Brainscape's Knowledge GenomeTM

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


See full index

Yr 5 - Cancer > Corrections > Flashcards

Corrections Flashcards

1
Q

Inheritance of neurofibromatosis?

A

Autosomal dominant

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

What condition can cafe au lait spots be seen in?

A

Neurofibromatosis type 1

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

What types of cancer can the following chemicals cause:

1) benzene

2) aromatic amines

3) vinyl chloride

4) wood dust

A

1) leukaemia

2) angiosarcoma

3) bladder cancer (TCC)

4) nadal adenocarcinoma

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

Which HPV strains are most commonly associated with cervical & anal cancer?

A

HPV 16 & 18

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

What cancer is strongly linked to H. pylori infection?

A

Gastric MALT lymphoma

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

Describe the TNM staging for cancer

A

T (size):
TX - can’t be assessed
T0 - no evidence of tumour
Tis - in situ
T1-T4 - increasing in size and/or local extent

N (nodal involvement):
NX - can’t be assessed
N0 - no nodal involvement
N1-N3 - increasing involvement in lymph nodes

M (distant mets):
MX - can’t be assessed
M0 - no mets
M1 - distant mets

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

What 2 key conditions can cause a raised hCG in women?

A

1) Pregnancy

2) Germ cell tumour (think choriocarcinoma)

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

What type of pregnancy is a choriocarcinoma more common following?

A

Molar pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common medical emergency amongst oncology and haematology patients?

A

Neutropenic sepsis

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

What are some possible sources of infection in neutropenic sepsis?

A

1) Chest

2) Urinary

3) Skin

4) GI

5) Indwelling devices e.g. cannula/central line

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

When taking blood cultures in neutropenic sepsis, how many samples are required? Where must they be taken from?

A

At least 2 sets from a peripheral vein

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

What microbiological cultures are indicated in neutropenic sepsis (if unsure of source)?

A

1) Wounds
2) Urine
3) Stools
4) Sputum
5) Line tip

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

What investigation should be done if an atypical chest source is suspected, such as Pneumocystis jirovecii?

A

Bronchoalveolar lavage

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

Typical 1st line abx in neutropenic sepsis?

A

IV tazocin (piperacillin + tazobactam)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can be used for prophylaxis in reducing risk of neutropenic sepsis?

A

Recombinant granulocyte-colony stimulating factor (G-CSF) e.g. Filgrastim

Works by stimulating the bone marrow to produce neutrophils and may form part of specific chemotherapy regimens.

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

Risk of mortality in neutropenic sepsis?

A

10%

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

What is the most common presenting symptom in MSCC?

A

Back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MSCC vs cauda equina?

A

Both usually presents with pain and weakness and should be treated the same way.

MSCC:
- Compression of spinal cord by cancer/metastasis
- UMN pattern of weakness

Cauda equina:
- Compression occurring at or below level of cauda equina (typically L1)
- LMN pattern of weakness

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

Describe weakness pattern seen in MSCC vs cauda equina

A

MSCC causes a pyramidal pattern of weakness:
- increased tone in both legs
- bilateral weakness in flexors
- brisk reflexes
- upgoing plantars

Cauda equina typically causes LMN weakness:
- flaccid tone in both legs
- bilateral weakness
- reduced or absent reflexes
- absent plantars

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

Describe sacral senstation in MSCC vs cauda equina

A

Sacral sensation is lost in cauda equina syndrome, but may be preserved MSCC

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

What is a key bedside investigation in MSCC?

A

Bladder scan to look for urinary retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Top 5 cancers that cause MSCC?

A

1) Prostate
2) Lung
3) Breast
4) Renal
5) Myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Initial mx of suspected MSCC?

A

16mg dexamethasone + PPI cover

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

What is most common definitive mx option in MSCC?

A

Radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of cancer most commonly causes SVCO?

A

Small cell lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What sign is examined for in suspected SVCO?

A

Pemberton’s sign –> pt lifts arms above head, worsening of symptoms

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

What may a CXR show in SVCO?

A

1) Widening of superior mediastinum

2) Right hilar prominance to indicate a mediastinal mass

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

Where is mediastinal mass seen on CXR in SVCO?

A

Right hilar prominance (compressing SVC)

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

What is the imaging of choice in SVCO?

A

CT chest w/ contrast

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

How many samples must be taken before diagnosing hypercalcaemia?

A

2 separate samples on 2 separate occasions

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

What are the 3 main mechanisms that result in hypercalcaemia of malignancy?

A

1) PTHrP secretion

2) Bony lesions (osteolytic)

3) Calcitriol secretion

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

What is the most common mechanism causing hypercalcaemia in malignancy?

A

PTHrP secretion

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

Via what 2 mechanisms does PTHrP secretion result in hypercalcaemia?

A

1) Stimulates osteoclastic resorption of bone and inhibits osteoblastic formation of bone

2) Reduces calcium clearance in kidney

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

what vitamin is needed for calcium absorption?

A

vitamin D (calcitriol is the active form)

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

What type of cancers does calcitriol-mediated hypercalcaemia usually occur in?

A

Lymphoma

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

Via what mechanism does multiple myeloma typically cause hypercalcaemia?

A

Osteolytic bone mets

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

Via what mechanism does squamous cell lung cancer typically cause hypercalcaemia?

A

PTHrP secretion

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

What are 2 key medications that can worsen hypercalcaemia?

A

1) Thiazide diuretics

2) Lithium

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

How does hypercalcaemia affect the kidneys?

A

Can lead to AKI due to:

a) reduced GFR
b) increased sodium excretion
c) depletion of total body water

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

PTH levels in malignancies producing PTHrP?

A

Often suppressed

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

2 key medical mx options in hypercalcaemia?

A

1) IV fluids
2) Bisphosphonates

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

Role of bisphosphonates in hypercalcaemia?

A

Inhibit osteoCLAST activity (hence why used in osteoporosis too)

42
Q

What is the first-line bisphosphonate used in hypercalcaemia of malignancy?

A

IV zolendronic acid

43
Q

What are some key complications of hypercalcaemia of malignancy?

A

1) AKI
2) Seizures
3) Arrhythmias
4) Acute pancreatitis
5) Coma

44
Q

What is the most common cause of SVCO?

A

Small cell lung cancer

45
Q

bronchoscopy results in lung adenocarcinoma?

A

Often normal due to peripheral location of lung adenocarcinoma

46
Q

What are the 2 most useful markers in detecting recurrence of testicular teratoma?

A

AFP & beta HCG

These are often elevated in germ cell tumours, including teratomas.

47
Q

What class of medication is domperidone?

A

Dopamine receptor antagonist

48
Q

How do PET scans work?

A

Inject a small amount of radioactive glucose into body.

Cancer cells are more metabolically active –> consume more glucose than normal cells.

49
Q

What is the only thyroid cancer that will cause a risk in calcitonin?

A

Medullary thyroid cancer

50
Q

What 2 types of chemo drugs can cause cardiomyopathy?

A

1) Anthracyclines e.g. doxorubicin

2) HER2 monoclonal antibodies e.g. Herceptin

51
Q

What type of chemotherapy agents can cause peripheral neuropathy and sensorineural hearing loss?

A

Platinum agents (cisplatin, carboplatin)

52
Q

What type of chemo agents can lead to haemorrhagic cystitis and transitional cell carcinoma of the bladder?

A

Cyclophosphamides

53
Q

Key risk factor of cisplatin?

A

1) ototoxicity
2) nephrotoxicity

54
Q

Mx of pneumonitis?

A

Oral steroids

55
Q

1st line imaging in prostate cancer?

A

Multiparametric MRI

56
Q

In the UK, at what age can men request a PSA?

A

≥50 y/o

57
Q

How are the results of an MRI in prostate cancer reported?

A

On a Likert scale:

1 – very low suspicion
2 – low suspicion
3 – equivocal
4 – probable cancer
5 – definite cancer

58
Q

Stepwise investigation of prostate cancer?

A

1) PR exam
2) PSA
3) Multiparametric MRI
4) Biopsy (TRUS)

59
Q

What Likert score would indicate the need for a prostate biopsy?

A

3 or above

60
Q

What scan is used to look for bony mets in prostate cancer?

A

Isotope bone scan

61
Q

The Gleason Grading System is used to grade prostate cancer.

What is this based on?

A

Histology of biopsy

62
Q

What Gleason score is considered high risk for prostate cancer?

A

≥8

63
Q

What are the 2 classes of drugs used in hormone therapy in prostate cancer?

A

1) GnRH agonists e.g. goserelin

2) Androgen receptor blockers eg. bicalutamide

64
Q

What class of drug is goserelin?

A

GnRH agonists

65
Q

What class of drug is bicalutamide?

A

Androgen-receptor blockers

66
Q

What are 2 key complications of a radical prostatectomy?

A

1) ED

2) Urinary incontinence

67
Q

What genes are involved in FAP?

A

Mutation of tumour suppressor gene APC (adenomatous polyposis coli)

68
Q

What 2 inherited conditions can increase risk of colorectal cancer?

A

1) FAP

2) HNPCC (Lynch)

69
Q

What genes are involved in HNPCC?

A

MMR (mismatch repair genes)

70
Q

Which IBD is more associated with bowel cancer?

A

UC

71
Q

NICE two week wait referral guidelines for colorectal cancer?

A

≥40 y/o with abdo pain & weight loss

≥50 y/o with unexplained rectal bleeding

≥60 y/o with change in bowel habit or iron def anaemia

N.B. Iron deficiency anaemia on its own without any other explanation (i.e. heavy menstruation) is an indication for a “two week wait” cancer referral for colonoscopy and gastroscopy (“top and tail”) for GI malignancy.

72
Q

What is the bowel cancer screening programme in the UK?

A

People aged 60-74 are sent a home FIT test to do every 2 years.

73
Q

If home FIT test results come back positive, what is the next investigation?

A

Colonoscopy

74
Q

When may a sigmoidoscopy be used instead of a colonoscopy?

A

This may be used in cases where the only feature is rectal bleeding.

(obvious risk of missing cancers in other parts of the colon).

75
Q

What investigation may be considered in patients less fit for a colonoscopy?

A

CT colonography - this is a CT scan with bowel prep and contrast to visualise the colon in more detail

76
Q

What is removed in the following colorectal surgeries:

a) right hemicolectomy
b) left hemicolectomy
c) high anterior resection
d) low anterior resection
e) abdomino-perineal resection (APR)

A

a) caecum, ascending colon & proximal transverse colon

b) distal transverse colon & descending colon

c) sigmoid colon

d) sigmoid colon and upper rectum (but sparing rectum and anus)

e) rectum and anus (plus or minus sigmoid colon) and suturing over the anus.

77
Q

What is Hartmann’s procedure?

What is removed?

A

Is usually an emergency procedure that involves the removal of the rectosigmoid colon and creation of an colostomy.

The rectal stump is sutured closed.

The colostomy may be permanent or reversed at a later date.

78
Q

What is the most common type of colorectal cancer?

A

Adenocarcinoma

79
Q

Describe Duke’s staging system for colorectal cancer

A

Duke’s A –> cancer is in inner lining of bowel, or slightly growing into muscle layer

Duke’s B –> cancer has grown through muscle layer of bowel

Duke’s C –> cancer has spread to at least 1 lymph node close to the bowel

Duke’s D –> cancer has spread to another part of the body, such as the liver, lungs or bones

80
Q

Can prostate cancer be seen with a normal PSA?

A

Yes

81
Q

What is the second most common association of HNPCC after colorectal cancer?

A

Endometrial cancer

82
Q

Which chemotherapy agent cause hypomagnesaemia?

A

Cisplatin

83
Q

Mechanism of methotrexate?

A

Inhibits dihydrofolate reductase

84
Q

Give some paraneoplastic syndromes associated with lung cancer?

A

1) Cushing’s syndrome (ectopic ACTH secretion)

2) Phrenic nerve palsy

3) Recurrent laryngeal nerve palsy

4) Lambert-Eaton syndrome

5) SIADH

6) Limbic encephalitis

7) SVCO

8) Hypercalcaemia (ectopic PTH)

85
Q

Presenting feature of recurrent laryngeal nerve palsy?

A

Hoarse voice

86
Q

Presenting feature of phrenic nerve palsy?

A

SOB

87
Q

Presenting feature of SIADH?

A

Hyponatraemia

88
Q

What antibodies is limbic encephalitis associated with?

A

Anti-Hu antibodies

89
Q

Which type of lung cancer is most commonly related to hypercalcaemia?

A

Squamous cell carcinoma

90
Q

What cells do small cell lung cancers arise from?

A

From endocrine cells (Kulchitsky cells) – these are APUD cells

91
Q

Which 2 hormones with SCLCs most typically secrete? Why?

A

1) ACTH
2) ADH

92
Q

What is Lambert-Eaton syndrome caused by?

A

The result of antibodies produced by the immune system against small cell lung cancer cells

93
Q

Why are SCLCs responsible for multiple paraneoplastic syndromes?

A

SCLCs contain neurosecretory granules that can release neuroendocrine hormones

94
Q

What type of lung cancer is gynaecomastia associated with?

A

Adenocarcinoma

95
Q

A patient is found to have a suspicious lung mass on CXR.

What investigation should be done next?

A

CT w/ contrast of chest, liver and adrenals

96
Q

Give some contraindications to surgery in NSCLC

A
  • poor general health
  • malignant pleural effusion
  • FEV1 < 1.5 litres
  • tumour near hilum
  • vocal cord paralysis
  • SVC obstruction
97
Q

What are 2 key complications of a radial prostetectomy?

A

1) ED
2) Urinary incontinence

98
Q

What is retrograde ejaculation a common complication of? (2)

A

1) alpha blocker therapy
2) TURP

99
Q

During the first stages of treatment, goserelin may cause a transient increase in symptoms of prostatic cancer (‘flare effect’).

What can be given to help avoid this?

A

Flutamide (a synthetic antiandrogen) can be given PRIOR to goserelin therapy –> antagonistic effects at androgen receptors.

100
Q

What is the most appropriate 1st line treatment for classical Hodgkin’s lymphoma?

A

Chemotherapy

101
Q

What is the most important initial step in mx of neutropenic sepsis?

A

Start broad spectrum abx (prior to any other action)

102
Q
A

Yr 5 - Cancer (10 decks)

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