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MKSAP - Internal > Oncology > Flashcards

Flashcards in Oncology Deck (41)
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1

next step with a BiRADs 2/3?

Breast USG - differentiates between cystic and solid masses

2

next step with a BiRADS 4/5?

fine needle aspiration or biopsy of nodule must be done

3

when should you test for BRCA1/2 mutations?

in women who appear to have genetic risk i.e. multiple relatives w/ breast or ovarian cancer, esp. early onset disease

4

young woman has a persisent, scaling, eczematous and ulcerated lesion over her nipple/areola; this lesion does not respond to medications - what should you consider?

Paget's dz of the nipple
- do a biopsy

5

Biopsy finding in Paget's dz of nipple?

malignant, intraepithelial adenocarcinoma cells w/in epidermis of nipple associated w/ underlying invasive ductal cancer

6

lichen simplex chronicus

localized disorder with intense pruritus, which leads to localized areas of thickened skin with increased and exagerated skin markings due to scratching

7

a women presents with a palpable breast mass but mammography comes back negative, what is the next best step?

fine-needle aspiration OR ultrasonagraphy

8

what do you recommend to a woman who just had cyst aspiration of her breast?

come back in 4-6 weeks to evaluate for recurrence or presence of residual lump

9

in whom should tumor estrogen/progesterone receptor assay be done?

patients with early stage breast cancer to determine optimal systemic therapy

10

breast conserving therapy

breast lumpectomy + radiation therapy

11

when do you perform axillary node dissection?

when sentinel LN shows metastatic involvement

12

screening for CRC in a person with a positive family history of CRC

start screening at age 40 or 10 years earlier than diagnosis of affected member; if normal colonscopy, repeat ever 3-5 years

13

when do you test for mutations of the APC gene?

in pts with polyposis

14

screening for CRC in normal-risk people

beginning age 50, then every 10 years if result is normal

15

screening recommendations for pts with IBD

annual colonoscopy beginning 8 years after diagnosis- take random biopsies in four-quadrants to evaluate for dysplastic changes

16

what test do you do in a pt presenting with signs of colon cancer?

colonscopy

17

findings that should prompt investigation for CRC

rectal or abdominal mass
hepatomegaly
abdominal tenderness
iron deficiency anemia

18

when can you choose flexible sigmoidoscopy over colonscopy?

pts < 40 yo with rectal bleeding

19

what is the appropriate follow-up for an asymptomatic patient with a positive FOBT sample?

colonscopy

20

what is capsule endoscopy used for?

visualization of the small bowel

21

how do you screen for lung cancer?

you dont

22

what is the appropriate follow-up in a pt who was found to have a 3 mm pulmonary nodule (incidental finding from abdominal CT)?

no further testing needed for pulm nodules < 4 mm bc risk of malignancy is extremely low in low risk patients; if the patient is at high risk for lung cancer, follow-up is with CT-scan at 12 months

23

first line management of someone with limited SCLC?

chemotherapy plus radiation therapy
- combo of carboplatin/cisplatin and etoposide/irinotecan

24

what is the next step in a man who comes in with a rising PSA (> 0.75 ng/ml/year)?

do a transrectal biopsy - even if pt is asymptomatic and DRE is non-specific

25

what is the appropriate screening method for prostate cancer?

inform patient about risks and benefits of screening; offer PSA testing to patients > 50 years old; no screening for men over 75

26

how do you tx. metastatic prostate cancer?

androgen deprivation therapy, w/ leuprolide or surgical castration (orchiectomy)
- leuprolide should be given with brief course of flutamide to prevent tumor flare

27

what is docetaxal+prednisone therapy used for?

patients with hormone-refractory prostate cancer

28

samarium 153 - what is this useful for?

radionuclide taken up by bone - useful in treating prostate cancer with painful bone mets that is unresponsive to other therapies

29

what is the next step in a female who has ASCUS on pap smear?

test for HPV
- if positive, do a colposcopy w/ biopsy

30

for whom in the HPV vaccine recommended for?

all girls and women between ages 9-26 regardless of sexual activity; high success rates for preventing infections with HPV strains 6,11,16 and 18