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456 Cards in this Set

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Q001. Down syndrome is associated with:
A001. ALL
Q002. Xeroderma pigmentosum, albinism is associated with:
A002. Melanoma and basal; squamous cell carcinoma
Q003. chronic atrophic gastritis, pernicious anemia, postsrurg gastric remnants is associated with:
A003. gastric adenocarcinoma
Q004. tuberous sclerosis (facial angiofibroma, seizures, MR) is associated with:
A004. astrocytoma; cardiac rhabdomyoma
Q005. Actinic keratosis is associated with:
A005. Squamous cell carcinoma
Q006. barretts esophagus is associated with:
A006. esophageal adenocarcinoma
Q007. Plummer Vinson sydrome (atrophic glossitis, esophageal webs, anemia, all due to Fe def) is associated with:
A007. squamous cell carcinoma of esophagus
Q008. cirrhosis (alcoholic, hep B or C) is associated with:
A008. hepatocellular carcinoma
Q009. ulcerative colitis (Crohns) is associated with:
A009. colonic adenocarcinoma
Q010. Pagets disease of bone is associated with:
A010. secondary osteosarcoma, fibrosarcoma
Q011. Immunodef states is associated with:
A011. malignant lymphomas
Q012. AIDS is associated with:
A012. aggressive malignant lyphomas (NHL) and Kaposis
Q013. AI disease (Hashimotos, MG) is associated with:
A013. benign and malignant thymomas
Q014. Acanthosis nigricans (hyperpigmentation and epidermal thickening) is associated with:
A014. visceral malignancy
Q015. dysplastic nevus is associated with:
A015. malignant melanoma
Q016. achalasia is associated with:
A016. squamous esophageal carcinoma
Q017. sjogrens is associated with:
A017. B cell lymphoma
Q018. abl gene is associated with:
A018. CML
Q019. c-myc gene is associated with:
A019. Burkitts lymphoma
Q020. bcl-2 is associated with:
A020. follicular and undifferentiated lymphoma
Q021. erb-B2 is associated with:
A021. breast, ovarian, gastric carcinoma
Q022. ras is associated with:
A022. colon carcinoma
Q023. L-myc is associated with:
A023. lung tumor
Q024. N-myc is associated with:
A024. neuroblastoma
Q025. ret is associated with:
A025. MEN II and III
Q026. Rb is associated with:
A026. retinoblastoma, osteosarcoma
Q027. BRCA 1 and 2 is associated with:
A027. breast and ovarian cancer
Q028. p53 is associated with:
A028. most human cancers, Li Fraumeni syndrome
Q029. p16 is associated with:
A029. melanoma
Q030. APC is associated with:
A030. colorectal cancer
Q031. WT1 is associated with:
A031. wilms tumor
Q032. NF1 is associated with:
A032. neurofibromatosis 1
Q033. NF2 is associated with:
A033. neurofibromatosis 2
Q034. DPC is associated with:
A034. pancreatic cancer
Q035. DCC is associated with:
A035. colon cancer
Q036. PSA is the blood marker of:
A036. prostate cancer; used for screening but increased with any prostate pathology
Q037. CEA is the blood marker of:
A037. carcinoembryonic antigen- colorectal, pancreatic, gastric, breast
Q038. AFP is the blood marker of:
A038. hepatocellular carcinoma, yolk sac tumor (germ cell tumor of testis)
Q039. B HCG is the blood marker of:
A039. hydatiform moles,; choriocarcinoma,; gestational trophoblastic tumor
Q040. CA-125 is the blood marker of:
A040. ovarian, malignant epithelial tumors
Q041. S-100 is the blood marker of:
A041. melanoma,; neural tumors,; astrocytomas
Q042. Alk phos is the blood marker of:
A042. metastasis to bone,; obstructive biliary disease,; Pagets
Q043. bombesin is the blood marker of:
A043. neuroblastoma,; lung and gastric cancer
Q044. TRAP is the blood marker of:
A044. hairy cell leukemia
Q045. CA-19-9 is the blood marker of:
A045. pancreatic adenocarcinoma
Q046. MTX mechanism
A046. folic acid analog that inhibits dihydrofolate reductase, resulting in decreased DNA and protein synthesis
Q047. clinical use MTX
A047. leukemias,; lymphomas,; choriocarcinoma,; sarcomas,; abortions, ectopic pregnancy,; RA,; psoriasis
Q048. MTX tox
A048. myelosuppression reversible with leucovorin (folinic acid),; macrovesicular fatty change in liver,; neural tube defects,; lung problems
Q049. 5FU mechanism
A049. pyrimidine analog inhibits thymidylate synthase
Q050. 5FU use
A050. colon cancer and other solid tumors,; basal cell carcinoma,; synergy with MTX (actinic keratoses); similar to flucytosine
Q051. 5FU tox
A051. myelosuppression which is not reversible with leucovorin, photosensitivity;; rescue with thymidine
Q052. 6MP mechanism
A052. blocks de novo purine synthesis by inhibiting PRPP synthetase,; activated by HGPRTase
Q053. 6MP use
A053. leukemias,; lymphomas
Q054. 6MP toxicity
A054. bone marrow, GI, liver; metabolized by xanthine ox so increased tox with allopurinol
Q055. ara-C
A055. inhibits DNA polymerase (just like acyclovir, foscarnet, and rifampin); used in AML; toxicity: leukopenia, TCP, megalo anemia
Q056. cyclophosphamide, ifosfamide
A056. alkylating agent- x link interstrand DNA, requires bioactivation by liver; used for NHL, breast/ovarian carcinoma, immunosupressant; toxicity: myelosuppression, hemorrhagic cystitis
Q057. nitrosureas
A057. "Mustines"; alkylate DNA, require bioactivation; cross BBB - use for brain cancers; toxicity: CNS problems
Q058. cisplatin, carboplatin
A058. alkylating agent; used for testicular, bladder, ovary and lung cancer; toxicity: nephrotoxic and acoustic nerve damage
Q059. busulfan
A059. alkylates DNA, used in CML, toxicity: pulm fibrosis, hyperpigmentation
Q060. doxorubicin, daunorubicin mechanism
A060. generate free radicals and noncovalent intercalate DNA (creating breaks in DNA); used for hodkins, myelomas, sarcomas, and solid tumors
Q061. doxorubin and daunorubicin toxicity
A061. cardiotoxicity
Q062. dactinomycin
A062. intercalates DNA; use: Wilms tumor, Ewings sarcoma, rhabdomyosarcoma; toxicity: myelosuppression
Q063. bleomycin
A063. induces formation of free radicals which cause breaks in DNA strands; used for testicular cancer, lymphomas; toxicity: pulmonary fibrosis, skin changes
Q064. etoposide
A064. inhibits topoisomerase II and increases DNA degradation; used in small cell carcinoma of lung, prostate and testicular carcinoma
Q065. prednisone tox
A065. Cushing like symtoms, immunosuppression, cataracts, acne, osteoporosis, hypertension, peptic ulcers, hyperglycemia, psychosis
Q066. predisone use
A066. CLL, Hodgkins lymphoma, AI disease
Q067. tamoxifen, raloxifene
A067. receptor antagonists in breast, agonists in bone; block binding of estrogen to estrogen receptor positive cells; use: breast cancer
Q068. SERM toxicity
A068. may increase risk of endomitrial carcinoma, hot flashes; raloxifene will not cause endomitral carcinoma because it is an antagonist at the uterus; can be used in breast cancer prevention
Q069. trastuzumab
A069. helps kill breast cancer cells that overexpress HER2, cardiotoxic
Q070. Imatinib
A070. philadelphia chromosome brc-abl tyrosine kinase inhibitor; CML, GI stromal tumors
Q071. paclitaxel, taxols
A071. bind to tubulin and hyperstabilize polymerized microtubules so that mitotic spindle cannot break down; used in ovarian and breast carcinoma
Q072. vincristine, vinblastine
A072. bind to tubulin and block polymerization of MT so that mitotic spindle cannot form; used for lymphoma, Wilms, choriocarcinoma; vincristine- neurotox, paralytic ileus; vinblastine- blasts bone marrow (suppression)
Q073. What age patients most commonly get ALL
A073. Children. Peak age is 3-5 year olds.
Q074. Trigger words for ALL
A074. Pancytopenia (bleeding, fever, anemia),; radiation therapy,; Down syndrome
Q075. What age patients usually get AML?
A075. >30 year olds
Q076. Trigger words for AML
A076. Pancytopenia (bleeding, fever, anemia),; Auer rods,; DIC
Q077. What age patients usually get CML?
A077. 30-50 year olds
Q078. Trigger words for CML?
A078. White blood cell count >50,000,; Philadelphia chromosome,; blast crisis,; splenomegaly.
Q079. What age patient usually get CLL?
A079. >50 year olds
Q080. Trigger words for CLL?
A080. Male sex,; lymphadenopathy,; lymphocytosis,; infections,; smudge cells,; splenomegaly
Q081. What age patient usually get hairy cell leukemia?
A081. Adults
Q082. Trigger words for Hairy cell leukemia?
A082. Hair-like projections, splenomegaly
Q083. What age patients usually get Mycosis fungoides/Sezary syndrome?
A083. >50 year olds
Q084. Trigger words for mycosis fungoides/Sezary syndrome
A084. plaque-like, itchy skin rash that does not improve with treatment,; blood smear (cerebriform nuclei known as "butt cells"),; Pautrier's abscesses in epidermis.
Q085. What are "butt cells"
A085. cells with cerebriform nuclei found in mycosis fungoides/Sezary syndrome
Q086. Define Pautrier's abscesses
A086. Microabscesses found in the epidermis in patients with mycosis fungoides/Sezary syndrome.
Q087. What age patients usually get Burkitt's lymphoma?
A087. Children
Q088. What virus is associated with Burkitt's lymphoma?
A088. Epstein-Barr virus (in Africa)
Q089. What age patients usually get CNS B cell lymphoma?
A089. Adults
Q090. Trigger words for CNS B cell lymphoma
A090. HIV positive patients, AIDS
Q091. What age patients usually get Hodgkin's disease?
A091. 15-34 year olds
Q092. Trigger words for Hodgkin's disease?
A092. Reed-Sternberg cells, cervical lymphadenopathy, night sweats
Q093. What age patients usually get T cell leukemia?
A093. Adults
Q094. What virus causes T cell leukemia?
A094. HTLV-1
Q095. Which type of non-Hodgkin's lymphoma has best prognosis?
A095. Small follicular type
Q096. What type of non-Hodgkin's lymphoma has worst prognosis?
A096. large diffuse type
Q097. What percent of non-Hodgkin's lymphoma is found in GI tract?
A097. 0.2
Q098. What age patients usually get myelodyplasia/myelofibrosis?
A098. >50 year olds
Q099. trigger words for myelodysplasia/myelofibrosis?
A099. Anemia,; teardrop cells,; "dry tap" on bone marrow biopsy,; high MCV and RDW,; associated with CML
Q100. What leukemia is associated with myelofibrosis/myelodysplasia?
A100. CML
Q101. What age patients usually get multiple myeloma?
A101. >40 year olds
Q102. Trigger words for multiple myeloma
A102. Bence-Jones proteins,; osteolytic lesions,; high calcium
Q103. What type of antibodies are Bence-Jones proteins?
A103. 50% are IgG, 25% are IgA
Q104. What age patients usually get Waldenstrom's macroglobulinemia?
A104. > 40 year olds
Q105. Trigger words for Waldenstrom's macroglobulinemia
A105. hyperviscosity,; IgM spike,; cold agglutinins,; Raynaud's phenomenon with cold
Q106. Which cancer is associated with Down Syndrome?
A106. ALL
Q107. What age patients usually get Polycythemia rubra vera?
A107. >40 year olds
Q108. Trigger words for polycythemia rubra vera
A108. high hematocrit,; pruritus (esp after shower)
Q109. Treatment for polycythemia rubra vera
A109. phlebotomy
Q110. What age patients usually get primary thrombocythemia?
A110. >50 year olds
Q111. what is the platelet count usually in primary thrombocythemia?
A111. >1,000,000
Q112. Si/Sx of primary thrombocythemia
A112. may have bleeding or thrombosis
Q113. Which blood dyscrasia is assoc with cold agglutinins?
A113. Waldenstrom's macroglobulinemia
Q114. What are the three cancers with the highest incidence in men? (list in order)
A114. 1. Prostate; 2. Lung; 3. Colon
Q115. What are the three cancers with the highest incidence in women? (list in order)
A115. 1. Breast; 2. Lung; 3. Colon
Q116. What are the three cancers with the highest mortality in men? (list in order)
A116. 1. Lung; 2. Prostate; 3. Colon
Q117. What are the three cancers with the highest mortality in women? (list in order)
A117. 1. Lung; 2. Breast; 3. Colon
Q118. What are the most common types of cancer in children and young adults (<30 years)?
A118. Leukemia and Lymphoma
Q119. What is the major risk factor for cancer?
A119. Age (incidence roughly doubles every 5 years after 25 years of age)
Q120. What is the major modifiable risk factor for cancer?
A120. Smoking
Q121. What is the most common cancer in most organs?
A121. Metastatic cancer
Q122. Metastatic cancer to the spine can cause spinal cord compression. How do you recognize and treat this medical emergency?
A122. Spinal cord compression causes local spinal pain and neuro si/sx (reflex changes, weakness, sensory loss, paralysis). It's rarely the first sign of malignancy. First step--start high dose corticosteroids, then order an MRI. Next, treat with radiation. Surgical decompression is used if radiation doesn't help or if the tumor is known to not be radiosensitive. Prompt intervention is essential. Outcome is closely related to pretreatment function.
Q123. Mode of inheritance of retinoblastoma?
A123. Autosomal dominant
Q124. Mode of inheritance of MEN syndromes?
A124. Autosomal dominant
Q125. Mode of inheritance of Familial polyposis coli?
A125. Autosomal dominant
Q126. Mode of inheritance of Gardner's syndrome
A126. Autosomal dominant
Q127. Mode of inheritance of Turcot's syndrome
A127. Autosomal dominant
Q128. Mode of inheritance of Peutz-Jegher's syndrome?
A128. Autosomal dominant
Q129. What is the mode of inheritance of Neurofibromatosis type 1?
A129. Autosomal dominant
Q130. What is the mode of inheritance of neurofibromatosis type 2?
A130. Autosomal dominant
Q131. What is the mode of inheritance of tuberous sclerosis?
A131. Autosomal dominant
Q132. What is the mode of inheritance of von-hippel-lindau disease?
A132. Autosomal dominant
Q133. What is the mode of inheritance of xeroderma pigmentosa?
A133. Autosomal recessive
Q134. What is the mode of inheritance of albinism?
A134. Autosomal recessive
Q135. What is the mode of inheritance of down syndrome?
A135. Trisomy 21, most commonly caused by maternal non- disjunction
Q136. Type of cancer assoc with retinoblastoma?
A136. retinoblastoma, osteogenic sarcoma later in life
Q137. Type of cancer assoc with MEN type 1
A137. Parathyroid adenoma, pituitary adenoma, pancreatic islet cell tumors
Q138. Type of cancer assoc with MEN type 2A?
A138. Parathyroid adenoma, Pheochromocytoma, Medullary thyroid cancer
Q139. Type of cancer assoc with MEN type 2B?
A139. Medullary thyroid cancer, pheochromocytoma, mucosal neuromas
Q140. Type of cancer assoc with familial polyposis coli?
A140. Colon cancer (these polyps always turn into cancer)
Q141. Type of cancer assoc with Gardner's syndrome?
A141. familial polyposis, osteomas, soft tissue tumors
Q142. Type of cancer assoc with Turcot's syndrome?
A142. familial polyposis, CNS tumors
Q143. Type of cancer assoc with peutz-jeghers syndrome?
A143. increased incidence of non-colon cancer (stomach, breast, ovaries), although they have GI polyps, they don't have increase incidence of colon cancer
Q144. Type of tumors assoc with neurofibromatosis type 1?
A144. multiple neurofibromas,; increased incidence of pheochromocytomas,; bone cysts,; Wilm's tumors,; leukemia
Q145. Type of tumors assoc with neurofibromatosis type 2?
A145. bilateral acoustic neuromas
Q146. Type of tumors assoc with tuberous sclerosis?
A146. adenoma sebaceum,; glial nodules in the brain,; renal angiomyolipomas,; cardiac rhabdomyosarcomas
Q147. Type of tumors assoc with von-hippel-lindau?
A147. hemangioblastomas in cerebellum,; renal cell cancer,; cysts in liver and kidney
Q148. Type of tumors assoc with xerderma pigmentosa?
A148. skin cancer
Q149. Type of tumors assoc with albinism?
A149. skin cancer
Q150. Type of cancer associated with Down Syndrome?
A150. ALL
Q151. What risk factors are associated with lung cancer?
A151. smoking, asbestos; (also nickel, radon, coal, arsenic, chromium, uranium)
Q152. What risk factors are associated with mesothelioma?
A152. asbestos
Q153. What risk factors are associated with leukemia?
A153. chemotherapy/radiotherapy,; other immunosuppressive drugs,; benzene
Q154. What risk factors are associated with bladder cancer?
A154. Smoking,; aniline dye,; schistosomiasis
Q155. What risk factors are associated with skin cancer?
A155. UV light,; coal tar,; arsenic
Q156. What risk factors are associated with liver cancer?
A156. alcohol,; vinyl chloride,; aflatoxins
Q157. What risk factors are associated with cancer of the oral cavity?
A157. smoking, alcohol
Q158. What risk factors are associated with pharyngeal/laryngeal cancer?
A158. smoking, alcohol
Q159. What risk factors are associated with esophageal cancer?
A159. smoking, alcohol
Q160. What risk factors are associated with pancreatic cancer?
A160. Smoking
Q161. What risk factors are associated with renal cell cancer?
A161. smoking
Q162. What risk factors are associated with stomach cancer?
A162. alcohol, nitrosamines/nitrites,
Q163. What risk factors are associated with clear cell cancer?
A163. in utero exposure to DES (diethylstilbestrol)
Q164. What risk factors are associated with colon/rectal cancer?
A164. Age (peak in 60-75),; family history,; inflammatory bowel disease (UC > crohn's,; high fat and low fiber diet
Q165. What risk factors are associated with breast cancer?
A165. Personal hx of breast cancer,; family history in 1st degree relativek age >40,; early menarche,; late menopause,; late first pregnancy,; nulliparity,; atypical hyperplasia of the breast,; radiation exposure before age 30,; prolong use of OCP (possibly),; high fat and low fiber diet
Q166. What risk factors are associated with cervical cancer?
A166. HPV,; age less than 20 at first coitus,; multiple sexual partners,; smoking,; high parity (protects against endometrial and breast),; coitus with promiscuous partner,; low SES
Q167. What risk factors are associated with thyroid cancer?
A167. childhood neck or chest irradiation
Q168. What risk factors are associated with endometrial cancer?
A168. unopposed estrogen stimulation,; obesity,; nulliparity,; late menopause,; diabetes,; HTN,; PCOS,; estrogen secreting neoplasm (granulosa/theca cell)
Q169. What risk factors are associated with all cancers overall?
A169. smoking (number two is alcohol)
Q170. What clinical vignette should make you suspect lung cancer?
A170. a change in the chronic cough of a smoker, high pack years of smoker, also hemoptysis, pneumonia, and weight loss. Chest x-ray may show a mass or pleural effusion. Put a needle in this fluid to examine cells.
Q171. How do you diagnose and treat lung cancer?
A171. As with all cancer, you need a tissue biopsy (via bronchoscopy, CT guided biopsy, open lung biopsy) to confirm malignancy and to determine histiologic type. Non small cell lung cancer can be treated with surgery if the cancer remains in the lung parenchyma (without involvement of the opposite lung, pleura, chest wall, spine, or mediastinal structures). Early metastases of small cell lung cancer make surgery innapropriate. Both can be treated with chemotherapy with or without radiation. Usually a platinum containing chemo regimen is used (cisplatin).
Q172. What can result from an apical (Pancoast) lung cancer?
A172. Horner's syndrome--from invasion and cervical sympathetic chain. Look for unilateral ptosis, miosis, and anhidrosis; Superior vena cava syndrome--compression causes impaired venous drainage. Look for edema and redness of neck and face and CNS sx like HA, visual sx, altered MS. Unilateral diaphragm paralysis--from phrenic nerve involvement; Hoarseness--from recurrent laryngeal nerve involvement
Q173. Define paraneoplastic syndrome
A173. condition caused by a malignancy but not due directly to destruction or invasion by the tumor
Q174. What types of paraneoplastic syndromes can be caused by small cell lung cancer?
A174. Cushing's syndrome--from ACTH; SIADH--ADH; Eaton-Lambert syndrome
Q175. Define Eaton-Lambert syndrome
A175. Myasthenia gravis-like disease that spares occular muscles. Muscles become stronger with repeated stimulation.
Q176. What types of paraneoplastic syndromes can be caused by squamous cell lung cancer?
A176. hypercalcemia--from parathyroid-like hormone
Q177. How do you manage a patient with a solitary pulmonary nodule on chest x-ray?
A177. 1st compare with previous cxr's. If it's the same size for >2 years, it is very unlikely to be a cancer. If no old films are available and the patient is a smoker for more than 5 years or is over 35 years old, get a CT (and possibly a PET). If these are not definitely benign, get a biopsy of the nodule. If the patient is younger than 35 or is a non-smoker, the cause is most likely infection, hamartoma, or collagen vascular disease. The patient should ahve CT and careful observation with follow-up imaging in 3-6 months.
Q178. How many women in the U.S. will develop breast cancer?
A178. 1 in 8
Q179. What classic si/sx indicate that a breast mass is cancer until proven otherwise?
A179. Fixation of breast mass to the chest wall or overlying skin. Satellite nodules or ulcers on the skin. Lymphedema (peau d'orange); Matted or fixed axillary lymph nodes. Inflammatory skin changes (peau d'orange); Prolonged unilateral scaling erosion of the nipple with or without discharge (may be Paget's disease of the nipple); Microcalcifications on mammography; ANY NEW BREAST MASS IN POSTMENOPAUSAL WOMAN.
Q180. What is the conservative approach to ensure that you don't miss a breast cancer?
A180. when in doubt, bx every breast mass in women over 35 that is not clearly a cyst (ultrasound needed), especially if risk factors present. If the step 2 question doesn't want you to biopsy the mass it will give definite cles that the mass is not a cancer (e.g., bilateral lumpy breasts that become symptomatic with every menses and have no dominant mass, patient younger than 30)
Q181. What should you do with a breast mass in a patient younger than 30?
A181. Breast cancer is rare here. With a discrete mass, think fibroadenoma. Get ultrasound of the breast and observe the patient over a few menstrual cycles before considering biopsy (unless ultrasound is suspicious).
Q182. What suggests breast fibroadenoma?
A182. Round, rubbery, freely movable mass.
Q183. What suggests fibrocystic changes.
A183. bilateral lumpy breasts that become symptomatic with every menses and have no dominant mass, patient younger than 30
Q184. What is the most common histiologic type of breast cancer?
A184. Invasive ductal carcinoma
Q185. What is the role of mammography in deciding whether or not to biopsy a breast mass?
A185. When a palpable breast mass is detected, the decision to biopsy is made on clinical grounds. A mammogram that looks benign should not deter you from biopsy if you're clinically suspicious.
Q186. True or false--a mmamogram should not be done in women under age 30
A186. True in most cases. The breast tissue is too dense for current techniques to be of value. Mammograms in women under age 30 are rarely helpful.
Q187. How does tamoxifen affect breast cancer?
A187. It improves survival if the breast cancer has estrogen receptors and even more so if the tumor cells also express progesteroen receptors.
Q188. True or false--mastectomy and breast conserving surgery with radiation are considered equal in efficacy.
A188. True. In either case, do an axillary node dissection or sentinel node biopsy. If nodes are positive, give chemotherapy.
Q189. What are the two main risk factors for prostate cancer?
A189. Age--it's not seen in patients <40 years old. 60% of men older than 80 years have prostate cancer. Race--black>white>asian
Q190. How do you recognize prostate cancer on step 2?
A190. Usually older than 50, usually present late, look for sx of BPH with hematuria and/or elevated PSA or acid phosphatase. Because acid phosphatase is only elevated when cancer breaks through the capsule, it has been replaced with PSA. Look for irregularities on rectal exam. Patients may have back pain from vertebral metastases, which are osteoBlastic.
Q191. How is prostate cancer treated?
A191. Prostatectomy or local radiation. With metastases, the patient has several options for hormonal therapy: orchiectomy, GRH agonist (leuprolide), androgen receptor antagonist (flutamide), estrogen and others. Radiation therapy is used for local disease or pain from metastases, standard chemo is usually ineffective.
Q192. How does colon cancer present?
A192. asymptomatic blood in stool, anemia, change in stool caliber, or frequency, large bowel obstruction, weight loss
Q193. How do you rule out colon cancer on a patient over 40 with occult blood in stool?
A193. Do a flexible sigmoidoscopy and barium enema OR total colonoscopy. If you see lesions on flex sig and barium enema, you have to follow up with colonoscopy to remove and examine polyps. This is why most docs start with colonoscopy.
Q194. How is colon cancer treated?
A194. Surgery, adjuvant chemo is sometimes given (5-FU and levamisole or leucovorin) for lymph node involvement. Distant metastases frequently go to the liver first. Surgical resection of a liver metastasis is often attempted. With metastases elsewhere, chemo is the only option, and prognosis is poor.
Q195. What is the tumor marker for colon cancer?
A195. CEA, if it's elevated before surgery, it should return to normal after surgery and monitored periodically. It is NOT a screening tool.
Q196. Classic presentation for pancreatic cancer?
A196. A smoker age 40-80 who has lost weight and is jaundiced. Also, can be depressed, have epigastric pain, migratory thrombophlebitis (Trousseau's sign), and palpable nontender gallbladder (Courvoisier's). More common in men than women, and in diabetics, and in blacks.
Q197. Treatment for pancreatic cancer?
A197. Surgery (Whipple) rarely successful, chemo isn't either.
Q198. What is the cell of origin of pancreatic cancer?
A198. ductal epithelium
Q199. What is the most common islet cell tumor of the pancreas?
A199. Insulinomas (beta cell tumor).
Q200. What are the findings with insulinomas?
A200. Whipple's triad--patient has 2/3 of the triad: hypoglycemia and CNS sx from hypoglycemia. The Doc provides the last 1/3 by giving glucose and relieving sx.
Q201. Are insulinomas malignant or benign?
A201. 90% are benign, curable with resection.
Q202. What test should you order in a patient you think has an insulinoma?
A202. C-peptide level, to make sure that the patient isn't diabetic and accidentally taking too much insulin or factitious. It will be high in insulinomas and low otherwise.
Q203. Define Zollinger-Ellison syndrome
A203. Gastrinoma, caused acid secretion and peptic ulcer disease. Ulcers are resistant to therapy and multiple.
Q204. Are gastrinomas malignant or benign?
A204. 50% are malignant
Q205. What are the findings with glucagonomas?
A205. alpha cell tumor causes hyperglycemia and migratory necrotizing skin erythema
Q206. What are the findings with VIPomas?
A206. watery diarrhea,; hypokalemia,; achlorhydria.
Q207. How does ovarian cancer typically present?
A207. usually late presentation,; weight loss,; pelvic mass,; ascites,; and/or bowel obstruction.
Q208. What test do you order for an ovarian lesion?
A208. ultrasound
Q209. How is ovarian cancer treated?
A209. debulking surgery and chemotherapy.
Q210. What is the cell of origin in ovarian cancer?
A210. most are from ovarian epithelium.
Q211. What is the most common type of ovarian cancer?
A211. Serous cystadenocarcinoma, mucinous cystadenocarcinomas are common too.
Q212. What is the classic finding on microscope of serous cystadenocarcinoma?
A212. Psammoma bodies
Q213. Name three common germ cell tumors
A213. 1. Teratoma; 2. Sertoli/Leydig cell; 3. Granulosa/theca cell
Q214. What's the most common germ cell tumor?
A214. Teratoma
Q215. Sx of sertoli/leydig cell tumor?
A215. virilization (hirsutism, receding hairline, deepening voice, clitoromegaly)
Q216. Sx of granulosa/theca cell tumors?
A216. feminization, precocious puberty, patients are usually under age 30.
Q217. What is Meig's syndrome?
A217. Ovarian fibroma, causes ascites and right hydrothorax.
Q218. What is a Krukenberg tumor?
A218. A stomach cancer (or other GI malignancy) with metastases to ovaries.
Q219. What medicine reduces the risk of ovarian cancer?
A219. OCPs
Q220. What is the best test to screen for cervical cancer?
A220. Pap test, give all females a pap smear if they're due, even if they present for a totally unrelated complaint
Q221. What do you do if Pap is abnormal?
A221. Colposcopy, directed biopsies, endocervical curettage. If pap shows microinvasive cancer, proceed to conization. If cancer is frankly invasive, give hysterectomy and/or radiation.
Q222. Where does cervical cancer begin?
A222. in the transformation zone,
Q223. Sx of cervical cancer?
A223. postcoital bleeding,; intermenstrual spotting,; abnormal menstrual bleeding
Q224. tx of cervical cancer?
A224. surgery and/or radiation
Q225. What do you do for postmenopausal bleeding?
A225. order an endometrial biopsy,; pap smear,; and endocervical curettage
Q226. What's the most common type of endometrial cancer?
A226. adenocarcinomas
Q227. Tx of endometrial cancer?
A227. Surgery and radiation
Q228. What medicine prevents endometrial cancer?
A228. OCPs
Q229. How do brain tumors usually present?
A229. new onset seizures,; neuro deficits,; headache,; blurred vision,; papilledema,; nausea,; projectile vomiting,; in children look for hydrocephalus and ataxia
Q230. What is the most common histiologic type of brain tumor in children?
A230. 1. cerebellar astrocytoma (benign pilocytic astrocytoma); 2. medulloblastoma; 3. ependymoma
Q231. What is the most common histiologic type of brain tumor in adults?
A231. 1. Glioma (usually astrocytoma); 2. Meningioma
Q232. Which cancers tend to metastasize to the brain?
A232. "Lots of Bad Stuff Kills Glia"; Lung Breast Skin Kidney GI
Q233. Presentation of pseudotumor cerebri?
A233. young obese woman with headaches,; papilledema,; vomiting,; negative CT/MRI
Q234. What causes pseudotumor cerebri?
A234. increased intracranial pressure (there's no tumor)
Q235. tx of pseudotumor cerebri?
A235. weight loss,; repeated lumbar punctures,; CSF shunt may need to be placed to prevent vision loss.
Q236. sx of craniopharyngioma?
A236. usually in children,; calcifications of skull radiographs,
Q237. Risk factors for testicular cancer?
A237. cryptorchidism,
Q238. How do you evaluate a testicular mass?
A238. transilluminationa and ultrasound
Q239. how do you tell a hydrocele from a testicular cancer?
A239. hydroceles transilluminate, cancers do not
Q240. Most common type of testicular cancer?
A240. seminoma
Q241. tx for seminoma
A241. radiation,; highly curable
Q242. what is a "bunch of grapes" coming out of the vagina
A242. sarcoma botryoides(embryonal rhabdomyosarcoma) usually seen in children
Q243. Sx of pituitary tumor?
A243. bitemporal hemianopsia,; increased ICP,
Q244. most common type of pituitary tumor?
A244. prolactinoma
Q245. sx of prolactinoma?
A245. galactorrhea,; menstrual or sexual dysfunction
Q246. What do you order on a patient with bitemporal hemianopsia?
A246. brain MRI
Q247. Describe nasopharyngeal carcinoma?
A247. usually seen in asians,; assoc with Epstein-Barr virus.
Q248. classic presentation of esophageal cancer?
A248. smoker,; drinker,; 40-60 years old,; blacks>whites,; weight loss,; anemia,; "my food is sticking," which progresses to dysphagia for liquids,
Q249. what's the most common type of esophageal cancer?
A249. adenocarcinoma--due to malignant degeneration of Barrett's esophagus
Q250. Define Barrett's esophagus
A250. columnar metaplasia of esophageal squamous epithelium due to acid reflux
Q251. What makes you think thyroid cancer?
A251. single, stony hard nodule or mass in the thyroid gland,; may be rapidly enlarging,; "cold" on nuclear scan,; worrisome findings include hoarseness,; increased calcitonin level,; history of radiation to the neck
Q252. How do you evaluate a thyroid nodule?
A252. TSH, then nuclear medicine, then ultrasound, then biopsy. If clinically suspicious, still get a biopsy if all tests are negative.
Q253. Sx of bladder cancer
A253. persistent painless hematuria,; older than 40,; smoker,; worker in rubber or dye industry (aniline dye),; history of shistosomiasis
Q254. How do you evaluate for bladder cancer?
A254. CT, or cystoscopy
Q255. Risk factors for hepatocellular carcinoma
A255. alcohol,; chronic hepatitis (C more than B),; hemochromatosis,
Q256. Tumor marker for hepatocellular carcinoma?
A256. AFP, measured to detect recurrences after surgery and used to screen high risk populations (cirrhotics)
Q257. Sx of hepatocellular carcinoma?
A257. Usually in the presence of cirrhosis,; patients have weight loss, right upper quadrant pain, enlarged liver.
Q258. tx for hepatocellular carcinoma?
A258. Surgery, prognosis is poor.
Q259. Most common primary tumor of liver?
A259. Hemangioma
Q260. tx for liver hemangioma?
A260. leave it alone,; only operate if sx (pain, bleeding)
Q261. what's the liver tumor in patients on birth control?
A261. hepatic adenoma,
Q262. tx for hepatic adenoma?
A262. stop OCPs, if tumor doesn't regress, surgery is needed to prevent hemorrhage and the rare malignant transformation.
Q263. Risk factors for cholangiosarcoma
A263. ulcerative colitis,; liver flukes (clonorchis)
Q264. What's the liver cancer associated with vinyl chloride?
A264. Angiosarcoma, these are malignant
Q265. What's the liver cancer found in children?
A265. Hepatoblastoma, these are malignant
Q266. Sx of stomach cancer?
A266. Weight loss,; anemia,; early satiety,; abdominal pain,; nonhealing gastric ulcer
Q267. workup for gastric ulcer?
A267. biopsy all gastric ulcers, follow with barium x-ray to document healing.
Q268. Define Virchow's node
A268. left supraclavicular node enlargement due to the spread of visceral cancer (usually stomach)
Q269. Where are osteosarcomas usually found?
A269. around the knee in children, around long standing Paget's disease or osteomyelitis in adults.
Q270. Sx of carcinoid tumors?
A270. only symptomatic if metastasized to the liver,; sx are flushing, diarrhea, abdominal cramps, right sided heart valve damage
Q271. where is the most common location for carcinoid tumors?
A271. small bowel, but remember that they're the most common tumor found in the appendix
Q272. what do you order if you're suspicious for carcinoid tumor?
A272. 5-HIAA
Q273. How do you spot a Kaposi's sarcoma?
A273. a rash that doesn't respond to multiple treatments in an HIV- positive patient; It's usually on the upper body, and can be in the mouth
Q274. what virus is associated with Kaposi's sarcoma?
A274. human herpesvirus 8
Q275. Explain ABCD's of melanoma
A275. A--Asymmetry; B--Border irregularity; C--Color change or multicolor; D--Diameter increase
Q276. what do you do for a suspected melanoma?
A276. excisional biopsy because of early metastasis
Q277. how do you evaluate the risk for metastasis in a melanoma?
A277. Brewlow depth of invasion
Q278. how do you spot a basal cell skin cancer?
A278. pearly umbilicated nodule with telangiestasias
Q279. What do you do for all lesions suspicious for skin cancer?
A279. excisional biopsy
Q280. How do you differentiate a wilm's tumor from a neuroblastoma in kids?
A280. both a flank masses. Neuroblastomas often contain calcifications,; wilm's rarely calcify.
Q281. What is the typical appearance of oral cancer?
A281. lesions begin as leukoplakia (white patch), or malakoplakia (red patch)
Q282. What does hairy oral leukoplakia look like?
A282. looks like leukoplakia on the sides of the tongue,; affects HIV pts,; assoc with Epstein Barr virus
Q283. What cytologic clues make you think histiocytosis?
A283. CD1 positive cells and Birbeck granules (intracytoplasmic inclusions that look like tennis rackets)
Q284. Define unicameral bone cyst, where is it usually found?
A284. expansile, lytic, well-demarcated benign,; usually in the proximal portion of humerus in children and adolescents
Q285. Are unicameral bone cysts malignant or benign?
A285. benign, but can weaken the bone enough to produce a pathologic fracture.
Q286. How does retinoblastoma present?
A286. usually in a child less than 3 years old,; leukocoria,; unilateral exopthalmos,; can be bilateral in inherited form
Q287. True or false--all patients with metastatic cancer should be encouraged to receive chemo
A287. false,; risks may outweigh benefits
Q288. what cancers are associated with the tumor marker AFP?
A288. hepatocellular carcinoma,; yolk-sac tumors
Q289. what cancers are associated with the tumor marker CEA?
A289. colon cancer,; pancreas,; other GI tumors
Q290. what cancers are associated with the tumor marker PSA?
A290. prostate
Q291. what cancers are associated with the tumor marker acid phosphatase?
A291. prostate (if extended through capsule)
Q292. what cancers are associated with the tumor marker hCG?
A292. hydatiform moles, choriocarcinoma
Q293. what cancers are associated with the tumor marker CA-125?
A293. Ovary
Q294. what cancers are associated with the tumor marker S-100?
A294. melanoma
Q295. what cancers are associated with the tumor marker CA 19- 9?
A295. Pancreas; (you better party like it's 19-9-ty nine because you don't have much time left)
Q296. what cancers are associated with the tumor marker 27-29?
A296. Breast
Q297. What diseases is alpha fetoprotein associated with?
A297. AFP is associated wiht the development of:; 1) hepatocellular carcinoma; 2) ovarian cancer; 3) non-seminomatous germ cell tumors
Q298. When do you answer AFP?
A298. Answer AFP when you see a patient with alcoholic cirrhosis or chronic hepatitis B or C. AFP together with radiologic imaging is used to screen for hepatocellular carcinoma.
Q299. What is carcinoembryonic Antigen (CEA)?
A299. CEA is a protein that is elevated in teh serum in a variety of cancers, including colorecttal cancer (CRC).
Q300. For which disease does CEA have prognostic value?
A300. Serum levels of CEA have prognostic value in patients with newly diagnosed CRC. Those with higher levels have a worse prognosis than those with lower levels.
Q301. When do you answer CEA?
A301. Answer CEA level to monitor colon cancer patients after surgical resection. This determines the presence of persistent, recurrent, or metatatic disease.
Q302. When do you answer CEA as a screening test?
A302. CEA levels are never the right answer as a screening test for colon cancer.
Q303. What is colposcopy?
A303. A colposcopy is the direct visualization of the cervix by placing a magnifying scope with a lamp into the vagina.
Q304. What must be visualized for a sufficient study?
A304. The transition zone must be visualized to ensure an adequate colposcopy. This is the border between squamous and columnar epithelium.
Q305. When is colposcopy the answer?
A305. Answer colposcopy when the case describes a patient with an abnormal Pap smear. The following findings on Pap smear necessitate colposcopy:; 1) Atypical squamous cells - cannot exclude high grade lesion (ASC-H); 2) Low-grade squamous intraepithelial lesion (LSIL); 3) High-grade squamous intraepithelial lesion (HSIL); 4) Atypical sqamous cells of undetermined significance (ASCUS) if HPV DNA testing is positive.
Q306. What are estrogen and progesterone receptor tests?
A306. Estrogen and progesterone receptors should be done on all patients with breast cancer in order to determine who should receive hormone receptor therapy.
Q307. What is the therapy for breast cancer?
A307. Therapy with either tamoxifen or raloxifene should be added for any patient wiht positive receptors. This is either for estrogen or progesterone positiveity alone or in combination. The response to tamoxifen is better if both receptors are positive.
Q308. When do you answer mammogram?
A308. Screening mammogram should begin at age 40 and should be performed every 1-2 years. Screening after age 50 is yearly.
Q309. When there is an abnormality what is the next best step?
A309. When the mammogram shows abnormalities, a core biopsy including sentinel node biopsy is the next best test. Carcinomas of the breast are associated with clustered polymorphic microcalcifications. Mammography is also used when a breast mass is found on exam to locate additional lesions in the same breast or bilateral disease.
Q310. When does screening lower mortality the most?
A310. Screening lowers mortality most after age 50, and the decrease is greater than that with colonoscopy or Pap smear.
Q311. What is Papanicolaou (Pap) Smear?
A311. The Pap smear is a test that examines the cells of the cervix. it is a screening method to find cancerous or precancerous cervical lesions. Pap smear does derease mortality in screened populations.
Q312. When is Pap smear the answer?
A312. Pap smear should be started at age 21 or within 3 years of the onset of sexual activity, whichever is earlier. The test should be done every 2-3 years and can be stopped at age 65.
Q313. If results are positive, what is the next best test?
A313. Abnormalities on Pap smear are evaluated with colposcopy in order to biopsy the cervix.
Q314. What is PET Scanning?
A314. PET means "positron emission tomography."; The measures teh metabolic activity of a lesion seen on a CT or MRI scan. It is based on the ability of most cancers and some infections to have the increased uptake of 18- fluorodeoxyglucose. It is a noninvasive test of the actual function of a mass lesion, not just its size and location.
Q315. What makes PET Scanning abnormal?
A315. Most cancers and some infections have an increased uptake of the tagged glucose.
Q316. When is PET Scanning the answer?
A316. A PET scan can tell if a lesion, such as a lung mass, that might otherwise look malignant, really is malignant. For instance, if you are shown a case of a localized lung cancer diagnosed wit biopsy, you can use the PET scan to see if there are metastases. If there is a mass in the contralateral chest that is malignant, it makes the patient ineligible for surgery with curative intent. If the PET scn shows a low uptake of the tagged glucose, then the lesion is likely benign and you should proceed wiht the surgery to remove the primary tumor site.
Q317. What is PSA (Prostate-Specific Antigen)?
A317. PSA increases can occur in prostatitis, BPH, prostate cancer, and prostate biopsies. Levels are undetectable after total resection of the prostate.
Q318. When should PSA be done?
A318. PSA testing is extremely controversial. There is no evidence that PSA testing lowers mortality when used as a routine screening test. If the question says the patient is requesting teh test, then you should do it.
Q319. What is the most accurate test for prostate cancer?
A319. Biopsy of the prostate is the most accurate diagnostic test.
Q320. When test is done next if the PSA is positive?
A320. If the PSA is elevated, a digital rectal exam is performed to palpate a lesion. If a lesion is found, it should be biopsied. If no lesion is found, a trans-rectal US should be performed to find a lesion to biopsy. If no lesion can be found, then "blind biopsies" should occur.
Q321. What is the sentinal node evaluation?
A321. The sentinel node biopsy is used in the evaluation of breast cancer.
Q322. How si sentinel node evaluation done?
A322. A sentinel node biopsy is when dye is introduced into the operative field. The first node it goes to it the "sentinel" node. If it has cancer, you dissect the axilla. If it is negative, you do not need to do an axillary lymph node dissection.
Q323. When is sentinel ode evaluation the answer?
A323. Look for a patient with an abnormal mammogram in whom the biopsy shows cancer. The answer sentinel node biopsy. Sentinel node biopsy is the best test to do after the initial diagnosis of breast cancer has been made with either a needle or excisional biopsy. Sentinel node biopsy can eliminate the need for axillary lymph node dissection.
Q324. What neoplasms are associated with:; Down's syndrome
A324. ALL & AML
Q325. What neoplasms are associated with:; Xeroderma pigmentosum
A325. Melanoma, Basal cell carcinoma & Squamous cell carcinoma
Q326. What neoplasms are associated with:; Chronic gastritis, Pernicious anemia & postsurgical gastric remnants
A326. Gastric adenocarcinoma
Q327. What neoplasms are associated with:; Tuberous Sclerosis
A327. Astrocytoma & cardiac rhabdomyoma
Q328. What neoplasms are associated with:; Actinic keratosis
A328. Squamous cell carcinoma of the skin
Q329. What neoplasms are associated with:; Barrett's esophagus
A329. Esophageal adenocarcinoma
Q330. What neoplasms are associated with:; Plummer-Vinson syndrome
A330. Squamous cell carcinoma of esophagous
Q331. What neoplasms are associated with:; Liver cirrhosis
A331. Hepatocellular carcinoma
Q332. What neoplasms are associated with:; Ulcerative colitis
A332. Colonic adenocarcinoma
Q333. What neoplasms are associated with:; Paget's disease of bone
A333. Secondary osteosarcoma & fibrosarcoma
Q334. What neoplasms are associated with:; Immunodeficiency states
A334. Malignant lymphomas
Q335. What neoplasms are associated with:; AIDS
A335. Aggresive malignant lymphomas(non-hodgkins) & Kaposi's sarcoma
Q336. What neoplasms are associated with:; Autoimmune disease
A336. Benign & malignant thymomas
Q337. What neoplasms are associated with:; Acanthosis nigricans
A337. Visceral malignancy (stomach, breast, lungs)
Q338. What neoplasms are associated with:; Dysplastic nevus
A338. Malignant melanoma
Q339. What is the following gene:; abl
A339. Oncogene; associated with CML
Q340. What is the following gene:; c-myc
A340. Oncogene; associated with Burkitt's lymphoma
Q341. What is the following gene:; bcl-2
A341. Oncogene; associated with Follicular & undifferentiated lymphomas
Q342. What is the following gene:; erb-B2
A342. Oncogene; associated with Breast, ovarian & gastric carcinoma
Q343. What is the following gene:; ras
A343. Oncogene; associated with Colon carcinoma
Q344. What is the following gene:; L-myc
A344. Oncogene; associated with Lung tumor
Q345. What is the following gene:; N-myc
A345. Oncogene; associated with Neuroblastoma
Q346. What is the following gene:; ret
A346. Oncogene; associated with MEN types II & III
Q347. What is the following gene:; Rb
A347. Tumor suppressor gene; associated with Retinoblastoma & Osteosarcoma; chrom 13q
Q348. What is the following gene:; BRCA 1 & 2
A348. Tumor suppressor gene; associated with Breast & Ovarian cancer; chrom 17q & 13q
Q349. What is the following gene:; p53
A349. Tumor suppressor gene; associated with Most human cancers, Li-Fraumeni syndrome; chrom 17p
Q350. What is the following gene:; p16
A350. Tumor suppressor gene; associated with Melanoma; chrom 9p
Q351. What is the following gene:; APC
A351. Tumor suppressor gene; associated with Colorectal cancer; chrom 5q
Q352. What is the following gene:; WT1
A352. Tumor suppressor gene; associated with Wilm's tumor; chrom 11q
Q353. What is the following gene:; NF1
A353. Tumor suppressor gene; associated with Neurofibromatosis type I; chrom 17q
Q354. What is the following gene:; NF2
A354. Tumor suppressor gene; associated with Neurofibromatosis type 2; chrom 22q
Q355. What is the following gene:; DPC
A355. Tumor suppressor gene; associated with Pancreatic cancer; chrom 18q
Q356. What is the following gene:; DCC
A356. Tumor suppressor gene; associated with Colon cancer; chrom 18q
Q357. Tumor marker for what?; PSA
A357. Prostatic carcinoma
Q358. Tumor marker for what?; CEA
A358. Nonspecific; Produced by 70% of colorectal & pancreatic cancers; Also produced by gastric & breast carcinomas
Q359. Tumor marker for what?; alpha-fetoprotein
A359. Hepatocellular carcinoma & nonseminomatous germ cell tumors of the testes(e.g yolk sac tumor)
Q360. Tumor marker for what?; beta-hCG
A360. Hydatidiform moles, Choriocarcinomas & Gestational trophoblastic tumors
Q361. Tumor marker for what?; CA-125
A361. Ovarian tumors & Malignant epithelial tumors
Q362. Tumor marker for what?; S-100
A362. Melanoma, neural tumors & astrocytoma
Q363. Tumor marker for what?; Alkaline phosphatase
A363. Metastases to bone(blastic),; Obstruuctive biliary disease; Paget's disease of bone
Q364. Tumor marker for what?; Bombesin
A364. Neuroblastoma,; Lung cancer,; Gastric cancer
Q365. Tumor marker for what?; TRAP
A365. Hairy cell leukemia(B-cell neoplasm)
Q366. Tumor marker for what?; CA-19-9
A366. Pancreatic adenocarcinoma
Q367. What cancer can be caused by:; HTLV-1
A367. Adult T-cell leukemia
Q368. What cancer can be caused by:; HBV & HCV
A368. Hepatocellular carcinoma
Q369. What cancer can be caused by:; EBV
A369. Burkitt's lymphoma & nasopharyngeal carcinoma
Q370. What cancer can be caused by:; HPV
A370. Cervical carcinoma & Penile/anal carcinomas; from types 16 & 18
Q371. What cancer can be caused by:; HHV-8
A371. Kaposi's sarcoma & Body cavity fluid B-cell lymphoma
Q372. Carcinogenic affect of:; Aflatoxin
A372. Hepatocellular carcinoma
Q373. Carcinogenic affect of:; Vinyl chloride
A373. Angiosarcoma of liver
Q374. Carcinogenic affect of:; CCl4
A374. Centrilobular necrosis & fatty change in liver
Q375. Carcinogenic affect of:; Nitrosamines
A375. Affects esophagus & stomach
Q376. Carcinogenic affect of:; Cigarete smoke
A376. Affects larynx & lungs
Q377. Carcinogenic affect of:; Asbestos
A377. Mesothelioma & bronchogenic carcinoma of the lung
Q378. Carcinogenic affect of:; Arsenic
A378. Squamous cell carcinoma of the skin
Q379. Carcinogenic affect of:; Naphthalene(aniline) dyes
A379. Transitional cell carcinoma of the bladder
Q380. Carcinogenic affect of:; Alkylating agents
A380. Leukemia
Q381. Most common cancer to metastasize to liver?
A381. Colon cancer
Q382. 2nd most common cancer to metastasize to liver?
A382. Stomach
Q383. Most common metastases to bone?
A383. Breast & Prostate cancers
Q384. Lytic or blastic?; Lung metastases to bone
A384. Lytic
Q385. Lytic or blastic?; Prostate metastases to bone
A385. Blastic
Q386. Lytic or blastic?; Breast metastases to bone
A386. Both lytic & blastic
Q387. Most common cancer in males?
A387. Prostate (32%)
Q388. 2nd most common cancer in males?
A388. Lung (16%)
Q389. 3rd most common cancer in males?
A389. Colorectal (12%)
Q390. Most common cancer in females?
A390. Breast (32%)
Q391. 2nd most common cancer in females?
A391. Lung (13%)
Q392. 3rd most common cancer in females?
A392. Colorectal (13%)
Q393. Most common cancer death in males?
A393. Lung (33%)
Q394. 2nd most common cancer death in males?
A394. Prostate (13%)
Q395. Most common cancer death in females?
A395. Lung (23%)
Q396. 2nd most common cancer death in females?
A396. Breast (18%)
Q397. "Starry-sky" appearance
A397. Burkitt's Lymphoma
Q398. t(14;18)
A398. Follicular Lymphoma
Q399. t(9;22)
A399. CML
Q400. c-myc gene translocation
A400. Burkitt's Lymphoma
Q401. bcl-2 activation
A401. Follicular Lymphoma
Q402. Bence Jones protein
A402. Multiple Myeloma
Q403. Leukemia that may spread to CNS and testes
A403. ALL
Q404. associated with EBV
A404. Hodgkin's Lymphoma & Burkitt's Lymphoma
Q405. Leukemia in children
A405. ALL
Q406. Hodgkin's Lymphoma- More common in men or women overall?
A406. Men
Q407. Erythroblastic AML
A407. M6
Q408. bcr-abl hybrid
A408. CML
Q409. Type of Hodgkin's Lymphoma w/ the worst prognosis
A409. Lymphocyte depleted type of Hodgkin's Lymphoma
Q410. Monoclonal Immunoglobulin spike of IgG or IgA
A410. M protein- associated with Multiple Myeloma
Q411. Reed-Sternberg Cells
A411. Hodgkin's Lymphoma
Q412. Leukemia that is most responsive to therapy
A412. ALL
Q413. Promyelocytic AML
A413. M3
Q414. Monoblastic AML
A414. M5
Q415. t(11;22)
A415. Ewing's Sarcoma
Q416. t(8;14)
A416. Burkitt's Lymphoma; c-myc & Ig heavy chain
Q417. Megakaryoblastic AML
A417. M7
Q418. "Fried Egg" Plasma Cells
A418. Multiple Myeloma
Q419. Leukemia in older adults
A419. CLL
Q420. Type of Hodgkin's Lymphoma w/ highest level of Reed- Sternberg cells
A420. Mixed Cellularity type of Hodgkin's Lymphoma
Q421. Type of Hodgkin's Lymphoma that is more common in women
A421. Nodular Sclerosing type of Hodgkin's Lymphoma
Q422. Lymphoma associated with jaw lesions in the endemic form in Africa
A422. Burkitt's Lymphoma
Q423. aggresive T-cell lymphoma in children
A423. Lymphoblastic Lymphoma
Q424. CD30+ and CD15+ B-cells
A424. Hodgkin's Lymphoma
Q425. 3rd most common type of Hodgkin's Lymphoma
A425. Lymphocyte Predominant type of Hodgkin's Lymphoma
Q426. CD5+ B Cells
A426. Mantle Cell Lymphoma
Q427. Most common type of Hodgkin's Lymphoma
A427. Nodular Sclerosing type of Hodgkin's Lymphoma
Q428. Undifferentiated AML
A428. M0
Q429. Philadelphia Chromosome
A429. CML
Q430. t(15;17)
A430. M3 type of AML
Q431. t(11:14)
A431. Mantle cell Lymphoma
Q432. Monoclonal Immunoglobulin spike of IgM
A432. Waldenstrom's macroglobulinemia
Q433. Myeloblastic AML
A433. M1
Q434. High RBC count w/ low or normal serum EPO
A434. Polycythemia Vera
Q435. Myeloproliferative Disorder associated with pruritis
A435. Polycythemia Vera
Q436. Myelomonoblastic AML
A436. M4
Q437. Myeloblastic with differentiation AML
A437. M2
Q438. 2nd most common type of Hodgkin's Lymphoma
A438. Mixed Cellularity type of Hodgkin's Lymphoma
Q439. Neutrophilic Leukocytosis w/ a left shift
A439. CML
Q440. Punched-out lytic bone lesions
A440. Multiple Myeloma
Q441. Least common type of Hodgkin's Lymphoma
A441. Lymphocyte Depleted type of Hodgkin's Lymphoma
Q442. Most common Lymphoma in children
A442. Burkitt's Lymphoma
Q443. Lymphoma that resembles CLL
A443. Small lymphocytic Lymphoma
Q444. Increased Leukocyte Alkaline Phosphate
A444. Leukemoid Reaction; Resembles CML but can be differentiated based on high LAP
Q445. Rouleau formation
A445. RBC's stacked like poker chips on Blood smear; associated with Multiple Myeloma
Q446. Ig light chains in urine
A446. Bence Jones protein; associated with Multiple Myeloma
Q447. "Blast Crisis"
A447. CML; Occurs when the CML accelerates to AML
Q448. Lacunar Cells
A448. type of Reed-Sternberg Cell; associated with Nodular Sclerosing type of Hodgkin's Lymphoma
Q449. Decreased Leukocyte Alkaline Phosphate
A449. CML; Very low LAP helps differentiate CML from leukemoid reaction (which has a high LAP)
Q450. Bilobed Tumor Giant Cell that looks like "owl's eyes"
A450. Reed-Sternberg Cells; associated with Hodgkin's Lymphoma
Q451. Auer Rods
A451. AML (Primarily seen in M3); Auer Rods- Peroxidase(+) cytoplasmic inclusions in granulocytes and myeloblasts
Q452. Leukemia w/ peak incidence from 35-50 years old
A452. CML
Q453. Leukemia that most commonly occurs in people older than 60
A453. CLL
Q454. Leukemia that most commonly affects children
A454. ALL
Q455. t(8;22)
A455. Burkitt's Lymphoma; c-myc & lambda light chain; This translocation is not as common as t(8;14)
Q456. t(2;8)
A456. Burkitt's Lymphoma; c-myc & kappa light chain; This translocation is not as common as t(8;14)