Duke PA Oncology diagnostic methods
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| The ability of a test to rule out a disease | Sensitivity
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| The percentage of people with cancer who will have an abnormal test | Sensitiviy
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| The percentage of people without cancer whose test is negative | Specificity
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| The ability of a test to rule in disease | Specificity
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| Probability that people with an abnormal test actually have cancer | Positive predictive value
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| Probability that a negative test will predict that a person does not have cancer | Negative predictive value
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| Proteins normally found in larger amounts during fetal development | Antigens
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| These are examples of which type of tumor marker; AFP, CEA, PSA, CA-125, Bence Jones Proteins | Antigens
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| These are examples of which type of tumor marker; Prostatic Acid Phosphatase, Galactosyl transferase II | Enzymes
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| This marker is often associated with tumors of endocrine glands | Hormones
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| These are examples of which type of tumor marker; Beta-HCG, Human Calcitonin | Hormones
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| Genes that are useful in fetal development but when activate in mature cells trigger tumor growth | Oncogenes
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| These are examples of which type of tumor marker; BRCA 1, BRCA 2, Philadelphia chromosome | Oncogenes
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| Philadelphia Chromosome is associated with which type of cancer | Chronic Myelogenous Leukemia-CML
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| Cell surface proteins that affect the rate of tumor development by binding to hormones and growth factors | Tissue receptors
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| These are examples of which type of tumor marker; ER assay, PR assay, EGFR | Tissue receptors
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| What goes down as prevalence of disease goes down | Positive predictive value
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| Increased in 80-90% of patients with hepatocellular carcinoma | Alpha-Fetoprotein (AFP)
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| Patients with cirrhosis and active hepatitis should be screened with which tumor marker every 3-4 months | Alpha-Fetoprotein (AFP)
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| Used primarily to detect and monitor clinical course of Multiple Myeloma. It is not found in the blood b/c it is effeciently filtered by the kidneys. Considered to be the first tumor marker. | Bence Jones Proteins
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| This hormone tumor marker is normally negative except in pregnancy, and is never found in cancer free males. | Beta-HCG
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| This hormone tumor marker is primarily associated with the following; Hydatidiform mole of the uterus, chriocarcinoma of the uterus, and germ cell tumors of the ovaries | Beta-HCG
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| High levels of this hormone are almost always pathognomonic for germ cell neoplasm in men. | Beta-HCG
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| This antigen is useful in diagnosis, evaluation of therapy, and sruveillance in patients with pancreatic and hepatobiliary cancer | CA 19-9
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| This antigen is elevated in 80-90% of women with ovarian cancer. | CA 125
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| This antigen is used in determining the extent of disease, prognosis, and response to therapy in patients with GI cancers. | Carcinoembryonic Antigen (CEA)
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| Baseline for this antigen is elevated in smokers. | Carcinoembryonic Antigen (CEA)
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| This antigen is used in screening for early detection of prostate cancer. | Prostate Specific Antigen (PSA)
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| When combined with a digital rectal exam 90% of clinically significant cancers can be detected. | Prostate Specific Antigen (PSA)
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| Not a tumor marker but a useful diagnostic tool for assessing risk of developing breast cancer in a woman in the general population | The Gail model
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| This tool takes into acount these factors when assessing 5 year and lifetime risk of developing breast cancer; current age, age at menarche, previous breast biopsies, age at first live birth, family history of breast cancer. | The Gail model
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| Breast cancer oncogenes | BRCA 1, BRCA 2
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| Men with this mutation carry a markedly increased risk of developing prostate cancer and or colorectal cancer, and may pass the mutation to their daughters. | BRCA 2
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| This tissue receptor indicates sensitivity to hormonal therapy. | Estrogen Receptor (ER) assay, and Progesterone Receptor (PR) Assay
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| Tumors positive for this tissue receptor are more than twice as likely to respond to hormone therapy. | ER assay
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| This tissue receptor is more often positive in postmenopausal breast cancer patients | PR assay
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| An increased level of this antigen is associated with more aggressive breast cancers. | HER 2 (neu)
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| Triple negative tumors have no hormonal target for therapy and are negative for which markers. | ER, PR, HER 2
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| This antigen is elevated in 70-80% of patients with metastatic disease, and is rarely elevated in early stage disease. | CA 15-3
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| This antigen is useful in monitoring response to therapy in metastatic breast cancer patients. | CA 27.29
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| This rare marker is associated with liquid tumors; lymphoma, leukemia, multiple myeloma. | Beta2 microglobulin
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| This rare antigen is not a good screening tool b/c levels can be elevated in UTI, renal calculi, recent urinary surgery | Bladder tumor antigen (BTA)
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| This rare marker is a good screening tool for patients at risk for bladder cancer | Nuclear Matrix protein 22 (NMP22)
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| A sensitive marker for detection of bladder cancer across all disease stages and grades | Survivin
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| This hormone is used to evaluat patients with at risk for/suspected medullary carcinoma of the thyroid. | Human Calcitonin
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| This enzyme is associated with Neuroblastoma, carcinoid, and small cell lung cancer | Neuron Specific Enolase (NSA)
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| This enzyme is primarily used to diagnose, stage, and monitor efficacy of treatment in prostate cancer | Prostatic Acid Phosphatase (PAP)
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| This cancer has a 30% recurrence rate even decades after successful treatment | Thyroid cancer
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| This protein is the primary marker for surveillance of well-differentiated thyroid cancers in postoperative patients. | Thyroglobulin
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| Common tumor marker for ovarian cancer | CA 125
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| k-ras, c-myc, abl, Her2/neu are all examples of what | Oncogenes
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| Genes that once mutated activates the growth pathway | Oncogenes
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| Only one copy needs to be mutated to induce tumorogensis | Oncogenes
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| Genes that normally inhibit growth | Tumor suppressor genes
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| A mutation of these causes a loss of inhibition | Tumor suppressor genes
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| Both copies need to be mutated to lose function | Tumor suppressor genes
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| Classic presentation fo this type of cancer is painless jaundice | Pancreatic cancer
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| Tumor marker for teratoma | Alpha-Fetoprotein (AFP)
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| No meat | No treat
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| Tissue | Is the issue
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| In what scenario do you not need a pathological specimen to initiate treatment | Pancreatic mass
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| A small needle is inserted into the mass and cells are removed for microscopic evaluation | Fine needle aspiration
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| Can be done guided or unguided | Fine needle aspiration
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| This type of biopsy is mainly applied to melanoma | Punch biopsy
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| What type of biopsy is not indicated for suspected melanoma | Shave biopsy
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| Once a tissue diagnosis positive for cancer is obtained what is the next step in treatment of the patient | Radiographic staging
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| Based on the theory that lymphatic spread proceeds through a consistent anatomic network of ducts and nodes based on tumor location | Sentinel lymph node biopsy
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| Looking for hot and blue nodes | Sentinel lymph node biopsy
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| It is recommended that those with this disorder start haveing colonoscopies in their teens | Familial adenomatous polyposis (FAP)
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| Should begin screening 10 years prior to the age of onset in the family member affected with what cancer. | Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
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