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Oncology > General Oncology > Flashcards

General Oncology Flashcards

0
Q

What cancer is associated with exposure to benzene?

A

Leukaemia

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1
Q

What cancer is the Epstein Barr virus associated with?

A

Hodgkins and non Hodgkin’s lymphoma

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2
Q

What cancer is associated with exposure to wood dust?

A

Nasal adenocarcinoma

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3
Q

What cancer is associated with exposure to vinyl chloride?

A

Angiosarcoma

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4
Q

What is the RECIST classification of imaging response to treatment?

A

Complete response - no disease detectable

Partial response - shrunk by >30%
Stable -shrunk by 20%
Progressive disease - new lesions or lesions that have increased by >20%

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5
Q

Who is eligible for mammography screening for breast cancer and how often?

A

Women from the ages of 50 to 65, every three years

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6
Q

How many CT scans does it take to cause one cancer?

A

1000 - 2000 ct scans

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7
Q

For what cancer is carcinoembryonic antigen raised, and in which other conditions may it also be raised?

A

Colorectal carcinoma

Smokers, IBD, hepatitis, pancreatitis, gastritis

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8
Q

For what cancer is CA125 raised, and in which other conditions?

A

Ovarian cancer- raised in 82%
Also raised in 6% of pregnancy, endometriosis, PID
Also raised in pancreatic, lung, colorectal and breast cancer

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9
Q

In what conditions is Alpha fetoprotein raised?

A

First year of life
Hepatitis
Hepatic ellipse carcinoma
Yolk sac cancers

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10
Q

In what conditions is human human chorionic gonadotropin raised?

A

Hydatiform mole
Choriocarcinoma
Non Seminomatous testicular cancer

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11
Q

When is PSA raised?

A 
Prostate cancer
BPH
UTI
After a DRE
prostatitis
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12
Q

In which inherited condition is a prophylactic colectomy sometimes considered?

A

Familial Adenomatous Polyposis

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13
Q

Which chemo drugs can be taken orally?

A

Cyclophosphamide
Capacitabine
Etoposide
Tamoxifen

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14
Q

Which cancer an be treated with chemotherapy administered intraperitoneally?

A

Ovarian cancer

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15
Q

How is chemotherapy dose usually calculated?

A

Body surface area using the Dubois and Dubois calculations

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16
Q

For which cancers is high dose chemo with bone marrow support an option?

A 
Non Hodgkin's lymphoma
Hodgkin's
Acute and chronic leukaemia
Multiple myeloma
Germ cell tumours
Ewing's sarcoma
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17
Q

Which drugs are administered with chemo to prevent nausea and vomiting?

A

Pre med
Ondansetron 8mg IV
Dexamethasone 8mg IV

Post dose
Metoclopramide TDS 14 days
Dexamethasone 6mg PO

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18
Q

Which drugs are most at risk of causing peripheral neuropathies?

A

Platinums eg cisplatin, carboplatin
Vinca alkaloids eg vincristine
Taxanes eg paclitaxel, docetaxel

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19
Q

Which chemo drug may cause cerebellar toxicity?

A

5FU

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20
Q

Which chemo drug may cause cochlear damage resulting in permanent high tone loss?

A

Cisplatin

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21
Q

Which chemo drugs are nephrotoxic

A

Cisplatin

Isosfamide

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22
Q

Which chemo drugs pose a risk of haemorrhagic cystitis, and what is the antidote?

A

Cyclophosphamide
Isosfamide

Antidote is mesna

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23
Q

Which chemo drugs may cause cardiac arrythmia

A

Doxorubicin

Paclitaxel

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24
Q

Which chemo drug may cause coronary artery spasm?

A

5FU

25
Q

Which chemo drugs may cause palmar plantar erythema?

A

5FU
Capacitabine
Sunitinib
Erlotinib

26
Q

Which chemo drug may cause photo sensitivity?

A

5FU

27
Q

Which chemo drug causes pigmentation changes

A

Bleomycin- also check for pulmonary fibrosis!

28
Q

Which drug may cause myalgia/arthralgia

A

Paclitaxel

29
Q

Which drugs may cause infertility?

A

Alkylating agents- cyclophosphamide, Isosfamide, melphalan, busulphan

30
Q

What is the nadir point for myelosuppression?

A

10-12 days after treatment

31
Q

Which cancers are most likely to cause bone narrow replacement by malignant infiltration, resulting in myelosuppression by pancytopenia?

A

Haematological
Breast
Lung
Prostate

32
Q

How and when is anaemia treated cancer?

A

Hb <10 gldl
Blood transfusion
Recombinant epo if symptomatic

33
Q

How does thrombocytopenia present in cancer, how is it treated?

A

Petechiae
Nosebleeds
Corneal haemorrhage

20x10*9- does not require platelets

34
Q

When does neutropenia typically occur after chemo?

A

7-14 days

35
Q

When is febrile neutropenia diagnosed?

A

WBC <1x10(9)
Fever greater than 38 degrees for an hour
Or fever greater than 38.5 degrees in a single reading

36
Q

How is febrile neutropenia treated?

A

IV tazocin within 60 mins
Consider switch to oral within 24 hours

5% overall mortality

Mostly no identifiable aetiology

37
Q

When does pneumonitis appear after radiotherapy, and what symptoms does it cause?

A

6-8 weeks after

Progressive SOB, dyspnoea

38
Q

When do acute side effects develop during radiotherapy

A

During treatment

Peak during first few weeks post treatment and resolve

39
Q

When do late side-effects develop during treatment

A

Develop greater than three months after radiotherapy.
May be years later
Often irreversible
Worsen over time
Include lung fibrosis, skin atrophy, infertility

40
Q

What is the difference between intercavitary and interstitial brachytherapy

A

Intercavitary- placed in body such as uterus or cervix

Interstitial- placed into target such as prostate

Patient is radioactive so counsel about risk!

41
Q

What is an example of radioisotope use in cancer treatment

A

Iodine 131 use in thyroid cancer
Preferentially taken up in normal or malignant thyroid tissue
Requires 4 days in lead lined room

42
Q

Who is eligible for cervical cancer screening?

A

25-49 every three years
49-64 every five years
Only women because only women have cervices

43
Q

What screening programme is used for colorectal cancer?

A

Faecal occult blood
Every two years
60-69

Currently being extended to 74

44
Q

In which part of the spine does metastatic spinal cord compression most commonly occur?

A

2/3 thoracic

1/3 lumbar/cervical

45
Q

What is the treatment for metastatic spinal cord compression

A

16mg dexamethasone
With PPI for gastric protection

8gy single fraction radiotherapy

Or refer to spine surgeons

46
Q

What is the prognosis for metastatic spinal cord compression for patients ambulance and paraplegic prior to treatment?

A

Ambulant- 70% retain function
Paraplegic- 5% retain function

Overall one fifth of patients will survive greater than one year

47
Q

What are the symptoms of superior vena cava obstruction?

A

Facial oedema
Prominent blood vessels
Cyanosis

48
Q

What is the treatment for superior vena cava obstruction?

A

Dexamethasone 16mg

Vascular stenting followed by radiotherapy, chemo

49
Q

What are the cardiac symptoms of hypercalcaemia?

A

Bradycardia
Short QT intervals
Prolonged PR interval
Wide T wave

50
Q

How is rehydration managed in hypercalcaemia?

A

Rehydration with saline 1l 4 hourly for 24 hours
IV pamidronate 60-90mg over 2-4 hour

Calcitonin and corticosteroids?

51
Q

What are the signs that someone is nearing the end of their life?

A 
Profound weakness
Confined to bed
Disorientated
Confused
Drowsiness for extended periods
Reduced attention
Loss of attention in food and drink
Too weak to swallow
52
Q

When is a blood transfusion indicated in cancer?

A

Prognosis >2 weeks

And

Symptoms of anaemia

And

Hb <8g/dl

53
Q

In what order are muscles affected in corticosteroid induced myopathy?

A

Legs then arms then chest muscles

Proximal muscles are affected before distal muscles

54
Q

What are the symptoms of metastatic spinal cord compression?

A

Low back pain - band like, increased in movement, coughing, or lying flat

Motor weakness

Subjective sensory disturbance

Bladder/bowel dysfunction

Increased reflexes

Clonus

55
Q

What is the investigations for MSCC?

A

MRI within 24 hours

FBC, calcium, LFTs (raised all phosphate)

56
Q

What causes superior vena cava obstruction?

A

Extrinsic compression, thrombosis or invasion if the wall of the vessel

Usually in lung cancer, lymphoma

57
Q

What are the symptoms of SVCO?

A

Facial oedema
Prominent blood vessels
Cyanosis

58
Q

How is SVCO managed?

A

Dexamethasone 16 mg

Vascular stenting - may be followed by radiotherapy, chemo

59
Q

What cancers commonly cause hypercalcaemia?

A 
Breast cancer
Lung cancer - NSCLC
SCC
Myeloma/lymphoma
Head and neck

Oncology (8 decks)

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