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Flashcards in Radiology Deck (44):
1

What is the most common type of renal carcinoma?

Clear cell variant

2

What is the MOA of cryoablation?

Freezing and thawing of tumor cells

3

True or false: you can monitor the ablation zone during a cryoablation procedure

True

4

What are the disadvantages of cryoablation?

cryoshock--systemic inflammatory response leading to hypotension, respiratory compromise, DIC, and multiorgan failure

5

What percent of all adult cancers are renal cell carcinomas?

2%

6

How is RCC usually found?

Incidentally in imaging

7

What is a stage 1A renal cell carcinoma?

Tumor

8

What are the advantages of cryoablation?

-Outpatient
-done without general anesthesia
-Preserves renal function
-Fewer complications

9

True or false: you can diagnose hepatocellular carcinoma with imaging only

True

10

What is the primary risk factor for the development of hepatocellular carcinoma in the world? US?

world = hep b
US = hep C

11

What alpha-1-antitrypsin disease?

protease malfunction causing liver and COPD

12

True or false: you need a cirrhotic liver to develop HCC

False

13

HCC mortality is (_)x greater in men with BMI

5x

14

What are the three main risk factors for the development of hepatocellular carcinoma?

HBV/HCV
Alcohol use
Obesity

15

Who has better 5 year survival rates: those who ablate the hepatocellular tumor, or those who get a liver transplant?

Liver transplant

16

What is transarterial chemoembolization?

Delivery of highly concentrated chemo in a lipid medium, combined with arterial embolization

17

What are the two blood supplies to the liver?

Hepatic artery
Hepatic portal vein

18

Why is the dual supply of blood to the liver important in chemoembolization?

allows to concentrate the chemo in the liver, and avoid high systemic doses (tumors usually get blood supply from the hepatic artery)

19

What is postembolization syndrome? What is the treatment?

N/v and abdominal pain following transarterial chemoembolization

Supportive

20

What is drug-eluting bead embolization?

300-700 micron beads loaded with chemotherapeutic drug, loaded into a specific tumor site

21

What is the most common drug used with drug-eluting bead embolization?

Doxorubicin

22

What is radiofrequency ablation?

Delivery of directed alternating current to create an ionic agitation, frictional heat, and cell death

23

What is microwave ablation?

Delivery of electromagnetic radiation causing agitation of the water molecules in the surrounding tissue, producing friction and heat

24

What is radioembolization?

Use of intra-arterially delivered microsphere emitting high dose radiation (Yttrium 90) for the treatment of unresectable liver tumors

25

What is radioembolization used for?

HCC and metastatic colorectal CA unresponsive to chemo

26

What is post-radioembolization syndrome?

mild pain and fatigue following radioembolization

27

What are the three most common cancers that cause malignant pleural effusions?

Lung
Breast
Ovarian

28

What is the prognosis fro pts with malignant pleural effusions?

4 months

29

What is a tunneled pleural catheter?

Tunneled, semi-permanent catheter placed in the pleural or peritoneal cavity, allowing the pt to perform home, or self drainage

30

What is the most common problem with a tunneled pleural catheter?

clogging/obstruction

31

About how many new cases of hepatocellular carcinomas are there per year? Deaths?

630,000 cases

600,000 deaths

32

What is the general trend of hepatocellular incidence?

Increasing

33

HCC incidence is increased how much in diabetics?

x2

34

What is the prevalence of NAFLD in western countries?

20-30% of adults

35

What is the survival rate of hepatocellular carcinoma?

36

Is transplant for HCC curative or non-curative?

Curative

37

Is transarterial therapy for HCC curative or non-curative?

Non Curative

38

Is surgical resection for HCC curative or non-curative?

Curative

39

Is percutaneous ablation for HCC curative or non-curative?

curative

40

Is systemic chemo for HCC curative or non-curative?

Non-curative

41

What is the best procedure for HCC? What percent of pts are eligible for this?

surgical resection

10-15%

42

Why are we able to target hepatomas so well?

Draw blood supply almost exclusively off of the hepatic artery

43

What percent of the liver's blood supply comes from the hepatic artery?

25%

44

What percent of the liver's blood supply comes from the portal vein?

75%