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STEP 3 COPY > oncology > Flashcards

oncology Flashcards

1
Q

What cancer screening test lowers mortality the most?

A

mammography above age 50 (until age 75)

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2
Q

What is the next best step in management for an abnormal mammogram?

A

sentinel node biopsy (detect cancer and assess for estrogen & progesterone receptors)

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3
Q

What is the next best step in management for a sentinel node biopsy that shows cancer?

A

axillary lymph node dissection

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4
Q

What two types of cancer are associated with BRCA gene?

A
  1. familial breast cancer

2. risk of ovarian cancer

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5
Q

What is the best initial therapy for breast cancer?

A

lumpectomy with radiation treatment

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6
Q

When is tamoxifen indicated for primary prevention of breast cancer?

A

pt that has 2 or more first degree relatives with breast cancer

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7
Q

What is the next best step in management of a breast cancer pt with estrogen and/or progresterone positive receptors after lumpectomy and radiation therapy?

A

tamoxifen

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8
Q

What is the next best step in management of a breast cancer pt with positive axillary nodes after lumpectomy and radiation therapy?

A

adjuvant chemotherapy

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9
Q

What are the three major side effects of tamoxifen treatment?

A
  1. deep venous thrombosis
  2. hot flashes
  3. endometrial cancer
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10
Q

What is the major side effect of aromatase inhibitors like anastrozole?

A

osteoporosis

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11
Q

When is adjuvant chemotherapy indicated in the treatment of breast cancer? (2)

A
  1. cancer in axilla
  2. cancer larger than 1 cm

(best in menstruating patient bc cant use estrogen antagonists)

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12
Q

What medication is a monoclonal antibody to HER-2/NEU and can be used in metastatic breast cancer?

A

trastuzumab

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13
Q

What is the best treatment for colon cancer?

A

surgical resection of colon with chemotherapy (5-fluorouracil if high risk stage 2-3)

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14
Q

What are the recommended routine screening guidelines for colon cancer?

A
  1. colonoscopy starting at age 50, every 10 years

2. fecal occult blood starting at age 50, yearly

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15
Q

What is the recommended colon cancer screening guidelines for a pt with a single family member with colon cancer?

A

colonoscop starting at age 40 or 10 years earlier than age at which family member was diagnose; every 10 years

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16
Q

What is the recommended colon cancer screening guidelines for a pt with family history of HNPCC (three family members affected over two generations with one being at diagnosed at less than 50 y/os)?

A

colonoscopy starting at age 25; every 1-2 years

17
Q

What is the recommended colon cancer screening guideline for pt with history of juvenile polyposis/ peutz-jeghers/ turcot’s syndrome/ gardner’s syndrome?

A

no additional screening

18
Q

What is the next best step in the management of a pt with a solitary lung nodule incidentally found on Chest X-ray or CT?

A

biopsy (if age > 50, smoker, nodule > 1cm, not calcified)

19
Q

What is the only indication for lung cancer screening and what diagnostic test is used?

A

all smokers with 30 pack years or more smoking history between ages 55-80; use chest CT

20
Q

What are the contraindications to surgical resection of lung cancer? (6)

A
  1. bilateral disease
  2. metastases
  3. malignant pleural effusion
  4. involvement of aorta/ vena cava/ heart
  5. lesions within 1-2 cm of carina
  6. small cell carcinoma (b/c usually has 1 of the above)
21
Q

What is the routine screening guideline for cervical cancer screening?

A

Pap smear starting at age 21 every 3 years until age 29; then can do Pap smear with HPV testing every 5 years until age 65

22
Q

What is the next best step in management of a pt with low grade/ high grade dysplasia on a Pap smear?

A

colposcopy and biopsy

23
Q

What is the next best step in management of a pt with atypical squamous cells of undetermined significance (ASCUS) on a Pap smear?

A

HPV testing

24
Q

What is the next best step in management of pt with positive HPV testing after discovering ASCUS on Pap smear?

A

colposcopy

25
Q

What is the next best step in management of pt with negative HPV testing after discovering ASCUS on Pap smear?

A

repeat Pap smear in 6-12 months

26
Q

Who should receive HPV quadrivalent vaccine (Gardisil) to prevent cervical caner?

A

all women age 13-26

27
Q

What is the next best step in management for a pt aged

A

perform PSA testing and digital rectal exam

do not routinely offer

28
Q

What is the most important prognostic factor for prostate cancer?

A

Gleason score (measures level of differentiation)

29
Q

What is the best treatment for localized prostate cancer?

A

surgical resection with external radiation/ implanted radioactive pellets

30
Q

What is the best treatment for metastatic prostate cancer?

A

flutamide (androgen blockade) with leuprolide/ goserelin (GnRH agonists)

31
Q

What is the next best step in management of a pt with cord compression secondary to metastatic prostate cancer after administering steroids?

A

flutamide (block temporary flare up in androgens that accompanies GnRH agonist) followed by GnRH agonist

32
Q

A female pt > 50 years old presents with increasing abdominal girth and weight loss most likely suffers from ….

A

ovarian cancer

33
Q

What test can be used as a marker for progression and response to therapy for ovarian cancer?

A

CA-125

34
Q

What is the best treatment for ovarian cancer?

A

surgical debulking followed by chemotherapy

35
Q

A male pt

A

testicular cancer

36
Q

What is the best way diagnosis testicular cancer?

A 
inguinal orchiectomy
(measuring AFP, LDH, beta-HCG can detect which type of testicular cancer is present)
37
Q

What diagnostic tool is used to stage testicular cancer?

A

CT scan of the abdomen and pelvis

38
Q

What is the treatment for local testicular cancer?

A

radiation

39
Q

What is the treatment for metastatic testicular cancer?

A

chemotherapy

STEP 3 COPY (19 decks)

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