Oncology Flashcards
(41 cards)
next step with a BiRADs 2/3?
Breast USG - differentiates between cystic and solid masses
next step with a BiRADS 4/5?
fine needle aspiration or biopsy of nodule must be done
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
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
Biopsy finding in Paget’s dz of nipple?
malignant, intraepithelial adenocarcinoma cells w/in epidermis of nipple associated w/ underlying invasive ductal cancer
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
a women presents with a palpable breast mass but mammography comes back negative, what is the next best step?
fine-needle aspiration OR ultrasonagraphy
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
in whom should tumor estrogen/progesterone receptor assay be done?
patients with early stage breast cancer to determine optimal systemic therapy
breast conserving therapy
breast lumpectomy + radiation therapy
when do you perform axillary node dissection?
when sentinel LN shows metastatic involvement
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
when do you test for mutations of the APC gene?
in pts with polyposis
screening for CRC in normal-risk people
beginning age 50, then every 10 years if result is normal
screening recommendations for pts with IBD
annual colonoscopy beginning 8 years after diagnosis- take random biopsies in four-quadrants to evaluate for dysplastic changes
what test do you do in a pt presenting with signs of colon cancer?
colonscopy
findings that should prompt investigation for CRC
rectal or abdominal mass
hepatomegaly
abdominal tenderness
iron deficiency anemia
when can you choose flexible sigmoidoscopy over colonscopy?
pts < 40 yo with rectal bleeding
what is the appropriate follow-up for an asymptomatic patient with a positive FOBT sample?
colonscopy
what is capsule endoscopy used for?
visualization of the small bowel
how do you screen for lung cancer?
you dont
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
first line management of someone with limited SCLC?
chemotherapy plus radiation therapy
- combo of carboplatin/cisplatin and etoposide/irinotecan
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
