Oncology Flashcards Preview

USMLE Step 3 > Oncology > Flashcards

Flashcards in Oncology Deck (48):
1

breast cancer screening with mammography begins at what age?

50

2

breast cancer screening with mammography is not routinely indicated at what age?

75

3

if a mammogram shows an abnormality, next step?

biopsy

4

what is the "sentinel node" in a sentinel node biopsy?

the FIRST node where the tracer goes

5

if sentinel node is FREE of cancer, then?

axillary node dissection is NOT necessary

6

if sentinel node HAS cancer, then?

axillary lymph node dissection

7

should BRCA genetic testing routinely be done?

NO

8

BRCA is associated with?

increased risk of familial breast cancer and ovarian cancer

9

best INITIAL treatment for breast cancer

lumpectomy WITH radiation

10

when should primary preventive treatment of breast cancer be given, at what age, and what should be given?

- multiple first-degree relatives with breast cancer
- age 40
- tamoxifen

11

treatment for estrogen receptor + or progesterone receptor + breast cancer

tamoxifen, or raloxifene

12

adverse effects of tamoxifen (3)

1. DVT
2. hot flashes
3. endometrial cancer

13

MOA of aromatase inhibitors (anastrozole, letrozole, exemestane)

pure estrogen antagonists

14

adverse effect of aromatase inhibitors (anastrozole, letrozole, exemestane)

osteoporosis

15

when should adjuvant chemotherapy be given in breast cancer?

- cancer in axilla
- cancer larger than 1cm
- patient is still menstruating

16

trastuzumab MOA

monoclonal Ab against HER-2/NEU

17

when do you use trastuzumab?

metastatic breast cancer

18

colon cancer treatment

surgical resection and 5-FU

19

colon cancer screening: routine

- colonoscopy starting at age 50
- every 10 years

20

colon cancer screening: single family member with colon cancer

- colonoscopy at age 40 or 10 years EARLIER than age at which family member was diagnosed
- every 10 years

21

colon cancer screening: HNPCC (3 family members, 2 generations, or one premature (less than 50 yoa))

- colonoscopy at age 25
- every 1-2 years

22

colon cancer screening: FAP

- sigmoidoscopy at age 12
- every 1-2 years

23

colon cancer screening: juvenile polyposis, Peutz-Jeghers, Turcot syndrome, Gardner syndrome

- no additional screening
- same as routine screening guidelines: start at age 50, every 10 years

24

which patients should be screened for lung cancer?

- more than 30 pack-years smoking history
- between ages 55-75
- chest CT scan at age 55

25

when and what is the treatment for lung cancer?

- if disease is LOCALIZED ENOUGH
- surgery

26

when is surgery not an option for lung cancer? (5 scenarios)

1. B/L disease
2. metastases
3. malignant pleural effusion
4. involvement of aorta, vena cava, or heart
5. lesions w/i 1-2cm of carina

27

is small-cell lung cancer resectable, and why?

NO, bc 1 of these features is present in more than 95% of cases

1. B/L disease
2. metastases
3. malignant pleural effusion
4. involvement of aorta, vena cava, or heart
5. lesions w/i 1-2cm of carina

28

is size alone a reason lung cancer is not resectable?

no, as long as it's peripheral, and without metastases

29

when do you start cervical cancer screening?

- age 21
- repeat every 3 years until age 29
- then do Pap WITH HPV every 5 years

30

abnormal Pap smear with low-grade or high-grade dysplasia; next step in management

COLPoscopy and biopsy

31

if Pap smear shows atypical squamous cells of undetermined significance (ASCUS); next step in management

test for HPV

32

if patient is HPV POSITIVE; next step in management

COLPoscopy, or repeat Pap in 6-12 months

33

when do you stop screening for cervical cancer?

greater than 65 yoa

34

should screening be performed for prostate cancer?

NO, not recommended

35

besides SPREAD OF DISEASE, most important PROGNOSTIC factor for prostate cancer

Gleason score

(higher score, more aggressive cancer)

36

LOCALIZED prostate cancer treatment

SURGERY, AND either external radiation, or implanted radioactive pellets

37

METASTATIC prostate cancer treatment

ANDROGEN blockade (flutamide), AND GnRH agonist (leuprolide, or goserelin)

38

- woman greater than 50 yoa
- increasing abdominal girth
- weight loss

ovarian cancer

39

marker of progression and response to therapy in ovarian cancer

CA-125 (carcinoma Ag)

40

treatment for ovarian cancer

surgical debulking, then chemotherapy

41

- man under 35 yoa
- painLESS scrotal lump

testicular cancer

42

diagnostic test for suspected testicular cancer

inguinal orchiectomy

(do NOT do a needle biopsy)

43

95% of all testicular cancers are

GERM CELL TUMORS (seminoma and nonseminoma)

44

AFP is secreted ONLY by this type of testicular cancer

NONSEMINOMA

45

what should be measured in testicular cancer?

- AFP
- LDH
- B-HCG

46

how do you stage testicular cancer?

CT scan of abd/pelvis

47

treatment for testicular cancer after orchiectomy: LOCAL disease

radiation

48

treatment for testicular cancer after orchiectomy: WIDESPREAD disease

chemotherapy