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Welcome! The Topic For Today Is CREOG ONC REVIEW Hosted by Emily Ko, MD

Welcome! The Topic For Today Is CREOG ONC REVIEW Hosted by Emily Ko, MD. CREOG ONC REVIEW. Topic 1: 200. Question: Name 2 tumor suppressor genes Answer P53, Rb, WT1, BRCA1, BRCA2 Usually autosomal recessive. Back. Topic 1: 400. Question: Name the 5 stages of the cell cycle Answer

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Welcome! The Topic For Today Is CREOG ONC REVIEW Hosted by Emily Ko, MD

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  1. Welcome! The Topic For Today Is CREOG ONC REVIEW Hosted by Emily Ko, MD

  2. CREOG ONC REVIEW

  3. Topic 1: 200 • Question: • Name 2 tumor suppressor genes • Answer • P53, Rb, WT1, BRCA1, BRCA2 • Usually autosomal recessive Back

  4. Topic 1: 400 • Question: • Name the 5 stages of the cell cycle • Answer • G0, alive but not actively dividing • G1, growing • S, replicates DNA • G2, preparing for mitosis • M, mitosis Back

  5. Topic 1: 600 • Question: • Name 3 testing criteria for hereditary ovarian-breast cancer • Answer • Personal hx breast ca + Dx age < 45 ; • Dx age < 45 and 1 close relative breast ca age < 50 or with ovarian ca; • 2 breast primaries; • breast ca + 2 or more relatives with breast or ovarian ca; • close relative with male breast ca; • personal hx ovarian ca; • high ethnic risk Back

  6. Topic 1: 800 • Question: • This type of HNPCC gene (name) causes cancers in these organs (name) Answer • Mismatch repair • Colon • Endometrial • Ovarian • Ureteral and renal Back

  7. Topic 1: 1000 • Question: • Answer • A embryonal carcinoma • B endodermal sinus tumor (Yolk sac tumor) • Dysgerminoma • Choriocarcinoma • Immature teratoma Back

  8. Topic 2: 200 • Question: • Name this stage: endometrial cancer with pelvic node metastasis • Answer • 3c1 (FIGO 2008) Back

  9. Topic 2: 400 • Question: • ovarian cancer confined to right ovary ruptured intraoperatively (name stage), treatment after surgery will be (name treatment) • Answer • Stage IC • Adjuvant chemotherapy Back

  10. Topic 2: 600 • Question: • Name the indications for CKC, simple hyst, radical hyst • Answer • CKC- no visible lesion, microinvasive ca or high grade dysplasia • Simple hyst- microinvasive ca, (IA1) • Radical hyst- IA2 to IIA Back

  11. Topic 2: 800 • Question: • Name indications for WLE, radical vulvectomy, unilateral LND, bilateral LND • Answer • WLE- IA (< 2 cm lesion, < 1 mm depth) • Rad vulvectomy- IB and beyond • Unilateral LND- unilateral lesion > 2 cm from midline and > 1 mm depth invasion • Bilateral LND- lesion within 2 cm from midline and > 1 mm depth invasion Back

  12. Topic 2: 1000 • Question: • Name the treatment for DCIS of breast • Answer • Lumpectomy and radiation Back

  13. Topic 3: 200 • Question: • Name 4 high risk HPV subtypes associated with cervical cancer • Answer • 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, and 73 • (6 and 11 associated with genital warts) Back

  14. Topic 3: 400 • Question: • DES is associated with this cancer • Answer • Adenocarcinoma of the vagina Back

  15. Topic 3: 600 • Question: • Treatment for 2 cm lesion of VIN 3 • Answer • Wide local excision • (alternatives laser for multifocal to 1 mm depth in non hair areas, 3mm in hair areas) • (5-FU but it burns) • VIN3 high risk prog to CA. 15% microinvas. Back

  16. Topic 3: 800 • Question: • Name the treatment: pap HSIL with colpo bx microinvasive SCC with 2 mm depth invasion • Answer • CKC • (not simple hyst because do not know extent of disease, whether IA1 or IA2) • (If turns out IA2 rad hyst) • Prolog 80 Back

  17. Topic 3: 1000 • Question: • Treatment for 25 wks pregnant with 1.5 cm SCC of cervix • Answer • C-section rad hyst, node dissection when reaches fetal lung maturity • (Immediate tx if bulky lesion > 4cm) • (vag delivery ok if microinvasive ca) Back

  18. Topic 4: 200 • Question: • Name the blood product/s with fibrinogen • Answer • FFP • cryoprecipitate Back

  19. Topic 4: 400 • Question: • Treatment for 2 cm enterotomy of ileum • Answer • Primary repair in 2 layers, perpendicular to axis of bowel Back

  20. Topic 4: 600 • Question: • Name 2 of 3 criteria for ARDS • Answer • Bilateral diffuse infiltrates on CXR • Ratio of PaO2 to FiO2 ≤ 200 mg Hg • No evidence of heart failure (elevated left atrial pressure) • Treatment is ventilation, abx, supportive care, avoid fluid overload Back

  21. Topic 4: 800 • Question: • Name the condition and treatment • Case: intraoperative elevation of temp to 40.5, patient is “tight” and hands are mottled • Answer • Malignant Hyperthermia (triggered by depolarizing agent or volatile gases ie succinyl choline, autosomal dominent, genetic testing by muscle biopsy) • Stop anesthesia, close incision site, give 100% O2, Dantrolene, ICU, cooling blanket • Prolog 43 Back

  22. Topic 4: 1000 • Question: • Match the type of shock to the correct row • Hypovolemic, cardiogenic, early septic • Answer • Hypovol B • Cardio A • Early septic C • Prolog 137 Back

  23. Topic 5: 200 • Question: • Name this vulvar lesion: itchy, eczematous, raised, red background, dotted with small pale islands, maybe multifocal • Answer • Extramammary Paget’s Disease • <1% vulvar malignancy • Biopsy to prove • Search for other sources of adenocarcinoma • Prolog 56, 72 Back

  24. Topic 5: 400 • Question: • 1. Risk of persistence after D&C 20% • 2. associated with HPL • 3. clinical presentation may be like MAB • 4. Fetal vessels present on H&E stain • 5. Chorionic villi not present • Answer • 1. B, 2. D, 3.A., 4.A., 5.C Back

  25. Topic 5: 600 • Question: • Name 3 methods of colon cancer screening • Answer • All starting at age 50 (for average risk) • FOBT: annually • Flex sigmoid: q5 years • FOBT + flex sig: q5 years • Double contrast barium enema: q5yr • Colonoscopy: q10 yr • Prolog 51, 70, 122 Back

  26. Topic 5: 800 • Question: • Name the gyn surveillance for women on tamoxifen • Answer • Annual gyn exam, workup for symptoms • No routine use of U/S or EMB • Agonist on endometrium • 2.3-2.7x risk of endometrial cancer • But OK to use after hysterectomy for endometrial cancer • Prolog 17, 132 Back

  27. Topic 5: 1000 • Question: • Name the hormone therapy for 45 yos/p TAHBSO for endometrial cancer, and risks/benefit associated with it based on WHI study • Answer • Estrogen only HRT • WHI: (Prolog 15, 77) • E/P increased risk for CHD, breast ca, VTE, stroke. • E/P decreased risk for osteoporotic fx and colon ca • E alone decreases risk for osteoporotic fx Back

  28. Bonus Question: 5000 pts. • Question: • What day is Creogs • Answer • … • (The answer here!) Back

  29. Daily Double The Winner Of The Last Round Write Down How Much Money You Are Willing To Risk If You get the Question write you win that money If you get it wrong you Loss the money!

  30. Daily Double The Winner Of The Last Round Write Down How Much Money You Are Willing To Risk If You get the Question write you win that money If you get it wrong you Loss the money!

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