Oncology Flashcards Preview

Internal Medicine Mnemonics > Oncology > Flashcards

Flashcards in Oncology Deck (188):
1

Alkylating Agent: Cyclophaphamide

Alopecia, bone marrow toxicity, gonadal failure;

2

Alkylating Agent: Cisplatin

Ototoxicity, nephrotoxicity, neuropathy -> give amifostine (antidote)

3

Alkylating Agent: Busulfan

Pulmonary fibrosis

4

Alkylating Agent: Nitrosureas

Neurotoxicity

5

Alkylating Agent: Oxaliplatin

Neurotoxicity

6

Alkylating Agent: Procarbazine

Disulfiram-like reaction

7

Antitumor Antibiotic: Bleomycin

Pulmonary fibrosis

8

Antitumor Antibiotic: Dactinomycin/Actinomycin D

Myelosuppresion

9

Antitumor Antibiotic: Doxorubicin/Adriamycin

Cardiotoxicity -> give dexrazoxane (antidote)

10

Antimetabolite: Methotrexate

Inhibits dihydrofolate reductase

11

Antimetabolite: 5-FU

Inhibits thymidylate synthase

12

Antimetabolite: Azathioprine and 6-Mercaptopurine

Purine analogue

13

Antimetabolite: Cytarabine

Pyrimidine analogue

14

Antimetabolite: Hydroxyurea

Inhibits ribonucleotide reductase

15

Microtubule Inhibitor: Taxanes

Hyperstabilize polymerized microtubules preventing their breakdown during anaphase

16

Microtubule Inhibitor: Vinblastine and Vincristine

Attach to B tubulin and inhibit polymerization

17

Topoisomerase Inhibitor: Etoposide, Teniposide

Inhibit topoisomerase II

18

Topoisomerase Inhibitor: Ironotecan, Topotecan

Inhibit topoisomerase I

19

Hypercalcemia

PTHrP: squamous cell carcinoma (lung, head & neck, skin, breast, GU, GI)

20

SIADH

Small cell carcinoma of the lung, carcinoid tumors, GI, GU, ovarian cancer

21

Cushing's syndrome

Ectopic ACTH: small cell lung cancer, carcinoid, pancreatic islet cell tumors

22

Hypoglycemia from IGF-2 excess

Mesenchymal tumors, hepatocellular and adrenal carcinomas

23

Erythrocytosis

Renal and hepatocellular cancer, cerebellar hemangioblastomas

24

Trousseau's Sndrome (migratory thrombophlebitis)

Pancreatic cancer

25

Myasthenia gravis, pure red cell aplasia

Thymoma

26

Lambert-Eaton myasthenic syndrome (LEMS)

Small cell carcinoma of the lung

27

Xeroderma pigmentosa

Lack of an endonuclease for thymidine dimer repair -> increased susceptibility to skin cancers of all types

28

Basal cell carcinomas

One or few small waxy, semitranslucent nodules forming around a central depression that may be ulcerated, crusted or bleeding, edge is rolled or pearly with rodent ulcer, rare metastasizes

29

Face/head and neck area

Most common site of basal cell carcinoma

30

Classical or nodular type

Most common type of basal cell carcinoma

31

Squamous cell carcinoma

Dome-shaped, elevated, hard infiltrating lesion (deeply nodular), may eventually develop an ulcer, occurs on sun-exposed areas

32

Bowen's disease

In situ form of squamous cell carcinoma

33

Chronic long term sun exposure

Major risk factor for squamous cell carcinoma of the skin

34

Actinic keratosis

Known precursor lesion of squamous cell carcinoma of the skin

35

Superficial spreading

Most common type of melanoma

36

Asymmetry

Characteristics of a malignant lesion melanoma (versus benign nevus

37

Depth of invasion (Breslow thickness)

Single greatest determinant of metastasis of melanoma

38

Personal history of melanoma

Single greatest risk factor for melanoma

39

Acral-lentiginous melanoma

Most common type of melanoma in dark-skinned individuals and Asians

40

Regional lymph node metastasis

Single most important prognostic factor for melanoma

41

Early excision

Most important determinant of outcome in melanoma

42

Wheal

Primary lesion erythematous edematous evanescent rash

43

Lichenification

Thickening of skin with accentuation of skin fold markings

44

Erosion

Loss of epidermis without loss of dermis

45

Ulcer

Loss of both epidermis and dermis

46

Lungs

Most common site of metastasis of soft tissue sarcomas

47

Chemotherapy

Mainstay of the treatment for Ewing's sarcoma, PNET, and rhabdomyosarcoma

48

Plasma cell tumors

Most common malignant tumor of bone

49

Osteosarcoma

Account for majority of bone sarcomas, predominant in young males, usually occurring on the metaphysis of long bones, distal femur, proximal tibia, and humerus

50

Moth-eaten appearance

Radiographic hallmarks of osteosarcoma

51

Response to chemotherapy

Most important prognostic factor for long-term survival in osteosarcoma

52

Vertebrae

Site most commonly involved in bone metastasis

53

Urinary bladder

Most common site of malignancy in the urinary tract

54

Urinary bladder

Most common source of gross hematuria

55

Painless hematuria

Most common presentation of bladder, renal pelvis, and ureteric cancer

56

BCG

Vaccine component used as intravesicular therapy in bladder cancer

57

Smoking

Most common environmental risk factor for bladder and renal cell carcinoma

58

Clear cell carcinoma

Most common hisopathologic type of renal carcinoma

59

Hematuria

Classic triad of renal cell carcinoma

60

Peripheral zone

Site where most prostate cancers develop

61

5-alpha reductase inhibitors (finasteride/dutasteride)

Predominant therapy to reduce future risk of prostate cancer

62

Free PSA <10%, PSA density >0.15ng/ml/cm^3

PSA levels suggestive of cancer requiring biopsy

63

Transrectal ultrasound-guided needle biopsy

Test to establish prostate cancer diagnosis

64

Gleason scoring

Scoring used to measure histologic aggressiveness of the dominant and secondary glandular histology of prostate cancers

65

Pancreatic head

Most common location of pancreatic cancer

66

Smoking

Most common environmental risk factor for pancreatic cancer

67

Hepatomegaly

Most common physical sign in hepatocellular carcinoma (HCC)

68

Non-cirrhotic or Child-Pugh A cirrhosis

Candidates for resection in HCC

69

Single lesion <=5cm or <=3 nodules each <=3cm, no gross vascular invasion

Criteria for orthotopic liver transplant (Milan criteria)

70

Fibrolamellar HCC

Variant of HCC associated with younger females, elevated blood neurotensin levels, no cirrhosis

71

Hemangioma

Most common benign liver tumor among women

72

Adenoma

Benign liver mass associated with contraceptive use, with low potential for malignant change and risk of bleeding

73

Focal nodular hyperplasia

Benign liver mass with characteristic central scar, hypovascular on arterial phase and hypervascular on delayed phase CT

74

Triphasic CT scan

Most useful diagnostic tool in differentiating between benign and malignant liver masses

75

Cholangiocarcinoma

Mucin-producing adenocarcinomas that arise from the bile ducts, majority of which are located in the hilar or central area

76

Klatskin tumors

Nodular tumors arising at the bifurcation of the common bile duct

77

Ampullary carcinoma

Adenocarcinoma arising within 2 cm of the distal end of the common bile duct

78

Courvoisier's sign

Palpable gallbladder associated with obstructive biliary malignancy

79

Pylorus preserving pancreaticoduodenectomy (modified Whipple's procedure)

Standard surgical procedure for pancreatic head and uncinate tumors

80

Villous sessile adenomatous polyps, >2.5 cm in size

Characteristics of colonic polyps most associated with malignancy

81

FAP (familiar adenomatous polyposis)

Familial autosomal dominant condition with multiple polyps (polyposis coli)

82

Gardner's syndrome

Multiple polyps in the small and large intestines with osteomas, fibromas, and congential hypertrophy of the retinal pigment epithelium

83

Turcot's syndrome

Multiple polyps in the large intestine with brain tumors

84

Peutz-Jeghers syndrome

Multiple small and large intestinal polyps (hamartomatous/juvenile), mucocutaneous pigmentation, tumors of the ovary, breast and pancreas

85

Hereditary nonpolyposis colon cancer (Lynch syndrome)

Hereditary autosomal dominant predisposition to colon, ovarian and endometrial cancers caused by defects in DNA mismatch repair

86

Aspirin and NSAIDs

Most effective class of agents to reduce the risk of colon adenomas and carcinomas

87

Right-sided colon cancers

Usually non-obstructive, discovered late, with iron-deficiency anemia

88

Left-sided colon cancers

Usually with obstructive symptoms and apple-core or napkin ring deformity on barium studies

89

Rectosigmoid cancers

Hematochezia, tenesmus, narrowing of stool caliber

90

Within the first 4 years

Period of time when most recurrencies after surgical resection of large bowel cancer occur

91

Minimum of 12 lymph nodes

Number of sampled lymph nodes necessary to accurately define tumor stage during surgery

92

Liver

Most frequent visceral site of metastasis for colon cancer

93

5-fluorouracil (5-FU)

Backbone chemotherapeutic agent for colon cancer and acts as a radiosensitizer for treatment of rectal cancer

94

Diarrhea

Major side effect of irinotecan used in FOLFIRI regiman for colon cancer

95

Dose-dependent sensory neuropathy

Common side effect of oxaliplatin used in FOLFOX regimen for colon cancer

96

Squamous cell carcinoma

Esophageal cancer related to smoking and alcohol, arising in the middle 1/3

97

Adenocarcinoma

Esophageal cancer related to acid reflux and Barrett's esophagus arising in the distal 1/3

98

Progressive dysphagia and weight loss

Initial symptoms of esophageal cancer in majority of patients

99

>60% of esophageal circumference is infiltrated

Threshold of dysphagia

100

Diffuse type

Type of gastric carcinoma with loss of cell cohesion developing throughout the stomach resulting to loss of distensibility (linitis plastica or leather bottle appearance)

101

Intestinal type

Type of gastric carcinoma frequently ulcerative and involving the antrum and lesser curvature, often initiated by H. pylori

102

Low socio-economic class, H. pylori infection, ingestion of high concentrations of nitrates in preserved foods, Menetrier's disease (hypertrophy of rugal folds), blood group A

Implicated risk factors for gastric cancer

103

Krukenberg tumor

Gastric cancer metastatic to the ovar

104

Sister Mary Joseph nodes

Gastric cancer metastatic to the periumbilical region

105

Blumer's nodes

Gastric cancer metastatic to the peritoneal cul-de-sac

106

Virchow's nodes

Gastric cancer metastatic to the supraclavicular lymph nodes

107

Liver

Most common site for hematogenous spread of gastric cancer

108

Complete surgical removal of the tumor with resection of adjacent lymph nodes

Only chance of cure for gastric cancer

109

Stomach

Most frequent site of extra-nodal lymphoma

110

Eradication of H. pylori

Primary treatment of gastric lymphoma

111

Age of menarche

Three dates in a woman's life with major impact on breast cancer risk

112

Days 5-7 of the menstrual cycle

Best time for breast examination

113

Tumor stage

Most important prognostic variable in breast cancer

114

Selective estrogen receptor modulators (SERM)

Hormonal treatment for breast cancer which increases the risk of endometrial cancer

115

Oral contraceptive pills

Treatment that increases breast cancer risk but decreases ovarian and endometrial cancer risk

116

Trastuzumab

Monoclonal antibody directed against the erb/her2-neu receptor used for breast cancers

117

Lobular neoplasia

Premalignant lsion that suggests elevated risk of breast cancer

118

Smoking

Primary cause of lung cancer worldwide

119

Small cell and squamous cell lung cancer

Types of lung cancer implicated with smoking which tend to present centrally

120

Adenocarcinoma of the lung

Most prevalent type of lung cancer among women, young adults and non-smokers presenting peripherally

121

Bronchioalveolar carcinoma

Subtype of lung adenocarcinoma that grows along the alveoli without invasion (lepidic growth), may present with classic ground glass appearance on CT

122

Pancoast syndrome or superior sulcus tumor

Results from local extension of tumor growing in the apex involving C8 and TI-T2 nerve roots with shoulder pain radiating to the ulnar distribution and Horner's syndrome

123

Hypercalcemia from extopic PTH/PTH-related protein production

Most common life-threatening metabolic complication of malignancy associated with squamous cell cancer of the lung

124

SIADH, Cushing's Syndrome, Lambert Eaton Syndrome

Paraneoplastic syndromes associated with small cell lung cancer

125

Chemotherapy

Treatment of choice for small cell lung cancer

126

Surgical resection

Treatment of choice for early (stage 1 or 2) non-small cell lung cancer

127

Lungs

Location of majority of hamartomas

128

Alyklating agents and benzene

AML

129

Aromatic dyes and Schistosoma hematobium

Bladder cancer

130

Asbestos, arsenic

Lung cancer, mesothelioma

131

Epstein-Barr virus

Burkitt's lymphoma, nasopharyngeal cancer

132

Diethylstilbestrol (DES)

Vaginal clear cell cancer (in daughters exposed to it during fetal development)

133

HIV

Lymphoma, Kaposi's sarcoma (HHV-8 Virus)

134

Human Papilloma Virus (HPV)

Cervical cancer, head and neck cancer

135

HTLV-1

Adult T-cell leukemia

136

UV radiation (sunlight)

Skin

137

Vinyl chloride

Liver angiosarcoma

138

Smoking

Bladder, lung, esophageal, kidney, head and neck and pancreatic cancers

139

H. pylori

Gastric adenocarcinoma and MALT lymphoma

140

HBV, HCV, aflatoxin-1, ethanol

Hepatocellular carcinoma

141

APC

Colon cancer (FAP)

142

BRCA1, BRCA2

Breast and ovarian cancer

143

DCC

Colon cancer

144

MEN1

MEN 1

145

NF1, NF2

Neurofibromatosis 1 and 2

146

p53 (guardian of the genome)

Li-Fraumeni Syndrome

147

Rb

Retinoblastoma, osteosarcoma

148

VHL

Von Hippel Lindau Syndrome

149

WT1, WT2

Wilm's Tumor

150

BRAF

Melanoma, lung, colorectal cancer

151

BCR-ABL

CML, ALL

152

BCL-2

Follicular lymphoma

153

C-myc

Burkitt's lymphoma

154

L-myc

Lung and bladder cancer

155

N-myc

Neuroblastoma, lung cancer

156

RAS

Colon, lung, pancreatic cancer

157

RET

Multiple endocrine neoplasia (MEN) 2A and 2B

158

hCG (human chorionic gonadotropin)

Trophoblastic disease, gonadal germ cell tumor, choriocarcinoma

159

Calcitonin

Medullary thyroid cancer

160

Catecholamines

Pheochromocytoma

161

AFP (alpha fetoprotein)

Hepatocellular, gonadadal germ cell tumor, yolk sac or endodermal sinus tumor

162

CEA (carcinoembryonic antigen)

Colon, pancreatic, breast, lung and ovarian cancer

163

Prostatic acid phosphatase, prostate specific antigen (PSA)

Prostate cancer

164

Neuron-specific enolase

Small cell lung cancer, neuroblastoma

165

Lactate dehydrogenase (LDH)

Lymphoma, Ewing's sarcoma, dysgerminoma

166

Monoclonal immunoglobulins

Myeloma

167

CA-125

Ovarian cancer, lymphoma

168

CA 19-9

Colon, pancreatic, and breast cancer

169

S-100

Cancers of neural crest origin (melanomas, schwannomas, Langerhans cell histiocytosis)

170

Sigmoidoscopy

Adults >=50 years old; screen every 5 years

171

FOBT (fecal occult blood testing)

Adults >=50 years old; screen every year

172

Colonoscopy

Adults >=50 years old; screen every 10 years

173

Pap smear

Begin 3 years after first intercourse or by age 21

174

Mammography

Women >=40 years old: screen annually (ACS)

175

DRE and PSA

Men >=50 years old: screen annually

176

Age

Most significant risk factor for cancer overall

177

Lung cancer

Most common cancer worldwide

178

Breast cancer

Second most common cancer worldwide

179

Lung cancer

Most common cause of cancer death

180

Tumor suppressor genes

Genes involved in restraining cell growth and requiring both alleles to be mutated for tumorigenesis

181

Oncogenes

Genes involved in cellular growth wherein mutation of one allele may lead to tumorigenesis

182

Surgery

Most effective means of treating cancer

183

Teletherapy

Delivery of radiation therapy from a distance

184

Brachytherapy

Encapsulated sealed sources of radiation implanted directly or adjacent to tumor

185

Systemic radiation therapy

Radionuclides targeted to the site of the tumor

186

Alcohol and smoking

Most significant risk factor for head and neck cancer

187

Chemoradiotherapy

Most commonly used treatment for head and neck cancers

188

Serotonin receptor antagonists (i.e. ondansetron)

Most effective drugs against highly emetogenic agents