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93 Cards in this Set
- Front
- Back
What is a carcinoma?
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Cancer that begins in the skin or in tissue that line or cover internal organs
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Cancer that begins in bone, cartilage, ___, muscle, blood vessels or other connective or __ tissue is called a ___
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fat; supportive; sarcoma
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What is a lymphoma or myeloma?
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cancere that begin in cells of the immune system
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Cancers that begin in the tissue of the brain and spinal cord are called ___.
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central nervous systems cancers
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List the characteristics of benign tumors
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-slow growing
-growth occurs within a capsule of fibrous tissue -do not invade adjacent tissues -do not metastasize -cytology reveal uniform, well differentiated cells that resemble tissue of origin |
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What are the characteristics of a malignant tumor?
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-high mitotic rate
-rapid growth -not encapsulated -invade surrounding tissue, lymp, and blood and metastasize to distant sites -anaplastic, more poorly differentiated |
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What is the term used to describe either a new primary cancer or a metastatic cancer?
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secondary
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cancer is a ___ diagnosis
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microscopic
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Tissue or cells are examined ___ to differentiate malignancy from benign problem
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histologically
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Screening tests should have adequate __ and __ and a high predictive value.
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sensitivity and specificity
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ToF: screening is definitive.
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False
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What types of medications would be important to record in a cancer workup?
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-estrogens/progestins
-tamoxifen |
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What is the definition of a symptom?
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Any subjective evidence of disease. A symptoms is a phenomenon that is experienced by an individual. Anxiety, lower back pain, and fatigue are all symptoms. they are sensations only the patient can perceive
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Define a sign?
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any objective evidence of disease. A sign can be detected by a person other an the affected individual. Gross blood in the stool is a sign.
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Does a change in bladder habits have a connection to cancer?
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Yes, it can be a symptom
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Prompt recognition of the __ signs and symptoms of cancer allows ____ when cancer is curable
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early; diagnosis
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what is the metal film that is collided with a concentrated beam of electrons to give an xray?
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tungsten
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Radiation flows easily through __ (black) and soft tissue (___), but not as easily through ___ where there is higher absorption (white)
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air; gray; bone
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What radiograph is used to see peripheral lung lesions>
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chest xray
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What are some typical uses for bone xrays?
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skeletal survey for multiple myeloma, metastatic boney disease
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What are the limitations to GI series?
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-fasting required
-bowel prep required -may limit other abdominal studies |
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Ultrasound is a method of using __ waves with high ___. Transducer sends __ and image made from reflections of those waves back from organs/tissue
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waves; frequencies; waves
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ToF; US can be used for biopsy guidance.
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True
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Why is US limited?
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it is not able to penetrate bone or air
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What is the most common diagnostic imaging test in oncology?
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CAT scan
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What is the test of choice to visual intra-abdominal lesions?
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CAT scan
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The CAT scan forms a full ___ computer model allowing the clinician to examine the body one narrow ___ at a time to pinpoint specific areas.
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3D; slice
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ToF: patients are exposed to ionizing radiation during a MRI?
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False
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what are the components of a MRI to make it work?
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-Powerful magnetic field
-radio frequency pulses -computer to produce detailed pictures of organs |
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What is the preferred imaging for musculoskeletal, brain or CNS tumors?
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MRI
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What is the Nephrotoxic IV contrast used for MRIs?
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Gadolinium
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Which is more expensive, PET or MRI scans?
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PET
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What must be done in order to conduct a bone scan?
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Injecting a radiolabeled substance into a vein. This substance is attracted to bone, particularly to areas of high bone activity.
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What is the gold standard in visualizing solitary pulmonary lesions?
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PET scans
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What is the radioactive tracer injected during a PET scan>?
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ususally F-FDG
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96% of pts with lung cancer will have an abnormal ___ ___
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PET Scan
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Metabolically active areas will take up __ and show up as a ___ spot on PET scan images
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glucose; hot
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ToF: all tumors will appear hot on a PET scan.
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FALSE: some will not because of limited glucose uptake: slow growing tumors such as bronchoalveolar carcinoma
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PET scan can help stage which cancers?
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esophageal, colorectal, melanoma and lymphoma, NSCLC, thyroid and breast
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What is the typical cost of a PET scan
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3-7000
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Diagnosis of cancer requires ___ confirmation by obtaining histologic or ___ proof of malignancy
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tissue; cytologic
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What are the technique methods for biopsy?
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-FNA
-core needle biopsy -stereostatic biopsy -excisional -incisional |
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What are the most common diagnostic procedures?
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-endoscopy
-colonoscopy -laparoscopy -bronchoscopy -thoracoscopy -mediastinoscopy |
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What is a histologic examination?
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tissue removed during biopsy is sent to a pathology lab, and sliced into thin sections for viewing under a microscope
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Describe cytologic evaluation.
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cells examined from fluids such as urine, CSF, sputum, peritoneal fluid, pleural fluid, cervical/vaginal smears and in fluid removed during biopsy
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What are permanent sections in pathology?
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-prepared by placing the tissue in fixative (usually formalin) to preserve the tissue, processing it through additional solutions, and then placing it in paraffin wax. After the wax has hardened, the tissue is cut into very thin slices, which are placed on slides and stained. The process usually takes several days
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When are frozen sections done?
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when an immediate answer is needed, to determine if the tissue is cancerous so the surgeon can cut properly
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What is the process of frozen sections?
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tissue prepared by freezing and slicing the tissue sample. They can be done in about 15 to 20 mins while the pt is in the OR
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What is the grading of a tumor dependent on?
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the histopathologic characteristics of tissue
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What are the degrees of tumor cells determined by pathologists?
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-well differentiated
-moderately well differentiated -poorly differentiated -undifferentiated |
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What are the tumors that require grading?
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-prostate
-soft tissue sarcoma -transitional cell carcinoma of the bladder -astrocytoma -chondrosarcoma -breast |
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what are the tumor where grading is not useful?
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-Testicular
-thyroid -neuroblastoma -osteosarcoma |
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what is the technique of immunohistochemistry?
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IHC uses antibodies for staining protein in tissues on microscopic glass slides and identifies specific antigens on the surface of cancer cells
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Why is IHC important?
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helps identify the site of origin of the tumor cells
-detects antigens that are used to determine prognostic information such as ER/PR and HER2/neu |
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What does IHC help determine with HER2 cells in particular?
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determines total amount of HER2 protein receptors on the surface of the cell. IHC determined by intensity and % of cells that exhibit a brown cell surface staining.
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What are tumor markers most useful for?
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in detecting early relapse and monitoring response to therapy
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What do tumor markers consist of?
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protein products, antigens, hormones, enzymes, excreted by cancer cells or released in response to the presence of cancer
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ToF; tumor markers have high enough sensitivity and specificity to be useful in screening
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False
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Where are tumor markers measured?
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in the serum or tissue of origin
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What is the tumor marker associated with neuroblastoma?
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VMA
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How does flow cytometry work?
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the cells are stained with a light-sensitive dye, placed in a fluid, and passed in a stream before a laser or other type of light. the measurements are based on how the light sensitive dye reacts to the light.
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What does flow cytometry reveal?
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the arrangement and amount of DNA in a cell, distinguishes benign cells from malignant ones, and monitors the effect of anticancer treatment
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What cancers often use flow cytometry?
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lymphoma, bladder cancers and leukemic disorders
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what are the 2 techniques used in cytogenetics?
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Fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR)
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WHat is FISH?
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determines the position of particular genes. it can be used to identify chromosomal abnormalities and to map genes.
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What is the name of the method of making many copies of particular DNA sequences of relevance to the diagnosis?
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PCR
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Cytogenetics is known for its use in detecting ___ __
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genetic alterations
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Why is staging important?
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-help the HCP plan appropriate treament
-estimate a person's prognosis -ID a clinical trial opportunity -helps researchers evaluate the results of a clinical trial |
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What are the elements of the stating system?
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-site of the primary tumor
-tumor size and number of tumors -lymph node involvement -cell type and grade -the presence or absence of metastasis |
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Patients are less likely to respond to treatment when __ __ than those athat re asymptomatic and able to maintain ADLs
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bed ridden
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what is the most widely used staging system for cancer?
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TNM system
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What is the TNM system based on ?
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T: extent of tumor
N: extent of spread to lymph nodes M: presence of distant metastasis |
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What are the specifics of the TNM classification system?
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Tx: tumor cannot be evaluated
Tis: carcinoma in situ T0: no signs of tumor T1, T2, T3, T4: size and/or extension of the primary tumor Nx: lymph nodes cannot be evaluated N0: tumor cells absent from regional lymph nodes N1: regional lymph node metastasis present; (at some sites: tumor spread to closest or small number of regional lymph nodes) N2: tumor spread to an extent between N1 and N3 (N2 is not used at all sites) N3: tumor spread to more distant or numerous regional lymph nodes (N3 is not used at all sites) Mx: distant metastasis cannot be evaluated M0: no distant metastasis M1: metastasis to distant organs (beyond regional lymph nodes |
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What is a 0 score on the eastern cooperative oncology group (ECOG) performance scale?
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fully active; no performance restriction
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ToF: the higher the number on the ECOG performance scale, the more functional the person?
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false! 0 is most functional, and 4 is completely disabled; no ADLs and confined to bed or chair
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Which scale is meant for children, the Karnofsky or the Lansky performance scale?
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The Lansky
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What is the 0 value for the Karnofsky and Lansky performance scales?
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K= dead
L=unresponsive |
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ToF: progression of the disease will change the initial stage of the disease
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FALSE
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The ___ is based on information acquired before treatment, supplemented or modified by information from surgery and the pathologic exam of a resected specimen including tumor, lymph nodes and distant metastases.
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pTNM
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What is the cTNM?
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based on information obtained from the PE, labs and imaging, endoscopy and biopsy. Clinical staging uses all information available before the initiation of definitive treatment.
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What is the definition of a screening mamogram?
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performed on women who are asymptomatic for breast cancer. A screening mam usually consists of 2 views of each breast. Additional views may be needed to adequately image all of the breast tissue, depending on the woman's tissue and other factors
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What is a diagnostic mammogram?
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Is performed on women or men who present with breast complaints or have an abnormal clinical exam, and in women who have an abnormal screening mamm. Patients with specific breast symptoms, such as palpable lump, nipple discharge, or focal pain require diagnostic mammogram
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What is the BI-RADS mammographic assessment?
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the assessment is placed into categories with corresponding recommendations and probabilities of malignancies
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Is a low or high number desirable on the BI-RADS?
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Low number: 1 is normal and a 6 is a biopsy-proven carcinoma
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ToF: the TNM staging for breast cancer goes into depth as where the cancer is located and the extent of the growth
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True
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What is the Ann Arbor Staging system most often used for?
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Hodgkins and non-hodgkins lymphoma
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What is stage I in the Ann Arbor system?
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involvement of 1 single lymph node region or of a single extralymphatic organ or site (IE)
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What is stage III ann arbor?
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involvement of lymph node regions on both sides of the diaphragm, which may include the spleen IIIS or limited contiguous extralymphatic organ or site IIIE or both IIIES
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what does in situ mean?
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abnormal cells present only in layer of cells in which they developed
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What is meant by regional staging?
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spread beyond primary site to nearby LNs or organ tissue
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___ spread is characterized by spread to further organs and LNs
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distant
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What are the 5 main categories of for grouping cancers according to the surveillance, epidemiology and end results program
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-in situ
-localized -regional -distant -unknown |
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What are the staging systems for multiple myelomas?>
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Durie-Salmon criteria/ISS criteria
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