amk oncology teach march

Question 1

difference between low grade and high grade

Answer 1

high grade cancer cells are grossly dissimilar to normal cells whereas in low grade cancer cells are similar to normal cells

Question 2

endometrial two subtypes

Answer 2

oestrogen dependent

non-oestrogen dependent

Question 3

endometrial presents in women who are postmenopausal and if on HRT risk what gene. also beast cancer treatment tamoxifen cause this

symtpoms

Answer 3

PTEN gene

abrnomal uterine bleeding
postmenopausal with bloating and weight loss and anaemia and haematuria

Question 4

METS of endometrial cancer

Answer 4

ovaries, cervix and vaginal

Question 5

Type 2- non oestrogen dependent is common in older women and is due to a mutation of what

what different symptom

Answer 5

p53

bleeding is uncommon and there is usually pelvic pain and localised mass

Question 6

what is the investigation for endometrial cancer

Answer 6

transvaginal US

and FBC and clotting factors

Question 7

what is the investigation for cervical cance r

Answer 7

colposcopy

Question 8

for diagnostic sent for 2ww referral to repaid access gynaecologist clinic
Ca125 cancer marker( if declines after treatment in remission) an TVS and bloods

treatment is what

Answer 8

hysterectomy with bilateral oopgerectomy and lymph node removal

progestins

Question 9

ovarian cancer

Answer 9

serous adenocarcinoma - epithelial tumour and most common malignant

granulose cell - sex cord stroll - peak 50-55

dysgerminoma - germ cell - young women and teens

teratoma is benign and germ cells - under 30 - most common under 30

Question 10

most indicative symptom of ovarian cancer

Answer 10

increase in abdominal girth

Question 11

sera adenocarcinoma is typically asymptomatic with abdomen distension and bloating and pain , early steity and loss of appetite and urinary ffreuqenxy and diarrhoea and constripation ( pushes down on the bowel - increasedses fullness) caused by what mutation

Answer 11

BRCA 1 and 2

Ca125

Question 12

granulose cell tumour are the ones that secrete hormones what are they

menstrual irregularities an breast tenderness

increases risk of endometrial and breast cancer due to increased oestrogen

Answer 12

oestrogen and progerstoens

inhbuin marker

Question 13

dysgerminoma - rapid growth of onset symptoms what tumour market

Answer 13

AFP

Question 14

does a teratoma have a cancer marker

Answer 14

no

Question 15

diagnostics of ovarian cancer - 2ww if ascites and abdominal mass
measure Ca-125 - if this raised abdomen USS

needle aspiration cotnradinidaces. as potential to spread metastasis

treatment

Answer 15

hysterectomy with bilateral salpingo-oopherectomy
chemo
targeted therapy fro BRCA1and2 positive tumours

Question 16

cervical carcinoma ( squamous or Aden0) 
peak age 35-44 
incidence decreased with vaccine 
serotype 16/18 for HPV 
cerivcla intreptiheila neoplasia CIN - precursor lesion in 25-35 

rf

Answer 16

mutliparitty, smoking, low economic status, STI, immunosuppression , early onset sexual activity

12-14 men and women

Question 17

symptoms of cervical cancer

Answer 17

abrnoaml vaginal bleeding - post coital and spotting and irregular heavy menstrual cycles
dyspareunia and pelvic pain and weight loss fevers and night sweats

Question 18

cervical screening programme

Answer 18

every 3 years to 49 and then every 5 to 65
25-65
transgender can access programme via GP

Question 19

diagnose of cervical cancer

Answer 19

colposcopy
further imagine then CT/MRI ADN PET-CT
take Ca-125 prior treatment

Question 20

treatment of cervical cancer

Answer 20

CIN - LEEP or cold colonisation - remove top cells and addition radiotherapy

immediate - chemo and hysterectomy and remove fallopian tubes too , if wants to be reproductive - trachlectomy - just removal of cervix keeps fertility ( stage 1b)

advanced stages - palliative chemo and hysterectomy etc

Question 21

biggest rf for breast cancer

Answer 21

family history of ovarian cancer and prostate - as BRCA genes

poher are early menarche, late meonppasue, lat prey, obesity, nulliparity, HRT and COCP.
African higher
BRCA1-2 and HER2 over expression

lead to restraction of nipple and peak d-orange

Question 22

two types of breast cancer

Answer 22

invasive ductal carcinoma - maxillary ducts - most common and more aggressive and unilateral and pagets disease) orange) of the breast

invasive lobular carcinoma - lobules - not as agressove, bilateral

Question 23

diagnosis of breast cancer

Answer 23

50-71 - mammogram every 3 years , all women over 30 with breast lump or over 50 with nipple symptoms go for mammogram
core needle biopsy
rector overexpressign testing - oestrogen receptro and progeterone receptor PR - HER2
tumour markets are CEA

Question 24

treatment of breast cancer

Answer 24

total mastectomy and sentinel node bipsosy and axillary node dissection

radiotherapy follow all surgeries

hormone therapy ( tamoxifen and anasstrazole _ target antibody therapy too for HER2 then trastuzamab

Question 25

most appropriate investigation fro symptoms of prostate cancer

Answer 25

serum PSA

Question 26

postate cancer most common non-germ cancer in males increased over 50 and African
most asymptomatic often incidental - UR , dibbling and incotneince, haemauria and constritual symtposm arises from what zone

diagnostic tests

Answer 26

peripheral zone - posterior and lateral aspect of the prostate

PSA above 4

mutliparametric MRI main form of imaging

Biopsy for TNM staging

Question 27

stage 1 prostate cancer what do you

Answer 27

active surveillance - early stage

prostectomy or radical radiotherapy if stage 2 or above and anti-androgen therapy
chemotherapy - metazoic condition
metastasis to bone and spine and LNs