Getting to the Bottom of it
Screening guidelines for colonoscopy for a person of average colon cancer risk?
Start at age 45, every 10 years for normal/low risk findings
HPV vaccine protects against which strains of cervical cancer?
16, 18
Lung cancer screening guidelines
Age 50-80 with 30 year pack year history or quit within 15 years require low dose CT scan of chest
Patient is 65, asks you if he should get PSA checked?
Talk about harms vs benefit. Age to check 55-69.
Screening recommendation for Male Age 65-75, smoked for 10 years then quit.
Triple AAA Screening
Patient diagnosed with Ulcerative Colitis, when should his next colonoscopy be?
8 years from diagnosis, then every 1-2 years.
Cervical cancer screening recomendations
Start age 21-29 - cytology every 3 years. 30-65 cytology every 3 years OR cytology + HPV co testing every 5 years.
Patient w. dizziness, n/v, dysarthria, diplopia, antibodies + (Anti-Yo, anti-Hu, anti-Ri), what type of lung cancer does he have?
Small cell. He is presenting with cerebellar degeneration.
Patient presents with weight loss, tachycardia, diarrhea. TSH < 0.03. Screen for cancer?
No further screening, treat hyperthyroidism,
Mammogram screening guidelines
50-75, mammogram every 2 years
30 year old pt's father was diagnosed with colon cancer at age 48. When should he get screening?
Age 38. (colonoscopy at 40 or 10 years prior to age of diagnosis in First degree Relative, whichever comes first). Repeat every 5 years.
Patient w cervical cancer s/p hysterectomy, screening?
Blind sweep
CT scan shows pleural plaques, which cancer is this patient at increased risk for?
mesothelioma
Prior to treatment with doxorubicin, what baseline screening should be performed?
TTE
Patient presents with muscle weakness and gottron papules and rash. What is the diagnosis and what cancer screening is recommended (hint: 4 types).
Adenocarcinoma (lung, breast, ovarian), Lymphoma
24 year old undergoes screening colonoscopy given family history, 100s of polyps screen, what do you do next?
colectomy
53 yo F with PAP smear of ASCUS (atypical squamous cells of undetermined significance).
HPV testing. If HPV positive, they are high risk for malignancy and require further evaluation (colposcopy). If HPV negative, repeat pap and HPV in 3 years.
Patient has shoulder pain, ipsilateral ptosis, miosis weakness in his hands, wt loss. Best next imaging?
CXR - superior pulmonary sulcus tumor. Most pancoast tumors are non-small cell lung cancers. Follow up with CT/MRI then core needle biopsy.
64 yo M has DRE with asymmetry and a nodule. PSA level 5, prior 1. What do you do?
Screen for prostate cancer - TRUS biopsy
CT scan shows 3.5 cm left adrenal mass, rounded, vascular and high attenuation. Next step?
test for adrenal hormonal hypersecretion [adrenal incidentaloma]
Patient diagnosed with Lynch syndrome at 18, what advice do you give her about colon cancer screening?
Begin at age 20-25 or 10 years earlier than youngest cancer in family, repeat every 1-2 years
Patient diagnosed with HIV, cervical cancer screening recommendations?
Onset of sexual intercourse, annually until > 3 normal results
50 yo M, CT scan with a 1 cm round, smooth border, lung nodule, patient has no history of smoking. Next CT scan?
CT scan in 3 months, for nodules > 0.8 cm, low probability for malignancy)
Patient treated with anthracycline for breast cancer 6 years ago, now presenting with weakness, severe thrombocytopenia, leukocytosis with immature cells on diff. What cancer should be screened for?
AML, people exposed to chemotherapeutic are at risk for developing myelodysplastic syndrome. Usually presents 5-10 years post-treatment.
US every 6 months.