Onco Flashcards by AlBatool Ali

Pancreatic Ca sign

Progressive jaundice

Curvoiser sign (painless palpable gallbladder)

Trousseau sign

Migratory thrombophlebitis

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What’s acoustic neuroma

Schwannoma of 8CN

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Acoustic neuroma Sx

Unilateral hearing loss (slow progressive sensoneural)

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Weber test (tuning fork) results.

Unilateral sensorineural: louder in normal ear

Unilateral conductive: louder in effected ear

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Rinne test results

Air > bone normal
Bone > air conductive loss
Bone = air sensorineural

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MC benign tumor of breast

Fibroadenoma

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Age for fibroadenoma

F < 30

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Fibroadenoma classic

Painless
Mobile
Small round
Well defined / encapsulated

Cut surface = grey white
Aspirate = no fluid

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Euthyroid nodule next step?

FNA

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MCC of esophageal cancer

SCC

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MCC of malignancies in Down Syndrome

AML
ALL
Testicular Ca
Liver Ca

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Risks for colon Cancer

FHx of CRC or polyp
IBD
High fat diet
Low fiber diet

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Is diverticular disease a cause of CRC?

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T/F: Marijuana smoking increases the risk of lung cancer.

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Risks of lung cancer

Tobacco 
Asbestosis
Radiation
Nickel mining 
Arsenic 
Radon 
Chromium 
Uranium 
Aromatic hydrocarbons

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Age of multiple myeloma

> 60 Yrs

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Pathophysiology of MM

Clonal expansion of abnormal plasma cells producing monoclonal paraprotein mainly IgG or IgA rarely IgD

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MM classic Sx

Bone pain: back +/- fractures

Anemia

Renal failure (high Cr)

Recurrent infections

High Ca + constipation

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Dx of MM

BM biopsy

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MCC of pituitary Adenoma

Prolactinoma

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Pituitary adenoma classic

Amenorrhea
Headaches
Bitemporal hemianopsia
Galactorrhea if prolactinoma

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MM Rx

< 65 YO:
If symptomatic only Rx
Stem cell transplant

> 65 YO:
Asymptomatic = No Rx
If symptomatic = melphalan + prednisolone +/- thalidomide.

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When to Rx MM?

If symptomatic.
Early Rx doesn’t improve mortality.
May increase risk of leukemia

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Recognize melanoma

ABCDE

Asymmetrical 
Irregular 
Color varying 
Diameter >6 mm
Evolution

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Rx melanoma

Deep excision with 1-2 mm margins

Prognostic marker of MM

B2 microglobulin | Albumin

Pathophysiology of CML

Philadelphia chromosome t(9;22)

Types of burkitts lymphoma

1. Africa = facial swelling in kids. 2. North America: abdominal 3. HIV

Histopath of Burkitts lymphoma

Starry sky

Mutation of Burkitts lymphoma

t(8-14) | Over expression of nuclear transcription factor c-MYC

MC type of renal tumors

Renal cell carcinoma

Carcinoid tumor classic

Flushing episodes Diarrhea Wheezes Rt heart disease

Cause of Sx in carcinoid tumors

Serotonin

Dx carcinoid tumors

Urine 5-HIAA | Hydroxyinolacentic acid

Gardenigo Syndrome

Ear infection. + eye symptoms ``` Triad of petros apicitis: Otorrhea Retro-orbital pain Diplopia 6CN palsy ```

Infection associated with Kaposi sarcoma

HHV-8

Dx Hodgkin lymphoma

LN biopsy to see Reed-Sternberg cells

6 Facts about hairy cell leukemia

1. Hairy cells in smear + BM 2. CD 11+ve 3. TRAP +ve 4. Hepatospleenomegaly 5. BM fibrosis 6. Cytopenia

What's TRAP in hairy cell leukemia?

Tartrate resistant acid phosphate

Rx of hairy cell leukemia

Cladribine | If resistant pentostatin

Risk factors for HCC

``` HBV HCV Hemochromatosis Alcoholic liver Fungal aflatoxin intake ```

Cause of nasopharyngeal carcinoma

EBV

Nasopharyngeal carcinoma Sx

Late Unilateral bloody nasal discharge Fascial swelling Numbness

Rx of nasopharyngeal carcinoma

Chemo + radiation

Dx acoustic neuroma

1st audiometer Definitive: MRI or CT

Substance used in PET scan

Fluorine-18-labeled tracer fluorodeoxyglucose (FDG) Analogue of glucose

SCLC Sx

``` Cough Hoarseness Weight loss SIADH Smoker Elderly ```

Other name for SCLC

Oat cell lung Ca

Red flags in thyroid nodule

``` Male Age < 20 or > 65 Rapid growth Dysphagia Hoarseness Neck pain Hard fixed nodule > 4cm Cervical LN ```

MC type of thyroid cancer

Papillary

Major types of skin cancer

BSC SCC Melanoma

Skin cancer with worst prognosis

Melanoma

Type of melanoma with Worst prognosis?

Nodular melanoma

Rx of SCC >20 mm

Surgical excision with 6mm margins

How to tell if lymphoma is advanced?

1. BM involvement | If you find multi nucleated RBC in peripheral smear look for them in BM biopsy.

Anal carcinoma is associated with what STD

HPV 16 + 18

What's thrombophlebitis migrans

Inflammation of veins related to thrombosis spears as erythematous firm nodules on legs.

Migratory thrombophlebitis indicates?

Malignancy

MCC of migratory thrombophlebitis

Pancreas and lung cancer

Other name for migrating thrombophlebitis

Trousseau's sign of malignancy

If see migratory thrombophlebitis, next step?

Look for pancreas or lung Ca by CT

Turners syndrome classic

``` 45 XO karyotype Primary amenorrhea Low estrogen High FSH, LH 2ry sexual characteristics ```

MCC of brain ventricular system?

Ependymoma

Location of epndymomas

Floor of 4th ventricle

What's Waldenstrom Macro-globulinemia?

Uncontrolled proliferation of plasma cells that produce IgM protein w/ light chains

Age of Dx in Waldenstrom macroglobulinemia?

>65

Classic Waldenstrom macroglobulinemia

Anemia Monoclonal IgM peaks Bence-Jones

Waldenstrom vs MGUS?

Bench-Jones protein in Waldenstrom but not in MGUS

Cancers that produce PTHrP?

Squamous cell of Lung Head / neck Ca Bladder Ca

When to order homovanillic acid + vanillymandelic acid?

Neuroblastoma | Pheochromocytoma

Dx pheochromocytoma or neuroblastoma

Serum neuron-specific enolase Homovanillic acid Vanillymandelic acid

Which tumors raise hCG?

Liver tumors | Germ cell

What Ca raise a-fetoprotein?

Liver Ca Teratomas Germ cells

What coul cause false positive PSA?

``` Prostate exam Prostate massage Cystoscope UTI Urinary retention ```

What BPH drug falsely decreases levels of PSA?

Finasteride

Rx prostate Ca?

``` - Symptomatic + mets: Castration: Surgery LH releasing hormone agonists like leuprolide Anti-androgen like Flutamide ``` Radical prostatectomy if <70 - Asymptomatic + >70: Watchful waiting

What increases the risk of endometrial cancer

PCOS

What protects against endometrial cancer

Multi parity Late menarche Copper IUD OCP

Marker of ovarian Ca

CA-125

CEA marker of what?

Follow up CRC

CA19-9 marker of what?

Pancreas Ca

Normal PSA

< 4 ng/ml

MCC of metastatic brain Ca?

Lung > breast > melanoma

Where dose pancreas Ca metastasize

Liver Lung Peritoneum