prior to age 60

63
Q

What is the diagnosis for a patient with mild microcytic, hypochromic anemia with target cells and a normal hemoglobin electrophoresis?

A

alpha thalassemia trait (alpha thalassemia minor)

64
Q

What are three clinical parameters indicating a low risk of prostate cancer progression?

A

Clinically localized prostate CA; Serum PSA <10 ng/mL; Gleason Score <8

65
Q

What is a cause of iron deficiency and red urine in a runner?

A

Exercise induced intravascular hemolysis

66
Q

The treatment regimen for a woman with CUP presenting with abdominal carcinomatosis and ascites should be focused towards what cancer type?

A

Ovarian

67
Q

Women with a personal and family history of ovarian, endometrial, or colon CA should undergo testing for this genetic syndrome

A

Lynch Syndrome (HNPCC)

68
Q

What is the diagnostic test to perform for B12 deficiency if the level is borderline low?

A

Methylmalonic Acid level

69
Q

This is the type of non-Hodgkin lymphoma characterized by extranodal involvement and overexpression Cyclin D1

A

Mantle Cell Lymphoma

70
Q

What is an important genetic mutation screening test for patients with lung adenocarcinoma?

A

EGFR mutation testing

71
Q

What is the threshold hemoglobin level to begin ESAs (erythropoiesis-stimulating agents) for patients with CKD and symptomatic anemia?

A

Hgb <10

72
Q

What are two anticoagulants safe in breastfeeding?

A

Warfarin (though not safe in pregnancy) and LMWH