Oncology

Question 1

How is Breast CA usually found

Answer 1

ASx women on screening mamography

Palpation of mass by pt or doctor

Question 2

Features of Breast CA mass

Answer 2

Palpable
Hard
Possible retraction of nipple
Painless

Question 3

Best initial test for breast CA

Answer 3

Bx

Question 4

Best method to Bx breast CA

Answer 4

FNA

Question 5

What is the upside of doing core needle bx for breast CA

Answer 5

Can test for ER, PR, Her2/neu

Question 6

Most accurate dx test for breast CA

Answer 6

Open Bx

Question 7

When is mammography indicated

Answer 7

Screen for breast CA in gen pop starting at 50

Question 8

Why do mammography in pt who is already undergoing FNA for a mass

Answer 8

5-10% have b/l disease

Question 9

When to do U/S in breast CA

Answer 9

Clinically indeterminant mass

• Painful
• Varies in size and pain during menses

Question 10

When to do a PET in breast CA

Answer 10

Determine content of abnormal LNs not accessble to bx

Question 11

What is BRCA associated w/

Answer 11

Increased risk of breast CA in families

Ovarian CA

Question 12

Does BRCA testing aid in mortality reduction

Answer 12

No

Question 13

Who gets sentinel node bx

Answer 13

All pts at time of lumpectomy or mastectomy

Question 14

Why do sentinal node Bx

Answer 14

Neg eliminates need for axillary dissection

Question 15

Who gets ER, PR testing

Answer 15

All pts

Question 16

When is hormone manipulation therapy done in breast CA

Answer 16

When ER or PR is positive

Question 17

What is the role of localized radiation in breast CA

Answer 17

Prevent recurrence

Question 18

What do all ER or PR positive pts receive

Answer 18

Tamoxifen, raloxifene or an aromatase inhibitor

Question 19

Which hormonal manipulation drug is most likely to benefit a breast CA pt

Answer 19

Aromatase inhibitors

Question 20

Tamoxifen AE

Answer 20

Endometrial CA

Clots

Question 21

Aromatase inhibitor AE

Answer 21

Osteoporosis

Question 22

When is trastuzumab (herceptin) given

Answer 22

Her2/neu positive

Reduces risk of recurrent disease

Question 23

When is adjuvant therapy given

Answer 23

Lesions >1cm

Positive axillary LNs

Question 24

When is tamoxifen given as PPx

Answer 24

Multiple 1st degree relatives have breast CA

Question 25

What lowers mortality from breast CA

Answer 25

``` Mammography ER/PR testing then tamoxifen/raloxifene Aromatase inhibitors Adjuvant chemo Lumpectomy and radiation Modified radical mastectomy Trastuzumab PPx w/ tamoxifen/raloxifene ```

Question 26

Presentation of prostate CA

Answer 26

Obstructive sx | Palpable lesion

Question 27

Best initial test and most accurate test for prostate CA

Answer 27

Bx

Question 28

MC complications of prostatectomy

Answer 28

ED | Urinary incontinence

Question 29

What is gleason grading

Answer 29

Measure of aggressiveness or malignant potential

Question 30

What does a high gleason grade suggest

Answer 30

Greater benefit of surgical removal

Question 31

What is NOT beneficial in prostate CA

Answer 31

Screening Lumpectomy Chemo Hormonal manipulation

Question 32

Why is PSA controversial

Answer 32

No clear mortality benefit Not routinely offered NL does not exclude >75 never done

Question 33

If pt is

Answer 33

Do it

Question 34

Elevated PSA and palpable mass, next step

Answer 34

Bx

Question 35

Elevated PSA and no palpable mass, next step

Answer 35

Transrectal U/S

Question 36

Elevated PSA,no palpable mass, Transrectal U/S shows mass, next step

Answer 36

Bx

Question 37

Elevated PSA,no palpable mass, Transrectal U/S doesn't show mass, next step

Answer 37

Multiple blind bx

Question 38

When is surgery not possible in lung CA

Answer 38

B/L Malignant pleural effusion Heart, carina, aorta, vena cava involvement Small cell

Question 39

Is there a screening test for ovarian CA

Answer 39

No

Question 40

Presentation of ovarian CA

Answer 40

Woman > 50 | Increasing abdominal girth but still losing weight

Question 41

Best initial test for ovarian CA

Answer 41

U/S or CT

Question 42

Most accurate test for ovarian CA

Answer 42

Bx

Question 43

Rx ovarian CA

Answer 43

Remove large amounts of locally metastatic disease | Chemo

Question 44

What does testicular CA look like on PE

Answer 44

Painless lump | Doesn't transilluminate

Question 45

Who is at increased risk of testicular CA

Answer 45

Hx of cryptorchidism

Question 46

Dx testing in testicular CA

Answer 46

Remove whole testical w/ inguinal orchiectomy

Question 47

What secretes alpha fetoprotein

Answer 47

Nonseminomatous CAs

Question 48

All testicular CAs have elevated

Answer 48

HCG

Question 49

How is staging done in testicular CA

Answer 49

CT abd, pelvis, chest

Question 50

Rx testicular CA

Answer 50

Orchiectomy Radiation for local disease Chemo for widespread disease

Question 51

Management of cervical CA

Answer 51

Hysterectomy

Question 52

Who gets HPV vax

Answer 52

All women 11-26

Question 53

Who gets PAP

Answer 53

Women at age 21 then every 3yrs until 65

Question 54

Low grade or high grade dysplasia on PAP, next step

Answer 54

Colposcopy for bx

Question 55

ASCUS on PAP, next step

Answer 55

HPV testing

Question 56

ASCUS on PAP, HPV+, next step

Answer 56

Colposcopy

Question 57

ASCUS on PAP, HPV-, next step

Answer 57

Repeat PAP in 6 months