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CCC > Blue book > Flashcards

Blue book Flashcards

1
Q

aromatic amines are associated with which cancer

A

bladder

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2
Q

benzene is associated with which cancer

A

leukaemia

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3
Q

wood dust si associated with which cancer

A

nasal adenocarcinoma

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4
Q

vinyl chloride is associated with which cancer

A

angiosarcomas

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5
Q

HPV assocated with which cancer

A

cervical and anal

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6
Q

EBV associated with which cancer

A

non-hodgkins lymphoma

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7
Q

Hep B associated with which Ca

A

hepatocellular

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8
Q

HTLV1 infection associated with which Ca

A

t-cell lympohma

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9
Q

h pylori associated with which Ca

A

MALT

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10
Q

T
N
M
what do they stand for?

A

tumour
node
mets

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11
Q

high grade is

A

poorly differentiated

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12
Q

which cancers do you use CT in?

which do you use MRI in?

A

CT - chest, abdo

MRI - post fossa of brain, pelvis. gold standard in neurospinal, rectal, prostate, MSK

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13
Q

what does the RECIST system assess?

A

response to treatment

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14
Q

sensitivity definition

A

ability to detect people with certain disease

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15
Q

specificity definition

A

accurately define who is disease-free

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16
Q

CEA

A

colorectal but also other cancers

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17
Q

ca125

A

ovarian

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18
Q

ca19.9

A

pancreatic

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19
Q

ca15.3

A

breast

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20
Q

aFP

A

hepatocellular carcimoma and some germ cell

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21
Q

beta HCG tumour marker

A

germ cell tumours incl Gestational trophoblastic disease (choriocarinoma and hydatiform mole) and testicular cancer and semionoma

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22
Q

other things that raise PSA

A

BPH, prostatitis, DRE, UTI

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23
Q

what type of cancer is waldenstroms macroglobulinaemia

A

non-hodgkin

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24
Q

bence jones protein in which cancers (2)

A

multiple myeloma

waldenstoms macroglobulinaemia

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25
Q

other things that can cause raised CEA (not cancer)

A

smoking

IBD, pancreatitis, gastritis, hepatitis

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26
Q

other things that can caused raised CA125

A

pregnancy, endometriosis, PID

Also other cancers

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27
Q

high levels of aFP and progosis in malignancy

A

poor

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28
Q

CSF appearance on T2 and T1 MRI

A

T1 - dark

T2 - bright

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29
Q

what is cytoreductive suregry

A

reduce bulk of tumour (then will do another treatment eg with chemo)

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30
Q

what marker is used in PET-CT

A

18F-FDG

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31
Q

how long after remission do you keep giving maintenance therapy in childhood leukaemia?

A

18 months

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32
Q

example of chemo given intravesically

A

superficial bladder cancer

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33
Q

example of chemo given intraperitoneally

A

ovarian

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34
Q

example of chemo given intra-arterially

A

tumour with well-defined blood supply eg hepatic artery infusion for liver mets

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35
Q

how is chemotherapy dose usually calculated and what formula is used?

A

body surface area

DeBois and DeBois

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36
Q

Which chemotherapy drug has a dose calculated from renal function

A

carboplatin

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37
Q

which chemotherapy drugs are more likely to cause peripheral neuopathy

A

platinum drugs esp cis platin
taxanes
vinca alkaloids

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38
Q

which chemotherapy drug is associated with pulmonary fibrosis

A

bleomycin and busulphan

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39
Q

which chemotherapy drugs is associated with conduction defects

A

doxorubicin

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40
Q

which solid cancers are associated with bone marrow replacement and subsequent pancytopenia

A

breast, lung, prostate

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41
Q

which type of anaemia is seen in blood loss from a tumour

A

iron deficiency

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42
Q

which type of anaemia is due to repeated chemotherapy

A

macrocytic

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43
Q

clinical features of thrombocytopenia

A

unprovoked nose bleeds, petichiae, haematuria, corneal haemorrhage

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44
Q

management of thrombocytopenia

A

platelts urgently if <10
platelets non-urgent if 10-20
nothing if >20

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45
Q

prophylactic antibiotics for patients with COPD + lymphoma (at risk of PCP pneumonia)

A

co-trimoxazole

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46
Q

what makes up maximum androgen blockade

A

non-steroidal anti-androgen + LHRH analogue

47
Q

positive side effect of progestogens in anti-cancer hormonal therapy

A

stimilate apetite

48
Q

what is the aim of phase 1 clinical trial

A

to determine toxicity and maximum tolderated dose

49
Q

who are phase 1 trials tested on

A

patients with any tumour
normal renal and heptaic function
fit
no conventional treatments appropriate

50
Q

phase 1 trial method (dose escalation)

A

10% of lethal dose/kg in mice starting
3 patients at each dose level until side effects
then 6 patients until side effects are intolerable

51
Q

aim of phase 2 of clinical trial

A

assess anti-tumour activity on a range of cancers

52
Q

primary outcome measure and how is assessed of phase 2

A

response rate - radiological shrinkage

53
Q

primary outcome measures in phase 3 (2 of them)

A

overall survival

progression -free survival

54
Q

secondary outcome measure in phase 3

A

response rate

55
Q

aim of phase 3

A

is it better than the exisiting drugs

56
Q

what is RECIST

A

define tumour responses radiologically

57
Q

what criteria is used to classify toxicity in clinical trials

A

WHO

58
Q

how many patients are required to test a 20% response rate to a new cancer treatment?

A

14

59
Q

how is survival data presented graphically . and what is plotted on each axis

A

kaplan meier curves

probability of survival plotted against time

60
Q

what is acturaral data in terms of clinical trials

A

estimated data for the patients lost to follow-up

61
Q

what are basket trials

A

all tumours with a particular mutation are tested with a drug that targets that mutation

62
Q

what are umbrella trials

A

all tumours of the same type are tested and then genetic profile and treated with different experimental treatments depending on the results

63
Q

what are platform trials

A

one control arm + lots of experimental arms

64
Q

5 things to measure for QoL

A 
Physcial functionung
psychological functioning
social functioning
disease and treatment-realted symptoms
other
65
Q

who gets breast scrennig? and how often

A

50-70yrs

every 3 yrs

66
Q

who gets bowel screening and how often

A

60-74

every 2yrs

67
Q

who gets cervical cancer screnening and how often

A

25-49 every 3 yrs

50-64 every 5 yrs

68
Q

prevention in women at high risk of breast Ca as determined by IBIS breast Ca risk evaluation tool

A

offer tamoxifen or raloxifene for 5 yrs

69
Q

What do you give to people with lynch syndrome to reduce risk of colorectal ca

A

aspirin

70
Q

3 ways to treat bone pain

A

nsaids eg diclofenac
radiotherapy
bisphosphonates eg pamidronate infusion

71
Q

dull ache over large area, worse on movement

A

bone pain

72
Q

dull, deep seated, poorly localised pain

A

visceral pain

73
Q

management of liver capsule pain

A

dexamethasone 8mg or nsaid

74
Q

management of bowel colic

A

SC hyoscine butylbromide

75
Q

managment of bladder spasm

A

PO oxybutynin

76
Q

dull, oppressive headache. worse on waking, coughing. associated with N&V

A

raised ICP

77
Q

management of raised ICP headache

A

16mg dexamethasone then reduce
NSAIDs
paracetamol
cyclizine for N&V

78
Q

side effects of nsaids

A

gi, renal impairment, fluid retention

79
Q

cautions for amitryptilline

A

CVD

80
Q

which laxative to prescribe for opiates

A

co-dranthamer

81
Q

management of anorexia in palliative

A

famliy education
advise small meals
give dexamethasone (but only works for a 2-3 weeks)
give megestrol acetate but may cause fluid retention

82
Q

which antiemetic for gastric stasis

A

metoclopramide

83
Q

causes of gastric statis N&V

A

ascites, hepatomegaly, dismoltility

84
Q

features of gastric stasis N&V

A

early satiety, epigastric fullness, hiccups, heartburn, minimal nausea, lots of vomiting

85
Q

management of toxic causes of N&V

A

haloperidol

86
Q

features of toxic causes of N&V

A

lots of nausea, retching, not much vomiting

87
Q

causes of toxic causes of N&V

A

drugs, hypercalcaemia, uraemia, infections

88
Q

management of anticipatory N&V

A

loraz, CBT, complementary therapies

89
Q

examples of softener laxiatives

A

lactulose, sodium docusate

90
Q

examples of stimulant laxatives

A

senna, dantron

91
Q

contraindications of stimulant laxatives

A

bowel obstruction, colic

92
Q

examples of combined laxatives

A

movicol, co-danthrusate (dantron + docusate), co-dranthramer

93
Q

normal/immediate release morphine - how quickly does it work and how long effective for?

A

20-30mins. effective for 4 hours

94
Q

which opiate should be prescribed to patients with renal failure

A

fentanyl or buprenorphine

95
Q

pain intervention for pain from femoral metastses

A

intramedullary nail

96
Q

what is allodynia

A

when non-painful stimulus is painful

97
Q

what is hyperalgesia

A

when things that are painful are more painful

98
Q

antiemetic of choice in last days of life

A

levomapromazine

99
Q

antiemetic for toxic causes

A

haloperidol

100
Q

antiemetic for chemo

A

ondansetron

101
Q

signs of MSCC (4)

A

weakness, parapepesis, paraplegia
clonus and painless bladder distention
hyperreflexia below level of lesion
changes in sensation below level of lesion

102
Q

definition of neutropenic sepsis

A

neutrophils <1 x 10^9

+ fever on >1 occasion or for >1hr (may have no fever though) or any other signs of infection

103
Q

pathogens in neutropenic sepsis ususally

A

70% are gram +ve - staph aureus, alpha and beta haemolytic strep
30% gram -ve eg e coli, klebsiella pneumoniae, pseudomonas aeriginosa

104
Q

where to take blood cultures from in neutropenic sepsis

A

line and peripheral

105
Q

antibiotics in neutropenic sepsis

A

tazocin (maybe + gent to cover pseudomonas)

106
Q

what score do you use to risk statify people with neutropenic sepsis?

A

MASCC score

107
Q

most common cancers associated with hypercalcaemia

A

squamous cell, breast, lymphoma

108
Q

managment of hypercalcaemia

A 
Normal saline (1 L every 4 hours for 24 hrs then 1L every 6 hrs for 48-72hrs + K+)
Give bisphosphonates after starting NaCl
109
Q

4 examinations to do in MSCC

A

Full neuro exam
PR - to assess anal tone
Abdo - palpate for urinary retention
Spine for tenderness

110
Q

what is pembertons sign

A

in SVCO

heand above head and JVP elevated, distended head and neck veins, insp stridor

111
Q

management of SVCO (immediate and definitive)

A

16mg dexamethasone + PPI

Stent + ?chemo/radio

112
Q

what is the most common type of breast cancer?

A

infiltrating/invasive ductal carcinoma

113
Q

screening questions for amber care bundle

A

is pt deterioriating, clinically unstable and with limited reversibility?
AND
is pt risk of dying in next 1-2 months, has life-limiting illness that will limit escalation of care, short prognosis

CCC (2 decks)

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