Oncology Flashcards Preview

Internal Medicine > Oncology > Flashcards

Flashcards in Oncology Deck (27):
1

70M
dyspnea
cough
worsened over the past 6 months
weight loss
anorexia
hemoptysis
40 pack year smoker
bilateral gynecomastia
acanthosis nigricans
digital clubbing (hypertrophic osteoarthropathy)

Diagnosis?

Lung cancer

with paraneoplastic syndrome

2

Lung Cancer:
what are the 2 main morphologic forms of this condition?

small cell lung cancer
non small cell lung cancer

3

Lung Cancer:
most significant risk factor for the development of this condition?

cigarette smoking

4

Lung Cancer:
next step in management upon PE?

CXR

5

Lung Cancer:
why gynecomastia, clubbing and acanthosis nigricans?

paraneoplastic syndromes

6

manifest with acanthosis nigricans (2)

visceral malignancies
gastric malignancies

7

Lung Cancer:
most appropriate diagnostic test after imaging studies?

lung biopsy

8

Lung Cancer:
if CXR = centrally located lung mass, considerations? (2)

Small cell lung cancer
Squamous cell lung cancer

Sentral, Small, Squamous

9

Lung Cancer:
differentiate based on their paraneoplastic syndromes:
small cell ca?
squamous cell ca?

small cell ca: ectopic cushing syndrome, SIADH, Lambert-Eaton myasthenia

squamous cell ca: hypercalcemia, clubbing, gynecomastia

10

Lung Cancer:
most appropriate treatment?

chemotherapy +/- radiotherapy

11

Lung Cancer:
complications?

SVC syndrome
Pancoast tumor leading to Horner syndrome, airway obstruction, hoarseness

12

Lung Cancer:
prognosis?

poor --- five year survival rate of 10%

13

70M
rectal bleeding
blood mixed in the stool
decreased stool caliber
crampy abdominal pain and weight loss

diagnosis?

Colorectal cancer

14

Colorectal Cancer:
pathology?

bleeding colorectal mass causing obstruction

15

Colorectal Cancer:
appropriate screening tests for those at risk?

FOBT yearly
Sigmoidoscopy every 5 years
Colonoscopy every 10 years

16

Colorectal Cancer:
what is FAP?

Familial Adenomatous Polyposis
Familial colon cancer syndrome associated with mutation of the APC gene

APC gene = adenomatous polyposis colon gene

17

Colorectal Cancer:
How is FAP diagnosed?

visualizing = 100 polyps during colonoscopy

18

Colorectal Cancer:
What is Gardner Syndrome?

FAP plus extraintestinal tumors such as osteomas, nasopharyngeal fibroma, lipoma

19

Colorectal Cancer:
What is Turcot Syndrome?

FAP plus brain tumors (medulloblastoma), cafe au lait spots and basal cell cancer

remember: Turcot = "turban like" = brain

20

Colorectal Cancer:
What is Peutz Jegher's Syndrome?

Hyperpigmented spots on lips or buccal mucosa and hamartomatous polyps (not premalignant)

21

Colorectal Cancer:
What is Lynch Syndrome?

Hereditay non polyposis cancer (HNPC) due to defective mismatch repair genes
(colon ca + endometrial ca)

22

Colorectal Cancer:
differentiate left sided and right sided colon cancer --- as to presentation?

RIGHT: fatigue and weakness due to iron deficiency anemia

LEFT: occult bleeding, changes in bowel habits, or cramping, left lower quadrant discomfort

23

Colorectal Cancer:
most important risk factor?

Dietary habits (low fiber, high refined CHO/fat)

24

Colorectal Cancer:
most important prognostic factors?

depth of invasion
presence or absence lymph node metastasis

25

Colorectal Cancer:
treatment?

localized disease: surgery
metastatic disease: chemotherapy

26

Colorectal Cancer:
most common site of metastasis?

Liver

27

Colorectal Cancer:
surgical treatment modalities based on anatomy location of the tumor
cecum?
right colon?
proximal or mid transverse?
splenic flexure and left colon?
sigmoid or rectosigmoid?
proximal rectum?
distal rectum?

right hemicolectomy
right hemicolectomy
right hemicolectomy
left hemicolectomy
sigmoid colectomy
low anterior resection
abdominoperineal resection