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Leeds MBCHB Year 4 CCC > Cancer > Flashcards

Cancer Flashcards

1
Q

FAP inheritance

A

AD

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2
Q

Most common type of RCC

A

Clear cell (think that wee is clear)

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3
Q

System to grade prostate histology

A

Gleason score

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4
Q

System to grade gynaecological cancer

A

Figo

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5
Q

System to grade gynaecological cancer

A

Figo

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6
Q

Two risk factors for developing squamous cell carcinoma of bladder

A

Smoking

Schistosomiasis infection

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7
Q

Which type of testicle cancer is AFP raised in

A

Non-seminoma

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8
Q

4 risk factors for TCC

A

Smoking
Aniline dyes
Rubber manufacture
Cyclophosphamide

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9
Q

First line investigation for ?prostate cancer

A

Multi parametric MRI

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10
Q

What cancer is acanthosis nigricans associated with

A

Gastric endocrine cancer

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11
Q

What cancer is acanthosis nigricans associated with

A

Gastric endocrine cancer

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12
Q

What blood group is associated with an increased risk of gastric cancer

A

Group A

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13
Q

Tumour marker for breast cancer

A

15-3

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14
Q

Sign seen on all imaging in pancreatic cancer

A

Double duct

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15
Q

Under what size tumour can an WLE be used

A

4 cm and under

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16
Q

When would Herceptin be used

A

In HER2 positive breast cancer patients (cannot be used in patients with cardiac disorders)

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17
Q

What axilla surgery should a women with no palpable lymph nodes have

A

None - US first to assess then if positive sentinel node biopsy

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18
Q

What must be given during the first weeks of Gosrelin

A

Antiandrogen to reduce tumour flare effect

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19
Q

Gold standard ix for ?oesphageal cancer

A

Endoscopy

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20
Q

Most likely oesophageal cancer by location

A

Top 2/3 - squamous cell ca

Bottom 1/3 - adenocarcinoma

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21
Q

Indicator in a FBC that may suggest lung cancer

A

Raised platelets

sorry for awful question

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22
Q

Main complication of prostate removal

A

ED

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23
Q

How long after a UTI can a PSA be taken

A

4 week

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24
Q

How long after exercise and ejactulation can a PSA be taken

A

48 hours

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25
Q

3 common paraneoplastic syndromes associated with small cell carcinoma

A

ADH
ACTH

Lambert Eaton syndrome (legs worse than arms)

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26
Q

Clubbing is most associated with what cancer

A

Squamous

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27
Q

All men over 60 with microcytic anaemia should receive

A

2 ww ?colorectal cancer and colonoscopy

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28
Q

What patients get a 2 ww for ?RCC

A

Over 45 with unexplained visible haematuria

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29
Q

Consequence of FAP

A

Malfunctioning of tumour suppressor gene: adenomatous polpyposis coli (APC)

Causes development of polyps (adenomas) in large colon.

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30
Q

Treatment of FAP mutation

A

Panproctocolectomy

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31
Q

2 genetic causes of increased bowel cancer risk

A

FAP

HNPCC (Lynch syndrome)

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32
Q

What is HNPCC

A

Hereditary nonpolyposis colorectal cancer

DOES NOT CAUSE ADENOMAS LIKE FAP

Increases risk of bowel cancer

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33
Q

Difference between FAP and HNPCC on colonoscopy

A

FAP causes multiple adenomas (polyps)

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34
Q

NICE 2ww criteria for ?bowel cancer

A

Over 40: abdominal pain and weight loss
Over 50: unexplained rectal bleeding
Over 60: iron deficiency anaemia or change in bowel habit

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35
Q

Difference between FIT test and FOB test

A

FIT test is for human hb (currently used)

FOC is for blood so could be from diet etc

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36
Q

When should a FIT test be used

A

In general practice if patient doesn’t meet NICE 2ww criteria

Over 50: unexplained weight loss
Under 60: change in bowel habit

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37
Q

Who for and how often is bowel cancer screening undergone

A

60-74 years

Every 2 years FIT test

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38
Q

Is CEA used for screening

A

Not useful in screening

Useful for checking for reoccurrence of cancer

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39
Q

Gold standard investigation for ?bowel cancer

A

Colonoscopy

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40
Q

2 classifications for bowel cancer

A

Dukes

TMN

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41
Q

3 specific treatments for bone pain

A

NSAIDS
Radiotherapy
Bisphosphonates (pamidronate infusion)

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42
Q

What is pamidronate infusion and whats it used for

A

Bisphosphonate
Bone pain
Hypercalcaemia

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43
Q

What is visceral pain

A

Deep seated poorly located pain that can be spasmodic

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44
Q

Treatment for visceral pain

A

Using WHO pain ladder

Spasms can be helped with anticholinergics - hycosine for bowels and oxybutyl for bladder

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45
Q

Drug used for bladder spasm

A

Ocybutynin

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46
Q

Pain due to raised ICP

A

Dex (16mg daily reduced to least effective dose)

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47
Q

Two classes of drugs used for neuropathic pain

A

Anti epileptic - pregablin

Anti depressant - amitriptyline

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48
Q

What may happen to patients started on mrophine that begin to feel nauseous

A

Improve after a few days

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49
Q

When titrating up pain relief, what does increase should be used

A

30-50%

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50
Q

Breakthrough pain relief dose

A

1/6th

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51
Q

How long do fentanyl patches last for

A

72 hours

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52
Q

2 drugs that can be used for anorexia

A 
Dex (4mg)
Megestrol acetate (can cause fluid retention)
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53
Q

4 key causes of nausea in oncology

A

Gastric stasis - metoclopramide
Toxins - haloperidol
Cerebral - (dex) plus cyclizine
Vestibular - cyclizine

Levomepramazine is a good all rounder

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54
Q

What type of drug is levomepromazine

A

Anti emetic

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55
Q

3 classes of laxative

A

Bulk forming (fibre - not used much)
Osmotic
Prokinetic

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56
Q

Give examples of pro kinetic and osmotic laxative

A

Osmotic: lactulose, docuaste
Stimulant: MCR, Senna, dantron

Mixed: movicol

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57
Q

What gene does cigarette smoke damage

A

p53 tumour suppressor

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58
Q

Aromatic amines are associated with what cancer

A

Blader

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59
Q

What cancer is benzene associated with

A

Leukaemia

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60
Q

What cancer is wood dust associated with

A

Nasal adenocarcinoma

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61
Q

What cancer is vinyl chloride associated with

A

Angiosarcomas

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62
Q

What cancers is EBV associated with

A

NH lymphoma

Burkitts

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63
Q

What is synergism

A

Giving multiple chemotherapy agents at once to maximise cell death

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64
Q

When is WBCs drop the lowest and what is this called

A

10-14 days after beginning of cycle

Nadir

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65
Q

When would you infuse patients having chemo with platelets

A

Less than 10x10^9 - always

10-20x10^9 if symptoms

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66
Q

5 types of non small cell lung cancer

A 
Adenocarcinoma (non smokers)
Squamous
Large cell
Alveolar (++ sputum)
Bronchial (mostly carcinoid)
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67
Q

What should women be offered after WLE

A

Radiotherapy

Plus potential other treatments

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68
Q

Most common type of thyroid cancer

A

Papillary

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69
Q

Second cancer associated with HNPCC

A

Endometrial

gastric, biliary and ovarian possible

70
Q

Triad of RCC

A

Haematuria
Loin pain
Abdominal pass

71
Q

Possible PNS of RCC

A

EPO (polycythemia)
PTH
ACTH

72
Q

Adjunctive therapy in postmenopausal women

A

Anastrazole (aromatase inhibitor)

73
Q

What is brachytherapy

A

When a radioactive substance is placed inside a cavity or cancerous organ

74
Q

What breast screening is offered in UK

A

Mammography to all women between 50 and 70 every 3 years

75
Q

What bowel screening is offered in UK

A

FOB every 2 years 60-70

76
Q

Hypertrophic oestoarthopathy triad and what disease is it associated with

A

Triad of osperiostitis, digital clubbing and painful arthropathy of the large joints

Lung cancer (squamous and adenocarcinoma)

77
Q

3 paraneoplatic syndromes associated with small cell lung cancer

A

ADH
ACTH
Lambert Eaton syndrome

78
Q

3 PNP syndromes associated with squamous cell

A

PTH -> hypercalcaemia
Hypertrophic pulmonary osteoarthopathy
Hyperthyroidism due to ectopic TSH

79
Q

2 PNP syndromes associated with adenocarcinoma

A

Gynaecomastia

Hypertrophic pulmonary osteoarthopy

80
Q

Lung cancer strongly associated with clubbing

A

Squamous

Central, PTHrp, HPOA

81
Q

Which lung cancer is most common in non-smokers

A

Adenocarcinoma

82
Q

Lung cancer that secrets bHCG

A

Large cell

83
Q

Lung cancers that grow peripherally

A

Adenocarcinoma

Large cell

84
Q

Prostatitis effect on GI system

A

Pain on bowel movements

85
Q

What hormones is prostate cancer dependant on

A

Androgens (testosterone)

86
Q

Most common type of prostate cancer

A

Adenocarcinoma (and grow peripherally)

87
Q

Ethnicity risk for prostate cancer

A

Black African and Caribbean

88
Q

2 key non LUTS prostate cancer symptoms

A

ED

Haematuria

89
Q

Age to request a PSA

A

50

90
Q

PSA rates of false positives and negative

A

FP: 75% of time
FN: 15% of time

91
Q

First line investigation in ?prostate cancer

A

Multiparametric MRI

92
Q

Grading score for prostate histology

A

Gleason

93
Q

What is Gleason score

A

Histology grading of two numbers between 1 and 5

10 is worst

94
Q

Hormone therapy in prostate cancer

A

Reduce testosterone levels

Androgen receptor blockers (bicalutamide)
GnRH agonists (goserelin)
Bilateral orchidectomy

95
Q

Two types of testicular cancer

A

Seminomas

Non-seminomas (teratomas)

96
Q

4 key risk factors for testicular ca

A

Undescended testicles
Male infertility
FH
Increased height

97
Q

Is testicular cancer normally painful

A

Painless

98
Q

Would a testicular cancer transilluminate

A

No

99
Q

What key symptom does Leydig cell tumour give

A

Gynaecomastia (testicular tumour)

100
Q

3 tumour markers in testicular cancer

A

AFP - non-seminomas
bHCG - both
LDH - very non specific

101
Q

4 most common mets location from testicle

A

Lymph, lung, liver, brain

102
Q

Over what age should a smoker with haemoptysis be referred to a 2ww clinic

A

40

103
Q

Which lung ca is most sensitive to radiotherapy

A

Small cell

104
Q

What cancer is BRACA2 associated with in men

A

Prostate

105
Q

Signet ring cells are assocoiated with…

A

Adenocarcinoma of lung

106
Q

Double duct sign is seen in

A

Pancreatic ca

107
Q

Triad of hypotension, haemconcentrate and low albumin

A

Capilary leak syndrome

108
Q

How do the majority of lymphoma patients present

A

Lymph nodes

109
Q

Why would uric acid be measured in lymphoma

A

Risk of tumour lysis syndrome with treatment

110
Q

Faulty BRCA1 gene leads to what increased risk

A

70% will develop breast cancer by 80
50% will develop ovarian cancer
Bowel and prostate cancer risk

111
Q

If you have a faulty BRAC2 gene, what are your increased risks

A

60% risk of breast cancer by 80

20% risk of ovarian cancer

112
Q

Which cancers effected by BRAC1

A

Breast, ovarian, bowel and prostate

113
Q

How does COOP affect breast cancer risk

A

Small increase but back to normal 10 years after stopping

114
Q

What chemoprevention may be offered to high risk men and women of breast cancer

A

Tamoxifen if pre

Anatrozole if postmenomausal

115
Q

Which lumps are the most concerning in breast cancer

A

Hard, irregular, painless and fixed in place

116
Q

NICE 2ww for breast cancer guidelines

A

Unexplained breast lump in over 30s

Unilateral nipple changes in over 50s

117
Q

Where does breast cancer mets to

A

2Ls 2Bs

Lung liver
Bones brain

118
Q

What two cancers can practically and regularly do, spread anywhere

A

Breast and melanoma

Lung, liver, bone, brain most common in breast

119
Q

When can aromatase inhibitor be used

A

In postmenapausal women with ER positive cancer

120
Q

How does tamoxifen work

A

Oestrogen receptor modulator (blocker)

121
Q

How long is hormonal treatment in breast cancer

A

5-10 years

122
Q

Why may ovaries be removed in breast cancer

A

If ER+ve to reduce oestrogen levels

123
Q

When is trstuzumab used and what is it

A

HER2 +ve breast cancer

124
Q

Key risk with trastuzumab

A

Alter heart function

125
Q

Under what eGFR should oxycodone be used

A

50

126
Q

Good non-pharmacological bone pain relief

A

Radiotherapy

127
Q

Once a patient is treated for breast cancer, how should they be managed.

A

Surveillance mammograms yearly for 5 years

Tamoxifen/ anastrozole for 5-10 years if ER+ve

128
Q

Most common cells affected in HandN cancer

A

Squamous cell

129
Q

How do head and neck cancers normally spread

A

Lymph nodes

130
Q

Risk factors for H and N cancers (5)

A

Smoking
Alcohol
HPV (16)
EBV

Betel quid (something chewed in SE Asia?)

131
Q

What is Kaposis sarcoma

A

Herpes virus 8 induced sarcoma seen in end stage HIV

Induces red purple rash over body

132
Q

Pt presents with liver mets, what scan should be arranged

A

Colononscopy

133
Q

Most common bug that causes line infections

A

Staph epididmitis

134
Q

Do seminomas raise AFP

A

No

135
Q

Testicle cancer type by age groups

A

30-50 seminoma

20-30 non seminoma

136
Q

What MST dose does NICE recommend for new pts

A

20-30 mg per day

137
Q

What would you prescribe for someone with spinal cord compression?

A

16mg dex PO

PPI - don’t forget!!!!

138
Q

Acronym for breaking bad news (and its meaning)

A 
SPIKES
Setting
Perception
Invitation (do they want to know today)
Emotions
Strategy and summary
139
Q

Average age of Hodgkins Lymphoma

A

Bimodal age

20 years and 75 years

140
Q

4 risk factors for Hodgkins lymphoma

A

HIV, EBV, AI conditions, FH

141
Q

Description of lymphoma lymph nodes

A

Non-tender and rubbery

WORSE ON DRINKING ALCOHOL

142
Q

Key diagnostic test in Hodgkins lymphoma

A

Biopsy that shows Reed Sternberg cells (large B cells with multiple nuclei)

143
Q

What are Reed Sternberg cells a sign of

A

Hodgkins lymphoma

144
Q

Staging system used in H lymphoma

A

Ann Arbor

(same in both)

1 = one region
4 = metastatic spread
145
Q

Staging system used in non H lymohoma

A

Ann Arbor

(same in both)

1 = one region
4 = metastatic spread
146
Q

Management of H lymohoma

A

Chemotherapy and radiotherapy

Chemo = risk of leukaemia and infertility
Radio = risk of cancer and hypothyroidism
147
Q

3 key non H lymphomas

A

Burkitt (EBV, malaria, HIV)
MALT (mucosa associated lymphoid tissue normally in stomach and associated with H Pylori)
Diffuse large B cell lymphoma (rapidly growing painless mass in over 65s)

148
Q

What is trichloroethylene a risk for

A

Non H lymphoma

149
Q

What is lymphoma a cancer of

A

Lymphocytes

150
Q

What is leukaemia a cancer of

A

Stem cells in bone marrow

151
Q

Blood results found in almost all leukaemias

A

Pancytopenia - anaemia, leukopenia, thrombocytopenia

152
Q

Age distribution of leukaemia

A

ALL CeLL (mates have) CoMmon AMbitions

ALL - under 5 over 45
CLL over 55
CML over 65
AML over 75

153
Q

Nice guidelines for suspected leukaemia

A

FBC within 48 hours

154
Q

Key test for leukaemia

A

Bone marrow biopsy

155
Q

ALL blood film shows

A

Blast cells

ALL blast off? bLAst off?

156
Q

Common association with ALL in kids

A

T21

Philadelphia chromosome

157
Q

CLL transforms to Lymphoma is called

A

Richters transformation

158
Q

What type of anaemia is CLL associated iwth

A

Warm auto immune haemolytic anaemia

159
Q

Two leukaemias associated with Philadelphia chromosome

A

ALL and CML

opposite besucase Philidelipa is opposite?

160
Q

Cells seen within CLL

A

Smudge/ smear

get the all CLLear when you go for a smear

161
Q

Most common adult leukaemia

A

AML

162
Q

What is seen on an AML blood film

A

Auer rods

163
Q

CML is broken down into three what?

A

Phases

Chronic - 5 years and normally asymptomatic expected a raised WCC

Accelerated - abnormal blast cells take up a high proportion of bone marrow cells so patients become anaemic, thrombocytopenia and immunocompromised

Blast - even higher proportion of cells - normally fatal

164
Q

Key chemical released in tumour lysis syndrome

A

Uric acid

165
Q

Two drugs used to treat tumour lysis syndrome

A

Allopurinol or rasburicase

166
Q

Electrolyte derangement seen in tumour lysis syndrome

A

High uric acid

High K
High PO4

(low calcium as high po4)

167
Q

calcium levels in tumour lysis syndrome

A

can be low as phosphate is high

168
Q

What cells is myeloma a cancer of

A

Plasma (B lymphocyte that makes anti bodies)

169
Q

What is Monoclonal gammopathy of undetermined significance (MGUS)

A

Similar to myeloma when body makes excess of a single type of antibody without other features of myeloma

170
Q

4 key features of myeloma

A

CRAB

Calcium (elevated)
Renal failure
Anaemia
Bone lesions/ pain

171
Q

Risk factors for myeloma

A

Older age, male, black African, FH, obesity

Leeds MBCHB Year 4 CCC (7 decks)

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