Oncology

Question 1

Melanoma in situ margins

Answer 1

5 mm

Question 2

Melanoma depth of invasion < 1mm margins

Answer 2

1 cm

Question 3

Melanoma depth of invasion 1-2 mm margins

Answer 3

1-2 cm

Question 4

Melanoma depth of invasion > 2mm margins

Answer 4

2cm

Question 5

When do you need sentinel lymph node for melanoma?

Answer 5

Depth of invasion >0.8 mm

Question 6

What malignant colon polyps need oncologist resection?

Answer 6

< 2mm margins
Histologic features: + LVI, poor differentiation, tumor budding
Incomplete or piecemeal resection, or inability to assess margins
Sessile polyps with SM3 invasion or > 1 mm submucosal invasion
Haggit 4 lesions

Question 7

Components of the Nigra protocol

Answer 7

5-FU and mitomycin

30 Gy radiation over 3 weeks

Question 8

RET proto-oncogene

Answer 8

MEN2

Familial medullary thyroid cancer

Question 9

PPAR gamma/ PAX 8

Answer 9

Follicular thyroid cancer

Question 10

BRAF

Answer 10

Papillary thyroid cancer

Question 11

P53 tumor suppressor gene

Answer 11

Anaplastic thyroid cancer
Small cell lung cancer
Li-Fraumeni syndrome

Question 12

Li-Fraumeni syndrome

Answer 12

Childhood sarcomas
Breast cancer 
Leukemia 
Brain tumors
Adrenal tumors

Question 13

C-myc

Answer 13

Burkitt lymphoma

Question 14

N-myc

Answer 14

Neuroblastoma

Question 15

CDK/MC1R

Answer 15

Melanoma

Question 16

APC gene

Answer 16

FAP

Question 17

KRAS

Answer 17

Adenocarcinomas (lung, colon, pancreas)

Question 18

MSH1/MSH2

Answer 18

Lynch syndrome/HNPCC

Question 19

CDH1-cadherin 1

Answer 19

Hereditary gastric cancer

Invasive lobular breast cancer

Question 20

EML4-ALK tyrosine kinase

Answer 20

Non-small cell lung cancer

Question 21

BCR/ABL

Answer 21

CML

Question 22

Loss of WT1/WT2

Answer 22

Wilms tumor

Question 23

What chromosome is WT1/WT2 on?

Answer 23

Chromosome 11

Question 24

BRCA1

Answer 24

ovarian cancer, triple negative breast cancers

Question 25

What chromosome is BRCA1 on?

Answer 25

Chromosome 17

Question 26

BRCA2

Answer 26

Breast, ovarian, pancreas, prostate, melanoma, male breast cancer

Question 27

What chromosome is BRCA2 on?

Answer 27

Chromosome 13

Question 28

PTEN

Answer 28

Cowden syndrome

Question 29

Cowden syndrome

Answer 29

GI hamartomas, endothelial cancer, breast cancer, oral papillomas

Question 30

SMAD4, BMPR1A

Answer 30

Juvenile polyposis syndrome

Question 31

STK11

Answer 31

Peutz-Jeghers syndrome

Question 32

Treatment for stage I and II NSCLC

Answer 32

Lobectomy, mediastinal node dissection

Question 33

What NSCLC gets neoadjuvant chemotherapy?

Answer 33

Stage IIIa disease (any T4 tumor, T3 tumors with N1 nodes, any N2 tumor Stage IIIb usually does not undergo surgery

Question 34

Stage III NSCLC

Answer 34

Nodes in single digit stations

Question 35

Superior mediastinal nodes

Answer 35

1: highest mediastinal 2: upper paratracheal 3: pre-vascular and retrotracheal 4: lower paratracheal (including Azygos nodes)

Question 36

Aortic nodes

Answer 36

5: subaortic (A-P window 6: para-aortic (ascending aorta or phrenic)

Question 37

Inferior mediastinal nodes

Answer 37

7: subcarinal 8: paraesophageal (below carina) 9: pulmonary ligament

Question 38

N1 nodes

Answer 38

10: hilar 11: interlobar 12: lobar 13: segmental 14: subsegmental

Question 39

Stage I NSCLC treatment

Answer 39

Surgery

Question 40

Stage II NSCLC treatment

Answer 40

Surgery

Question 41

Stage IIIa NSCLC treatment

Answer 41

Chemotherapy followed by radiation or surgery

Question 42

Stage IIIb NSCLC treatment

Answer 42

Combination chemo and radiation

Question 43

Stage IV NSCLC treatment

Answer 43

Chemotherapy and/or palliative care

Question 44

Who gets surgery for small cell lung cancer?

Answer 44

Tumor <5cm No nodal metastasis No metastatic disease (Only T1-2N0M0)

Question 45

Ovarian type stoma indicates what type of pancreatic lesion?

Answer 45

Mucinous cystic neoplasm

Question 46

Fish mouth or patulous papilla?

Answer 46

Main duct IPMN

Question 47

T1a gastric cancer

Answer 47

Invades lamina propecia, muscularis mucosa

Question 48

T1b gastric cancer

Answer 48

Invades submucosa but not muscularis propria

Question 49

T2 gastric cancer

Answer 49

Invades muscularis propria

Question 50

T3 gastric cancer

Answer 50

Penetrates subserosal connective tissue without invasion of visceral peritoneum

Question 51

T4 gastric cancer

Answer 51

Invades visceral peritoneum (T4a) | Invades adjacent organ structures (T4b)

Question 52

N1 gastric cancer

Answer 52

1-2 nodes

Question 53

N2 gastric cancer

Answer 53

3-6 nodes

Question 54

N3 gastric cancer

Answer 54

7+ nodes

Question 55

Which patients with gastric cancer should undergo laparoscopy peritoneal washings, and cytology?

Answer 55

Clinical T3 or clinical N+

Question 56

Which patients with gastric cancer should undergo endoscopic resection?

Answer 56

Tis or T1a

Question 57

Procedure for a T1b-T3 adenocarcinoma of the body of the stomach?

Answer 57

Total gastrectomy and D2 lymphadenectomy (15 nodes) | RNY esophagojejunostomy

Question 58

Procedure for a T1b-T3 adenocarcinoma of the antrum of the stomach?

Answer 58

Subtotal gastrectomy and D2 lymphadenectomy (15 nodes) | Bilroth I or II reconstruction

Question 59

Procedure for a T1b-T3 adenocarcinoma of the cardia of the stomach

Answer 59

Depends of Siewart classification

Question 60

Siewart I

Answer 60

Tumor center located between 5 and 1 cm proximal to the anatomic cardia Approached as esophageal or EGJ cancer

Question 61

Siewart II

Answer 61

Tumor center located between 1cm proximal and 2cm distal to the anatomic cardia Approached as esophageal or EGJ cancer

Question 62

Siewart III

Answer 62

Tumor center located between 2 and 5 cm distal to the anatomic cardia Approached as gastric cancer

Question 63

cT4bN1M0 gastric cancer invading the spleen and diaphragm. What treatment should be offered?

Answer 63

Total gastrectomy, en bloc splenectomy and diaphragm resection, D2 lymphadenectomy (15 nodes)

Question 64

Who gets neoadjuvant ch6in gastric cancer?

Answer 64

Everyone | Can consider surgery first in cT2N0 tumors

Question 65

Neoadjuvant radiation for gastric cancer?

Answer 65

No, unless it is gastric cardia and being treated as esophageal

Question 66

Adjuvant radiation for gastric cancer?

Answer 66

For R1 resection

Question 67

Who gets adjuvant chemotherapy after R0 resection for gastric cancer?

Answer 67

T3 tumors | N+ disease

Question 68

Most common subtype of malignant melanoma

Answer 68

Superficial spreading