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Flashcards in Onco Deck (84):
1

Pancreatic Ca sign

Progressive jaundice

Curvoiser sign (painless palpable gallbladder)

Trousseau sign

Migratory thrombophlebitis

2

What's acoustic neuroma

Schwannoma of 8CN

3

Acoustic neuroma Sx

Unilateral hearing loss (slow progressive sensoneural)

4

Weber test (tuning fork) results.

Unilateral sensorineural: louder in normal ear


Unilateral conductive: louder in effected ear

5

Rinne test results

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

6

MC benign tumor of breast

Fibroadenoma

7

Age for fibroadenoma

F < 30

8

Fibroadenoma classic

Painless
Mobile
Small round
Well defined / encapsulated

Cut surface = grey white
Aspirate = no fluid

9

Euthyroid nodule next step?

FNA

10

MCC of esophageal cancer

SCC

11

MCC of malignancies in Down Syndrome

AML
ALL
Testicular Ca
Liver Ca

12

Risks for colon Cancer

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

13

Is diverticular disease a cause of CRC?

No

14

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

F.

15

Risks of lung cancer

Tobacco
Asbestosis
Radiation
Nickel mining
Arsenic
Radon
Chromium
Uranium
Aromatic hydrocarbons

16

Age of multiple myeloma

> 60 Yrs

17

Pathophysiology of MM

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

18

MM classic Sx

Bone pain: back +/- fractures

Anemia

Renal failure (high Cr)

Recurrent infections

High Ca + constipation

19

Dx of MM

BM biopsy

20

MCC of pituitary Adenoma

Prolactinoma

21

Pituitary adenoma classic

Amenorrhea
Headaches
Bitemporal hemianopsia
Galactorrhea if prolactinoma

22

MM Rx

< 65 YO:
If symptomatic only Rx
Stem cell transplant

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

23

When to Rx MM?

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

24

Recognize melanoma

ABCDE

Asymmetrical
Irregular
Color varying
Diameter >6 mm
Evolution

25

Rx melanoma

Deep excision with 1-2 mm margins

26

Prognostic marker of MM

B2 microglobulin
Albumin

27

Pathophysiology of CML

Philadelphia chromosome t(9;22)

28

Types of burkitts lymphoma

1. Africa = facial swelling in kids.

2. North America: abdominal

3. HIV

29

Histopath of Burkitts lymphoma

Starry sky

30

Mutation of Burkitts lymphoma

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

31

MC type of renal tumors

Renal cell carcinoma

32

Carcinoid tumor classic

Flushing episodes
Diarrhea
Wheezes
Rt heart disease

33

Cause of Sx in carcinoid tumors

Serotonin

34

Dx carcinoid tumors

Urine 5-HIAA
(Hydroxyinolacentic acid)

35

Gardenigo Syndrome

Ear infection. + eye symptoms

Triad of petros apicitis:
Otorrhea
Retro-orbital pain
Diplopia
6CN palsy

36

Infection associated with Kaposi sarcoma

HHV-8

37

Dx Hodgkin lymphoma

LN biopsy to see Reed-Sternberg cells

38

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

39

What's TRAP in hairy cell leukemia?

Tartrate resistant acid phosphate

40

Rx of hairy cell leukemia

Cladribine
If resistant pentostatin

41

Risk factors for HCC

HBV
HCV
Hemochromatosis
Alcoholic liver
Fungal aflatoxin intake

42

Cause of nasopharyngeal carcinoma

EBV

43

Nasopharyngeal carcinoma Sx

Late
Unilateral bloody nasal discharge

Fascial swelling

Numbness

44

Rx of nasopharyngeal carcinoma

Chemo + radiation

45

Dx acoustic neuroma

1st audiometer

Definitive: MRI or CT

46

Substance used in PET scan

Fluorine-18-labeled tracer fluorodeoxyglucose (FDG)

Analogue of glucose

47

SCLC Sx

Cough
Hoarseness
Weight loss
SIADH
Smoker
Elderly

48

Other name for SCLC

Oat cell lung Ca

49

Red flags in thyroid nodule

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

50

MC type of thyroid cancer

Papillary

51

Major types of skin cancer

BSC
SCC
Melanoma

52

Skin cancer with worst prognosis

Melanoma

53

Type of melanoma with Worst prognosis?

Nodular melanoma

54

Rx of SCC >20 mm

Surgical excision with 6mm margins

55

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.

56

Anal carcinoma is associated with what STD

HPV 16 + 18

57

What's thrombophlebitis migrans

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

58

Migratory thrombophlebitis indicates?

Malignancy

59

MCC of migratory thrombophlebitis

Pancreas and lung cancer

60

Other name for migrating thrombophlebitis

Trousseau's sign of malignancy

61

If see migratory thrombophlebitis, next step?

Look for pancreas or lung Ca by CT

62

Turners syndrome classic

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

63

MCC of brain ventricular system?

Ependymoma

64

Location of epndymomas

Floor of 4th ventricle

65

What's Waldenstrom Macro-globulinemia?

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

66

Age of Dx in Waldenstrom macroglobulinemia?

>65

67

Classic Waldenstrom macroglobulinemia

Anemia
Monoclonal IgM peaks
Bence-Jones

68

Waldenstrom vs MGUS?

Bench-Jones protein in Waldenstrom but not in MGUS

69

Cancers that produce PTHrP?

Squamous cell of Lung
Head / neck Ca
Bladder Ca

70

When to order homovanillic acid + vanillymandelic acid?

Neuroblastoma
Pheochromocytoma

71

Dx pheochromocytoma or neuroblastoma

Serum neuron-specific enolase

Homovanillic acid

Vanillymandelic acid

72

Which tumors raise hCG?

Liver tumors
Germ cell

73

What Ca raise a-fetoprotein?

Liver Ca
Teratomas
Germ cells

74

What coul cause false positive PSA?

Prostate exam
Prostate massage
Cystoscope
UTI
Urinary retention

75

What BPH drug falsely decreases levels of PSA?

Finasteride

76

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

77

What increases the risk of endometrial cancer

PCOS

78

What protects against endometrial cancer

Multi parity
Late menarche
Copper IUD
OCP

79

Marker of ovarian Ca

CA-125

80

CEA marker of what?

Follow up CRC

81

CA19-9 marker of what?

Pancreas Ca

82

Normal PSA

< 4 ng/ml

83

MCC of metastatic brain Ca?

Lung > breast > melanoma

84

Where dose pancreas Ca metastasize

Liver
Lung
Peritoneum