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Cancer > Clinical presentation of cancer general > Flashcards

Clinical presentation of cancer general Flashcards

1
Q

Metastatic effects presnetation

A

Circulatory invasion
Organomegaly
Metastasis
Effusions

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2
Q

Direct effects of cancer

A

Mass - pressure, pain, often palaple
Obstruction of a conduit (blockage)
Ulceration serosl or mucosal surface, perforation

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3
Q

Non metastatic effects of cancer

A

Temperature rise
Weight loss unintentional
Paraneoplastic effects

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4
Q

Cancer spread

A

Blood
Lymph
Transcoloemic - through abdomen

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5
Q

What is virchows node associated with

A

Upper 1/3 GI tract - middle and distal oeophagus or stomach

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6
Q

Supraclavicular lymphadenopathy cacners

A

Breast
Lung
Oesophagus
Stomach
THink thorax!

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7
Q

What does invasion of the skin in a tumour mean

A

T4

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8
Q

Pectoral muscle attachment

A

one nipple higher than the other when raise ar

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9
Q

Area of breast and likely lymph node involvement

A

Lateral = axillary
Superior - SCL lymph nodes
Inferior - internal mamillary lymph nodes
Outer = multiple

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10
Q

What is carcinoid syndrome

A

Excess 5HT/serotonin causing flushing, diarrhoea and bronchospasm
Urine measurement - 5HIAA - use lab
Marker for intervetion
Liver mets

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11
Q

What need to examine if positive para aortic lymph nodes

A

Testes or ovaries - blood supply drains to these lymph nodes

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12
Q

Is JVP pulsatile in SVC

A

No

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13
Q

What is achalasia

A

Rats tail at gastro oesophageal junction
Likely to aspirate to RHS chest

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14
Q

Direct and metastatic effects cancer

A

Compression - nerve symptoms
Direct invasion
Effusion
Ascites
Orgna involvement

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15
Q

Charcteristic level of tumor causing horners syndrome

A

T1 - NSCLC

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16
Q

What is absent in horners syndrome if lesion distal to carotid bifurcationa nd why

A

Anhydrosis
After this point the nerve supplies the skin

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17
Q

What innervation do you lose in horners syndrome

A

Sympathetic innervation
Unopposed constriction of pupil
Drooping

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18
Q

What is important if spinal cord compression above C5

A

No innervation to phrenic nerve -> respiratory failure as no innervation of resp mucles

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19
Q

Involvementof spinal cord compression

A

MRI investigate
70% thoracic
15% lumbar
5% sacral - cauda equina - LMN
10% cervical

20
Q

What level of spine differentiates cauda equina vs spinal cord compression

A

L2
Spinal cord = UMN signs bilateral
Cauda equina = LMN bilateral signs

21
Q

What skin change is characteristic of peutz jegher syndrome

A

Peri oral freckles eg on lips

22
Q

Karposis sarcoma

A

Skin, resp, GI
HIV +
HHV 8 ass

23
Q

what can cause polycythaemia in cancer

A

Tumours producing EPO -> excess RBC

24
Q

Dermal features of dermatomyositis

A

Heliotropic rash - pinky discolouration peri orbitally
Gottrens patches - over extensor tendons in hands

25
Q

Why is dermatomyositis important

A

40% of patients have a malignancy

26
Q

Types of paraneoplastic syndrome

A

SIADH
Ectopic ACTH
Hypercalcemia
HPOA
skin manifestations

27
Q

Pronathism

A

Lower jaw protrudes eg acromegaly

28
Q

Cushings syndrome causes

A

Cushings disease - pituitary adenoma
Exogenous steroids
Adrenal adenoma
Ectopic ACTH - SCLC

29
Q

thickening of areolar disc hat is it

A

Gynaecomastia

30
Q

What cancer can cause myasthenia gravis

A

SCLC -> lambert eaton syndrome

31
Q

Why can some paraneoplastic syndromes persist after cancer cured

A

If tehyre an immune response eg AI - antibody production persisits

32
Q

Complications of chemotherapy

A

Neutropenic sepsis
Anaemia - bone marrwo supression
VTE
neuropathy

33
Q

Complications of radiotherapy

A

PNeumonitis
Toxicity to normal tissue eg spinal cord
Secondary malignancy
Reduced exercise tolerance

34
Q

Hypertrophy vs hyperplasia

A

Hypertrophy = increased size of cells
Hyperplasia - increase number of cells

35
Q

Metaplasia vs dysplasia

A

Metaplasia - replacement of one type of tissue by another, can revert
Dysplasia - architectual and cytological change - pre malignant

36
Q

Carcingoens

A

Cigarettes
Vinyl chloride - PVC plastic
Aflatoxin
N-hydroxylated metaboites of azo dyes - textile industry
Alkyldiazonium ions from nitrosamines - textile

37
Q

Carcinogenesis steps

A

Initiation - fail to repair DNA damage
Promtor - repeatled contact with cells
Progression

38
Q

Why does smojing increase the risk of bladder cancer

A

Processed by kidney and excreted - sit in the bladder

39
Q

Lung cancer gendered

A

Male decreasing deaths
Female increasing deaths

40
Q

Where does mesothelioma arise from

A

Surface serosal cells of pleural peritoneal and peridcardial cavities

41
Q

Presentation of mesothelioma

A

SOB - feeling of suffocating - loss of plasticity of pleural membranes, lung can’t expand

42
Q

What are young females <20 more at risk of with non hodgkins lymphoma treatment

A

Radiotherapy to chest while breast cells still developing -> breast cancer later in life

43
Q

Viruses causing cancer

A

Retrovirsus - HTLV1, II, III, HIV-2
Herpes viruses - HSV 1, 2, VZV
CMV, HHV-6, HHV-7
EBV, HHV-8 (KS, PEL, castleman)
Hepatitis - HBV, HCV - (HCC cause)
Papillomarviruses
HPV 16,18,31,45
HPV 6,11 (condylomata)

44
Q

Bacterial infections increasing caner risk

A

H.pylori - gastric cancer, gastric lymphoma, Mycobacterium TB
Helminths
Schistosoma haematobium - bladder cancer
Schistosoma japonicum - colorectal hepatocellular, lymphoreticular cancers
Clonorchis sinensis -> cholagniocarcinoma

Make into separate cards?

45
Q

Factors genetic disposition of factor

A

Family clustering of specific types of cancer
Cases occuring in v young individuals
Ass between different tumour types
Multiplicity of cancer eg bilateral breast cancer

46
Q
A

Cancer (22 decks)

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