Oncology from Step 2 Secrets

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What age patients most commonly get ALL: Children. Peak age is 3-5 year olds.
Trigger words for ALL: Pancytopenia (bleeding, fever, anemia), radiation therapy, Down syndrome
What age patients usually get AML?: >30 year olds
Trigger words for AML: Pancytopenia (bleeding, fever, anemia), Auer rods, DIC
What age patients usually get CML?: 30-50 year olds
Trigger words for CML?: White blood cell count >50,000, Philadelphia chromosome, blast crisis, splenomegaly.
What age patient usually get CLL?: >50 year olds
Trigger words for CLL?: Male sex, lymphadenopathy, lymphocytosis, infections, smudge cells, splenomegaly
What age patient usually get hairy cell leukemia?: Adults
Trigger words for Hairy cell leukemia?: Hair-like projections, splenomegaly
What age patients usually get Mycosis fungoides/Sezary syndrome?: >50 year olds
Trigger words for mycosis fungoides/Sezary syndrome: plaque-like, itchy skin rash that does not improve with treatment, blood smear (cerebriform nuclei known as "butt cells"), Pautrier's abscesses in epidermis.
What are "butt cells": cells with cerebriform nuclei found in mycosis fungoides/Sezary syndrome
Define Pautrier's abscesses: Microabscesses found in the epidermis in pts with mycosis fungoides/Sezary syndrome.
What age patients usually get Burkitt's lymphoma?: Children
What virus is associated with Burkitt's lymphoma?: Epstein-Barr virus (in Africa)
What age patients usually get CNS B cell lymphoma?: Adults
Trigger words for CNS B cell lymphoma: HIV positive patients, AIDS
What age patients usually get Hodgkin's disease?: 15-34 year olds
Trigger words for Hodgkin's disease?: Reed-Sternberg cells, cervical lymphadenopathy, night sweats
What age patients usually get T cell leukemia?: Adults
What virus causes T cell leukemia?: HTLV-1
Which type of non-Hodgkin's lymphoma has best prognosis?: Small follicular type
What type of non-Hodgkin's lymphoma has worst prognosis?: large diffuse type
What percent of non-Hodgkin's lymphoma is found in GI tract?: 20%
What age patients usually get myelodyplasia/myelofibrosis?: >50 year olds
trigger words for myelodysplasia/myelofibrosis?: Anemia, teardrop cells, "dry tap" on bone marrow biopsy, high MCV and RDW, associated with CML
What leukemia is associated with myelofibrosis/myelodysplasia?: CML
What age patients usually get multiple myeloma?: >40 year olds
Trigger words for multiple myeloma: Bence-Jones proteins, osteolytic lesions, high calcium
What type of antibodies are Bence-Jones proteins?: 50% are IgG, 25% are IgA
What age patients usually get Waldenstrom's macroglobulinemia?: > 40 year olds
Trigger words for Waldenstrom's macroglobulinemia: hyperviscosity, IgM spike, cold agglutinins, Raynaud's phenomenon with cold
Which cancer is associated with Down Syndrome?: ALL
What age patients usually get Polycythemia rubra vera?: >40 year olds
Trigger words for polycythemia rubra vera: high hematocrit, pruritus (esp after shower)
Treatment for polycythemia rubra vera: phlebotomy
What age patients usually get primary thrombocythemia?: >50 year olds
what is the platelet count usually in primary thrombocythemia?: >1,000,000
Si/Sx of primary thrombocythemia: may have bleeding or thrombosis
Which blood dyscrasia is assoc with cold agglutinins?: Waldenstrom's macroglobulinemia
What are the three cancers with the highest incidence in men? (list in order): 1. Prostate
2. Lung
3. Colon
What are the three cancers with the highest incidence in women? (list in order): 1. Breast
2. Lung
3. Colon
What are the three cancers with the highest mortality in men? (list in order): 1. Lung
2. Prostate
3. Colon
What are the three cancers with the highest mortality in women? (list in order): 1. Lung
2. Breast
3. Colon
What are the most common types of cancer in children and young adults (<30 years)?: Leukemia and Lymphoma
What is the major risk factor for cancer?: Age (incidence roughly doubles every 5 years after 25 years of age)
What is the major modifiable risk factor for cancer?: Smoking
What is the most common cancer in most organs?: Metastatic cancer
Metastatic cancer to the spine can cause spinal cord compression. How do you recognize and treat this medical emergency?: 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.
Mode of inheritance of retinoblastoma?: Autosomal dominant
Mode of inheritance of MEN syndromes?: Autosomal dominant
Mode of inheritance of Familial polyposis coli?: Autosomal dominant
Mode of inheritance of Gardner's syndrome: Autosomal dominant
Mode of inheritance of Turcot's syndrome: Autosomal dominant
Mode of inheritance of Peutz-Jegher's syndrome?: Autosomal dominant
What is the mode of inheritance of Neurofibromatosis type 1?: Autosomal dominant
What is the mode of inheritance of neurofibromatosis type 2?: Autosomal dominant
What is the mode of inheritance of tuberous sclerosis?: Autosomal dominant
What is the mode of inheritance of von-hippel-lindau disease?: Autosomal dominant
What is the mode of inheritance of xeroderma pigmentosa?: Autosomal recessive
What is the mode of inheritance of albinism?: Autosomal recessive
What is the mode of inheritance of down syndrome?: Trisomy 21, most commonly caused by maternal non-disjunction
Type of cancer assoc with retinoblastoma?: retinoblastoma, osteogenic sarcoma later in life
Type of cancer assoc with MEN type 1: Parathyroid adenoma, pituitary adenoma, pancreatic islet cell tumors
Type of cancer assoc with MEN type 2A?: Parathyroid adenoma, Pheochromocytoma, Medullary thyroid cancer
Type of cancer assoc with MEN type 2B?: Medullary thyroid cancer, pheochromocytoma, mucosal neuromas
Type of cancer assoc with familial polyposis coli?: Colon cancer (these polyps always turn into cancer)
Type of cancer assoc with Gardner's syndrome?: familial polyposis, osteomas, soft tissue tumors
Type of cancer assoc with Turcot's syndrome?: familial polyposis, CNS tumors
Type of cancer assoc with peutz-jeghers syndrome?: increased incidence of non-colon cancer (stomach, breast, ovaries), although they have GI polyps, they don't have increase incidence of colon cancer
Type of tumors assoc with neurofibromatosis type 1?: multiple neurofibromas, increased incidence of pheochromocytomas, bone cysts, Wilm's tumors, leukemia
Type of tumors assoc with neurofibromatosis type 2?: bilateral acoustic neuromas
Type of tumors assoc with tuberous sclerosis?: adenoma sebaceum, glial nodules in the brain, renal angiomyolipomas, cardiac rhabdomyosarcomas
Type of tumors assoc with von-hippel-lindau?: hemangioblastomas in cerebellum, renal cell cancer, cysts in liver and kidney
Type of tumors assoc with xerderma pigmentosa?: skin cancer
Type of tumors assoc with albinism?: skin cancer
Type of cancer associated with Down Syndrome?: ALL
What risk factors are associated with lung cancer?: smoking, asbestos (also nickel, radon, coal, arsenic, chromium, uranium)
What risk factors are associated with mesothelioma?: asbestos
What risk factors are associated with leukemia?: chemotherapy/radiotherapy, other immunosuppressive drugs, benzene
What risk factors are associated with bladder cancer?: Smoking, aniline dye, schistosomiasis
What risk factors are associated with skin cancer?: UV light, coal tar, arsenic
What risk factors are associated with liver cancer?: alcohol, vinyl chloride, aflatoxins
What risk factors are associated with cancer of the oral cavity?: smoking, alcohol
What risk factors are associated with pharyngeal/laryngeal cancer?: smoking, alcohol
What risk factors are associated with esophageal cancer?: smoking, alcohol
What risk factors are associated with pancreactic cancer?: Smoking
What risk factors are associated with renal cell cancer?: smoking
What risk factors are associated with stomach cancer?: alcohol,nitrosamines/nitrites,
What risk factors are associated with clear cell cancer?: in utero exposure to DES (diethylstilbestrol)
What risk factors are associated with colon/rectal cancer?: Age (peak in 60-75), family hx, inflammatory bowel disease (UC > crohn's, high fat and low fiber diet
What risk factors are associated with breast cancer?: Personal hx of breast cancer, family hx 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
What risk factors are associated with cervical cancer?: 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
What risk factors are associated with thyroid cancer?: childhood neck or chest irradiation
What risk factors are associated with endometrial cancer?: unopposed estrogen stimulation, obesity, nulliparity, late menopause, diabetes, HTN, PCOS, estrogen secreting neoplasm (granulosa/theca cell)
What risk factors are associated with all cancers overall?: smoking (number two is alcohol)
What clinical vignette should make you suspect lung cancer?: 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.
How do you diagnose and treat lung cancer?: 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).
What can result from an apical (Pancoast) lung cancer?: 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
Define paraneoplastic syndrome: condition caused by a malignancy but not due directly to destruction or invasion by the tumor
What types of paraneoplastic syndromes can be caused by small cell lung cancer?: Cushing's syndrome--from ACTH
SIADH--ADH
Eaton-Lambert syndrome
Define Eaton-Lambert syndrome: Myasthenia gravis-like disease that spares occular muscles. Muscles become stronger with repeated stimulation.
What types of paraneoplastic syndromes can be caused by squamous cell lung cancer?: hypercalcemia--from parathyroid-like hormone
How do you manage a pt with a solitary pulmonary nodule on chest x-ray?: 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 pt 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 pt is younger than 35 or is a non-smoker, the cause is most likely infection, hamartoma, or collagen vascular disease. The pt should ahve CT and careful observation with follow-up imaging in 3-6 months.
How many women in the U.S. will develop breast cancer?: 1 in 8
What classic si/sx indicate that a breast mass is cancer until proven otherwise?: 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.
What is the conservative approach to ensure that you don't miss a breast cancer?: 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)
What should you do with a breast mass in a pt younger than 30?: Breast cancer is rare here. With a discrete mass, think fibroadenoma. Get ultrasound of the breast and observe the pt over a few menstrual cycles before considering biopsy (unless ultrasound is suspicious).
What suggests breast fibroadenoma?: Round, rubbery, freely movable mass.
What suggests fibrocystic changes.: bilateral lumpy breasts that become symptomatic with every menses and have no dominant mass, patient younger than 30
What is the most common histiologic type of breast cancer?: Invasive ductal carcinoma
What is the role of mammography in deciding whether or not to biopsy a breast mass?: 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.
True or false--a mmamogram should not be done in women under age 30: 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.
How does tamoxifen affect breast cancer?: It improves survival if the breast cancer has estrogen receptors and even more so if the tumor cells also express progesteroen receptors.
True or false--mastectomy and breast conserving surgery with radiation are considered equal in efficacy.: True. In either case, do an axillary node dissection or sentinel node biopsy. If nodes are positive, give chemotherapy.
What are the two main risk factors for prostate cancer?: Age--it's not seen in pts <40 years old. 60% of men older than 80 years have prostate cancer.
Race--black>white>asian
How do you recognize prostate cancer on step 2?: 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. Pts may have back pain from vertebral metastases, which are osteoBlastic.
How is prostate cancer treated?: Prostatectomy or local radiation. With metastases, the pt 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.
How does colon cancer present?: asymptomatic blood in stool, anemia, change in stool caliber, or frequency, large bowel obstruction, weight loss
How do you rule out colon cancer on a pt over 40 with occult blood in stool?: 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.
How is colon cancer treated?: 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.
What is the tumor marker for colon cancer?: CEA, if it's elevated before surgery, it should return to normal after surgery and monitored periodically. It is NOT a screening tool.
Classic presentation for pancreatic cancer?: 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.
Treatment for pancreatic cancer?: Surgery (Whipple) rarely successful, chemo isn't either.
What is the cell of origin of pancreatic cancer?: ductal epithelium
What is the most common islet cell tumor of the pancreas?: Insulinomas (beta cell tumor).
What are the findings with insulinomas?: Whipple's triad--pt 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.
Are insulinomas malignant or benign?: 90% are benign, curable with resection.
What test should you order in a pt you think has an insulinoma?: C-peptide level, to make sure that the pt isn't diabetic and accidentally taking too much insulin or factitious.
It will be high in insulinomas and low otherwise.
Define Zollinger-Ellison syndrome: Gastrinoma, caused acid secretion and peptic ulcer disease. Ulcers are resistant to therapy and multiple.
Are gastrinomas malignant or benign?: 50% are malignant
What are the findings with glucagonomas?: alpha cell tumor causes hyperglycemia and migratory necrotizing skin erythema
What are the findings with VIPomas?: watery diarrhea, hypokalemia, achlorhydria.
How does ovarian cancer typically present?: usually late presentation, weight loss, pelvic mass, ascites, and/or bowel obstruction.
What test do you order for an ovarian lesion?: ultrasound
How is ovarian cancer treated?: debulking surgery and chemotherapy.
What is the cell of origin in ovarian cancer?: most are from ovarian epithelium.
What is the most common type of ovarian cancer?: Serous cystadenocarcinoma, mucinous cystadenocarcinomas are common too.
What is the classic finding on microscope of serous cystadenocarcinoma?: Psammoma bodies
Name three common germ cell tumors: 1. Teratoma
2. Sertoli/Leydig cell
3. Granulosa/theca cell
What's the most common germ cell tumor?: Teratoma
Sx of sertoli/leydig cell tumor?: virilization (hirsutism, receding hairline, deepening voice, clitoromegaly)
Sx of granulosa/theca cell tumors?: feminization, precocious puberty, pts are usually under age 30.
What is Meig's syndrome?: Ovarian fibroma, causes ascites and right hydrothorax.
What is a Krukenberg tumor?: A stomach cancer (or other GI malignancy) with metastases to ovaries.
What medicine reduces the risk of ovarian cancer?: OCPs
What is the best test to screen for cervical cancer?: Pap test, give all females a pap smear if they're due, even if they present for a totally unrelated complaint
What do you do if Pap is abnormal?: Colposcopy, directed biopsies, endocervical curettage. If pap shows microinvasive cancer, proceed to conization. If cancer is frankly invasive, give hysterectomy and/or radiation.
Where does cervical cancer begin?: in the transformation zone,
Sx of cervical cancer?: postcoital bleeding, intermenstrual spotting, abnormal menstrual bleeding
tx of cervical cancer?: surgery and/or radiation
What do you do for postmenopausal bleeding?: order an endometrial biopsy, pap smear, and endocervical curettage
What's the most common type of endometrial cancer?: adenocarcinomas
Tx of endometrial cancer?: Surgery and radiation
What medicine prevents endometrial cancer?: OCPs
How do brain tumors usually present?: new onset seizures, neuro deficits, headache, blurred vision, papilledema, nausea, projectile vomiting, in children look for hydrocephalus and ataxia
What is the most common histiologic type of brain tumor in children?: 1. cerebellar astrocytoma (benign pilocytic astrocytoma)
2. medulloblastoma
3. ependymoma
What is the most common histiologic type of brain tumor in adults?: 1. Glioma (usually astrocytoma)
2. Meningioma
Which cancers tend to metastasize to the brain?: "Lots of Bad Stuff Kills Glia"
Lung Breast Skin Kidney GI
Presentation of pseudotumor cerebri?: young obese woman with headaches, papilledema, vomiting, negative CT/MRI
What causes pseudotumor cerebri?: increased intracranial pressure (there's no tumor)
tx of pseudotumor cerebri?: weight loss, repeated lumbar punctures, CSF shunt may need to be placed to prevent vision loss.
sx of craniopharyngioma?: usually in children, calcifications of skull radiographs,
Risk factors for testicular cancer?: cryptorchidism,
How do you evaluate a testicular mass?: transilluminationa and ultrasound
how do you tell a hydrocele from a testicular cancer?: hydroceles transilluminate, cancers do not
Most common type of testicular cancer?: seminoma
tx for seminoma: radiation, highly curable
what is a "bunch of grapes" coming out of the vagina: sarcoma botryoides(embryonal rhabdomyosarcoma) usually seen in children
Sx of pituitary tumor?: bitemporal hemianopsia, increased ICP,
most common type of pituitary tumor?: prolactinoma
sx of prolactinoma?: galactorrhea, menstrual or sexual dysfunction
What do you order on a pt with bitemporal hemianopsia?: brain MRI
Describe nasopharyngeal carcinoma?: usually seen in asians, assoc with Epstein-Barr virus.
classic presentation of esophageal cancer?: smoker, drinker, 40-60 years old, blacks>whites, weight loss, anemia, "my food is sticking," which progresses to dysphagia for liquids,
what's the most common type of esophageal cancer?: adenocarcinoma--due to malignant degeneration of Barrett's esophagus
Define Barrett's esophagus: columnar metaplasia of esophageal squamous epithelium due to acid reflux
What makes you think thyroid cancer?: 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
How do you evaluate a thyroid nodule?: TSH, then nuclear medicine, then ultrasound, then biopsy. If clinically suspicious, still get a biopsy if all tests are negative.
Sx of bladder cancer: persistent painless hematuria, older than 40, smoker, worker in rubber or dye industry (aniline dye), h/o shistosomiasis
How do you evaluate for bladder cancer?: CT, or cystoscopy
Risk factors for hepatocellular carcinoma: alcohol, chronic hepatitis (C more than B), hemochromatosis,
Tumor marker for hepatocellular carcinoma?: AFP, measured to detect recurrences after surgery and used to screen high risk populations (cirrhotics)
Sx of hepatocellular carcinoma?: Usually in the presence of cirrhosis, pts have weight loss, right upper quadrant pain, enlarged liver.
tx for hepatocellular carcinoma?: Surgery, prognosis is poor.
Most common primary tumor of liver?: Hemangioma
tx for liver hemangioma?: leave it alone, only operate if sx (pain, bleeding)
what's the liver tumor in pts on birth control?: hepatic adenoma,
tx for hepatic adenoma?: stop OCPs, if tumor doesn't regress, surgery is needed to prevent hemorrhage and the rare malignant transformation.
Risk factors for cholangiosarcoma: ulcerative colitis, liver flukes (clonorchis)
What's the liver cancer associated with vinyl chloride?: Angiosarcoma, these are malignant
What's the liver cancer found in children?: Hepatoblastoma, these are malignant
Sx of stomach cancer?: Weight loss, anemia, early satiety, abdominal pain, nonhealing gastric ulcer
workup for gastric ulcer?: biopsy all gastric ulcers, follow with barium x-ray to document healing.
Define Virchow's node: left supraclavicular node enlargement due to the spread of visceral cancer (usually stomach)
Where are osteosarcomas usually found?: around the knee in children, around long standing Paget's disease or osteomyelitis in adults.
Sx of carcinoid tumors?: only symptomatic if metastasized to the liver, sx are flushing, diarrhea, abdominal cramps, right sided heart valve damage
where is the most common location for carcinoid tumors?: small bowel, but remember that they're the most common tumor found in the appendix
what do you order if you're suspicious for carcinoid tumor?: 5-HIAA
How do you spot a Kaposi's sarcoma?: a rash that doesn't respond to multiple treatments in an HIV-positive pt. It's usually on the upper body, and can be in the mouth
what virus is associated with Kaposi's sarcoma?: human herpesvirus 8
Explain ABCD's of melanoma: A--Asymmetry
B--Border irregularity
C--Color change or multicolor
D--Diameter increase
what do you do for a suspected melanoma?: excisional biopsy because of early metastasis
how do you evaluate the risk for metastasis in a melanoma?: Brewlow depth of invasion
how do you spot a basal cell skin cancer?: pearly umbilicated nodule with telangiestasias
What do you do for all lesions suspicious for skin cancer?: excisional biopsy
How do you differentiate a wilm's tumor from a neuroblastoma in kids?: both a flank masses. Neuroblastomas often contain calcifications, wilm's rarely calcify.
What is the typical appearance of oral cancer?: lesions begin as leukoplakia (white patch), or malakoplakia (red patch)
What does hairy oral leukoplakia look like?: looks like leukoplakia on the sides of the tongue, affects HIV pts, assoc with Epstein Barr virus
What cytologic clues make you think histiocytosis?: CD1 positive cells and Birbeck granules (intracytoplasmic inclusions that look like tennis rackets)
Define unicameral bone cyst, where is it usually found?: expansile, lytic, well-demarcated benign, usually in the proximal portion of humerus in children and adolescents
Are unicameral bone cysts malignant or benign?: benign, but can weaken the bone enough to produce a pathologic fracture.
How does retinoblastoma present?: usually in a child less than 3 years old, leukocoria, unilateral exopthalmos, can be bilateral in inherited form
True or false--all pts with metastatic cancer should be encouraged to receive chemo: false, risks may outweight benefits
what cancers are associated with the tumor marker AFP?: hepatocellular carcinoma, yolk-sac tumors
what cancers are associated with the tumor marker CEA?: colon cancer, pancreas, other GI tumors
what cancers are associated with the tumor marker PSA?: prostate
what cancers are associated with the tumor marker acid phosphatase?: prostate (if extended through capsule)
what cancers are associated with the tumor marker hCG?: hydatiform moles, choriocarcinoma
what cancers are associated with the tumor marker CA-125?: Ovary
what cancers are associated with the tumor marker S-100?: melanoma
what cancers are associated with the tumor marker CA 19-9?: Pancreas
(you better party like it's 19-9-ty nine because you don't have much time left)
what cancers are associated with the tumor marker 27-29?: Breast

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