Oncology Diagnosis, Staging, and Management

Vocabulary practice flashcards covering oncologic diagnostic methods, statistical screening principles, oncologic emergencies, metastatic dissemination routes, and performance scales.

Which statistical measure reflects the probability of obtaining a positive screening test result among individuals who truly have the disease?

Sensitivity

Which diagnostic metric is highest when a test yields minimal false positives, making it especially effective for ruling in disease?

Specificity

Which imaging modality uses superparamagnetic iron oxide nanoparticles that accumulate in normal reticuloendothelial tissue, causing normal nodes to appear dark on scans while tumor-involved nodes remain bright?

Molecular magnetic resonance imaging (molecular MRI)

Which pan-endoscopic evaluation conducted under general anesthesia integrates nasopharyngoscopy, laryngoscopy, esophagoscopy, and bronchoscopy to stage head and neck tumors?

Quadroscopy

Which oncologic emergency presents with facial swelling, distended superficial chest veins, upper extremity edema, and dyspnea resulting from mediastinal venous compression?

Superior vena cava obstruction (SVCO)

Which metabolic oncologic emergency triggered by rapid cytotoxic breakdown of leukemia or lymphoma cells presents with hyperkalemia, hyperphosphatemia, hypocalcemia, and acute kidney injury?

Tumor lysis syndrome

Which paraneoplastic metabolic emergency is caused by tumor secretion of parathyroid hormone-related protein (PTHrP) and manifests with nephrolithiasis, bone pain, abdominal symptoms, and confusion?

Hypercalcemia of malignancy

Which route of metastatic dissemination occurs when malignant cells shed across body cavity surfaces, characteristically causing ascites or malignant pleural effusions?

Transcoelomic spread

Which cell adhesion glycoprotein is characteristically lost during direct tumor invasion to permit cell detachment and motility into adjacent structures?

E-cadherin

What is the recommended annual low-dose computed tomography (LDCT) lung cancer screening guideline for high-risk individuals?

Annual screening for adults aged $55$ to $80$ years with a $\\ge 20$ pack-year smoking history

Which biopsy procedure aspirates cells and tissue fluid for cytologic evaluation but cannot assess tissue architecture or tumor grade?

Fine-needle aspiration (FNA)

What timeframe and setting officially define a patient death as an operative mortality following a surgical intervention?

Any patient death occurring within $30$ days following surgery, taking place inside or outside the hospital

Which term describes an objectively measurable clinical or biologic feature at diagnosis that provides information regarding the expected natural history and survival of untreated cancer?

Prognostic factor

Which term describes a clinical or biologic characteristic that indicates whether a patient is likely to experience therapeutic benefit or resistance from a specific therapeutic agent?

Predictive factor

Which functional assessment scale uses a numerical continuum from $0$ (dead) to $100$ (normal activity, no complaints) validated in patients aged $16$ and older?

Karnofsky Performance Status Scale

Which multigene genomic assay analyzes 21 genes (16 cancer-related and 5 reference genes) to calculate a Recurrence Score for ER-positive, lymph node-negative breast cancer?

Oncotype DX

Which prophylactic surgical procedure is recommended by age $20$ to $30$ for patients with familial adenomatous polyposis (FAP) carrying the APC mutation to achieve $100\%$ colorectal cancer risk reduction?

Total proctocolectomy

In radiobiology, which of the '5 Rs' describes the cellular process where normal tissues recover from sublethal radiation injury between fractions?

Repair

During which cell cycle phases do mammalian cancer cells exhibit their highest radiosensitivity to ionizing radiation?

Early S phase and late $G_2/M$ phase

What is the minimum recommended interval between radiation fractions to ensure adequate sublethal damage recovery in sensitive structures such as the spinal cord?

$6$ to $8$ hours

Which serum biomarker is utilized in routine clinical practice for screening, diagnosis, and post-treatment recurrence monitoring of prostate adenocarcinoma?

Prostate-specific antigen (PSA)

What are the recommended screening intervals for routine cervical cancer screening using cytology (Pap smear) alone versus HPV DNA testing in individuals aged 25 and older?

Every $3$ years for Pap smear alone, or every $5$ years for HPV DNA testing

What is the minimum tumor burden and cell count that is physically detectable on clinical examination or routine imaging?

Approximately $10^9$ cells, corresponding to a mass of about $1\text{ g}$

Which functional performance status scale assesses oncology patients on a simplified numerical continuum from $0$ (fully active) to $5$ (dead)?

Eastern Cooperative Oncology Group (ECOG) Scale

In an oncology patient presenting with severe neutropenia, which clinical sign must be managed urgently as systemic sepsis until proven otherwise?

Low-grade fever

How does the Oxygen Enhancement Ratio (OER) behave when tissues are irradiated with densely ionizing radiation compared to standard photon beams?

The OER decreases to approximately $1$, indicating an absence of the oxygen enhancement effect

Which surgical intervention is indicated for malignancies situated in the distal third of the rectum or persistent anal canal carcinoma, resulting in a permanent colostomy?

Abdominoperineal resection (APR)

What is the recommended colorectal cancer screening protocol for average-risk adults aged $45$ to $74$ years using stool tests or colonoscopy?

FIT or FOBT every $1$ to $2$ years, or colonoscopy every $10$ years

What is the recommended routine screening frequency and modality for average-risk individuals aged $40$ to $74$ regarding breast cancer?

Mammography once every $2$ years

By approximately what percentage does bilateral prophylactic mastectomy reduce breast cancer risk in individuals carrying high-penetrance BRCA mutations?

Approximately $90\%$ risk reduction

What is the critical therapeutic window for identifying and treating malignant spinal cord compression to prevent permanent motor deficit or paraplegia?

Within a $6$ to $12$ hour window

Which biopsy modality uses circular trephine blades sized from $0.5\text{ mm}$ to $6\text{ mm}$ to harvest full-thickness skin including subcutaneous adipose under local anesthesia?

Cutaneous punch biopsy

Which two serum biomarkers are routinely quantified to evaluate, stage, and track recurrence in testicular germ cell neoplasms?

Alpha-fetoprotein (AFP) and human chorionic gonadotropin ($\beta\text{-hCG}$)

Which serum biomarker is primarily tracked in clinical practice to evaluate treatment response and monitor disease recurrence in ovarian epithelial carcinoma?

Cancer antigen 125 (CA-125)

Through which vascular pathway does renal cell carcinoma characteristically achieve direct hematogenous spread prior to pulmonary metastasis?

Invasion into the renal vein and extension into the inferior vena cava (IVC)

Which pediatric posterior fossa brain malignancy characteristically metastasizes via cerebrospinal fluid pathways throughout the craniospinal axis?

Medulloblastoma

Which surgical technique utilizes dual mapping with technetium-labeled colloid and blue dye to identify the primary draining regional lymphatic station?

Sentinel lymph node biopsy (SLNB)

What is the most common histological subtype of invasive breast malignancy, accounting for roughly $78\%$ of presentations?

Infiltrating ductal carcinoma

In radiation biology, which category of cellular injury represents irreparable DNA damage resulting in permanent cell death under all conditions?

Lethal radiation damage

What term describes the initial administration of chemotherapy or radiation prior to primary definitive surgical resection to downstage tumor volume?

Neoadjuvant therapy

Which surgical procedure removes tumors situated in the upper two-thirds of the rectum while successfully preserving anal sphincter continence?

Low anterior resection (LAR)

Which prophylactic surgical procedure repositions an undescended testicle into the scrotum to reduce future malignancy risk and enable clinical examination?

Orchiopexy

Which invasive operative staging procedure accesses the pretracheal space via a suprasternal notch incision under general anesthesia to sample lymph nodes in patients with suspected lung cancer?

Mediastinoscopy

Which functional imaging modality utilizes a fluorine-18-labeled glucose analogue to detect and stage metabolically active neoplastic tissues based on elevated glycolytic rates?

Fluorodeoxyglucose positron emission tomography (FDG-PET)

Which nuclear medicine scan binds selectively to sites of active cellular proliferation and inflammation, primarily serving to evaluate disease activity and post-treatment response in lymphoma?

Gallium-67 scan

Which radioisotope is routinely administered intravenously during diagnostic bone scintigraphy to localize osteoblastic metastasis and regions of increased skeletal turnover?

Technetium-$99\text{m}$ ($^{99\text{m}}\text{Tc}$)

In Paget's classic 'seed and soil' hypothesis of metastasis, what specific biological component does the 'soil' represent?

The receptive microenvironment of the distant target organ

What term describes the histological phenomenon in which contiguous cords or nests of malignant cells migrate continuously along the lumina of blood or lymphatic vessels?

Vascular or lymphatic permeation

Which level of cancer prevention focuses on population-wide public health policies, lifestyle modification, and vaccination campaigns to prevent malignancy from initiating?

Primary prevention

According to statistical risk data, what is the approximate lifetime risk for a woman to be diagnosed with invasive breast carcinoma?

Approximately $12.8\%$ (or $1$ in $8$ women)

In the Oncotype DX 21-gene recurrence assay, which score range designates high risk for systemic recurrence in patients with node-negative, ER-positive early breast cancer?

Recurrence Score (RS) $\ge 31$

Which surgical biopsy technique entails complete macroscopic removal of a suspicious lesion along with an adequate margin of surrounding healthy tissue, serving both diagnostic and definitive therapeutic roles?

Excisional biopsy

In cellular radiobiology, which type of damage describes non-lethal cellular DNA alterations that can be repaired within hours provided additional radiation is not administered prematurely?

Sublethal radiation damage (SLD)

In radiobiology, which of the '5 Rs' explains why fractionated therapy improves tumor cell kill by allowing hypoxic tumor cells access to oxygen between doses?

Reoxygenation

In the '5 Rs' of radiotherapy, which phenomenon describes the accelerated cellular division and proliferation of surviving clonogenic cells that can compromise tumor control during prolonged treatment breaks?

Repopulation

Which premalignant esophageal condition resulting from chronic gastroesophageal reflux disease requires endoscopic surveillance or surgery to prevent progression to adenocarcinoma?

Barrett's esophagus

Which oncofetal glycoprotein is predominantly measured in clinical practice to monitor disease progression and detect recurrence following surgical resection of colorectal carcinoma?

Carcinoembryonic antigen (CEA)

Which surgical reconstructive procedure involves detaching donor tissue with its supplying vascular pedicle and re-anastomosing them microscopically to vessels at the recipient defect site?

Free flap reconstruction

Which clinical procedure involves percutaneous needle drainage of accumulated peritoneal fluid to evaluate for malignant cells and alleviate symptomatic abdominal distension?

Paracentesis

Which procedural examination involves applying acetic acid to the cervix to highlight abnormal dysplastic or malignant epithelium as aceto-white lesions prior to targeted biopsy?

Colposcopy

Which gynecologic condition describes ovarian metastasis arising from a primary gastrointestinal adenocarcinoma that has spread transcoelomically across the peritoneal cavity?

Krukenberg tumor

Which surgical biopsy technique involves harvesting only a small representative wedge or fragment of tissue from a large or unresectable mass for diagnostic confirmation?

Incisional biopsy

What are the three primary anatomical skeletal sites routinely accessed for bone marrow aspiration or trephine biopsy in suspected hematologic disorders?

Posterior superior iliac crest, anterior superior iliac crest, and proximal sternum

In radiation biology, which category of cellular damage can be repaired if post-irradiation environmental conditions are suboptimal for cellular growth and division?

Potentially lethal radiation damage (PLD)

In radiobiology, which of the '5 Rs' describes how radiation blocks surviving cells in the $G_2$ phase, synchronizing the surviving population into more radiosensitive cell-cycle stages?

Redistribution

For low-dose conventional photon radiotherapy (doses below $200\text{ cGy}$), what is the approximate Oxygen Enhancement Ratio (OER)?

Approximately $2.5$

For photon radiation delivered at high single doses exceeding $200\text{ cGy}$, what range does the Oxygen Enhancement Ratio (OER) typically reach?

Approximately $3.0$ to $3.5$

During a course of fractionated radiotherapy, to what accelerated rate can clonogenic tumor cell doubling time drop as repopulation occurs?

Approximately $2$ days

Which biomarker evaluation criterion assesses a laboratory test's accuracy, reproducibility, and reliability across varying pre-analytical conditions?

Analytical validity

Which evaluation standard requires clear evidence that utilizing a biomarker test alters clinical management decisions and improves patient outcomes?

Clinical utility

What are the four prognostic classification groupings used to evaluate axillary lymph node status in early-stage breast cancer?

Negative, $1$ to $3$ positive nodes, $4$ to $9$ positive nodes, and $\ge 10$ positive nodes

According to epidemiological risk statistics, what is the estimated lifetime risk for a woman of dying from breast cancer?

Approximately $2.6\%$ (or $1$ in $39$ women)

Which routine coagulation blood tests are mandatory prior to invasive biopsies or operative resections to evaluate hemostatic competence and bleeding risk?

PT/INR and PTT

Which acute vascular event involving the tracheobronchial tree represents a life-threatening, often terminal surgical emergency in thoracic oncology?

Massive hemoptysis

Which trio of primary neoplasms arising in the neck or mediastinum commonly causes acute extrinsic mechanical compression of the trachea?

Lymphoma, thyroid carcinoma, and thymoma

In post-lumpectomy breast irradiation, what is the primary clinical rationale for administering an extra radiation 'boost' to the surgical cavity bed using photons or electrons?

Increased local tumor control

Which fluoroscopic imaging examination utilizes swallowed radiopaque contrast material to define the anatomical location and lumen narrowing of an esophageal neoplasm?

Barium swallow

Which common physiological or benign conditions are recognized causes of non-malignant serum PSA elevation?

BPH, prostatitis, UTI, catheterization, and recent ejaculation

Which term describes definitive non-surgical cancer treatment administered with curative intent that combines ionizing radiation and systemic chemotherapy concurrently?

Concurrent chemoradiation

Which minimally invasive gynecologic procedure uses an electrically heated wire loop to excise dysplastic cervical epithelium and early cervical lesions?

Loop electrosurgical excision procedure (LEEP)

Which endoscopic procedure is utilized for direct visualization of the lower urinary tract, stent placement, and transurethral instillation of Bacillus Calmette-Gurin (BCG)?

Cystoscopy

Which diagnostic visualization procedure uses a fiberoptic scope passed transnasally to assess vocal cord mobility and airway patency without the ability to perform a tissue biopsy?

Flexible laryngoscopy

Which minimally invasive operative procedure utilizes two to three small abdominal incisions to evaluate primary tumor extension, nodal involvement, and peritoneal seeding?

Staging laparoscopy

What is the approximate Oxygen Enhancement Ratio (OER) for radiation of intermediate ionizing density compared to standard photon irradiation?

Approximately $1.6$

Which biomarker assessment standard evaluates a test's capacity to divide a target patient population into two or more distinct subgroups that differ in biological characteristics or clinical outcomes?

Clinical validity

Which family of proteolytic zinc-dependent enzymes is actively secreted by tumor cells to degrade type IV collagen and extracellular matrix components during local invasion?

Matrix metalloproteinases (MMPs)

What term designates aggregates of circulating malignant cells clumped with platelets and fibrin that occlude distant vascular lumens, fostering metastatic recurrence?

Tumor emboli

Which level of cancer prevention aims to detect pre-malignant changes or asymptomatic localized early-stage disease through interventions such as Pap smears and colonoscopies?

Secondary prevention

Which rare and catastrophic thoracic oncologic emergency occurs when an invasive esophageal tumor erodes directly into the thoracic aorta, producing sudden exsanguination?

Aortoesophageal fistula

Which supportive central vascular access device is inserted into peripheral arm veins and advanced until its catheter tip terminates in the superior vena cava?

Peripherally inserted central catheter (PICC)

Which intensive nutritional support modality delivers hypertonic amino acids, dextrose, and lipid emulsions intravenously via a central line for oncology patients unable to tolerate enteral feeding?

Total parenteral nutrition (TPN)

Which risk-reducing surgical intervention is recommended for women with BRCA mutations to dramatically reduce the incidence of high-grade serous epithelial ovarian and fallopian tube cancers?

Prophylactic bilateral salpingo-oophorectomy

What therapeutic term refers to primary radical cancer treatment—such as concurrent chemoradiotherapy or definitive surgical resection—delivered with specific curative intent after evaluating all modalities?

Definitive therapy

In the Oncotype DX breast cancer assay, how many total genes are evaluated, and what is their breakdown between cancer-related and reference control genes?

$21$ total genes ($16$ cancer-related genes and $5$ reference genes)

What is the chronological progression of steps required for malignant solid tumor cells to complete hematogenous metastasis?

Local invasion, intravasation, survival in circulation, extravasation, and colonization

Which diagnostic and therapeutic nuclear medicine procedure evaluates functional thyroid tissue, detects residual thyroid cancer, and assesses sensitivity to radioablation?

Radioactive iodine-$131$ ($^{131}\text{I}$) scan

Which palliative surgical intervention involves surgical debridement or partial resection of an ulcerated, necrotic, or fungating tumor to manage malodor, pain, and secondary infection?

Wound toilet resection

Which regional anesthesia technique involves infusing local anesthetics or opioids into the space outside the dura mater to provide operative and postoperative analgesia?

Epidural anesthesia

Which nuclear antigen measured by immunohistochemistry serves as an established cellular proliferation marker that correlates with increased recurrence risk in early breast carcinoma?

Ki-$67$ antigen

Which bedside visualization technique utilizes an angled mirror and a light source to examine the larynx and evaluate vocal cord mobility without entering the airway?

Indirect laryngoscopy