ONC

Question 1

what is a radical hysterectomy

Answer 1

remove uterus, cervix, parametrial tissue, complete pelvic lymphadenectomy, upper 2 cm of vagina

Question 2

what nodes are removed for complete pelvic?

Answer 2

internal, external, common, iliac nodes, obturator nodes

Question 3

what is a radical trachelectomy?

Answer 3

preserve uterine arteries, cervix and parametria resected. (IA2 and small IB1 tumor

Question 4

criteria for cervical cancer without LN with high risk of recurrnce

Answer 4

deep stromal invasion (>15), LVSI, Tumor > 4 cm

Question 5

how do alkylating agents work?

Answer 5

NON specific, bind to DNA and cause breaks

Question 6

example of alkylating?

Answer 6

cyclophosphamide (ADE hemorrhagic cystitis) MESNA salvage

Question 7

how do platinum agents work?

Answer 7

Cell cycle non specific, cROSS LINKS to DNA and RNA. toxicities include myelosuppreession, N/V, renal failure

Question 8

Carboplatin vs Cisplatin

Answer 8

cisplatin WAY more emetogenic

Question 9

anthracyclines?

Answer 9

cell cycle nonspecific, intercalate DNA pair (ex: doxorubicin) Need central line

Question 10

S phase specific chemo, two types?

Answer 10

antimetabolites: pyrmidine antag. BLOCKS DNA synthesis, tox is myelo AND Folate Antag (Tetrahydrofolic acid blocker)

Question 11

Vinca Alkaloid?

Answer 11

Mitosis phase specific! spindle cell POISON! ex: vinblastin, vincristine

Question 12

G2 phase inhibit?

Answer 12

Topoisomerase I and II inhibitors

Question 13

MOA of paclitaxel?

Answer 13

M phase specific! stabilizes microtubules. NEUROPATHY

Question 14

what is BEVACIZUMAB?

Answer 14

AVASTIN! veg-F inhibitor (*monoclonal AB) ADE: htn, renal, pres, bowel perf

Question 15

what is a parp inhibitor

Answer 15

inhibit DNA repair!

Question 16

why BRCA for PARP?

Answer 16

Inhibit DNA repair which is already inhibited! so causes SYNTHETIC LETHALITY!!

Question 17

chemo for uterine cancer (endometrial)

Answer 17

Taxol/Carboplatin

Question 18

chemo for leiomyosark?

Answer 18

adriamycin, GEm/Tax

Question 19

why use immunotherapy

Answer 19

boost or restore ability of immune system to detect and destroy cancer cells by overcoming mechs by which tumors evade and suppress the immune system

Question 20

What is the DIRECT mech of RADIATION

Answer 20

Damage to DNA directly! causes cellular death in 1/3 of reaction

Question 21

what is the INDIRECT mech of radiation

Answer 21

formation of free radicals via interaction of radiation with water

Question 22

how to determine dose of brachytherapy

Answer 22

inverse square law