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4th Year > CCC > Flashcards

CCC Flashcards

1
Q

What is CA 19-9 primarily a tumour marker for ?

A

Pancreatic cancer

Others = colorectal

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2
Q

Tumour marker CA 15-3 is useful in the prognosis for which cancer ?

A

Breast cancer

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3
Q

What is tumour marker CA 27.29 used for ?

A

Breast cancer - monitoring and prognosis, no role in screening or diagnosis

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4
Q

Name non malignant causes of raised PSA?

A
  • BPH
  • protastitis
  • instrumentation
  • urinary retention/UTI
  • strenuous exercise
  • ejaculation
  • old age
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5
Q

Which malignant conditions is the tumour marker AFP raised in ?

A

Hepatocellular carcinoma

Teratomas (if hCG also raised)

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6
Q

Name three cancers in which bombesin may be raised?

A
  • SCLC
  • gastric cancer
  • neuroblastoma
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7
Q

s-100 is a tumour marker for which malignancies ?

A
  • melanoma

- schwannomas

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8
Q

Carcinoembryonic antigen (CEA) is a tumour marker used in the monitoring of which malignancy ?

A

Colorectal carcinoma esp adenocarcinoma

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9
Q

Dose of lorazepam for rapid relief of anxiety ? And alternative if nil by mouth

A

Lorazepam 0.5-1mg SL

Alternative = midazolam 2.5mg SC

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10
Q

Analgesics used for cancer bone pain (5)

A
  • NSAIDS
  • Bisphosphonates
  • Corticosteroids
  • opioids
  • palliative radiotherapy
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11
Q

Which analgesics are used for painful muscle spasms in palliative patients ?

A

Diazepam 2-5mg nocte

Baclofen 5mg TDS

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12
Q

How might pain from liver capsule stretch be managed ?

A

NSAIDS (e.g. Ibuprofen 400mg QDS)

Dexamethosone 4-8mg OD

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13
Q

Symptomatic treatment of raised ICP?

A

Dexamethosone 4-8mg, or 16mg if severe

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14
Q

Symptomatic treatment of intestinal colic ?

A

Hyoscine butyl bromide 20mg SC

AKA buscopan

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15
Q

Treatment for symptomatic relief of nausea and vomiting caused by chemical e.g. Drugs or hypercalcaemia ? (Stat dose and 24hr range)

A

Haloperidol 500 micrograms PO or SC

24hr range = 1-5mg

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16
Q

treatment for symptomatic relief of nausea and vomiting caused by raised ICP?

A

Dexamethosone 8-16mg PO

+/- cyclizine 50mg PO or SC

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17
Q

reatment for symptomatic relief of nausea and vomiting caused by gastric irritation or stasis? (Stat dose and 24 Hr range)

A

Metoclopramide OR domperidone (+/- PPI) 10mg stat dose or 30-60mg in 24hrs

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18
Q

treatment for symptomatic relief of nausea and vomiting caused by bowel obstruction WITHOUT colic?

A

Metoclopramide 10mg SC

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19
Q

reatment for symptomatic relief of nausea and vomiting caused by bowel obstruction WITH colic?

A

Cyclizine 50mg SC
+/- haloperidol 1mg SC
+/- buscopan 20mg SC

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20
Q

If nausea and vomiting are treatment resistant or multi factorial which antiemetic should be used ?

A

Levomapromazine 6.25-12.5mg PO/SC

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21
Q

Name laxatives which are stool softeners (5)

A 
Docusate (also mild stimulant)
Poloxamer
Lactulose
Movicol
My salts (for rapid evacuation)
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22
Q

Main adverse effect of lactulose ?

A

Significant bloating and flatulence

23
Q

What type of laxative is Senna ?

A

Stimulant

24
Q

What is codanthramer?

A

Combined laxative - dantron (stimulant) and poloxamer (softener)

25
Q

Which opioid is used SC for advanced cancer pain?

A

Diamorphine

26
Q

Which pains don’t tend to be opioid responsive? (7)

A
  • tension headache
  • tenesmoid pain
  • bone pain
  • muscle spasm
  • visceral distension/spasm
  • activity provoked pain
  • treatment induced e.g. Post chemo nephropathy
27
Q

Which opioids do have a rigid upper limit for dose ? (3)

A
  • buprenorphine
  • codeine
  • tramadol
28
Q

What are the effects on resp rate and oxygen sats if opioid overdose ?

A

Both reduced

29
Q

Main tumour marker for ovarian cancer?

A

CA-125

30
Q

EBV is associated with which malignancies ?

A

Non Hodgkin’s lymphoma and Burkitts lymphoma
- EBNA, 14:8 translocation in which Proto-oncogene c-MHC on chr8 becomes transcriptionally controlled by the control elements of immunoglobulin genes on chr14

31
Q

Radiation is associated with which malignancy ?

A

Leukaemia

32
Q

What is Li-Fraumeni syndrome ?

  • inheritance pattern
  • causes which conditions
  • associated with which mutation
A

Rare autosomal dominant hereditary disorder

  • predisposes carriers to cancer development
  • SBLA syndrome
    • sarcoma, breast, leukaemia, adrenal gland
  • germline mutation of p53 tumour suppressor gene
33
Q

Which mutation is associated with von Hippel-Lindau syndrome

A

VHL tumour suppressor gene on chromosome 3(p.25.3)

34
Q

What is von Hippel-Lindau syndrome?

A

Inherited disorder causing benign and malignant tumours in CNS and viscera:
- retinal, CNS haemangioblastomas, RCC, renal cysts, phaeochromocytoma

35
Q

Bladder cancer is associated with which chemical carcinogen ?

A

Aromatic amines

36
Q

Benzene is associated with which malignancy?

A

Leukaemia

37
Q

Nasal adenocarcinoma is associated with which chemical carcinogen ?

A

Wood dust

38
Q

Vinyl chloride is associated with which malignancies ?

A

Angiosarcomas

39
Q

How does cigarette smoke cause cancer ?

A

Carcinogens in the smoke cause specific mutations in p53 tumour suppressor genes

40
Q

How much does HBV increase risk of hepatocellular cancer

A

100 fold

41
Q

What infective organism is associated with mucosal associated lymphoid tissue (MALT) tumours ?.

A

H pylori

42
Q

Expressive aphasia is associated with which area of the brain ?

A

Broca’s area - posterior inferior frontal lobe

43
Q

How are patients affected by brocas aphasia ?

A

Know what want to say but can’t get it out

  • can comprehend smile words and sentences but can’t generate speech
  • problems with fluency, articulation, word finding, word repetition
  • difficultly understanding complex grammatical sentences (both spoken and written)
44
Q

Which type of aphasia tend to have good ability to self monitor language output ? (Whereas others seem unaware of mistakes)

A

Brocas aphasia aka expressive aphasia

45
Q

A head injury resulting in head and eye paralysis, deviated to the left, suggests which part of the brain is affected ?

A

Left supplementary motor area

46
Q

A change in personality would suggest a head injury to which part of the brain ?

A

Prefrontal cortex

47
Q

Damage to the para central lobule causes what effects ?

A
  • incontinence, urinary or bowel

- contralateral lower limb weakness

48
Q

A brain injury causing loss of smell is likely to have affected which area of the Brain?

A

The orbital surface of the frontal lobe

49
Q

In which area of the brain could an injury cause loss of 2 point discrimination ?

A

Post central gyrus sensory cortex of parietal lobe

50
Q

What is Gerstmann syndrome ? (4 symptoms)

A

Syndrome resulting from injury to inferior parietal lobule of dominant hemisphere

  1. Dysgraphia
  2. Dyscalculi
  3. Agnosia
  4. Left-right disorientation
51
Q

Injury to non dominant parietal lobe causes what symptoms ?

A
  • neglect of contralateral limb
  • ansognosia - denial of deficits
  • constructional dyspraxia
  • spatial neglect
  • geographical agnosia (unable to find defined places)
52
Q

Role of post-central gyrus?

A

Sense of touch, sensory homunculus for contralateral side

53
Q

Functions of temporal lobe? (4)

A

Hearing ability
Memory acquisition
Some visual perceptions
Categorization of objects

54
Q

When does Wernicke’s aphasia occur ?

A

Damage to dominant temporal lobe

- difficulty understanding spoken word

4th Year (5 decks)

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