Cancer

Question 1

Gene associated with pancreatic cancer

Answer 1

KRAS

Question 2

HNPCC AND FAP mutations are associated with

Answer 2

Colorectal cancer

Question 3

Common cause of erysipelas

Answer 3

Streptococcus pyogenes (superficial limited cellulitis)

Question 4

BRCA 1 and 2 associated risks

Answer 4

Both confer risk for breast and ovarian cancer (BRCA 1 a bit more than 2). Also linked to prostate, peritoneal and pancreatic.

Question 5

Testing if positive BRCA or TP53

Answer 5

BRCA: MRI in 30-49 and mammogram in 50-69
TP53: MRI in 20-69

Question 6

TP53 gene explain

Answer 6

À tumour suppressor gene that encodes P53, a protein that stops various cell proliferating mechanisms

Question 7

RAS oncogene

Answer 7

A gene that controls the cell proliferation cycle. When it is over activated can lead to hyper proliferation,

Question 8

Her2 is an example of

Answer 8

Pronto oncogene (overactivation leads to cancer)

Question 9

Knudson two hit hypotheses

Answer 9

A tumour suppressor gene requires both alleles mutated in order to be inactivated

Question 10

Role of BRCA 1 and 2

Answer 10

Repairs ds-DNA breaks

Question 11

EGFR is…

Answer 11

A proto oncogene (overactivation leads to cancer)

Question 12

Troisier sign

Answer 12

Solitary lymph node palpable in the left supraclavicular chain. Sign of gastric carcinoma

Question 13

Common presentation of pancreatic carcinoma

Answer 13

Painless jaundice, trousseau sign (thrombophlebitis), atypical back pain

Question 14

Metaplasia in oesophageal carcinoma

Answer 14

Reflux of acid content - Barrett’s oesophagus -> squamous epithelium changes to columnar epithelium, adenocarcinoma occurs

Question 15

Most common symptom in esophageal carcinoma

Answer 15

Dysphasia

Question 16

Common complication of oesophageal cancer treatment

Answer 16

Anatomical leak, leading to intrathoracic anastomoses a d mediastinitis (high mortality)

Question 17

Common finding in histology of gastric cancer

Answer 17

Signet ring cells (large vacuole of mucin displacing nucleus to the side)

Question 18

FAP causes and inheritance e

Answer 18

Autosomal dominant inheritance of APC tumour suppressor gene that causes thousands of adenomatous polyps that almost always develop to colorectal cancer

Question 19

Chronic lymphocytic leukaemia what is it

Answer 19

Most common leukaemia in adults, caused by proliferation of well deferentiated B cells (99% cases).

Question 20

Complication of chronic lymphocytic leukaemia

Answer 20

Richter’s transformation - cells change into high grade fast growing non hodgkings lymphoma through lymph infiltration.

Question 21

Chronic myeloid leukaemia phases and genetics

Answer 21

Defined by presence of Philadelphia chromosome, chronic, accelerated and blast crisis phases

Question 22

Treatment for chronic myeloid leukaemia

Answer 22

Imatinib (TK inhibitor) is first line and works well

Question 23

What is myelofibrosis

Answer 23

Proliferation of stem cells and myeloid cells in spleen, bone marrow and others. Megakaryocytes cause fibrosis of spleen.

Question 24

Classical finding on myelofibrosis blood film

Answer 24

Tear drop poikilocyte

Question 25

Classic cells seen in hodgkings lymphoma

Answer 25

Malignancy involving mature B cells.
Classic HL : Reed steinberg cells
Modular lymphocyte dominant HL: popcorn cells

Question 26

ClAssociated findings in multiple myeloma

Answer 26

Bence Jones protein (urine)

Serum free light chain (serum)

Question 27

Ovarian cancer risk factors

Answer 27

BRCA, many ovulations

Question 28

Ovarian cancer initial investigations

Answer 28

CA125, if >35!, do pelvic and abdo US.

Question 29

Common metastasis of ovarian cancer

Answer 29

Para aortic nodes and peritoneum.

Question 30

Cervical cancer risk factors

Answer 30

HOV 16,18 and 33 infection, combine contraceptive pill and high parity

Question 31

HOV subtypes associated with gentian warts

Answer 31

6 and 11