Flashcards in Oncology Deck (32):
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
What is craniopharyngioma? Common diagnostic clues?
Suprasellar (above optic chiasm) tumor that can cause BITEMPORAL HEMIANOPSIA
- Arises from remnant of Rathke's pouch
- Heavy calcifications
- Unilocular/multilocular cysts
- Viscous YELLOW fluid content
What types of cancers metastasize to bone?
Prostate, breast, lung, kidney, bladder, thyroid
**MOST COMMONLY prostate, breast, lung
Risk factors for hepatocellular carcinoma? What serum marker is specific for this cancer?
Risk factors = any chronic inflammation of liver:
-Viral hepatitis (b,c)
S/S of brain tumor?
Most common cause of metastatic tumor to brain?
1) HA worsening w/ recumbancy
2) HA wakes patient from sleep
3) HA present in morning after waking up
MCC = lung cancer
Patients undergoing chemo should receive what 2 vaccines? Live or inactivated?
*Influenza + Pneumococcal
What cancer shows ruptured cells on peripheral smear?
What blood findings correlates with poor prognosis?
CLL (smudge cells)
Lynch syndrome is associated with what other type of cancer?
Risk factors for colon polyps developing into cancer?
What is the mgmt for hyper plastic polyps?
Sessile (wide base)
Size > 2.5cm
Hyperplastic = NOTHING!
Most common site of colon cancer mets?
What clinical picture suggests metastatic spread?
Person with long-standing Fe-def anemia and (+) hem occult test who has low grade RUQ pain and slightly elevated LFTs
Most common type of CNS tumor in children? Where are they located?
Both supratentorial and infratentorial
When is brain surgery for cancer indicated?
Solitary metastasis in areas with good performance status (grey-white jxn)
Radiation exposure and family hx of thyroid cancer are risk factors for the most common cause of thyroid cancer - what is it?
Cancer-related anorexia can be treated with what?
Progesterone analogs (megestrol acetate)
Smudge cells are characteristic of what?
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
Painless testicular mass with ultrasound findings suggestive of cancer - what is next best step?
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
Hard, non-tender, solitary lymph node in older male with smoking hx - what are you suspecting?
SCC (head/neck cancer)
Only vaccine known to reduce risk of developing cancer?
Hepatitis B vaccine
Reduced hepatocellular cancer
Person has unprovoked DVT - what must you consider?
*Look for wt loss
Detailed age-appropriate screening and CXR
This drug can cause peripheral neuropathy?
Most common source for brain metastasis?
Best choice of treatment for chemotherapy-induced N/V?
Mechanism of action?
Serotonin blockers (antagonist) (5HT3 receptors)
What has increased levels of myelocytes?
Tartrate-resistant acid phosphatase?
AML --> look for Auer rods
Hairy cell leukemia
What is characterized by increased size of liver/spleen/lymph nodes, fatigue, easy bruisability, headaches/dizziness, and pain/numbness in extremities?
*Fatigue = anemia
*Demyelinating sensorimotor neuropathy
IgM spike + hyperviscotity?
How do you differentiate seminoma vs nonseminomatous germ cell tumors?
Seminoma: NO aFP
Nonseminomatous: b-HCG + aFP
Solitary, painful lytic bone lesion with overlying swelling and hypercalcemia?
Langerhans cell histiocytosis
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?
*Smokeless tobacco + EtOH
Progresses to SCC in 10 yrs
Unique stain to hairy cell leukemia?
Tartrate-resistant acid phosphatase (TRAP) stain