Oncology

Question 1

Colon Cancer, what is the standard chemo regimen? Think IIB to IV

Answer 1

FOLFOX: 5 Flurouracil, Leucovorin, and Oxaliplatin with oral capecitabine

Question 2

Rectal Cancer has a high recurrence rate, what is normally done?

Answer 2

Radiation

Question 3

Stage 1 breast cancer, does it require further imaging?

Answer 3

No

Question 4

Large Cell Lymphoma, what routine testing is usually done for risk stratification?

Answer 4

Lactate Dehydrogenase (LDH), bone biopsy is rarely done.

Question 5

Cervical Cancer Stage III, what treatment should be done?

Answer 5

Cisplatin and Radiation Therapy

Question 6

A patient with CLL, repeat respiratory infections, repeat IV antibiotics, hospitalizations, what should be given?

Answer 6

IVIG, increase antibody concentration

Question 7

Hepatocellular Carcinoma treatment for a Child-Turcotte-Pugh score < 7, is what?

Answer 7

Sorafenib

Question 8

What type of thyroid cancer has biphasic spindle and giant cell tumor?

Answer 8

Anaplastic Thyroid Cancer, BRAF V600 mutation

Question 9

What type of thyroid cancer has large cells with ground glass cytoplasm and prominent nucleoli with clefts, grooves, and holes due to intranuclear cytoplasmic inclusions, some call “Orphan Annie Eyes”?

Answer 9

Papillary Thyroid Cancer

Question 10

Colon Cancer Stage I-IIA, what is the treatment?

Answer 10

Capecitabine or 5-FU/leucovorin or Surgery without treatment

Question 11

What does FOLFOX stand for? Colon Cancer IIB to IV

Answer 11

Oxaliplatin + leucovorin + 5 FU + folinic acid (calcium)

Question 12

What is a IIB to IV Colon Cancer Regimen?
Not FOLFOX

Answer 12

FOLFIRI -> Irinotecan, leuocovorin, 5-FU

Question 13

Patient has AML with PML-RARA and FLT3-ITD mutations, what is a good chemo starting point?

Answer 13

Cytarabine plus daunorubicin

Question 14

What foot stress fracture area is concerning for malunion healing? This should be a quick referral to orthopedic surgery/podiatry

Answer 14

Proximal fifth metatarsal shaft fracture

Question 15

Patient’s using bisphosphonates should have a drug holiday of how long with the following routes?

Oral?

IV?

Answer 15

Oral Bisphosphonates can have a holiday after 5 years

IV Bisphosphonates can have a holiday after 3 years

Question 16

Non-hodgkin lymphoma, advanced stage follicular lymphoma, what is the treatment?

Answer 16

Rituximab + chemotherapy or lenalidomide

Question 17

CLL is diagnosed how?

Answer 17

CD19, CD20, and CD 23, co-expression of CD-5. Bone Marrow biopsy is not needed.

Question 18

CLL via pathology slide has what?

Answer 18

Smudge Cells and elevated Basophils

Question 19

Hairy Cell Leukemia has what with bone marrow?

Answer 19

Dry Tap

Question 20

What is the first line treatment for hairy cell leukemia?

Hairy Cell Leukemia may have BRAF V600E mutation, as well

Answer 20

Pentostatin or Cladribine

Relapses can have Rituximab

BRAF inhibitor -> Vemurafenib

Question 21

Diffuse B cell Lymphoma has what elevated gene expression?

Answer 21

BCL6

Question 22

Advanced-stage diffuse large B-cell lymphoma has what standard treatment regimen?

Answer 22

Rituximab + Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (R-CHOP regimen)

Question 23

What type of tumor can spread to the Pouch of Douglas, indicative of metastatic gastric cancer?

Answer 23

Blumer shelf tumor

Question 24

What is the following? What could it indicate?

Answer 24

Gastric Cancer, Sister Mary Joseph Nodule

Question 25

# What is the following? What could this indicate?

Answer 25

Gastric Cancer, Virchow Node

Question 26

# What could this mean? What does this indicate?

Answer 26

Leser Trelat Sign, Gastric Cancer

Question 27

A woman has an enlarged ovary, the biopsy is shown, what could could this indicate? What is it?

Answer 27

Krukenberg Tumor, Gastric Cancer

Question 28

Gastric cancer should have what type of treatment?

Answer 28

Neoadjuvant Chemotherapy and surgery Cisplatin-based regimen, if HER2 monoclonal antibody, trastuzumab can be used

Question 29

What is the following, what disease is this usually assoicated with?

Answer 29

Pancreatic Cancer, Trousseau Syndrome, vascular thrombosis 2/2 pancreatic cancer, gastric cancer, or other cancers ## Footnote From google images

Question 30

What are the two pancreatic cancer treatment recommendations?

Answer 30

5-FU plus radiation therapy or Gemcitabine (single agent chemotherapy)

Question 31

Cervical cancer stage II to IV, what is the most likely chemotherapy regimen?

Answer 31

Cisplatin

Question 32

Women with advanced stage ovarian cancer receive adjuvant platinum-based chemotherapy. What other treatment can be done that has shown survival benefit?

Answer 32

Intraperitoneal chemotherapy

Question 33

Low Molecular weight heparin is 1/3 the size of unfractionated heparin, does this require laboratory monitoring?

Answer 33

No, lab monitoring, less bleeding risk verson UFH, adjust dose based on kidney function or actual body weight Poorly binds thrombin, binds to Factor Xa instead Prefer LMWH versus unfractionated heparin in most circumstances, less side effects and bleeding

Question 34

Unfractionated heparin, inactivates thrombin and factor Xa What can it be used for?

Answer 34

Treatment of DVT Typically use unfractionated heparin with renal insufficiency

Question 35

If anticoagulation is needed during pregnancy (atrial fibrillation, mitral valve stenosis), what is the best course of action?

Answer 35

Early in pregnancy, use LMWH, later in pregnancy near labor, use unfracionated heparin Unfractionated heparin is easier to reverse | LMWH and UFH are not teratogenic