Cancers Flashcards
What is the mechanism behind a testicular germ cell tumour
These tumours release beta HCG which increases oestrogen levels and causes proliferation of the breast tissue
How likely are patients with genetics condition HNPCC to get colorectal cancer
90%
non tender, rubbery lymph nodes and night sweats and weight loss
Hodgkins lymphoma
non healing mouth ulcers is a sign for what cancer?
squamous cell carcinoma
What is Lymphoma (different types)
Hodgkin’s lymphoma
Non Hodgkin’s lymphoma
Symptoms of lymphoma
Fever and night sweats
Haemoptyosis
Fever
Chest pain
Biopsy shows keratin pearls
Squamous cell carcinoma
Orphan Annie cells in biopsy
Papillary thyroid cancer
Reed stern berg cells in biopsy
Hodgkin’s lymphoma
Signet cells on biopsy
Gastric carcinoma
What is CEA a marker for
Colorectal cancer
what are carcinoid tumours
tumours of the neuroendocrine system
presentation of carcinoid tumours
right sided abdomen pain
weight loss
long history of diarrhoea
metastatic cancers and painkillers - which ones are used?
they do not respond to NSAIDS or paracetamol
so have to use morphine
careful with patients with deranged renal function - morphine will get excreted slowly so more of it will stay in the blood for longer
common complication of opioids
respiratory distress
RR drops
so give Nelzon - it is the reverse of an opioid and given to patients in respiratory distress
normal dose of morphine in adults?
10mg
why does chemotherapy affect neutrophils
it attacks any rapidly dividing cells
neutrophils are often killed
- neutrophils come from the bone marrow
what medication is given post chemotherapy in order to stimulate bone marrow growth
GRAFIL
what is the first line management in neutropenic sepsis
broad spectrum antibiotics like tazocin
stage 1 cancer
cancer is small and contained within the organ it orginated from
stage 2 cancer
hasn’t spread to surrounding tissues
stage 3 cancer
large
has spread to surrounding tissues and lymph nodes nearby
stage 4 cancer
has spread to another body organ
ductal carcinoma in-situ
tumour grows in the ducts
- if left untreated then can get invasive
- cancer cells can migrate along the lactiferous ducts and over the nipple skin (pagets disease of the breast/nipple)
lobular carcinoma in-situ
tumour clusters grow in the lobules
don’t invade the ducts
not a discrete lump
signs and symptoms of breast cancer
hard and painless lump
swelling under armpits in the lymph nodes
breast is immobile and fixed
dimpling of the skin - peau d’orange
retraction of the nipple
pagets disease - itching, redness and discharge
small cell carcinoma
main bronchus or hilar regions
older smokers
QUICKEST TO GROW
side effects:
SIADH - too much ADH, retain lots of water, can cause hyponatraemia and hypertension
cushings syndrome - XS release of cortisol, causes moon face, hypokalaemia and hyperglycaemia
Lambert-eatin myasthenic syndrome - muscles are unable to contract properly
bronchial carcinoid tumour side effects
releases serotonin
bronchoconstriction
squamous cell carcinoma
SMOKERS
causes horner syndrome - causes miosis, ptosis and anhidrosis
PTH-rp: hypercalacaemia
clubbing
hyperthyroidism
adenocarcinoma
found in the smaller airways
NON SMOKERS AND ASIAN FEMALES
effects:
gynaecomastia
Horner syndrome
symptoms of lung cancer
unexplained cough for over 3 weeks
blood in cough
weight loss
SOB
chest pain
fatigue
symptoms of prostate cancer
- difficulty urinating
- blood in semen
- bone pain
PSA levels are done to test for prostate cancer
these levels are high when patient has:
- acute urinary retention
- recent ejaculation
- UTI
Testicular cancer symptoms
- most common cancer in men aged 20-30 years
risks:
<45 years
caucasian
HIV
family history
Klinefelters syndrome
presentation - painless scrotal lump
basal cell carcinoma
most common skin cancer
DNA mutations due to UV light
small
pink pearly nodules
central depression
usually on head or neck
new vascularisation
risks: men and age
management - cryotherapy or Imiquimod or 5-florouracil
squamous cell carcinoma - skin
malignant tumour of the epidermal keratinocytes
painful
tender
bleeding
irregular nodules
scaly and ulcer like
melanoma
most aggressive skin cancer
over production of melanin causes mole to start over growing and look irregular shaped
more pigemented
irregular looking
growing rapidly
Asymmetrical
Border is irregular
Colour is different
Diameter is >6mm
Evolves fast over time
cervical cancer
due to HPV
younger patients
dysplasia - can evolve over the cervix in 3 grades
carcinoma in-situ: affects the entire thickness of the epithelium
signs of cervical cancer:
abnormal vaginal bleeding - after sex
vaginal discomfort
vaginal discharge and foul smell
dysuria
bloody urine and constipation if spread beyond the pelvic wall
endometrial cancer
risks - nulliparity
obesity
early menarche
late menopause
PCOS
Signs of endometrial cancer
post menopausal bleeding
intermentrual bleeding
pain and discharge
ovarian cancer
risks - older age
smoking
late menopause
early menarche
obesity
HRT
signs:
bloating
abdo pain
urine frequency and urgency
change in bowel habits
vulvar cancer
skin cancers that can affect the vulva
signs:
itching
non healing ulcer
vulvar pain
vulvar cancer
skin cancers that can affect the vulva
signs:
itching
non healing ulcer
vulvar pain
when to refer gynaecological cancers
if post menopausal bleeding in <55 years
oesophageal carcinoma
GORD is a risk factor
mainly adenocarcinoma and squamous CC that cause it
signs
weight loss
dysphagia
hoarseness
hepatocellular carcinoma
tumour of the liver
risks - Hep B or C
cirrhosis
alcohol misuse
signs - jaundice
ascites
hepatomegaly
splenomegaly
upper Gi cancers 2WW
aged >55 with weight loss with: upper abdo pain
reflux and dyspepsia
and abdo mass
what is MEN1 syndrome
it is multiple endocrine neoplasias
- characterised by 3 tumours
- parathyroid
- pituitary
and pancreatic
What can be the presentation of a pituitary gland adenoma?
This will present with excessive prolactin hormone production, and in men can cause less body hair and nipple discharge in women. It can cause no periods and infertility.
What are the symptoms of a TSHoma - a type of pituitary gland adenoma
It causes hyper thyroidism
What are the symptoms of a ACTH producing tumour - a type of pituitary gland adenoma
Too much cortisol, and therefore Cushing’s disease
What are the symptoms of a growth hormone producing tumour - a type of pituitary gland adenoma
It will cause acromegaly
