Mer Scott
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PHCY320 (Oncology) Quiz sobre ON12 Prostate Cancer, criado por Mer Scott em 08-10-2019.

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ON12 Prostate Cancer

Questão 1 de 14

1

Epidemiology​:
Median age at diagnosis is years​.
5 year survival rate with local or regional disease​
5 year survival rate with distant disease​
95% are (cancer that starts in the mucous glands in epithelial tissue).

In New Zealand…​
cancer in men (3000 new cases/year, 600 deaths/year)​.

Arraste e solte para completar o texto.

    66
    100%
    28.7%
    adenocarcinoma
    Most common

Explicação

Questão 2 de 14

1

Which of these is NOT a risk factor for prostate cancer?

Selecione uma das seguintes:

  • Male

  • Age >40

  • Black (race)

  • Family history ​

  • Alcohol consumption

Explicação

Questão 3 de 14

1

There is controversy with screening​ for prostate cancer as there is no clear evidence of mortality benefit with screening​.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 4 de 14

1

Screening methods:

- Digital rectal exam (circa 1900s)​.
BUT not , poor interobserver reliability, poor

- PSA blood test (prostate specific antigen)​
Low ​. Many other causes (BPH, acute , urinary ,benign prostatic )​.

Arraste e solte para completar o texto.

    Cheap, safe, easy
    sensitive
    compliance
    specificity
    prostatitis
    retention
    hypertrophy

Explicação

Questão 5 de 14

1

Select ALL the symptoms of prostate cancer which indicate advanced disease.

Selecione uma ou mais das seguintes:

  • Painful urination​

  • Erectile dysfunction

  • Urinary hesitance​

  • Urinary retention​

  • Hematuria​

  • Weight loss​

  • Back pain​

  • Lower extremity oedema​

  • Anemia​

Explicação

Questão 6 de 14

1

Diagnosis​
History and physical exam​.
DRE​ and PSA.
TRUS - - if one of above positive).
(confirmative)​

Arraste e solte para completar o texto.

    transrectal ultrasound
    Biopsy

Explicação

Questão 7 de 14

1

Staging:
Stage A​ -
Stage B​ -
Stage C​ -
Stage D​ - Metastatic disease ​

(non-palpable)​
​ - Not palpable or visible by imaging​
​ - Confined within prostate​
​ - Extends through capsule​
- Fixed or invades adjacent structures (other than seminal vesicles)​

Arraste e solte para completar o texto.

    Occult or palpable​
    Confined to the prostate​
    Localised to periprostatic area​
    T0N0M0
    T1
    T2
    T3
    T4​

Explicação

Questão 8 de 14

1

Gleason Score​:
Histologic grade of tumor​. Calculated based on dominant grades. Scores range from 1 = well healthy tissue, to 5 = very differentiated​ abnormal tissue. Gleason score = sum of pattern grades ()​. Higher is worse.

Arraste e solte para completar o texto.

    histological
    differentiated
    poorly
    two most common
    2 to 10

Explicação

Questão 9 de 14

1

Factors influencing prognosis:​
Extent of
Histological of tumor​
Patient’s
(Bcl-2, Bax, Ki67, p53, p27, E-cadherin, Microvessel density, DNA ploidy, p16)​
PSA level? ​

Arraste e solte para completar o texto.

    tumor
    grade
    age and health​
    Molecular markers

Explicação

Questão 10 de 14

1

Initial treatment depends on the stage, Gleason score, presence of symptoms, and life expectancy​.

Low risk patients (T1 or T2, GS of , PSA<10ng/ml) – excellent survival (10yr)​:

Radical

Life expectancy <10 years​?
Observation​
Radiation therapy ​

Arraste e solte para completar o texto.

    2-6
    prostatectomy ​
    Observation​, radiation​

Explicação

Questão 11 de 14

1

Nonpharmacological Treatments:
Observation​ - DRE and PSA performed every months and biopsy if signs of
Radiation​ - Effective yet complications ()​
Radical prostatectom y - Complications: , impotence, , fistula​
Bilateral orchiectomy (removal of testes)​. Need ​.

Arraste e solte para completar o texto.

    6
    progression
    hematuria, impotence, diarrhea, cystitis
    blood loss
    incontinence
    androgen deprivation therapy

Explicação

Questão 12 de 14

1

Hormonal Treatment​:
Rationale​ - Androgens stimulate prostate cancer cells to . Main androgens are and dihydrotestosterone (DHT)​. Most androgens made by but also by adrenal glands​. Lowering androgen levels makes prostate cancer cells shrink or grow more but does not cure prostate cancer.

Indication​ - If cancer cannot be cured by surgery or radiation or ​... In combination with radiation therapy if high (high Gleason)​... OR before radiation to shrink cancer and make radiation more .

Arraste e solte para completar o texto.

    grow
    testosterone
    testicles
    slowly
    remains/relapses
    risk of recurrence
    effective

Explicação

Questão 13 de 14

1

Pharmacological (hormone) Treatment​:
1. LHRH ​ - Reversible method of androgen ablation as effective as orchiectomy​. Puts patient at risk for ​. Drugs: Triptorelin, Histrelin​.

2. GnRH ​ - Works directly in to reduce testosterone ​

3. Antiandrogens - Bind to receptors so androgens cannot. Not used alone, typically with LHRH agonists/removal of testicles. Drugs:

Arraste e solte para completar o texto.

    agonists
    osteoporosis
    Leuprolide, Goserelin,
    antagonists
    pituitary
    androgen
    Flutamide, Bicalutamide, Nilutamide​

Explicação

Questão 14 de 14

1

Which of these is not an ADR of androgen lowering therapies?

Selecione uma das seguintes:

  • Reduced or absent sexual desire​

  • Erectile dysfunction​

  • Shrinkage of testicles and penis​

  • Hot flushes​

  • Osteoporosis

  • Anemia​

  • Loss muscle mass​

  • Weight gain​

  • Depression​

  • Weight loss

Explicação