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Flashcards in Oncology Deck (32):
1

Common side effect of cyclophosphamide? What is given to prevent it?

Hemorrhagic cystitis --> breakdown product (acrolein) causes bladder epithelium to slough and form thin, vascular, friable mucosal lining.
- Look for hematuria, urinary retention, elevated BP, palpable bladder

*MESNA --> binds to and inactivates acrolein and is peed out

2

What is craniopharyngioma? Common diagnostic clues?

Suprasellar (above optic chiasm) tumor that can cause BITEMPORAL HEMIANOPSIA
- Arises from remnant of Rathke's pouch

Diagnostic clues:
- Heavy calcifications
- Unilocular/multilocular cysts
- Viscous YELLOW fluid content

3

What types of cancers metastasize to bone?

Prostate, breast, lung, kidney, bladder, thyroid

**MOST COMMONLY prostate, breast, lung

4

Risk factors for hepatocellular carcinoma? What serum marker is specific for this cancer?

Risk factors = any chronic inflammation of liver:
-Viral hepatitis (b,c)
-Alcoholic cirrhosis
-NAFLD
-Hemochromatosis
-Wilson disease
-Alpha-1-antitrypsin
-Aflatoxin exposure

5

S/S of brain tumor?

Most common cause of metastatic tumor to brain?

S/S:
1) HA worsening w/ recumbancy
2) HA wakes patient from sleep
3) HA present in morning after waking up
4) Nausea

MCC = lung cancer

6

Patients undergoing chemo should receive what 2 vaccines? Live or inactivated?

ALWAYS INACTIVATED!!!

*Influenza + Pneumococcal

7

What cancer shows ruptured cells on peripheral smear?

What blood findings correlates with poor prognosis?

CLL (smudge cells)

Low platelets

8

Lynch syndrome is associated with what other type of cancer?

Endometrial cancer

9

Risk factors for colon polyps developing into cancer?

What is the mgmt for hyper plastic polyps?

Villous
Sessile (wide base)
Size > 2.5cm

Hyperplastic = NOTHING!

10

Most common site of colon cancer mets?

What clinical picture suggests metastatic spread?

Liver

Person with long-standing Fe-def anemia and (+) hem occult test who has low grade RUQ pain and slightly elevated LFTs

11

Most common type of CNS tumor in children? Where are they located?

Astrocytoma

Both supratentorial and infratentorial

12

When is brain surgery for cancer indicated?

Solitary metastasis in areas with good performance status (grey-white jxn)

13

Radiation exposure and family hx of thyroid cancer are risk factors for the most common cause of thyroid cancer - what is it?

Papillary carcinoma

14

Cancer-related anorexia can be treated with what?

Progesterone analogs (megestrol acetate)

15

Smudge cells are characteristic of what?

CLL

16

Patients with Hodgkin's lymphoma are at risk for what complications if treated under 30 yo?

Secondary malignancies --> from radiation and chemotherapy at younger ages

*Common in lung, thyroid, bone, and GI

17

Painless testicular mass with ultrasound findings suggestive of cancer - what is next best step?

Radical orchiectomy

18

Person with UC wants to know when and how often to get colonoscopies?

*UC = increased risk of colon cancer

*Start 8 yrs after diagnosis --> every 1-2 years afterwards

19

Hard, non-tender, solitary lymph node in older male with smoking hx - what are you suspecting?

SCC (head/neck cancer)

20

Only vaccine known to reduce risk of developing cancer?

What cancer?

Hepatitis B vaccine

Reduced hepatocellular cancer

21

Person has unprovoked DVT - what must you consider?

Follow up?

Malignancy!
*Look for wt loss

Detailed age-appropriate screening and CXR

22

This drug can cause peripheral neuropathy?

Vincristine/Vinblastine

23

Most common source for brain metastasis?

Lung

24

Best choice of treatment for chemotherapy-induced N/V?

Mechanism of action?

Serotonin blockers (antagonist) (5HT3 receptors)

Ondansetron

25

What has increased levels of myelocytes?

Promyelocytes?

Tartrate-resistant acid phosphatase?

CML

AML --> look for Auer rods

Hairy cell leukemia

26

What is characterized by increased size of liver/spleen/lymph nodes, fatigue, easy bruisability, headaches/dizziness, and pain/numbness in extremities?

Waldenstrom's Macroglobulinemia

*Fatigue = anemia
*Demyelinating sensorimotor neuropathy

27

IgM spike + hyperviscotity?

Waldenstrom's macroglobulinemia

28

How do you differentiate seminoma vs nonseminomatous germ cell tumors?

Seminoma: NO aFP

Nonseminomatous: b-HCG + aFP

29

Solitary, painful lytic bone lesion with overlying swelling and hypercalcemia?

Langerhans cell histiocytosis

30

Person with significant smoking history that now takes up chewing tobacco. He also drinks regularly. He has a white, granular patch over his R inner cheek. What is it?

Leukoplakia

*Smokeless tobacco + EtOH
Progresses to SCC in 10 yrs

31

Unique stain to hairy cell leukemia?

Tx?

Tartrate-resistant acid phosphatase (TRAP) stain

Tx: Cladribine

32

Lab findings in tumor lysis syndrome?

Potassium --> increased
Uric acid --> increased
Phosphate --> released from cells when lysed and bind to Ca
Calcium --> decreased (bound to phosphate)

*Both K and Phos are intracellular ions --> released when cells lyse