cancer

Question 1

SCLC- other syndromes associated with

Answer 1

S- SIADH
C- Cushing syndrome
L- Lambert-Eaton myasthenia syndrome (LEMS)
C- Calciaemia (Hypercalcemia)

Question 2

Which tumour markers assessed for testicular cancer.

Answer 2

• AFP
• B-Hcg
• LDH

Question 3

Spinal cord compression first line investigation

Answer 3

MRI

Question 4

AFP

Answer 4

• fetal serum protein that becomes undetectable after birth
• frequently used for the diagnosis of hepatocellular carcinoma

Question 5

Conditions where AFP is raised

Answer 5

GI cancer
Lung cancer
Pregnancy
Germ cell tumours

Question 6

Clinical presentation of Hepatocellular carcinoma

Answer 6

• abdominal pain
• weight loss
• Jaundice

Question 7

Gastro-intestinal cancer presentation

Answer 7

Persistent abdominal pain
Unexplained weight loss
Change in bowel habit

Question 8

Metastatic lung cancer presentation

Answer 8

persistent cough, breathlessness, unexplained weight loss, fatigue

Question 9

AFP and pregnancy

Answer 9

AFP levels are typically higher in pregnancy, with significantly elevated levels potentially indicative of fetal neural tube defects

Question 10

Germ cell tumour presentation

Answer 10

palpable mass
testicular pain or discomfort
gynecomastia in men
irregular menstruation or vaginal bleeding in women

Question 11

Clinical features of head and neck cancers

Answer 11

• Dysphagia
• Odynophagia
• Dysphonia
• ALARM symptoms (tiredness, unexplained weight loss, loss of appetite)
• Lymphadenopathy
• Airway compromise (stridor)
• Bad breath (halitosis)
• Focal neurology (VII cranial nerve palsy)

Question 12

Head and neck cancer investigations

Answer 12

• CT, MRI, PET scans
• Endoscopy to visualise tumour
• Biopsy and histological subtype of cancer

Question 13

Management of head and neck cancer

Answer 13

• Surgery: To remove the tumor and regional lymph nodes if necessary.
• Radiotherapy: Can be used as a primary treatment, adjuvant therapy, or for palliation.
• Chemotherapy: Used in combination with radiotherapy for locally advanced disease or as palliative treatment for metastatic disease.

Question 14

Tumour lysis syndrome

Answer 14

*Lethal metabolic condition
* Rapid death of tumour cells in response to chemo
* Results in massive release of intracellular contents in bloodstream
* Results in significant electrolyte imbalance

Question 15

Epidemiology of TLS

Answer 15

acute leukaemia and high-grade lymphomas, particularly after the initiation of cytotoxic therapy.

Question 16

Signs and symptoms of Tumour Lysis syndrome

Answer 16

• Dysuria or oliguria
• Abdominal pain
• Weakness
• Nausea or vomiting
• Muscle cramps
• Seizures
• Cardiac arrhythmias
• Gout/joint swelling

Question 17

Tumor lysis syndrome investigations

Answer 17

U&E: Potassium and phosphate are usually raised, raised Cr suggestive of AKI/renal failure.
Calcium: Typically low in tumour lysis syndrome.
Uric acid: Usually elevated.
ECG: To identify any metabolic abnormalities such as hyperkalaemia that may precipitate life-threatening arrhythmias.

Question 18

Management of tumor lysis syndrome

Answer 18

• correct electrolyte imbalances
• administer IV fluids (flush out intracellular content)
• Rasburicase

Question 19

Prevention of TLS

Answer 19

• combination of hydration and allopurinol.
• Rasburicase

Question 20

Colorectal cancer

Answer 20

• uncontrolled cell growth in the lining of the colon or rectum
• may start as benign polyps

Question 21

Strong risk factors of colorectal cancer

Answer 21

Increasing age
Hereditary syndromes
Familial adenomatous polyposis
Hereditary nonpolyposis colorectal cancer (Lynch Syndrome)
Juvenile polyposis
Peutz-Jeghers syndrome
Increased alcohol intake
Smoking tobacco
Processed meat
Obesity
Previous exposure to radiation
Inflammatory bowel disease

Question 22

Weak risk factors of colorectal cancer

Answer 22

Lack of dietary fibre
Limited physical activity
Asbestos exposure
Red meat (non-processed)

Question 23

Signs and symptoms of colorectal cancer

Answer 23

*rectal bleeding
* unexplained weight loss
* change in bowel habit
* Abdominal pain
* Iron-deficiency anaemia
* Bowel obstruction

Question 24

Colorectal cancer screening

Answer 24

Faecal immunochemical test (FIT) every 2 years for men and women age 60-74. If positive patients are referred for colonoscopy.

Screening programme has reduced death by 16%

Question 25

common association of HNPCC

Answer 25

colorectal cancer
Endometrial cancer

Lynch syndrome

Question 26

Lynch syndrome association (10)

Answer 26

Colorectal cancer
Endometrial cancer
Ovarian cancer
Stomach cancer
Small intestine cancer
Liver cancer
Urinary tract cancer
Gallbladder duct cancer
Brain cancer
Skin cancer

Question 27

Three types of the colorectal cancers

Answer 27

sporadic (95%)
hereditary non-polyposis colorectal carcinoma (HNPCC, 5%)
familial adenomatous polyposis (FAP, <1%)

Question 28

Three criteria of Lynch syndrome

Answer 28

at least 3 family members with colon cancer
the cases span at least two generations
at least one case diagnosed before the age of 50 years

Question 29

Three criteria of Lynch syndrome

Answer 29

at least 3 family members with colon cancer
the cases span at least two generations
at least one case diagnosed before the age of 50 years