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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 ?

24
Q

What is codanthramer?

A

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

25
Which opioid is used SC for advanced cancer pain?
Diamorphine
26
Which pains don't tend to be opioid responsive? (7)
- tension headache - tenesmoid pain - bone pain - muscle spasm - visceral distension/spasm - activity provoked pain - treatment induced e.g. Post chemo nephropathy
27
Which opioids do have a rigid upper limit for dose ? (3)
- buprenorphine - codeine - tramadol
28
What are the effects on resp rate and oxygen sats if opioid overdose ?
Both reduced
29
Main tumour marker for ovarian cancer?
CA-125
30
EBV is associated with which malignancies ?
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
Radiation is associated with which malignancy ?
Leukaemia
32
What is Li-Fraumeni syndrome ? - inheritance pattern - causes which conditions - associated with which mutation
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
Which mutation is associated with von Hippel-Lindau syndrome
VHL tumour suppressor gene on chromosome 3(p.25.3)
34
What is von Hippel-Lindau syndrome?
Inherited disorder causing benign and malignant tumours in CNS and viscera: - retinal, CNS haemangioblastomas, RCC, renal cysts, phaeochromocytoma
35
Bladder cancer is associated with which chemical carcinogen ?
Aromatic amines
36
Benzene is associated with which malignancy?
Leukaemia
37
Nasal adenocarcinoma is associated with which chemical carcinogen ?
Wood dust
38
Vinyl chloride is associated with which malignancies ?
Angiosarcomas
39
How does cigarette smoke cause cancer ?
Carcinogens in the smoke cause specific mutations in p53 tumour suppressor genes
40
How much does HBV increase risk of hepatocellular cancer
100 fold
41
What infective organism is associated with mucosal associated lymphoid tissue (MALT) tumours ?.
H pylori
42
Expressive aphasia is associated with which area of the brain ?
Broca's area - posterior inferior frontal lobe
43
How are patients affected by brocas aphasia ?
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
Which type of aphasia tend to have good ability to self monitor language output ? (Whereas others seem unaware of mistakes)
Brocas aphasia aka expressive aphasia
45
A head injury resulting in head and eye paralysis, deviated to the left, suggests which part of the brain is affected ?
Left supplementary motor area
46
A change in personality would suggest a head injury to which part of the brain ?
Prefrontal cortex
47
Damage to the para central lobule causes what effects ?
- incontinence, urinary or bowel | - contralateral lower limb weakness
48
A brain injury causing loss of smell is likely to have affected which area of the Brain?
The orbital surface of the frontal lobe
49
In which area of the brain could an injury cause loss of 2 point discrimination ?
Post central gyrus sensory cortex of parietal lobe
50
What is Gerstmann syndrome ? (4 symptoms)
Syndrome resulting from injury to inferior parietal lobule of dominant hemisphere 1. Dysgraphia 2. Dyscalculi 3. Agnosia 4. Left-right disorientation
51
Injury to non dominant parietal lobe causes what symptoms ?
- neglect of contralateral limb - ansognosia - denial of deficits - constructional dyspraxia - spatial neglect - geographical agnosia (unable to find defined places)
52
Role of post-central gyrus?
Sense of touch, sensory homunculus for contralateral side
53
Functions of temporal lobe? (4)
Hearing ability Memory acquisition Some visual perceptions Categorization of objects
54
When does Wernicke's aphasia occur ?
Damage to dominant temporal lobe | - difficulty understanding spoken word

4th Year (5 decks)

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