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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)?
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leukemia and lymphoma
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what is the most curable type of leukemia?
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ALL (acute lymphblastic leukemia)
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which of the leukemias presents in young kids with mediastinal widening?
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ALL
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what is the most common CA in most organs?
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metastatic CA
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spinal cord compression 2* to metastatic CA can cause local spinal pain and neuro sx. what are the first 3 steps of mgmt?
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1. high dose corticosteroids
2. MRI scan of spine 3. radiation tx |
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retinoblastoma, osteogenic sarcoma (later in life). syndrome?
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retinoblastoma
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parathyroid CA, pituitary CA, pancreatic CA (islet cell tumors): syndrome?
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MEN, type I
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thyroid CA (medullary), parathyroid CA, pheochromocytoma: syndrome?
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MEN, type IIa
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thyroid CA (medullary), pheochromocytoma, mucosal neuroma: syndrome?
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MEN, type IIb
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hundreds of colon polyps that ALWAYS become CA: syndrome?
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familial polyposis coli
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familial polyposis plus osteomas and soft tissue tumors: syndrome?
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Gardner's syndrome
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familial polyposis plus CNS tumors: syndrome?
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Turcot's syndrome
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perioral freckles and multiple non-cancerous GI polyps; increased incidence of non-colon CA (stomach, breast, ovaries); no increased risk of colon CA: syndrome?
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Peutz-Jegher's syndrome
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multiple neurofibromas, cafe-au-lait spots; increased number of pheochromocytomas, bones cysts, Wilms' tumor, leukemia: syndrome?
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neurofibromatosis, type 1
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bilateral acoustic neuromas: syndrome?
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neurofibromatosis, type 2
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adenoma sebaceum, seizures, mental retardation, glial nodules in brain; increased renal angiomyolipomas and cardiac rhabdomyomas: syndrome?
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tuberous sclerosis
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hemangioblastomas in cerebellum, renal cell CA, cysts in liver and/or kidney: syndrome?
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von Hippel-Lindau disease
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does small cell carcinoma, or oat cell carcinoma, have a good or bad prognosis?
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WORST lung CA prognosis due to early invasion and metastasis
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what are the 4 types of paraneoplastic syndromes?
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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 |
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first step in managing a pt with a solitary pulmonary nodule on chest radiograph? what do you think if nodule is unchanged over 2yrs?
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compare with prior chest radiographs
unlikely to be CA |
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risk factors for breast CA?
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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) |
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new breast mass in postmenopausal woman, shows as microcalcifications on mammography. suspicion?
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high suspicion for breast CA
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what do you think about when a woman <30yrs presents with a breast mass?
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fibroadenoma
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what does a fibroadenoma feel like?
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roundish, rubbery, freely movable
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most common histological type of breast CA?
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invasive ductal CA
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should mammograms be done in women younger than 30yrs?
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NO. rarely helpful.
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when is tamoxifen useful in treating breast CA?
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when breast CA has estrogen receptors and especially when the tumor cells also express progesterone receptors
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classic presentation of prostate CA on step 2?
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pt >50yrs
hesitancy, dysuria, frequency hematuria high PSA prostate irregularities (nodules) back pain from vertebral mets (osteoblastic) |
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how is prostate CA treated? how about prostate CA mets?
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surgery (prostatectomy) or local radiation
orchiectomy, GRH agonist (leuprolide), androgen receptor antagonist (flutamide) |
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primary risk factors for colon CA?
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1. age (peak 60 to 75yrs)
2. FH (esp. familial polyposis, Gardner's, Turcot's, Lynch syndrome) 3. IBD (UC > Crohn's) |
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how may pts with colon CA present?
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1. asymptomatic blood in stool
2. anemia is classic in R sided colon CA 3. change in stool caliber 4. alternating frequency and constipation |
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pt over 40 presents with occult blood in stool. how do you rule out colon CA?
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total colonoscopy with removal and histo examination of all polyps and lesions
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where do most GI cancers go to first?
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liver
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what is the classic tumor marker for colon CA? how is it used?
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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 |
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what is the cell of origin in pancreatic CA?
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ductal epithelium
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what is Trousseau's syndrome?
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migratory thrombophlebitis associated with pancreatic CA and other visceral CA's
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what is Courvoisier's sign?
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palpable, non-tender gallbladder
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how does pancreatic CA present?
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pt is smoker, 40 to 80yo
lost weight, jaundiced depression, epigastic pain palpable, non-tender gall bladder |
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most common islet cell tumor of the pancreas? how does it present? what do you do?
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insulinoma (beta cell tumor)
hypoglycemia and associated neuro sx give glucose, check C-peptide levels (HIGH in insulinoma) |
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what % of insulinomas are benign?
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90%
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what is Zollinger Ellison syndrome?
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pancreatic gastrinoma that causes acid hypersecretion and peptic ulcer disease (many, refractory to tx, in odd places)
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how are ZE syndrome ulcers different than normal peptic ulcers?
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many
hard to treat in odd places (distal duodenum or jejunum) |
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what tumor causes hyperglycemia with high glucagon levels and migratory necrotizing skin erythema?
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glucagonoma (alpha cell tumor), a pancreatic islet cell tumor
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what type of pancreatic cancer causes watery diarrhea, hypokalemia, and achlorhydria?
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VIPoma
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