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44 Cards in this Set

  • Front
  • Back
what are the most common types of cancer in children and young adults (<30yrs)?
leukemia and lymphoma
what is the most curable type of leukemia?
ALL (acute lymphblastic leukemia)
which of the leukemias presents in young kids with mediastinal widening?
ALL
what is the most common CA in most organs?
metastatic CA
spinal cord compression 2* to metastatic CA can cause local spinal pain and neuro sx. what are the first 3 steps of mgmt?
1. high dose corticosteroids
2. MRI scan of spine
3. radiation tx
retinoblastoma, osteogenic sarcoma (later in life). syndrome?
retinoblastoma
parathyroid CA, pituitary CA, pancreatic CA (islet cell tumors): syndrome?
MEN, type I
thyroid CA (medullary), parathyroid CA, pheochromocytoma: syndrome?
MEN, type IIa
thyroid CA (medullary), pheochromocytoma, mucosal neuroma: syndrome?
MEN, type IIb
hundreds of colon polyps that ALWAYS become CA: syndrome?
familial polyposis coli
familial polyposis plus osteomas and soft tissue tumors: syndrome?
Gardner's syndrome
familial polyposis plus CNS tumors: syndrome?
Turcot's syndrome
perioral freckles and multiple non-cancerous GI polyps; increased incidence of non-colon CA (stomach, breast, ovaries); no increased risk of colon CA: syndrome?
Peutz-Jegher's syndrome
multiple neurofibromas, cafe-au-lait spots; increased number of pheochromocytomas, bones cysts, Wilms' tumor, leukemia: syndrome?
neurofibromatosis, type 1
bilateral acoustic neuromas: syndrome?
neurofibromatosis, type 2
adenoma sebaceum, seizures, mental retardation, glial nodules in brain; increased renal angiomyolipomas and cardiac rhabdomyomas: syndrome?
tuberous sclerosis
hemangioblastomas in cerebellum, renal cell CA, cysts in liver and/or kidney: syndrome?
von Hippel-Lindau disease
does small cell carcinoma, or oat cell carcinoma, have a good or bad prognosis?
WORST lung CA prognosis due to early invasion and metastasis
what are the 4 types of paraneoplastic syndromes?
1. Cushing's syndrome: ACTH, small cell CA
2. SIADH: anti-diuretic hormone, small cell CA
3. hypercalcemia: parathyroid-like hormone production, squamous cell CA
4. Eaton-Lambert syndrome: myasthenia gravis-like disease from lung CA that spares ocular muscles (muscles get stronger during the day), small cell CA
first step in managing a pt with a solitary pulmonary nodule on chest radiograph? what do you think if nodule is unchanged over 2yrs?
compare with prior chest radiographs

unlikely to be CA
risk factors for breast CA?
personal hx of breast CA
FH in 1st degree relatives
age >40yrs
early menarche
late menopause
late first pregnancy, or nulliparity (more cycles = higher risk)
new breast mass in postmenopausal woman, shows as microcalcifications on mammography. suspicion?
high suspicion for breast CA
what do you think about when a woman <30yrs presents with a breast mass?
fibroadenoma
what does a fibroadenoma feel like?
roundish, rubbery, freely movable
most common histological type of breast CA?
invasive ductal CA
should mammograms be done in women younger than 30yrs?
NO. rarely helpful.
when is tamoxifen useful in treating breast CA?
when breast CA has estrogen receptors and especially when the tumor cells also express progesterone receptors
classic presentation of prostate CA on step 2?
pt >50yrs
hesitancy, dysuria, frequency
hematuria
high PSA
prostate irregularities (nodules)
back pain from vertebral mets (osteoblastic)
how is prostate CA treated? how about prostate CA mets?
surgery (prostatectomy) or local radiation

orchiectomy, GRH agonist (leuprolide), androgen receptor antagonist (flutamide)
primary risk factors for colon CA?
1. age (peak 60 to 75yrs)
2. FH (esp. familial polyposis, Gardner's, Turcot's, Lynch syndrome)
3. IBD (UC > Crohn's)
how may pts with colon CA present?
1. asymptomatic blood in stool
2. anemia is classic in R sided colon CA
3. change in stool caliber
4. alternating frequency and constipation
pt over 40 presents with occult blood in stool. how do you rule out colon CA?
total colonoscopy with removal and histo examination of all polyps and lesions
where do most GI cancers go to first?
liver
what is the classic tumor marker for colon CA? how is it used?
carcinoembryonic antigen (CEA) may be elevated with colon CA

if pt is found to have colon CA, then pre-op CEA levels are checked

NOT a screening tool
what is the cell of origin in pancreatic CA?
ductal epithelium
what is Trousseau's syndrome?
migratory thrombophlebitis associated with pancreatic CA and other visceral CA's
what is Courvoisier's sign?
palpable, non-tender gallbladder
how does pancreatic CA present?
pt is smoker, 40 to 80yo
lost weight, jaundiced
depression, epigastic pain
palpable, non-tender gall bladder
most common islet cell tumor of the pancreas? how does it present? what do you do?
insulinoma (beta cell tumor)

hypoglycemia and associated neuro sx

give glucose, check C-peptide levels (HIGH in insulinoma)
what % of insulinomas are benign?
90%
what is Zollinger Ellison syndrome?
pancreatic gastrinoma that causes acid hypersecretion and peptic ulcer disease (many, refractory to tx, in odd places)
how are ZE syndrome ulcers different than normal peptic ulcers?
many
hard to treat
in odd places (distal duodenum or jejunum)
what tumor causes hyperglycemia with high glucagon levels and migratory necrotizing skin erythema?
glucagonoma (alpha cell tumor), a pancreatic islet cell tumor
what type of pancreatic cancer causes watery diarrhea, hypokalemia, and achlorhydria?
VIPoma