Cancer Flashcards

1
Q

List examples of lab tests

A

Complete blood count
Blood protein staining
Tumour marker test
Circulating tumour cell tests (uncommon)

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2
Q

Give a basic explanation of complete blood count

A

Count the number of different types of cell in the blood
Abnormality in number or morphology

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3
Q

What is bone marrow biopsy used for?

A

Confirm blood cancer diagnosis

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4
Q

Explain blood protein staining

A

Test of abnormal immunoglobulins

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5
Q

Example of tumour marker tests

A

CA-125 for ovarian cancer

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6
Q

Explain circulating tumour cell tests

A

Test of cancer cells floating in the bloodstream

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7
Q

Examples of Complete Blood Count

A

RBC test
WCB test
Platelets Test (PLTs)

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8
Q

Explain what is measured in RBC test

A

RBC count
Hemoglobin
Hematocrit
Reticulocyte

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9
Q

Define hemoglobin

A

Carrying protein for O2 and CO2

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10
Q

Define hematocrit

A

Volume proportion of blood that consists of RBC

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11
Q

Define reticulocyte count

A

Count of immature RBCs

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12
Q

Explain what is measured in WBC test

A

WBC count
WBC differential

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13
Q

List types of WBC

A

Monocytes
Lymphocytes
Neutrophils
Basophils
Eosinophils

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14
Q

What is measured in platelet test?

A

Platelet count
Mean platelet volume
Platelet distribution width

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15
Q

What diagnosis need blood protein staining test?

A

Lymphoma
Chronic lymphocytic leukemia
Multiple myeloma

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16
Q

List the electrophoretic zones

A

Albumin
Alpha 1 anti trypsin
Alpha 2 macro globulin
Beta 1 & beta 2 Transferrin
Gamma globulin

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17
Q

What is blood protein staining testing for?

A

Testing for abnormality in protein
Loss of proteins

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18
Q

What is cancer is marker Ca-125 for?

A

Ovarian cancer

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19
Q

What is the cancer with marker CD25?

A

Non-Hodgkin lymphoma

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20
Q

What cancer is associated with EGFR gene mutation?

A

Non-small cell lung cancer

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21
Q

What cancer is associated with estrogen receptor marker?

A

Breast cancer

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22
Q

How is Ca125 tested by?

A

Immunoassay

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23
Q

List conditions that CA-125 will be higher?

A

Ovarian cancer
Endometriosis
Liver disease
Menstruation
Pregnancy
Uterine fibroids

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24
Q

What is a normal range of CA125?

A

Less than 46 U/ml

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25
Q

What is 70-gene signature used to predict?

A

Predict metastasis and recurrence of breast cancer

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26
Q

What is 70-gene signature used to test?

A

Test the activity of 70 different genes in the breast cancer tissue

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27
Q

What does 70-gene signature used to aid with?

A

Aid to early stage breast cancer treatment

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28
Q

What type of CTC tests are available?

A

Breast cancer
Colorectal
Prostate

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29
Q

What type of technology is used in CTC test?

A

Ferrofluid nano particle based technology

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30
Q

List cancer diagnostic imaging

A

Breast mammogram
CT scan
PET scan
MRI imaging

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31
Q

Explain what a breast mammogram

A

Low-dose X-ray imaging
Two images of each breast
Show abnormal areas in the breast

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32
Q

What is breast mammogram used to screen for?

A

Breast cancer

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33
Q

What does CT stand for?

A

Computerized tomography

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34
Q

Explain how CT scan works?

A

Ray scan from different angles and computer processed cross sectional images

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35
Q

What does PET stand for?

A

Positron Emission Tomography

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36
Q

Explain how PET scans work

A

Use a radioactive drug as a tracer, such as fluorodeoxyglycose (18F-FDG)

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37
Q

What does MRI stand for?

A

Magnetic resonance imaging

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38
Q

Explain how MRI scan work

A

Uses magnetism, radio waves and a computer to produce images

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39
Q

What is the main way to diagnose cancer?

A

Biopsy

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40
Q

What is a biopsy?

A

Remove a piece of tissue from a pt body and analyze it in a laboratory

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41
Q

List type of biopsy

A

Bone marrow
Needle
Skin
Surgical

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42
Q

What is done in the analysis of the biopsy?

A

Confirmation of cancer
Cancer grade
Targets for targeted therapy

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43
Q

Example what the process of endoscopic biopsy

A
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44
Q

List the available cancer treatments

A

Surgery
Radiation therapy
Chemotherapy
Target therapy
Immunotherapy

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45
Q

Explain what surgery is for cancer?

A

Remove the entire tumour

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46
Q

What is the advantages of surgery?

A

Debunk a tumor
Ease cancer symptoms

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47
Q

Explain debunk a tumor

A

Remove some but not all of a tumour because entire tumour removal might damage the organ

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48
Q

Explain how surgery can ease cancer symptoms

A

Removal of tumours causing pain and pressure

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49
Q

List the types of surgery

A

Open
Minimally invasive
Cryosurgery
Laser surgery
Hyperthermia

50
Q

Explain minimally invasive surgery

A

Through tiny incisions, no robotic and robotic surgery

51
Q

Explain cryosurgery

A

Use liquid nitrogen to treat skin cancers and retinoblastoma

52
Q

Explain when laser surgery is used

A

Tumours on the surface of the body

53
Q

Explain what hyperthermia is

A

Radio frequency ablation

54
Q

Explain what radiation therapy is

A

Apply high doses of radiation to kill cancer cells and reduce tumor size

55
Q

What is the purpose of radiation therapy?

A

Treatment and palliative care

56
Q

List the types of external beam radiation therapy

A

Photons, protons and electrons
3D conformal radiation therapy (3D-CRT)
Intensity modulated radiotherapy (IMRT)

57
Q

Explain conformal radiation therapy (3D-CRT)

A

Allows doctors to direct radiation beams to conform the shape of a tumor
CT scan is used to provide the 3D dimension of the tumor and nearby organs
Beams are arranged to avoid normal organs and target the tumor

58
Q

Explain Intensity modulated radiotherapy (IMRT)

A

CT scan is used to provide the 3D dimension of the tumor and nearby organs
Multiple beams are positioned for the therapy
Each big beam is divided into many small beams
Special software is sued to identify beam-let patterns

59
Q

Define brachytherapy

A

A sealed container of radioactive material into tumours

60
Q

List types of internal radiation therapy

A

Brachytherapy
Radioisotope
Radioimmunotherapy
Radioembolization

61
Q

Explain an example of radioisotherapy

A

I-131 is used for thyroid cancer

62
Q

Explain radioimmunotherapy

A

Combination of radioisotopes and monoclonal antibodies

63
Q

Explain radioembolization

A

Radioactive beads along with embnolization
(Reduced blood supply to an organ)

64
Q

What are two caterogories of chemotherapy?

A

Adjuvant chemo
Neoadjuvant chemo

65
Q

Explain when adjuvant chemo is used

A

Often used after primary treatments such as surgery or radiotherapy
Destroy micro metastasis
Prevent or reduce cancer recurring

66
Q

Explain when neoadjuvant chemo is used

A

Given before the main treatment such as surgery or radiotherapy

67
Q

Explain why chemo might be used before the main treatment

A

Reduce tumor size to make primary treatment easier or more effective

68
Q

List the types of chemotherapy

A

DNA damaging agents
Antimetabolites
Antimitotics
Anti tumor antibiotics
DNA repair enzyme inhibitors

69
Q

What is a class of DNA damaging agents

A

Alkylating agents

70
Q

List classes of antimetabolites

A

Purine antagonists
Pyrimidine antagonists

71
Q

List classes of antimitotics

A

Taxanes and vinca alkaloids

72
Q

List classes of anti tumor antibiotics

A

Intercalating agents

73
Q

List classes of DNA repair enzyme inhibitors

A

PARP inhibitors

74
Q

List classes of alkylating agents

A

Nitrogen mustards
Nitrosoureas
Platinum drugs
Miscellaneous alkylating drugs

75
Q

List nitrogen mustards

A

Melphalan
Cyclophosphamide
Ifosfamide
Chlorambucil
Estramustine

76
Q

List nitrosoureas

A

Carmustine
Lomustine
Nimustine
Streptozocin

77
Q

List platinum drugs

A

Carboplatin
Crisp Latin
Oxaliplatin

78
Q

List the miscellaneous alkylating drugs

A

Busulfan
Procarbazine

79
Q

MOA of nitrogen mustard alkylating agents

A
80
Q

MOA of nitrosourea alkylating agents

A
81
Q

MOA of streptozocin

A

CH3 is cleaved from the N
Get a cation (carbonyl) (CH3+)
It is targeted by the O6 of G
Mysel group

82
Q

Platinum alkylating agents MOA

A

Alkylate and cross link DNA
Cell cycle non specific
DNA protein cross links (rare)

83
Q

MAO of buslfan

A

Remove mesylate to form R-CH2
Nonspecific alkylating agent
Cause intra and inter cross link of DNA molecules

84
Q

What is busulfan used for?

A

Treat chronic myelogenous leukaemia

85
Q

Procarbazine MOA

A

Form methyldiazonium and methyl cation
Nonspecific alkylating agent which methylates guanine at O6
May inhibit protein, RNA and DNA synthesis

86
Q

What is Procarbazine used for?

A

Used to treat Hodgkin’s lymphoma, non Hodgkin’s lymphoma and gliomas

87
Q

Explain what antimetabolites work

A

Prevent the biosynthesis of normal cellular metabolites
Pyrimidine antimetabolites, purine antimetabolites, folic acid analogues, and other

88
Q

MOA of cytarabine

A

Inhibit the conversion of cytidylic acid to 2 deoxycytidylic acid
DNA-dependent DNA polymerase
Miscoding due to incorporation into DNA/RNA
Effective during S phase

89
Q

Explain antimitotics - taxanes

A

Bind to free tubulin
Produce stable microtubules
Inhibit microtubule disassembly
Microtubules arrange in a parallel fashion rather than a spindle

90
Q

What is paclitaxel used for

A

Breast , lung and ovarian cancers

91
Q

What is docetaxel used for?

A

Breast, lung, stomach, prostate and head and neck cancers

92
Q

List the antimitotics - taxanes

A

Paclitaxel
Docetaxel

93
Q

What is the function of vinca alkaloids

A

Opposite of that for taxanes

94
Q

MOA of vinca alkaloids

A

Prevent microtube polymerization

95
Q

What is vinca alkaloids used for?

A

Treat cancers like Hodgkin’s lymphoma, non-small cell lung cancer, bladder cancer and melanoma

96
Q

List the vinca alkaloids

A

Vinblastine
Vincristine
Vindesine
Vinorelbine

97
Q

Example of anti tumor antibiotics

A

Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mitoxantrone

98
Q

What is the risk of radiation?

A

There is a chance that it can cause another type of cancer

99
Q

MOA of anthracyclines

A

Intercalate with DNA perpendicular to its longitudinal axis
Cause single and double stranded DNA cleavage

100
Q

What does PARP stand for

A

Poly (ADP -ribose) polymerase

101
Q

Explain PARP inhibitors

A

Involved in DNA repair
Over expressed in many types of cancer

102
Q

MOA of PARP inhibitors

A

block DNA repair in cancer cells and cause cancer cell death

103
Q

List the PARP inhibitors

A

Olaparib
Rucaparib
Niraparib
Iniparib
Talazoparib

104
Q

Explain targeted therapy

A

Slow down cancer growth
Kill cancer cells
Relieve symptoms caused by cancer
Small molecule agents and monoclonal antibodies

105
Q

List the types of targeted therapy agents

A

Tyrosine kinase inhibitors
Monoclonal antibodies
Apoptosis inducing agents
Angiogenesis inhibitors

106
Q

What is the link between drug resistance in alkylating agents?

A

Drug resistance forms very quickly
But they will forgot and can be used about 1-2 years later

107
Q

Explain what tyrosine kinase does

A

Tyrosine kinase (TK) domain is present in growth factor receptors, such as epidermal growth factor receptor (EGFR) and vascular endothelial growth factor receptor (VEGFR), and signaling protein kinases such as Ras and Raf

108
Q

What is Imatinib used for?

A

Treat chronic myelogenous leukemia and acute lymphocytic leukemia

109
Q

MOA of imatinib

A

Inhibit BCR-ABL tyrosine kinase
Inhibit proliferation and induce apoptosis in BCR-ABL positive cells

110
Q

MOA of gefitinib

A

Inhibitor of epidermal growth factor receptor
Signalling via EGF-EGFR promotes DNA synthesis, proliferation, migration and survival

111
Q

List tyrosine kinase inhibitors

A

Imatinib
Gefitinib
Ibrutinib

112
Q

List monoclonal antibodies

A

Trastuzmab
Pertuzumab
T-DM1
Bevacizumab
Rituximab

113
Q

List example of apoptosis inducing agents

A

Bortezomab
Oblimersen

114
Q

List examples of angiogenesis inhibitors

A

Bevacizumab
Sunitinib

115
Q

What is gefitinib used for?

A

Prescribed for non-small lung cancer with EGFR exon 19 deletion or exon 21 L858R mutation

116
Q

Which nucleotide does most chemo attack?

A

G

117
Q

Which positions on G does most chemo attack?

A

N7 or O6

118
Q

MOA of trastuzumab

A

Targeting Her2
Monocolonal antibody targeting Her2/new/Erbb2 proteins
Binds to subdomain IV

119
Q

What is trastuzumab used for?

A

Her2 - subtype breast cancer

120
Q

What are some side effects of trastuzumab?

A

Chills
Fever
Body pain
Weakness
Nausea

121
Q

Slide 55

A