Oncology and Cardiology Quiz

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Questions and Answers

What physical exam finding is indicative of aortic stenosis?

  • Tachycardia
  • Bounding pulses
  • Bradycardia
  • Pulsus parvus et tardus (correct)

What is the most important therapeutic step in managing acute pancreatitis?

  • Surgical intervention
  • Pain management
  • Administering antibiotics
  • IV fluid resuscitation (correct)

Which two factors are the leading risk factors in the development of hepatocellular carcinoma (HCC)?

  • Chronic alcohol use and Hep C infection
  • Cirrhosis and Hep B infection (correct)
  • Obesity and diabetes
  • Chronic hepatitis and smoking

Which is the most common opportunistic pathogen observed in transplant patients?

<p>CMV (C)</p> Signup and view all the answers

What is recognized as the primary risk factor for prostate cancer?

<p>Age (A)</p> Signup and view all the answers

At what gestational week should screening for gestational diabetes start?

<p>24 weeks (B)</p> Signup and view all the answers

Which test is administered after a positive result from the 1-hour glucose test for gestational diabetes?

<p>3-hour glucose tolerance test (C)</p> Signup and view all the answers

What age range is recommended for lung cancer screening?

<p>50-80 years (B)</p> Signup and view all the answers

What is the minimum pack-year history required to qualify for lung cancer screening?

<p>20 pack-years (C)</p> Signup and view all the answers

How frequently should lung cancer screening be conducted once eligible?

<p>Three times a year (B)</p> Signup and view all the answers

What is the screening protocol for colon cancer in patients diagnosed with Inflammatory Bowel Disease and primary sclerosing cholangitis?

<p>Screen at the time of diagnosis, then every 1-2 years (C)</p> Signup and view all the answers

When should someone begin screening for colon cancer after being diagnosed with Inflammatory Bowel Disease?

<p>8 years after diagnosis (D)</p> Signup and view all the answers

What is the significance of diagnosing primary sclerosing cholangitis in a patient with Inflammatory Bowel Disease?

<p>It requires immediate colon cancer screening. (B)</p> Signup and view all the answers

What follow-up frequency is recommended for colon cancer screening in a patient with Inflammatory Bowel Disease but without primary sclerosing cholangitis?

<p>Every 1-3 years (B)</p> Signup and view all the answers

What is the recommended action for patients with MEN 2A or 2B concerning medullary thyroid cancer?

<p>Prophylactic thyroidectomy (C)</p> Signup and view all the answers

At what age should screening for colon cancer begin for individuals with Familial Adenomatous Polyposis?

<p>Age 10 (C)</p> Signup and view all the answers

What is the screening guideline for women with BRCA mutations who are aged over 30?

<p>Annual breast MRI and annual mammography (C)</p> Signup and view all the answers

During which years should women with BRCA mutations undergo annual breast mammograms?

<p>25-29 years (B)</p> Signup and view all the answers

How frequently should colon cancer screening be conducted for individuals with Familial Adenomatous Polyposis?

<p>Every year (D)</p> Signup and view all the answers

At what age should hypertension screening start and how frequently should it be done for individuals aged 18 to 40?

<p>Begin at age 18 and screen every 3-5 years (A)</p> Signup and view all the answers

Which group of individuals requires screening for diabetes every 6 months?

<p>Obese individuals between ages 40-70 (A)</p> Signup and view all the answers

How often should individuals with diabetes undergo hyperlipidemia screening?

<p>Every year (A)</p> Signup and view all the answers

For individuals who have had a hysterectomy due to cervical cancer, how long will they continue to have pap smears?

<p>For 20 years after the surgery (C)</p> Signup and view all the answers

What is the initial screening age for hyperlipidemia?

<p>Age 20 (D)</p> Signup and view all the answers

At what age does the USPSTF recommend starting breast cancer screening?

<p>Age 50 (C)</p> Signup and view all the answers

What is the recommended screening frequency for breast cancer according to the ACS?

<p>Every year starting at age 40 (B)</p> Signup and view all the answers

Which procedure necessitates a Pap smear of the vaginal cuff?

<p>Hysterectomy for endometrial hyperplasia (C)</p> Signup and view all the answers

What is the primary recommendation for individuals who have had a hysterectomy for benign reasons regarding cervical cancer screening?

<p>No screening is needed (B)</p> Signup and view all the answers

When is cervical cancer screening no longer required after a hysterectomy?

<p>After a hysterectomy for benign reasons (D)</p> Signup and view all the answers

Flashcards

What is pulsus parvus et tardus?

A weak and slow carotid pulse, characterized by a delayed upstroke, is a physical exam finding observed in patients with aortic stenosis.

How do you treat acute pancreatitis?

Intravenous fluid resuscitation is the primary therapeutic step in the management of acute pancreatitis.

What are the main risk factors for HCC?

Cirrhosis and Hepatitis B infection are the two most frequent risk factors for the development of hepatocellular carcinoma (HCC).

What is an opportunistic pathogen seen in transplant patients?

Cytomegalovirus (CMV) is a common opportunistic pathogen affecting transplant recipients.

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What is the main risk factor for prostate cancer?

Age is the number one risk factor for prostate cancer.

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When is gestational diabetes screened for?

Women should be screened for gestational diabetes between 24 and 28 weeks of pregnancy with a 1-hour glucose tolerance test.

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What happens if the initial gestational diabetes screening is positive?

If the 1-hour glucose tolerance test is positive, a 3-hour glucose tolerance test is performed to confirm the diagnosis of gestational diabetes.

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Who should be screened for lung cancer?

Individuals between the ages of 50-80 with a 20 pack-year smoking history should be screened for lung cancer.

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What type of screening test is used for lung cancer?

A low-dose CT scan of the chest is used to screen for lung cancer.

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How often should lung cancer screening be done?

Lung cancer screening with a low-dose CT scan is recommended to be performed 3 times every year.

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When do IBD patients start colon cancer screening?

Inflammatory Bowel Disease (IBD) patients are recommended to start screening for colon cancer 8 years after their initial diagnosis.

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How often should IBD patients be screened for colon cancer after the initial screening?

After the initial screening for colon cancer, individuals with IBD should continue screening every 1-3 years.

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What is the exception to the colon cancer screening timing for IBD patients?

Patients diagnosed with Primary Sclerosing Cholangitis (PSC) require colon cancer screening at the time of PSC diagnosis.

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How often should PSC patients be screened for colon cancer after the initial screening?

Individuals with PSC should undergo colon cancer screening every 1-2 years after their initial screening.

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Why do PSC patients require colon cancer screening at the time of diagnosis?

Individuals diagnosed with Primary Sclerosing Cholangitis (PSC) are at increased risk for colon cancer and require earlier and more frequent screenings compared to other IBD patients.

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What is the recommended treatment for patients with MEN 2A or 2B?

Prophylactic thyroidectomy is recommended for patients with MEN 2A or 2B to prevent medullary thyroid cancer.

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When should colon cancer screening begin for patients with FAP?

Patients with familial adenomatous polyposis (FAP) should begin colon cancer screenings at age 10 and continue annually.

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What are the breast cancer screening guidelines for women with BRCA mutations?

Women with BRCA mutations should receive annual breast mammograms starting between ages 25-29.

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What breast cancer screening is recommended for BRCA mutation carriers over 30?

Women with BRCA mutations over 30 years old should receive annual mammograms and breast MRIs.

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Why is a prophylactic thyroidectomy recommended in MEN 2A/B?

The decision to undergo prophylactic thyroidectomy is based on the understanding that medullary thyroid cancer is almost inevitable in patients with MEN 2A or 2B.

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Hypertension Screening Frequency

Individuals between 18 and 40 years of age should have their blood pressure checked every 3 to 5 years. After turning 40, screening is recommended every 1 to 2 years.

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Diabetes Screening for Obese Individuals

Those between 40 and 70 years old who are obese need to get screened for diabetes every 6 months.

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Diabetes Screening for Hypertensives

Individuals with hypertension (blood pressure 135/80 or higher) and over 45 years old need to see a doctor for diabetes screening every 6 months.

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Initial and Ongoing Hyperlipidemia Screening

Everyone should have a baseline cholesterol screening at age 20. Diabetics require annual screening.

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Post-Hysterectomy Pap Smear Guidelines

Women who have had a hysterectomy due to cervical cancer should continue to get Pap smears until 20 years after the surgery.

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Hysterectomy for Benign Reasons: Cervical Cancer Screening?

Women who have had a hysterectomy for benign reasons, such as fibroids or heavy bleeding, no longer need cervical cancer screening.

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Hysterectomy for Endometrial Cancer: Cervical Cancer Screening?

Women who have had a hysterectomy for endometrial hyperplasia or cancer should have Pap smears of the vaginal cuff.

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Breast Cancer Screening Guidelines: USPSTF vs ACS

The USPSTF recommends starting breast cancer screening at age 50 and performing it every 2 years. The ACS recommends starting at age 40 and doing it annually.

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Colon Cancer Screening in FAP

Patients with familial adenomatous polyposis (FAP) should start colon cancer screening at age 10 and continue annually.

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Breast Cancer Screening: BRCA Mutations

Women with BRCA mutations should receive annual breast mammograms starting between ages 25-29. Over 30, they should also get annual breast MRIs.

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Study Notes

Acute Myocardial Infarction (MI)

  • Physical Exam Finding: Pulsus parvus et tardus (delayed upstroke in carotid pulse).
  • Therapeutic Step in Acute Pancreatitis Management: IV fluid resuscitation.
  • Opportunistic Pathogen in Transplant Patients: Cytomegalovirus (CMV).

Hepatocellular Carcinoma (HCC)

  • Risk Factors:
    • Cirrhosis
    • Hepatitis B infection

Prostate Cancer

  • Number 1 Risk Factor: Age

Bladder Cancer

  • Number 1 Risk Factor: Smoking

Gestational Diabetes

  • Screening: Start at 24 weeks with a 1-hour glucose test.
  • Follow-up: If positive, follow with a 3-hour glucose tolerance test.
  • Initial Pregnancy Screening: HIV, HBV, and syphilis.

Lung Cancer

  • Screening Eligibility: Individuals aged 50-80.
  • Screening Criteria: 20+ pack-year smoking history, current smoking or quit less than 15 years ago.
  • Screening Method: Low-dose CT scan, performed every 3 years.

Inflammatory Bowel Disease (IBD)

  • Colon Cancer Screening: Begin screening 8 years after initial IBD diagnosis.
  • Frequency: Screen every 1-3 years thereafter.
  • Exception: If diagnosed with primary sclerosing cholangitis (PSC), screen for colon cancer at diagnosis, then every 1-2 years.

Medullary Thyroid Cancer

  • MEN 2A or 2B: Prophylactic thyroidectomy is recommended. Medullary thyroid cancer is virtually guaranteed to occur.

Familial Adenomatous Polyposis (FAP)

  • Colon Cancer Screening: Start at age 10.
  • Frequency: Continue annual screening.

Breast Cancer Screening for Women with BRCA Mutations

  • Age 25-29: Annual breast mammogram.
  • Age 30+: Annual breast MRI and annual mammogram.

Hypertension Screening

  • Screening: Age 18-40 every 3-5 years.
  • Screening: Age 40+ every 1-2 years.

Diabetes Screening

  • Screening: Obese individuals (age 40-70) every 6 months.
  • Screening: Hypertension over 135/80 (age 45+) every 6 months.

Hyperlipidemia Screening

  • Initial Screening: Age 20.
  • Diabetic Screening: Annual.

Cervical Cancer

  • If hysterectomy for benign reasons → no screening
  • If hysterectomy for endometrial hyperplasia/cancer → Pap of vaginal cuff.
  • If hysterectomy for cervical cancer: No further pap smears for 20 years after surgery.

Breast Cancer Screening

  • USPSTF recommendation: Start at age 50, every 2 years.
  • ACS recommendation: Start at age 40, every year.

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