Oncology: General, Treatments, Head, GIT and Abdominal masses (E2) Flashcards Preview

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Flashcards in Oncology: General, Treatments, Head, GIT and Abdominal masses (E2) Deck (159)
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1

What are the 6 hallmarks of a cancer cell?

Self-sufficiency in growth signals 

Insensititvity to anti-growth signals

Tissue invasion and metastasis

Limitless replicative potential

Sustained angiogenesis

Evading apoptosis

2

What are a few causes of cancer?

Genes- DNA mutation

Diet- high fat, low fiber diets 

Exposure to carcinogens and mutagens 

Viruses

Age/alterations in immune system

3

What are the phases of multistep carcinogenesis? Which is rapid and which is slow? At what point do the changes stop being reversible?

Initiation- rapid, DNA damage but not enough to induce neoplastic trasformation 

Promotion- reversible changes 

Progression- slow and irreversible 

4

What are 3 important aspects of obtaining a comprehensive history of a patient with a tumor?

1. Doubling time (rapid vs slow growth)

2.  Extent of involvement (local vs systemic)

3. Co-morbidities (continuum of disease)

5

How do you definitively establish a tissue diagnosis?

Cytopatholoy 

6

From what 3 distinct cell types do most cancers come from?

Round cells

Mesenchymal cells

Epithelial cells 

7

What are the types of round cell tumors?

Plasmacytoma

Histocytoma

MCT

Lymphoma

TVT

+/- Melanoma 

(Please Help Me Learn This, Meow?)

8

Under a microscope, which tumor hass spindle-shaped, stellate or oval cells arranged in individually or in non-cohensive aggregates? What are some examples of these types of tumors?

Mesenchymal 

Sarcomas: OSA, Chondrosarcoma, Fibrosarcoma, HSA

9

Which tumor has the best diagnostic yield (i.e. exfoliates the best), which has the lowest yield?

Best: Round cell

Poorest: Mesenchymal

10

How do carcinomas look microscopically? What type of cell tumor are these?

Round, cuboidal, columnar or olygonal cells arranged in cohesive sheets or clusters

Epithelial cell tumors

11

What does anisokaryosis mean?

Variation in nuclear size (characterstic of malignancy) 

12

What does it mean that cytopatholgy has low sensitivity but high specificity?

Low sensitivity = false negatives likely 

High specificity = false positives unlikely 

13

With which neoplasm has needle tract implantation been reported?

Urogenital carcinomas 

14

What are the 2 clinical techniques for FNA? Which is better?

Needle off- coring: better- less blood contamination and better needle control

Needle on-suction 

15

What is the preferred technique for cytology slide preparation? When should you use the other technique?

Horizontal pull-apart 

Use vertical pull-apart with fragile cells (e.g. LNs)

16

What question does staging answer? What system is it based on? What does staging require?

Is the tumor localized, spread regionally or diffusely? 

WHO TNM (tumor, node, metastasis) system (0-IV)

Staging requires a series of generally non-invasive testing 

17

What is required to grade a tissue? What does it establish/determine?

A block of tissue (e.g. biopsy, FNA)

It establishes inherent aggressiveness and allows definitive prognostication 

Also inflences therapeutic recommendations

18

What do the stages T1-T4 indicate? What does the N stand for (in staging)? What does the M stand for?

The size and/or extent of the primary tumor

N= regional LNs

M= distant metastasis

19

T/F: If lymph nodes are normally sized (i.e. not enlaged), they are most likely not metastatic. 

False, never assume!

20

How large does a nodule have to be in order for it to be visible on an x-ray?

7-9mm

21

What do you call tumor associated alternations in bodily structure or function occuring distant to the tumor?

Paraneoplastic syndromes

22

What tumors commonly cause the PNS hypercalcemia?

Anal sac ACA

LSA

Multiple myeloma

Mammary tumor

23

What type of tumor commonly causes the PNS hypoglycemia?

Intestinal leiomyosarcoma

24

What tumor causes neurologic PNS? 

Thymoma

25

What is the cutaneous PNS that occurs with renal cyadenocarcinoma?

Nodular dermatofibrosis

26

What is the bone PNS caused by many primary lung tumors, esophageal tumors and metastatic tumors?

Hypertrophic osteopathy 

27

T/F: Conventional chemoterapy drugs target all rapidly dividing cells. 

True

28

What is adjuvant chemotherapy?

Chemo given as adjunct to local therapy (i.e. after sx)

29

Why is neoadjuvant chemo given?

To try to shrink the tumor prior to definitive treatment (i.e. sx)

30

What is it called when you are using chemo as the sole treatment for measurable disease?

Induction/maintenance chemotherapy