Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oncology > Chapter 2- Vicki > Flashcards

Chapter 2- Vicki Flashcards

1
Q

Give 8 things to check for breast cancer

A

1) changes in texture (puckering/dimpling)
2) feel lumps and thickening
3) nipple discharge
4) nipple inversion/direction
5) swelling in armpit/collar bone
6) change in size/shape
7) constant pain in armpit/breast
8) rash/crusting or nipple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name 4 diagnostic tests for breast cancer

A

1) examination of symptoms
2) mammography (low level x-ray)
3) breast ultrasound
4) fine needle aspirate/biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What gives a worse breast cancer prognosis?

A

1) higher TNM stage
2) poorly differentiated
3) lymph or vascular invasion (metastatic)
4) ER or PR -ve
5) HER2+
6) Young diagnosis (<34yrs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the 6 categories of treatments for breast cancer

A 
Surgery
Radiotherapy 
Chemotherapy 
Hormonal therapies 
Monoclonal antibodies 
New agents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What’s the rationale for using hormonal therapies to treat breast cancer?

A

Sensitive cancer cells need oestrogen to stay alive therefore by removing oestrogen is very effective at controlling or killing hormone-sensitive cancer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name four hormonal therapies used in the treatment of breast cancer

A

Tamoxifen
Anastrozole
Letrozole
Exemestane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name the types of drug that come under the class known as aromatase inhibitors and describe how they work

A

Anastrozole
Letrozole
Exemestane

Blocks the conversion of androgens from adrenal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List the side effects of anastrozole

A 
Decrease bone density 
Arthritis 
Diarrhoea 
Anorexia 
Bone pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What’s the hormonal drug of choice in postmenopausal women with ER/PR+be breast cancer

A

Anastrozole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name three drugs used in the FEV100 chemotherapy regimen for breast cancer

A

Fluorouracil
Epirubicin
Cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drug in the FEV100 chemo regimen is responsible for the cardiac problems?

A

Epirubicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name a monoclonal antibody used in the treatment of HER2+ breast cancer

A

trastuzumab (herceptin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does trastuzumab work?

A

Recombinant humanised monoclonal antibody- binds HER2 prevents binding of EGF and also involved in antibody-dependent cell-mediated cytotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name 5 side effects of trastuzumab

A 
Cardiotoxicity 
Nausea and vomiting 
Diarrhoea 
Myalgia/arthralgia
Rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is everolimus?

A

Selective mammalian target of rapamycin inhibitor (mTOR)

-mTOR is a key serine-threonine kinase which is upregulated in breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is everolimus licensed for?

A

Oral agent licensed for treatment of ER/PR +ve, HER2-ve advanced metastatic breast cancer, in combination with exemestane in postmenopausal women after progression following hormonal treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Side effect of everolimus

A 
Stomatitis
Rash
Fatigue 
Diarrhoea 
Infections
Nausea
Decreased appetite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name a new monoclonal antibody licensed in breast cancer and explain its mechanism of action

A

Pertuzumab: recombinant humanised antibody that specifically targets the extracellular dimerisation domain (subdomain 2) of the HER2 thereby blocking ligand-dependent heterodimerisation of HER2. It inhibits ligand-initiated intracellular signalling through MAP/PI3K therefore inhibiting cell growth and causing apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is pertuzumab licensed for?

A

Neoadjuvant treatment of early breast cancer and in metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Side effects of pertuzumab

A 
Anaemia 
Arthralgia
Chills
Constipation 
Cough 
Decreased appetite 
Dry skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List 6 risk factors for lung cancer

A 
Smoking 
Passive smoking 
Asbestos exposure
Radon gas exposure 
Previous lung disease 
Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Non small cell carcinoma can be divided into 3 types what are these?

A

Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

List 6 symptoms of lung cancer

A 
Persistent chronic cough
SoB/wheezing 
Haemoptysis
Chest/shoulder/back pain 
Weight loss 
Fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How can you diagnose lung cancer

A 
Symptoms 
Chest X-ray 
Bronchoscopy &amp; biopsy
Sputum cytology 
CT scan 
Lung function tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Name two stages of SCLC

A

Limited stage disease

Extensive stage disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What’s the treatment of limited stage small cell lung cancer

A

1st line 4-6 cycles of cisplatin/carboplatin-based chemo + concurrent use of radiotherapy in patients with good performance status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What’s the treatment of extensive small cell lung disease

A

Platinum based chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Treatment of advanced/metastatic NSCLC depends on what things

A

1) specific tumour histological subtype (adenocarinoma/squamous cell)
2) biomarkers/mutations (EGFR/ALK gene translocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is crizotinib and when would it be used

A

It’s a small molecule ALK receptor inhibitor used to treat advanced/metastatic NSCLC that’s an adenocarcinoma with ALK translocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How would you treat adenocarcinoma NSCLC with no EGFR/ALK mutations?

A

Cisplatin/pemetrexed chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What should the urine output be during and for 6-8 hours post cisplatin chemo?

A

> 100ml/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What fluids should be prescribed for someone on cisplatin

A

Pre and post hydration- 3L IV fluids before and after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Before giving cisplatin what should the GFR be?

A

> 55ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

You must monitor patient for cisplatin induced wasting of electrolytes - what supplements may be needed?

A

Mg
Ca
k

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pemetrexed is an antifolate agent- to minimise toxity what should be given

A

Vitamin B12

Folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

To reduce skin reactions of from pemetrexed - what is given?

A

Dexamethasone steroid for 3 days before chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is pembrolizumab and how does it work

A

Humanised monoclonal antibody that acts to block the ‘programmed-death 1’ protein in order to promote an anti-tumour immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is PD-1 and what monoclonal antibody acts to block it

A

Programmed cell death 1 protein –> part f immune check point pathway (pembrolizumab)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Name three drugs you could use in squamous cell carcinoma with EGFR mutation (lung cancer)

A

Gefitinib (iressa)
Erlotinib (tarceva)
Afatinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Name the two types of non-melanoma skin cancers

A

Basal cell carcinoma (BCC)

Squamous cell carcinoma (SCC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What does the letters in the ABCDEF identification of melanoma stand for?

A 
A= asymmetrical 
B= border
C= colour 
D= diameter 
E= evolution/elevation
F= funny mole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

List four risk factors for melanoma

A

Sun exposure (intermittent)
Number of moles
Skin type
Family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How is melanoma diagnosed

A

1) physical examination
2) dermascope
3) excisional biopsy
4) histopathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Name 4 biological therapies used to treat stage 4 advanced melanoma

A

Ipilimumab
Pembrolizumab
Vemurafenib
Dabrafenib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Name the chemotherapy used the treat stage 4 advanced melanoma

A

Dacarbazine (alkylating agent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is ipilimumab

A

Recombinant human monoclonal antibody that binds to CTLA-4 immune checkpoint blocking the Ligand CD80 and CD86 from binding therefore potentiating the antitumour T-cell response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Name a CTLA-4 blocker used in he treatment of sage 4 melanoma

A

Ipilimumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is ipilimumab NICE approved for

A

Previously untreated advanced malignant melanoma or after prior therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

List side effects of ipilimumab

A 
Diarrhoea 
Rash
Pruritus
Fatigue 
Nausea and vomiting 
Decreased appetite 
Abdominal pain 
Colitis, hepatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Down side of ipilimumab

A

Costs £25,000 for 1 dose (given every 3weeks for 4 doses in total)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is vemurafenib

A

Is an oral tyrosine kinase inhibitor of BRAF (BRAF is constitutively active in melanoma as a result of a point mutation from glutamic acid to valine at aa 600)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Name a BRAF inhibitor

A

Vemurafenib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

List side effects of vemurafenib

A 
Fatigue 
Joint paint 
Rash 
Sensitive to sun 
Nausea
Alopecia 
Pruritus 
Headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Which tyrosine kinase inhibitor has been reported to cause cutaneous squamous cell carcinomas and should be stopped if blistering of the skin occurs

A

Vemurafenib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Name two BRAF inhibitors used in malignant melanoma with BRAF V600 mutation

A

Vemurafenib

Dabrafenib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is dabrafenib

A

BRAF inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

List side effects of dabrafenib

A 
Fever 
Rash
Headache
Nausea 
Joint pain
Diarrhoea 
Fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What two serious effects can dabrafenib cause

A

1) cutaneous squamous cell carcinomas

2) uveitis (can damage vision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is pembrolizumab indicated for

A

Previously untreated advanced malignant melanoma or following ipilimumab/BRAF inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Which of the two BRAF inhibitors used in malignant melanoma should be taken preferably with food?

A

Vemurafenib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Which of the two BRAF inhibitors used in malignant melanoma should be taken on an empty stomach

A

Dabrafenib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

List five risk factors for developing prostate cancer

A 
Age
Race 
Genetic 
Androgens 
Diet high in fat &amp; red meat
63
Q

List two protective factors against prostate cancer

A

Frequent ejaculation

Diet high in lyocpenes (tomatoes)

64
Q

Where is the prostate gland and what does it do

A

Lies below bladder neck (anterior to rectum, traversed by urethra) it produces the fluid part of semen

65
Q

What type of cancer is cancer of the prostate and where does it commonly metastasise to

A

Adenocarcinoma

Bones

66
Q

What are prostate cancer symptoms similar to

A

Benign prostatic hyperplasia

67
Q

List 6 clinical presentations of prostate cancer

A 
Hesitancy 
Post-micturition dribbling 
Reduced void pressure 
Frequency 
Urgency 
Nocturia
68
Q

List 4 extra symptoms of locally invasive prostate cancer

A

Perineal pain
Impotence
Incontinence
Haematospermia

69
Q

List 6 symptoms of metastatic prostate cancer

A 
Bone pain 
Hypercalcaemia 
Spinal cord compression 
Sciatica/paraplegia 
Fracture 
Lymphoedema
70
Q

In prostate cancer: locally invasive symptoms result from what?

A

Invasion of neural structures, bladder base and perirectal tissues

71
Q

Name five diagnostic techniques used for prostate cancer

A 
Digital rectal examination
Prostate specific antigen 
Transurethral ultrasound 
CT/MRI scan 
Radiolabelled bone scanning
72
Q

What’s the problem with a digital rectal examination in prostate cancer

A

It cannot detect T1 disease

73
Q

In prostate cancer, are increased levels of PSA completely diagnostic?

A

No:
20% won’t have raised levels
PSA can be raised for other reasons (age, BPH)

74
Q

List 6 treatment options in prostate cancer

A 
Watchful waiting 
Surgery (radical prostatectomy) 
Radiotherapy 
Brachytherapy 
Hormonal therapy 
Chemotherapy
75
Q

What are the side effects of radical prostatectomy surgery and when is it performed

A

Impotence and incontinence, performed in a potentially curative setting

76
Q

When is radiotherapy indicated in prostate cancer

A

Patients who are not suitable for surgery but have good life expectancy and localised disease. Also used for symptoms control in advanced disease and bony metastasis

77
Q

What is brachytherapy, what cancer is it used in

A

It delivers radiation through implantation of needles containing radioactive pellets into the prostate gland (prostate cancer)

78
Q

How long are brachytherapy pellets left in the prostate gland for?

A

Permanently and they emit low levels of radiation over several weeks/months

79
Q

How is brachytherapy carried out?

A

Under general/spinal anaesthesia

80
Q

What’s the rationale for hormonal therapies in prostate cancer

A

Hormone therapies block the androgen drive that sustains most prostate cancers

81
Q

Testosterone and other androgens are metabolised to what active metabolite

A

Dihydrotestosterone (DHT)

82
Q

Where are androgens produced

A

Testosterone- tests

10% of androgens produced by adrenal gland

83
Q

What’s the pathway to testosterone release

A

hypothalamus–> luteinizing hormone releasing hormone –> pituitary gland –> luteinizing hormone –> testes –> testosterone

84
Q

Why is LHRH released from the hypothalamus in a pulsatile manner?

A

Pulsatile release is important as receptors for LHRH will become desensitised if they are permanently occupied

85
Q

Name five ways to achieve androgen blockade in prostate cancer

A

1) bilateral orchidectomy
2) LHRH analogues
3) androgen blockers
4) LHRH analogues + androgen blockers
5) intermittent hormonal therapy

86
Q

In prostate cancer how does bilateral orchidectomy work

A

Hormonal therapy used to stop testicular secretion of testosterone

87
Q

What’s the rationale for using LHRH analogues in prostate cancer

A

Disrupt normal pulsatile release of LHRH causing desensitisation of receptors eventually resulting in a decrease in LH and testosterone (after initial increase release tumour flare)

88
Q

Name two LHRH analogues used as hormonal therapies in prostate cancer

A

Goserelin

Triptorelin

89
Q

What should be used for the first few weeks of using LHRH analogues in prostate cancer and why

A

Androgen blocking drug- bicalutamide/cyproterone due to initial increase in LH and testosterone (tumour flare)

90
Q

Name two androgen blockers

A

Bicalutamide

Cyproterone

91
Q

What’s the MOA of bicalutamide and cyproterone

A

Block the active metabolite of androgens (dihydrotestosterone) at the receptor level within prostate cells

92
Q

List side effects of using hormonal therapies in prostate cancer and why do they occur?

A 
Impotence 
Loss of libido 
Gynaecomastia
Breast tenderness 
Hot flushes 
Depression/mood changes 
Fatigue
--> due to reduced testosterone
93
Q

Name a new therapy for metastatic prostate cancer

A

Abiraterone

94
Q

How does abiraterone work

A

Used in metastatic prostate cancer- irreversible inhibitor of CYP17A1 (enzyme responsible for androgen and cortisol production)

95
Q

What must abiraterone be given with?

A

Steroid (prednisone)

96
Q

Abiraterone inhibits the production of androgens from where?

A

3 sources:
Testes
Adrenal gland
Prostate tumour cells

97
Q

What is enzalutamide

A

New therapy used in prostate cancer: is a potent androgen receptor signalling inhibitor that blocks several steps in the androgen receptor signalling pathway

98
Q

How does enzalutamide work

A

1) inhibits binding of androgens to androgen receptors
2) inhibits nuclear translocation of activated receptors
3) inhibits the associated of the activated androgen receptor with DNA

99
Q

List the side effects of enzalutamide

A 
Headache 
Hot flushes 
Memory problems 
Visual hallucinations 
Risk of seizures
100
Q

Name two new therapies used in metastatic prostate cancer

A

Abiraterone

Enzalutamide

101
Q

When is abiraterone and enzalutamide indicated?

A

In metastatic prostate cancer that’s not yet requiring chemo or in failure of hormonal/chemotherapy

102
Q

Commonly used Chemo regimen in prostate cancer

A

Docetaxel and prednisolone

103
Q

Why do patients not like docetaxel

A

Many side effects and given IV

104
Q

Why is prednisolone given alongside docetaxel

A

We think docetaxel inhibits androgen from adrenal glands (combination used in prostate cancer)

105
Q

When is the chemo regimen docetaxel and prednisolone indicated in prostate cancer

A

Hormone refractory metastatic prostate cancer

106
Q

List side effects of the docetaxel prednisolone regimen used in prostate cancer

A 
Bone marrow suppression 
Severe alopecia 
Nausea and vomiting 
Myalgia/arthralgia 
Fluid retention 
Hypersensitivity
107
Q

What do you give before the docetaxel and prednisolone regimen in prostate cancer

A

Dexamethasone

108
Q

What type of chemo is most effective in breast cancer

A

Anthracycline based chemo

109
Q

what is DD3PCA3

A

New prostate specific - way of monitoring better than PSA

110
Q

What is molecular and functional imagining (MFI)?

A

Molecular shows receptor/gene expression, functional shows aspects of angiogenesis and metabolism - way of imaging

111
Q

Micro arrays allow the measurement of what?

A

Gene expression levels

112
Q

Two main applications of using microarrays in cancer

A

1) Determination of expression levels of genes

2) Identification of sequence (gene mutation)

113
Q

Microarray technology utilises what?

A

The fact that mRNA is designed as a complementary sequence to the DNA it was copied from

114
Q

Colorectal cancer is more common in females

A

False MALES

115
Q

What is FAP

A

Familial adenomatous polyposis -> autosomally dominant inherited condition (colorectal cancer)

116
Q

What is HNPCC

A

Hereditary non-polyposis colorectal cancer accounts for higher hereditary colorectal cancer than FAP

117
Q

Pathology of colorectal cancer

A

Polyp–> benign adenocarcinoma –> malignant tumour

118
Q

List the risk factors for colorectal cancer

A 
Familial (FAP/HNPCC)
Animal fat/red meat
Low fibre 
Inactive 
Obesity 
Smoking 
Previous colorectal cancer
Crohns and colitis 
Male
Age
119
Q

Signs of colorectal cancer

A 
Change in bowel habit 
Abdominal pain 
Rectal bleeding/mucus 
Weight loss
Anorexia 
Anaemia due to chronic bleeding from tumour site
120
Q

What is FOB and when is it used

A

Faecal occult blood –> used in the screening for colorectal cancer in everyone aged 60-74 every 2 years

121
Q

Name the two types of surgery in colorectal cancer

A

Hemicolectomy

Sigmoid colectomy

122
Q

True or false, colorectal cancers radiation is only used for rectal cancers

A

True

123
Q

Adjuvant chemo used in colorectal cancer 5-FU .. why do we give folinic acid as well

A

Increases and prolongs inhibition of thymidylate synthase improving clinical outcome

124
Q

Side effects of 5-FU

A 
Diarrhoea 
Stomatitis
N&amp;V 
Bone marrow suppression 
Hand and foot syndrome 
Excessive tear shedding
125
Q

What is the oxaliplatin de gramont (FOLFOX) regime for what cancer

A

Oxaliplatin
5-FU
folinic acid

Colorectal cancer

126
Q

Side effects of oxaliplatin

A

Peripheral neuropathy
Acute pharyngolaryngeal dysasthesia
Bone marrow suppression
Mild alopecia

127
Q

Why is the oxaliplatin de gramont regime an infusion in colorectal cancers

A

Tumour cells have low growth fraction and 5-FU is S phase specific and has a T1/2 of 10 mins

128
Q

Negative of oxaliplatin de gramont being an infusion?

A

Increased incidence of hand and foot syndrome

129
Q

What are the issues with infusion devices

A

Anxiety for patients
Disposal of cytotoxics in home
Time consuming to fill

130
Q

What’s in the XELOX regime and what cancer is it used for

A

Oxaliplatin and capecitabine

131
Q

What is capecitabine and how is it activated

A

Oral prodrug of 5-FU -> 3 step activation, 2 of which occur in tumour cells

132
Q

4 advantages of oral chemo

A

Less invasive/distressing
No issues with sterility/expiry
Reduced pharmacy costs and time
Patient can administer themselves

133
Q

Side effects of capecitabine

A

Diarrhoea
N&v
Hand and foot syndrome
Stomatitis

134
Q

What is irinotecan

A

Topoisomerase 1 inhibitor (used in metastatic colorectal cancer to prevent unwinding of DNA and therefore preventing DNA replication)

135
Q

What is in Lonsurf and what cancer is it used to treat

A

Trifluridine-tipiracil

Trifluridine= thymidine analogue (degraded by thymidine phosphorylase TPase)

Tipiracil= TPase inhibitor

Used in metastatic colorectal cancer

136
Q

Side effects of lonsurf (trifluridine-tipiracil)

A 
N&amp;V 
Diarrhoea/constipation 
Source mouth 
Taste changes 
Bone marrow suppression 
Anaemia 
Hand and foot syndrome 
Alopecia 
Tiredness
137
Q

Name two monoclonal antibodies used in metastatic colorectal cancer

A

Bevacizumab

Cetuximab

138
Q

Name 4 treatment related oncological ermergencies

A

Neutropenia sepsis
Extravasation
Tumour Lydia syndrome
Thrombocytopenia

139
Q

What are the levels in hypercalcaemia

A 
Normal= 2.2-2.7mmol/L
Treat= 2.7-3.7mmol/L
Emergency= > 3.7mmol/L
140
Q

Calcium levels >3.7mmol/L can cause what

A

Cardiac arrhythmias/arrest

141
Q

Hypercalcaemia particularly occurs in what 4 cancers

A

Lung
Breast
Prostate
Myeloma

142
Q

Treatment of hypercalcaemia

A

Rehydration

Bisphosphonates

143
Q

How long do bisphosphonates take to have maximal effect in hypercalcaemia

A

3-5 days

144
Q

Example of bisphosphonate used to treat hypercalcaemia

A

Disodium pamidronate IV infusion

145
Q

What is the levels of neutrophils in neutropenia

A

<1.5 * 10^9/L

146
Q

What can cause neutropenia

A

Chemo
Radio
Disease with bone marrow

147
Q

Neutropenic sepsis is often caused by part of hosts own gut or skin flora which involve what 4 pathogens

A

Staphylococcus aureus
Streptococcus
Klebsiella
E.Coli

148
Q

The longer an individual has neutropenia the higher their risk of what type of infection

A

Fungal (candida or aspergillus)

149
Q

Risk factors for neutropenic sepsis

A

Neutrophil count <0.5*10^9/L
Neutropenia lasting >7days
Patients with mucositis

150
Q

Treatment of neutropenic sepsis

A 
Tazocin + gentamicin 
(+metronidazole)
After 48hrs change to:
Ceftazidime + vancomycin 
(+ amphotericin B)
151
Q

Treatments used for fungal infections in neutropenic sepsis

A

Fluconazole -candida
Itracobazole -candida, aspergillus
Amphotericin B- best spectrum

152
Q

Prophylaxis of neutropenic sepsis

A

Ciprofloxacin
Antifungal- nystatin, fluconazole, itraconazole
Mouthcare-chlorhexidine

153
Q

What is lenograstim

A

Granulocyte colony stimulating factor may shorten the period of neutropenia after chemo

Oncology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions