Flashcards in Oncology Deck (92)
CEA is used to monitor for progression of these two cancers mainly:
AFP is elevated in (2):
Yolk sac tumors
CA-125 is used to monitor:
S-100 is used to monitor (2):
Alk phos, when you have ruled out biliary disease, might be elevated in (2):
Elevated bombesin levels can be associated with these three cancers:
TRAP is associated with this malignancy:
Tartrate resistant acid phosphatase
Hairy cell leukemia
Two tumor markers elevated in pancreatic cancer:
Four cancers in which you might see Psammoma bodies:
Papillary thyroid cancer
Serous cystadenocarcinoma of the ovary
The cancers (2) associated with the tumor suppressor gene Rb:
The cancer associated with the tumor suppressor gene DPC:
The cancer associated with the tumor suppressor gene APC:
The cancer associated with the tumor suppressor gene WTI:
Cancers associated with K-RAS (3):
The cancer associated with the H-RAS oncogene:
"H is for Hematuria"
Bladder / kidney
The cancers associated with the N-RAS oncogene (2):
Cancer associated with each of the following:
C-myc = Burkitt's lymphoma
L-myc = lung cancer
N-myc = neuroblastoma (adrenal)
Tumor in which you see Homer-Wright pseudorosettes:
Small cell lung cancer
Aflatoxins cause this cancer:
Cancers associated with asbestos exposure (2):
Bronchogenic carcinoma (most common)
Two major risks for transitional cell cancer of the bladder:
Three cancers associated with tuberous sclerosis:
Plummer-Vinson syndrome is a risk for this type of cancer:
Squamous cell cancer of the esophagus
Pagets disease is a risk for these two cancers:
Acanthosis nigricans may be a marker for this type of malignancy:
Name three diseases associated with DNA repair defects:
HNPCC = Lynch
Ataxia telangiectasia (lymphoma / leukemia)
Strep. bovis infection is a risk for this cancer:
H. pylori infection is a risk for this cancer:
Infection with Schistosoma haematobium is a risk for this cancer:
Small cell cancer of the bladder
Infection with Clonorchis sinensis is a risk for this cancer:
Hep C is a risk for this kind of thyroid cancer:
EBV is associated with these three cancers:
This virus is associated with Kaposi's sarcoma:
Autosomal dominant mutation in p53 leads to what syndrome?
Li-Fraumeni syndrome, multiple cancers of all kinds.
RET mutation leads to these cancers (3):
Papillary thyroid cancer
Small cell lung cancer is known for causing three paraneoplastic syndromes:
Cushing (via ACTH secretion)
SIADH (via ADH secretion)
Lambert-Eaton (Ab vs. pre-synaptic nerve terminals, cause weakness)
How do you diagnose Lambert-Eaton?
Isometric muscle test, activity improves weakness.
This peptide is secreted by squamous lung cancers and others and increases serum calcium:
Parathyroid hormone related peptide
Four cancers that secrete erythropoietin:
Renal cell carcinoma
Most common sources of metastases to bone:
Permanently Relocated Tumors Like Long Bones:
Thyroid / Testes
Most common sources of metastases to liver:
Cancer Sometimes Penetrates Benign Liver:
Most common sources of metastases to brain:
Lots of Bad Stuff Kills Glia:
Stain for epithelial cancers:
Tumor markers you would use to follow pancreatic cancer:
CA 19-9, CEA
Tumor marker you would use to follow astrocytoma:
Tumor marker used to follow hepatocellular carcinoma:
What is the USPTF recommendation regarding screening for breast cancer?
Start at age 50 for sure, q2 years by mammography. At age 40 may want to do case-by-case.
What is the USPTF recommendation regarding screening for cervical cancer?
Start at 21 or 3-years post intercourse, PAP every 3 years until age 65 or the lady doesn't have the relevant parts anymore.
What is the USPTF recommendation regarding screening for prostate cancer?
Below 75, no clear evidence to suggest PSA is a good tool, above 75 there is clear evidence of harm.
What is the USPTF recommendation regarding screening for colon cancer?
Colonoscopy every 10 years after the age of 50 until age 75, after which there is no clear benefit.
OR Flex. sig every 5 years
OR annual FOBT.
If family history, start screening 10 years earlier than age of dx of affected family member.
Single best preventive measure to avoid renal cell carcinoma?
Mechanism of action of methotrexate:
S-phase antimetabolite that prevents dTMP formation and therefore slows DNA synthesis.
The myelosuppression caused by methotrexate is reversible with this medication:
This drug, in the S-phase antimetabolite class, causes myelosuppression not reversible with leucovorin:
Leucovorin = folinic acid
Mechanism of action of 5-FU:
Activated to 5F-dUMP which covalently binds folic acid.
Prevents dTMP from being made, prevents DNA synthesis.
What is cytarabine?
Pyrimidine anti-metabolite, inhibits DNA pol.
The "rescue" drug for 5-FU:
"Rescue" for methotrexate:
Leucovorin = folinic acid
This antibiotic works at DHF reductase in a mechanism analogous to methotrexate:
Azathioprine is converted to which active metabolite? What does this drug do?
Azathioprine -> 6-mercaptopurine
Decreases de novo purine synthesis.
Special consideration re the metabolism of azathioprine by the body:
It is metabolized by xanthine oxidase.
Allopurinol inhibits this enzyme, can see toxicity if both are used together.
This drug works in a similar manner to azathioprine, except it can be given with allopurinol:
Not metabolized by xanthine oxidase.
Mecahanism of action for dactinomycin:
Intercalates itself into DNA.
Used in tumors in children (children ACT out, they also fit in small places)
Three tumors dactinomycin can be used to treat:
A drug that works in an entirely different manner from dactinomycin can also be used to treat some common childhood tumors. What is it, and what are the indications they share in common?
Vincristine can also be used to treat:
The drugs doxorubacin and daunorubicin work in two ways:
1. Free radical generation
2. Intercalate in DNA (non-covalent)
Special toxicity of doxorubicin / daunorubicin:
This chelating agent is used to prevent the cardiotoxicity caused by doxorubicin and daunorubicin:
Mechanism of action of bleomycin:
Free radical generator.
What is an alkylating agent?
Drug that adds an alkyl group to DNA and cross-links the strands.
This alkylating agent class crosses the BBB and is used in treatment of brain tumors. Can you name all four?
Mechanism of action of streptozocin:
Both are DNA alkylating agents, nitrosoureas.
Cross the BBB.
Three anti-cancer drugs with pulmonary fibrosis as a common side-effect:
Mechanism of action of busulfan:
This alkylating agent requires bioactivation by the liver:
Anti-cancer drug associated with hemorrhagic cystitis:
Drug used to partially prevent this complication:
Three most commonly used drugs for testicular CA:
Eradicate Ball Cancer:
Drugs / classes that act on microtubules (5):
This class of anti-cancer drugs blocks microtubule polymerization:
This class of anti-cancer drugs hyper-stabilizes microtubules:
Vinca alkaloids block polymerization
Taxols hyper-stabilize (TAXes stabilize society)
Vincristine has these main indications (6):
Solid tumors, leukemias, & lymphomas
Taxols are used to treat:
Ovarian and breast cancer
Mechanism of action of cisplatin / carboplatin:
Anti-cancer drugs that cause acoustic nerve damage and are also nephrotoxic:
Can you think of three other random drugs that are both oto- and nephrotoxic?
Cisplatin / carboplatin
(Won't be able to hear that PLATinum label)
Aminoglycosides (a MEAN guy hit the baby in the ear)
Mechanism of action of etoposide:
Drug that acts in an analogous fashion:
Inhibits topoisomerase II
Mechanism of action of hydroxyurea:
Inhibits ribonucleotide reductase, decreases DNA synthesis (is S-phase specific).
How are steroids useful in treatment of cancer?
They may trigger apoptosis.
Troublesome side effect of vinblastine:
Serious bone marrow suppression
VinBLASTine BLASTs bone.
Mechanism of action of tamoxifen / raloxifene:
SERMs. Antagonists in breast, agonists in bone.
How do tamoxifen and raloxifene differ?
Both drugs = SERMs, antagonize estrogen receptors in breast and agonize them in bone.
Tamoxifen = partial agonist in endometrium, increases the risk of CA in women who do not have it.
Raloxifene = endometrial antagonist, safe for use in women without cancer.
Drug used to treat cancers that over-express HER-2 and its two names:
Trastuzumab = herceptin
This drug is used in CML and is a bcr-abl tyrosine kinase inhibitor, it has two names:
Imatinib = Gleevec
This drug is used against B-cell neoplasms. How does it work?
Ab vs. CD20, B-cell surface marker.
Mech. of action of Herceptin:
Binds HER-2, a tyrosine kinase, and kills cancer cells that over-express it.