Path: Clinical Aspects of Neoplasia Flashcards Preview

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Flashcards in Path: Clinical Aspects of Neoplasia Deck (28)
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1
Q

What are the 3 most common symptoms of of lung cancer, starting from most common?

A

cough, hemoptysis (blood in cough), dyspnea

2
Q

Do most pts with prostate cancer present with symptoms upon diagnosis?

A

No

3
Q

How is prostate cancer Dx’d if no symptoms usually present?

A

screening for PSA (normal <4) or rectal exam

4
Q

T/F: 55% of women with breast cancer have no symptoms at the time of Dx. How do we Dx it if no symptoms?

A

True; mammography (that’s why mammography is important)

5
Q

T/F: risk for breast cancer increases with age

A

True

6
Q

T/F: risk for breast cancer increases with later onset of menarche

A

False, increases with early menarche (more exposure to estrogen?)

7
Q

T/F: risk for breast cancer increases with later menopause.

A

True (more exposure to estrogen?)

8
Q

At what age begins a risk factor for colon cancer?

A

60

9
Q

What are the 3 most common symptoms of colon cancer?

A
Abdominal pain (44%)
Changes in bowel habits: diarrhea, constipation (43%) hematochezia, melena (40%)
10
Q

T/F: many colon cancer pts are asymptomatic at the time of Dx by screening colonoscopy.

A

True

11
Q

What does the prognosis of colon cancer depend on?

A

Stage (goes from 74% 5-yr survival Stage I to 6% 5-yr survival for stage IV)

12
Q

T/F: a substantial body of evidence supports a protective effect of aspirin and other NSAIDs on the development of colonic adenomas and cancer.

A

True

13
Q

List 4 risk factors for colon cancer.

A

hereditary forms of colon cancer, age, family/personal history, inflammatory bowel disease

14
Q

What foods should one stay away from and what foods are good when attempting a diet protective of colon cancer.

A

avoid: processed and charred red meat, EtOH, high calorie diet
good: veggies, wheat bran (unprocessed), folate

15
Q

What is a paraneoplastic syndrome?

A

symptoms not attributable to direct effects of tumor (or hormones native to the primary tumor organ)
Occur in about 10% of cancer pts
-cachexia does not count

16
Q

What is the type of cancer most likely to cause a para-neoplastic syndrome and why?

A

small cell carcinoma because it is a neuroendocrine tumor

17
Q

What are the 3 most common paraneoplastic syndromes?

A

Hypercalcemia, Cushing syndrome (moon-face–ACTH), Carcinoid syndrome (flushing & diarrhea–Serotonin)

18
Q

What are the symptoms of hypercalcemia of malignancy and why are they happening?
Also, how do you treat it?

A

nausea, vomiting, constipation, polyuria, disorientation, lethargy, seizures
Mech: parathyroid hormone-related protein (PTRHP), etc.
Tx: hydration, bisphosphonates (prevent osteopenia)

19
Q

What is the most common lung cancer type to cause hypercalcemia?

A

squamous cell carcinoma

20
Q

What are the signs & symptoms of Cushing syndrome?

A

weight gain, central obesity, moon face, weakness, hirsutism, hypertension, glucose intolerance, depression, etc…but also buffalo hump fat deposition, bc don’t you dare forget that shit, it’s hilarious.

21
Q

What is the most common source of ACTH causing Cushing syndrome?

A

pituitary adenoma

22
Q

What are the symptoms of carcinoid syndrome?

A

attacks of cutaneous flushing, diarrhea, cramps, nausea, vomiting, cough, etc…

23
Q

List the 5 main direct effects of tumors.

A
1- impingement on adjacent structures
2- obstruction (e.g. of intestine)
3- functional activity (e.g. hormones)
4- surface ulceration (+/- bleeding, infection)
5- infarction +/- rupture
24
Q

What are the two steps in Dx of cancer?

A

1- discovery (S&S, screening)
2- specific Dx (biopsy [most common, usually best], fine needle aspiration cytology, exfoliative cytology)
+/- immunohistochemistry, flow cytometry, molecular testing

25
Q

What is a Dx method that can reveal the presence of individual tumor cells in a biopsy (under microscope) when they may be hard to identify otherwise?

A

immunostaining

26
Q

Remind me, what is anaplasia?

A

condition whereby cells lose the morphological characteristics of mature cells and their orientation with respect to each other and to endothelial cells.
Features: larger than differentiated cells, higher nuclear/cytoplasmic ratio [bigger nuclei, less cytoplasm] pleomorphic (varying in shape and size)
Nuclear abnormalities: angulated shape, hyperchromatism, clumped chromatin, mitoses, nucleoli

27
Q

How do you determine tumor stage, again?

A

Anatomic extent of tumor, including tumor primary size, extent of lymph node and distant metastases.

28
Q

What is the tumor grade?

A

A qualitative assessment of the differentiation of a tumor (extent to which it resembles normal tissue at primary site)