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Cancer Flashcards

1
Q

What are the risk factors for basal cell carcinoma ?

A

UV radiation
fair skin
scars and ulcers
chemical agent exposure
previous skin cancer
immunosuppression

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2
Q

which is the most common basal cell carcinoma and how does it present ?

A

Nodular BCC
Presents on the head ( eyelids, cheeks and forehead) as pearly shiny papules or nodules with small telangiectasias and depressed centre on ulceration.

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3
Q

what is the most common site for BCC

A

head / neck ( sun-exposed sites)

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4
Q

how is a BCC referred and managed ?

A

Routine referral

Managed through :
Surgical removal
Curettage
Cryotherapy

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5
Q

what are the other types of basal cell carcinoma and which has the worst prognosis ?

A

Superficial BCC
Pigmented BCC
Morpheaform BCC : worst prognosis

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6
Q

why are BCC known as rodent ulcers ?

A

due to slow growth and local invasion

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7
Q

what are the risk factors for bladder cancer ?

A

smoking
increasing age
aromatic amines ( dye and rubber industry)
schistosomiasis can lead to SCC

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8
Q

what is the most common type of bladder cancer ?

A

Transitional cell carcinoma

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9
Q

How does bladder cancer present ?

A

Painless macroscopic haematuria

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10
Q

what is the referral process for suspected bladder cancer ?

A

2 week wait is recommended when
1) patient is >45 with unexplained visible haematuria ( with or without UTI)
2) patient is >60 with microscopic haematuria PLUS dysuria / raised WCC

> 60 with recurrent UTI –> refer non-urgently

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11
Q

how is bladder cancer managed

A

Non invasive bladder cancer can be managed by TURBT : Transurethral resection of bladder cancer

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12
Q

what are the risk factors for breast cancer ?

A

BRCA1, BRCA2
1st degree relative premenopausal with breast cancer
Nulliparity, 1st pregnancy > 30
early menarche and late menopause
previous breast cancer
obesity
smoking
combined contraceptive pill : risk reduces to normal after 10 years of stopping
HRT

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13
Q

which is the most common kind of breast cancer ?

A

Invasive ductal carcinoma

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14
Q

what are the common breast cancers ?

A

Invasive ductal carcinoma
Invasive lobular carcinoma
ductal carcinoma in situ
lobular carcinoma in situ

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15
Q

what is triple negative breast cancer ?

A

cancer that lacks oestrogen receptors progesterone receptors and does not have HER2 proteins

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16
Q

How does inflammatory breast cancer present ?

A

presents like breast abscess or mastitis
swollen, warm, tender breast with pitting skin ( peau d’orange)
non-responding to abx

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17
Q

how does Paget’s disease of the nipple present?

A

eczema of nipple / areola
erythematous scaly rash
breast cancer could involve the nipple

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18
Q

how often is breast cancer screening done and what is the test called ?

A

mammogram
every 3 years
women between 50-70

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19
Q

what is the criteria for someone to be at high risk of developing breast cancer ?

A

1st degree relative :
under 40 with breast cancer
male with with breast cancer
bilateral breast cancer < 50
2 first degree relatives

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20
Q

what is the screening process for breast cancer in those at high risk for it ?

A

mammogram to women from age 30 annually

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21
Q

what chemo preventive drugs can be offered to those at high risk of breast cancer

A

tamoxifen : Premenopausal
anastrozole : post-menopausal

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22
Q

how does breast cancer present ?

A

hard irregular painless lumps
tethered to skin or chest wall
nipple retraction
lymphadenopathy

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23
Q

when is the 2 week wait recommended for suspected breast cancer ?

A
  • Unexplained breast lump in patients 30 or above
  • Unilateral nipple changes in patients aged 50 or above

consider 2 week wait :
unexplained lump in the axilla in patients 30/above
skin changes suggesting breast cancer

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24
Q

what does triple assessment involve ?

A

Clinical assessment ( history and exam)
Imaging ( ultrasound / mammography)
Biopsy ( fine needle aspiration / core biopsy)

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25
Q

what is the management of oestrogen receptor positive breast cancer ?

A

Tamoxifen : selective oestrogen receptor modulator
Aromatase inhibitors

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26
Q

what medications are used in the management of HER2 receptor positive cancer ?

A

Trastuzumab
Pertuzumab

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27
Q

what are the risk factors in the development of cervical cancer ?

A

HPV
smoking
HIV
early first intercourse, many sexual partners
high parity
lower socioeconomic status
COCP

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28
Q

which is the most common type of cervical cancer ?

A

SCC

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29
Q

What is the presentation of cervical cancer ?

A

abnormal vaginal bleeding
vaginal discharge
pelvic pain
dyspareunia

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30
Q

how often are women with HIV screened for cervical cancer ?

A

Annually

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31
Q

what is the screening process for cervical cancer?

A

high risk HPV test where cytological examination is only performed if hrHPV is positive
every 3 years (25-49)
every 5 years ( 50-64)

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32
Q

explain the management of an inadequate smear sample

A

repeat in 3 months
if still inadequate, refer to colposcopy

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33
Q

how is a hrHPV positive sample managed ?

A

cytological examination

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34
Q

what is the management of abnormal cytology of sample

A

colposcopy referral

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35
Q

what is the management of normal cytology of sample after hrHPV +ve

A

repeat test at 12 months
hrHPV -ve : normal recall

hrHPV +ve at 12 months : repeat test at 12 months again

hrHPV +ve : Colposcopy
hrHPV -ve : normal recall

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36
Q

what is the management of cervical intra-epithelial neoplasia

A

large loop excision of transformation zone

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37
Q

explain the management of cervical cancer by stage

A

stage 1A : cone biopsy ( for fertility)
gold standard : hysterectomy and lymph node clearance

1B : radiotherapy with concurrent chemotherapy
1B2 : radical hysterectomy with pelvic node dissection

II,III : concurrent chemotherapy

IV : radiotherapy and / or chemotherapy
Palliative chemotherapy for IVB

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38
Q

what is the most common location for colorectal cancer tumours

A

rectum ( 40%)

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39
Q

describe FIT screening

A

National screening programme
every 2 years
Men and women aged 60-74

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40
Q

In which groups is a FIT test recommended ?

A

abdominal mass / change in bowel habit / IDA

40/over = unexplained weight loss AND abdominal pain
<50 with rectal bleeding AND abdominal pain OR weight loss
50/ over : rectal bleeding OR abdominal pain OR weight loss
60/ over anaemia

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41
Q

under what circumstances should a patient immediately be offered a colonoscopy

A

rectal mass
unexplained anal mass
unexplained anal ulceration

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42
Q

what are the risk factors for endometrial cancer ?

A

Excess oestrogen :
Nulliparity
Early menarche and Late menopause
Unopposed oestrogen

metabolic :
obesity
diabetes mellitus
PCOS

Tamoxifen
HNPCC

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43
Q

what are protective factors to the development of endometrial cancer ?

A

Multiparity
COCP
Smoking

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44
Q

what is the classical feature of endometrial cancer ?

A

Post menopausal bleeding

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45
Q

what is the suspected cancer referral pathway for endometrial cancer ?

A

post menopausal bleeding in a woman > 55

TVUSS ( > 4mm thickness cancer (?)
hysteroscopy with biopsy

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46
Q

what is the management of endometrial cancer ?

A

total abdominal hysterectomy with bilateral salpingo-oophrectomy

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47
Q

what are the risk factors for gastric cancer ?

A

Helio-bacter Pylori
Atrophic gastritis
Diet
smoking
blood group A

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48
Q

what are the features of Gastric cancer ?

A

abdominal pain
weight loss and anorexia
nausea and vomiting
dysphagia

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49
Q

how does lymphatic spread in gastric cancer present?

A

Left supraclavicular lymph node ; Virchow’s node
Periumbilical node : Sister Mary Josephs node

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50
Q

how is gastric cancer diagnosed and what sign may be present

A

OGD with biopsy
signet ring cells

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51
Q

what is a fibroadenoma? how does it present?

A

Common benign tumours of breast tissue. common in young women between the ages of 20-40.
They present as :

Painless, smooth, round, well circumscribed, firm, mobile lumps up to 3 cm in diameter

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52
Q

what are fibrocystic breast changes and how do they present

A

cyclical symptoms due to the cumulative effect of oestrogen and progesterone leading to bilateral lumpy breasts and breast pain.

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53
Q

what is fat necrosis of the breast

A

benign lump usually triggered by localised trauma, radiotherapy or surgery.
Painless, firm, irregular, fixed in local structures.

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54
Q

what is a galactocele

A

Occurs in women that are lactating , after stopping breastfeeding.
Usually present with a firm, mobile, painless lump generally below the areola.

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55
Q

what is a phyllodes tumour ?

A

rare tumours of the connective tissue occurring most often between ages 40 and 50. Large and fast growing.

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56
Q

what are the features of hypercalcaemia

A

Bones, stones moans groans
corneal calcification
short QT
HTN

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57
Q

what is the management of Hypercalcaemia

A

rehydration with normal saline followed by bisphosphonates ( IV Zoledronate)
2nd line : Calcitonin

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58
Q

what is leukaemia ? what are its major types ?

A

cancer of stem cells of the bone marrow with excessive production of one type of abnormal white blood cell and supressing other cell lines causing underproduction of other cell types.

4 major types:

Acute lymphoblastic leukaemia
Acute myeloid leukaemia
Chronic myeloid leukaemia
Chronic lymphocytic leukaemia

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59
Q

What is the presentation of leukaemia?

A

Non specific presentation of :

Fever
Fatigue
Pallor
Petechiae
Abnormal bleeding
Lymphadenopathy
Failure to thrive
hepatosplenomegaly

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60
Q

Expand on Acute lymphoblastic leukaemia :
Who does it affect ?
What are its features?
What are poor prognostic factors for it ?

A

most common malignancy affecting children accounting for 80% of childhood malignancies.
Occurs between the ages of 2-5.

features are :
Anaemia : Lethargy and pallor
Neutropenia : frequent + severe infections
Thrombocytopenia: Easy bruising / petechiae

poor prognostic factors include :
age <2 or >10
WBC > 20
T/B cell surface markers
non white
male

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61
Q

what can precipitate acute myeloid leukaemia ? What is its characteristic feature on bone marrow biopsy ?

A

Myeloproliferative disorders such as polycythaemia rubra vera or myelofibrosis.

blood film/ bone marrow biopsy : blast cells + Auer rods

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62
Q

what is chronic lymphocytic leukaemia ? What is Richter’s transformation? What type of cells are associated with chronic lymphocytic leukaemia ?

A

Slow proliferation of a single well differentiated lymphocyte, usually B-lymphocyte.

Richter’s transformation is when the CLL transforms into high grade B lymphoma.

Smear or Smudge cells are associated with CLL.

63
Q

what are the three phases of chronic myeloid leukaemia ?

A

Chronic : asymptomatic, incidental raised WCC
Accelerated : abnormal blast cells take up a high proportion of bone marrow and blood cells and patients become symptomatic.
Blast phase: high proportion of blast cells in the blood. severe symptoms

64
Q

what chromosome is CML associated with?

A

Philadelphia chromosome. reciprocal translocation of genetic material between chromosome 9 and 22.

65
Q

what is the most common form of leukaemia seen in adults

A

chronic lymphocytic leukaemia

66
Q

what medication can be used to manage chronic myeloid leukaemia

A

Imatinib: tyrosine kinase inhibitor

67
Q

what is tumour lysis syndrome? How does it present? How do you treat it ?

A

Tumour lysis syndrome: results from chemicals released when cells are destroyed by chemotherapy leading to high uric acid, high potassium, high phosphate, low calcium.

hydration is needed and allopurinol can be given.

68
Q

how is leukaemia diagnosed?

A

FBC within 48 hours for suspected leukaemia
Blood film
Bone marrow biopsy : definitive diagnosis
Lymph node biopsy

69
Q

what are the features of lung cancer?

A

Persistent cough
haemoptysis
dyspnoea
chest pain
WL + anorexia
Hoarseness : Pancoast tumour pressing on recurrent laryngeal nerve

70
Q

what are examination findings in lung cancer

A

Fixed monophasic wheeze
supraclavicular lymphadenopathy / cervical lymphadenopathy.
Clubbing

71
Q

what is the most common type of cancer in :
smokers
non smokers
overall

A

squamous cell carcinoma
adenocarcinoma
adenocarcinoma

72
Q

what paraneoplastic features are the following associated with
1) SCLG
2) Squamous cell carcinoma
3) Adenocarcinoma

A

1) ADH, ACTH, Lambert Eaton syndrome
2) PTH –> hypercalcaemia, hyperthyroidism , hypertrophic pulmonary osteoarthropathy
3) gynaecomastia

73
Q

what is the 2 week wait referral criteria for someone with suspected lung cancer?

A

CXR suggesting lung cancer
40/over + unexplained haemoptysis

74
Q

what is a mesothelioma ? What is it associated with ?

A

affects the mesothelial cells of the pleura, and strongly linked to asbestos inhalation.

75
Q

what is superior vena cava obstruction? How does it present?
What is Pemberton’s sign?

A

Complication of lung cancer that occurs due to direct compression of the tumour on the superior vena cava, presenting with facial swelling, difficulty breathing and distended veins in the neck and upper chest.

76
Q

What is a lymphoma? What are its two major types?

A

It is a type of cancer affecting the lymphocytes inside the lymphatic system.

Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma

77
Q

What are the risk factors for Hodgkin’s lymphoma? At what age does it occur?

A

Risk factors:
HIV
EBV
Auto-immune conditions
Fhx

Bimodal age distribution with peaks around 20-25 and 80 years.

78
Q

what are the types of Non-Hodgkin’s lymphoma?

A

Diffuse large B cell lymphoma
Burkitt lymphoma
MALT lymphoma

79
Q

what are the risk factors for Non-Hodgkin’s lymphoma?

A

HIV
EBV
H. Pylori
Hepatitis B/C

80
Q

How does lymphoma present ?

A

Lymphadenopathy : key presenting feature ( pain may be worse on drinking alcohol)

B symptoms:
Fever
weight loss
night sweats

81
Q

What are the investigations done when a lymphoma is suspected? What is a characteristic finding?

A

Lymph node biopsy
Reed-Sternberg cells ; characteristic findings

82
Q

what system is used for the classification of lymphoma? expand on it ?

A

Lugano classification

stage 1 : confined to one node / group of nodes
Stage 2 : More than one group of nodes but same side of diaphragm
Stage 3: lymph nodes both above and below the diaphragm
stage 4 : widespread involvement including non lymphatic organs like lung or liver

83
Q

what is the management of Lymphoma?

A

Chemotherapy and radiotherapy
ABVD : ( Adriamycin) doxorubicin, bleomycin, vinblastine, dacarbazine.

84
Q

which is the most aggressive form of melanoma?

A

nodular melanoma

85
Q

what are the main symptoms of a malignant melanoma

A

ABCDE

Asymmetry
Borders ( Irregular)
Colour variation
Diameter > 6 mm
Elevation

86
Q

what are the types of malignant melanoma?

A

Superficial spreading : long radial phase + most common
Lentigo : Hutchinson’s freckle, very long radial phase
Nodular : no radial phase, aggressive type
Acral lentiginous : short radial phase + dark skin tones on palms and soles
Sub-ungal: under nail
Amelanotic

87
Q

What are the risk factors for malignant melanoma?

A

history of skin cancer, melanoma
fhx of melanoma
pale skin ( Fitzpatrick skin type 1/2)
sunburn
sun exposure
moles
age
immunosuppression

88
Q

what is the management of a malignant melanoma?

A

wide local excision
sentinel node biopsy to check for the spread of cancer

89
Q

what is multiple myeloma?

A

haematological malignancy in which b -lymphocytes differentiate into mature plasma cells ( antibodies producing b lymphocytes)

90
Q

what are the features of myeloma

A

CRABBI
Calcium : hypercalcaemia
Renal failure
Anaemia
Bleeding
Bone lesions and bone pain
Infection

91
Q

What are the investigations performed for myeloma?

A

Bloods
Blood film : Rouleaux formation
U+E : renal failure ( Bence jones proteins in urine)
Bone profile : Hypercalcaemia

Bone marrow aspiration : plasma cells significantly raised

Imaging : whole body MRI
X-ray shows rain drop skull

92
Q

what is the diagnostic criteria for myeloma?

A

one major + minor
3 minor

Major:
Plasmacytoma
30% plasma cells in bone marrow samples
elevated M protein in blood urine

Minor :

10-30% plasma cells in bone marrow sample
minor elevation in M protein
osteolytic lesions
low levels of antibodies

93
Q

what are the features of myeloma?

A

Persistent bone pain
pathological fractures
unexplained fatigue
unexplained weight loss
fever
hypercalcaemia
anaemia
renal impairment

94
Q

what is the management of myeloma

A

chemotherapy ( bortezomib)
Thalidomide
dexamethasone

high dose chemo and stem cell transplant

95
Q

what are some differentials to myeloma

A

Monoclonal gammopathy of undetermined significance (MGUS) involves the production of a specific paraprotein without other features of myeloma or cancer. MGUS is often an incidental finding in an otherwise healthy person. It has a small risk of progression to myeloma (about 1% per year).

Smouldering myeloma involves abnormal plasma cells and paraproteins but no organ damage or symptoms. It has a greater risk of progression to myeloma (about 10% per year).

96
Q

what are the main 2 types of oesophageal cancer and which is more common

A

Adenocarcinoma ( most common in developed countries) : Lower third
Squamous cell cancer ( developing) : Upper third

97
Q

what are the risk factors for oesophageal cancer

A

GORD
Barrets
smoking
Obesity

98
Q

what are the common presenting features of oesophageal cancer?

A

Dysphagia -painful dysphagia with solids then liquids and weight loss suggests oesophageal pathology.
Anorexia + WL
vomiting
odynophagia, hoarseness, melaena, cough

99
Q

how is oesophageal cancer diagnosed

A

Upper GI endoscopy

100
Q

what are the risk factors for ovarian cancer ?

A

Age
BRCA1/2
Increased number of ovulations ( no pregnancies, early onset of periods, late menopause)
Obesity
Smoking
recurrent clomiphene use

101
Q

what are protective factors in the development of ovarian cancer?

A

COCP
Breastfeeding
Pregnancy

102
Q

what is the presentation of ovarian cancer

A

Abdominal bloating
early satiety
Loss of appetite
Pelvic pain
urinary symptoms ( frequency/urgency)
weight loss
abdominal/ pelvic mass
ascites

103
Q

What investigations are recommended for suspected ovarian cancer?

A

CA125 blood test
Ultrasound of pelvis

104
Q

what is the criteria for a 2 week wait for suspected ovarian cancer?

A

physical examination shows :

Ascites
Pelvic mass
Abdominal mass

105
Q

what is the risk of malignancy index?

A

estimates risk of an ovarian mass being malignant :

Menopausal status
Ultrasound findings
CA125

106
Q

what are the most common ovarian cancers

A

epithelial cell tumours= serous carcinomas
germ cell tumours in young people

107
Q

what is a krukenberg tumour

A

refers to a metastasis in the ovary generally from a GI tract cancer. Characteristic signet ring cells

108
Q

what is the most common benign ovarian tumour?

A

Serous cystadenoma

109
Q

what is the most common pancreatic tumour? How does it present?

A

Adenocarcinoma
Presents as :
Painless jaundice
pale stools, dark urine and pruritic
hepatomegaly
palpable gallbladder
anorexia, weight loss and epigastric pain

110
Q

what is the imaging of choice for pancreatic cancer? How does it present?
How is pancreatic cancer managed?

A

high resolution CT
double duct sign
Whipple’s resection: Pancreaticoduodenectomy

111
Q

what is the referral criteria for suspected pancreatic cancer?

A

2 week wait for -

over 40 with jaundice
over 60 with weight loss plus ( diarrhoea, back pain, abdominal pain, nausea, vomiting, constipation

112
Q

what are the features of prostate cancer ?

A

Lower urinary tract symptoms
hesitancy
frequency
weak flow
terminal bleeding
nocturia
haematuria
erectile dysfunction

113
Q

how is breast cancer managed

A

surgery dependent on palpable axillary lymphadenopathy
present : axillary node clearance
absent : sentinel node biopsy

wide local excision / mastectomy

114
Q

what is the first line investigation of suspected clinically localized prostate cancer?

A

MRI ( Multi-parametric)

115
Q

what are the risk factors for prostate cancer?

A

Increasing age
Obesity
Afro-Caribbean ethnicity
family history

116
Q

what is a common complication of radical prostatectomy?

A

erectile dysfunction

117
Q

How is prostate cancer diagnosed and managed

A

PS test
DRE
Transrectal USS + biopsy

118
Q

what types of tumours are present in testicular cancer

A

germ cell tumours ( seminomas and non-seminomas)
non germ cell tumours ( Leydig cell tumours and sarcomas)

119
Q

what are the symptoms of testicular cancer ?

A

Painless lump ( most common symptom)
Pain
Hydrocele
Gynaecomastia

120
Q

what are the tumour markers for testicular cancer ?
How is it diagnosed?

A

seminomas : hCG ( elevated in 20% of cases)
Non-seminomas : AFP/ B-hcg

Diagnosis is made by ultrasound

121
Q

what are the risk factors for squamous cell carcinoma?

A

exposure to sunlight
actinic keratosis
immunosuppression
Bowens disease
smoking
leg ulcers
genetic conditions

122
Q

what are the features of squamous cell carcinoma

A

sun-exposed sites like head and neck/dorsum of hands arms
rapidly expanding painless nodules
cauliflower like appearance

123
Q

what is the purpose of neo-adjuvant chemotherapy?

A

to downsize the primary tumour meaning that breast conserving surgery can be performed instead of a mastectomy

124
Q

when is radiotherapy recommended in the management of breast cancer

A

when a woman has had a wide local excision as this may reduce risk of re-occurrence by 2/3rds

125
Q

what haematological finding is seen in lung cancer ?

A

Raised platelets

126
Q

what is the most common form of prostate cancer

A

adenocarcinoma

127
Q

what is the investigation of choice in multiple myeloma

A

MRI whole body

128
Q

what are the complications of radiotherapy for prostate cancer?

A

proctitis, bladder, colon and rectal cancer following radiotherapy

129
Q

what medications are used in the medical management of prostate cancer ?

A

GnRH agonists / antagonists ( Goserelin)

130
Q

where are bone metastases most likely to originate in a woman

A

breast

131
Q

what is the most common site of bone metastases

A

spine

132
Q

how is ovarian cancer staged

A

stage 1 - confined to ovary
stage 2 - outside ovary within pelvis
stage 3 outside pelvis within abdomen
stage 4 distant metastases

133
Q

what is the most relevant risk factor for bladder cancer

A

smoking

134
Q

what thrombotic complication is associated with ALL

A

disseminated intravascular coagulation

135
Q

what paraneoplastic syndrome is associated with squamous cell carcinoma

A

parathyroid hormone related protein secretion

136
Q

what is the effect of aromatase inhibitors

A

Inhibition of peripheral oestrogen synthesis

137
Q

what are the complications of axillary lymph node clearance?

A

arm lymphedema and functional arm impairment

138
Q

in which patients does spinal cord compression most commonly present in ?

A

Patients with lung breast and prostate cancer

139
Q

what are the features of spinal cord compression

A

back pain ( earliest and most common symptom)
worse on lying down and coughing
lower limb weakness and sensory changes

140
Q

how is spinal cord compression investigated and managed

A

urgent MRI within 24h of presentation

managed with high dose oral dex and urgent oncological assessment

141
Q

what is seen on blood film in acute pro-myelocytic leukaemia

A

auer rods

142
Q

explain cannonball metastases

A

The multiple large, round, well-circumscribed masses in both lungs seen on Chest X-ray here are a characteristic description for ‘cannonball metastases’. Metastases with this appearance are often due to renal cell carcinoma,

143
Q

which type of testicular cancer has the better prognosis ?

A

Seminomas

144
Q

what is the first line investigation of a testicular mass ?

A

Testicular ultrasound scan

145
Q

what are the risk factors for testicular cancer?

A

Infertility
Cryptorchidism
Family history
Klinefelter’s syndrome
Mums orchitis

146
Q

what is mammary duct ectasia?

A

Non malignant breast disease seen with increasing age and can have nipple retraction and can mimic breast cancer.

147
Q

depending on the lesion, how does spinal cord compression present?

A

Lesions above L1 result in upper motor neuron signs in the legs and a sensory level.

Lesions below L1 causes lower motor neuron signs in the legs + perianal numbness

148
Q

which type of lymphoma carries the best prognosis ?
Which one carries the worst prognosis ?

A

lymphocyte predominant
Lymphocyte depleted

149
Q

What are the investigations performed for suspected myeloma?

A

Bloods : FBC, blood film : Rouleaux formation, U+E = Renal failure
Bone Profile : Hypercalcaemia

Protein electrophoresis : Increased IgA, IgG , known as Bence Jones proteins in urine.

Bone marrow aspiration : plasma cells significantly raised.

150
Q

what is the diagnostic investigation for pancreatic cancer ?

A

High resolution CT

151
Q

What can be used pre-emtively to reduce tumour flare

A

Flutamide

152
Q

what can caused raised PSA?

A

BPH, prostatitis, UTI, ejaculation in last 48h, vigorous exercise 48h, urinary retention

153
Q

what is the importance of taking cyproterone acetate

A

prevents a paradoxical rise in symptoms with GnRH agonistys

154
Q
A

SAQ style flashcards (4 decks)

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