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MSRA > Cancers > Flashcards

Cancers Flashcards

1
Q

Young male testicular cancer - which one is more common?

A

Teratoma
- 20-30yo
- worse prognosis than seminoma

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2
Q

Older male testicular cancer - which one is more common?

A

Seminoma
- 35-45yo
- better prognosis than teratoma

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3
Q

Cancers that cause spinal metastases

A

Breast
Bronchus
Prostate
kidney (more common to metastasise to lung first than bone)
thyroid
Multiple myeloma
High grade non-Hodgkin’s lymphoma

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4
Q

Cancer that spread to lungs

A

Osteosarcoma

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5
Q

Cancer that spread to liver

A

Colorectal

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6
Q

? diagnosis - young child. Afro-Carribean. fever, irritability, reduced feeding. fingers and toes are swollen/tense.

strawberry tongue, dry cracked lips, rashes that are peeling

A

Kawasaki disease

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7
Q

Cancer of corpus uteri is known as

A

endometrial cancer

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8
Q

what increases iron absorption?

A

vitamin C

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9
Q

In ALL, what do the lymphocyte immature cells express?

A

they express a protein called TdT (terminal deoxynucleotide transferase)

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10
Q

what is pott’s disease

A

most dangerous form of musculoskeletal TB as it causes bone destruction, deformity and parapleia

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11
Q

poor prognostic factor of breast cancer

A

young patients

other prognosis factors: axillary nodal status, tumour type and grade, lymphatic/vascular invasion/proliferation markers, ethnicity and patient’s age of diagnosis, oestrogen/progesterone receptor status, HER2/neu overexpression

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12
Q

first line tx for CLL with 17p deletion or TP53 mutation

A

acalabrutinib

(also use this if no 17p deletion or TP53 mutation, but patient is not tolerating FCR and BR treatment)

FCR: fludarabine and cyclophosphamide and rituximab
BR: bendamustine and rituximab

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13
Q

best initial tx of AML

A

chemotherapy

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14
Q

what is the monitoing regimen for someone with gene for HNPPCC?

A

colonoscopy beginning 20-25yo

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15
Q

what is Hughes syndrome?

A

anti-phospholipid syndrome

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16
Q

indications for mastectomy

A

large tumour in small breast
multifocal tumour
central tumour
DCIS >4cm
tumour at nipple
patient’s request

17
Q

what is the cytology stages for breast biopsy?

A

C1 (inadequtae)
C2 (benign)
C3 (atypia but probabbly benign)
C4 (suspicious of malignnacy)
C5 (malignant)

18
Q

Prognosis factors for multiple myeloma

A

beta-2 microglobulin

19
Q

?diagnosis - pregnant lady, AKI, confusion, fever, thrombocytopenia, microagiopathic haemolytic anaemia

A

Thrombotic thrombocytopenic purpura

20
Q

how soon can radiation enteritis occur post-radiation to pelvis?

A

acute (within 2 weeks of tx): anorexia, diarrhoea, foaecal urgency, bloating, colicky abdo pain

chronic (18 months to 6 years later!) : weight loss, steatorrhoea, small bowel obstruction, nausea, anorexia

21
Q

Tumour marker:
LDH
ALP
…used for what diseases?

A

LDH - testicular cancer
ALP - Paget’s disease, teratoma (not seminoma)

22
Q

patient recently diagnosed with colorectal cancer - what disease must this patient be screened for?

A

Lynch syndrome
- autosomal dominant
- also increases risk of cancer in endometrial, stomach, breast, ovarian, small bowel, pancreatic, prostate, urinary, kidney, liver.

23
Q

what does haptoglobin do?

A

bind to free Hb (released in haemolytic diseases)

THerefore, low levels of haptoglobin in haemolytic anaemias -> test to do is osmotic fragility test to look for RBC breaking down

24
Q

basophilic stippling in blood film ? cause

A

toxic - eg lead poisoning

25
Q

Types of hypersensitivity reaction

A

1 - allergic (IgE)
2 - antibody (complement, phagocytosis)
3 - immune complex
4 - Delayed (T-helper cells)

26
Q

Graft rejection - what happens:
- Acute allograft reaction
- Hyperacute allograft reaction
- Chronic allograft reaction

A

Acute: lymphocyte, T-cell, cytokine activation. donor MHC 1 antigens react with host CD8 resulting in direct cytotoxic damage

Hyperacute: class 1 HLA antibody activation, granulocyte adhesion, thrombosis

Chronic: interstitial fibrosis

27
Q

metastasis to the brain comes from where?

A

breast
lung
melanoma

28
Q

what is paraneoplastic cerebellum disorder

A

rare
non-metastatic
immune mediated
complication of cancers : ovarian, breast, uterus, SCLC, Hodgkin’s lymphoma
CSF: elevated protein and presence of anti-neuronal antibodies
MRI may be normal in early stages

29
Q

treatment of oestrogen-positive breast cancer - what medication to give patients?

A

post-menopausal women: aromatase inhibitors (eg anastrozole and letrozole) - to prevent peripheral oestrogen synthesis

pre-menopausal/young patients: tamoxifen - selective oestrogen receptor modulators (side effect: endometrial cancer, VTE, menstural disturbance)

30
Q

Risk factors for bladder cancer

A

Transitional cell carcinoma:
smoking (most significant) x4
exposure to aniline dyes
rubber manufacture
cyclophosphamide

Squamous cell carcinoma:
schistosomiasis
smoking

31
Q

how soon after xxxx can you do the PSA test?
- prostatitis
- prostate biopsy
- ejaculation
- vigorous exercise
- UTI

A

prostatitis : 1 month
prostate biopsy:
ejac/exercise: 48hrs
UTI: 4 weeks
DRE: 1 week

32
Q

PSA test & sensitivity/specificty

A

low sensitivtiyt and specificity

33
Q

what type of cancers are more prevalent in the following:
Chinese
Indian
White
Afro-Caribbean
Ashkenazi Jews

A

Chinese: nasopharyngeal?
Indian:
White:
Afro-Carribean: prostate
Ashkenazi Jews: breast and ovarian cancer (BRCA 1 and 2)

34
Q

positive predictive value of faecal occult blood test

A

5-15%

35
Q

Risk factor for ovarian cancer

A

Nulliparous
subfertile women
has a familial tendency
hormone therapy post menopause
fertility medication
obesity

36
Q

Risk factor for breast cancer

A

female sex
obesity
lack of physical exercise
regular consumption of alcohol
ionising radiation
early age of menstruation

BRCA1, BRCA2 genes - 40% lifetime risk of breast/ovarian cancer
1st degree relative premenopausal relative with breast cancer (e.g. mother)
nulliparity, 1st pregnancy > 30 yrs (twice risk of women having 1st child < 25 yrs)
early menarche, late menopause
combined hormone replacement therapy (relative risk increase * 1.023/year of use), combined oral contraceptive use
past breast cancer
not breastfeeding
ionising radiation
p53 gene mutations
obesity
previous surgery for benign disease (?more follow-up, scar hides lump)

37
Q

Risk factor for endometrial cancer

A

excess oestrogen
nulliparity
early menarche
late menopause
unopposed oestrogen. The addition of a progestogen to oestrogen reduces this risk (e.g. In HRT). The BNF states that the additional risk is eliminated if a progestogen is given continuously

metabolic syndrome
obesity
diabetes mellitus
polycystic ovarian syndrome
tamoxifen
hereditary non-polyposis colorectal carcinoma

MSRA (21 decks)

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