Cancer care

Question 1

Types of radiotherapy

Answer 1

Question 2

What acute toxicities occur with radiotherapy ?

Answer 2

Question 3

What late toxicity occurs with radiotherapy?

Answer 3

Question 4

What is chemotherapy? What is treatment intent and the different types?

Answer 4

Question 5

Chemotherapy- Classes of drugs?

Answer 5

Question 6

Explain the cell cycle and cell checkpoints ? Where do chemotherapy drugs work?

Answer 6

Question 7

Why does chemotherapy that acts on cell cycle work better on fast growing cancer?

Answer 7

As they are replicating quickly so you can stop them from replicating, slow growing cancers need other agents

Question 8

Name alkylating agents and MOA?

Answer 8

Question 9

Name taxanes and MOA? ( don’t need to know the specific side effects, just general chemo toxicity )

Answer 9

Question 10

Name vina alkaloids and MOA?

Answer 10

Question 11

Name platinums and MOA?

Answer 11

Question 12

Name antimetabolites and MOA?

Answer 12

Question 13

Name topoisomerase I inhibitors and MOA?

Answer 13

Question 14

Name topoisomerase II inhibitors and MOA?

Answer 14

Question 15

Is polycythaemia Vera JAK2 mutation inherited ?

Answer 15

No it is purely a acquired mutation
Can’t pass it down

Question 16

Treatment for polycythaemia Vera?

Answer 16

Venesection
Aspirin
Medications- Hydroxycarbamide, ruxolitinib

Question 17

Polycythaemia Vera secondary causes

Answer 17

Hypoxia
- smoking
- COPD
-OSA
High altitude
Excess EPO
- tumour
- exogenous use
Dehydration
- alcoholics

Question 18

Essential thrombocytosis: secondary causes

Answer 18

Malignancy
Chronic inflammation- rheumatic diseases- RA, SLE, autoimmune conditions
Poorly controlled diabetes
Infection
Bleeding
Splenectomy

Question 19

What can a platelet count over 1000 cause?

Answer 19

Bleeding as the high platelets can start absorbing Von Willebrand factor

Question 20

Why does malignancy cause VTE?

Answer 20

Tumour cells can release Tissue factor - pro thrombotic state
Surgeries for cancer - immobilisation and endothelial injury
Infections- neuropenic sepsis
Chemotherapy- endovascular injury if injected
Radiotherapy - increase inflammation around lesion recieving radiotherapy

Question 21

Which side effects of opioids are transient and which persist?

Answer 21

Transient
- N+V
- sedation/drowsiness
Persist
- constipation

Question 22

Which drugs to stop or carry on in end of life care (imminent death)

Answer 22

• statin
  -aspirin
• diabetic oral meds
• anti-coagulants (usually)
  Carry on
• AEDs- can switch to keppra( levetiracetam)
• insulin