Miscellaneous

Question 1

most common tumours causing mets to bone (3- in descending order)

Answer 1

Prostate (sclerotic/ blastic)
Breast (mixed)
Lung (lytic)

Question 2

features of bony mets?

Answer 2

bone pain
pathological fractures
hypercalcaemia
raised ALP

Question 3

⚠️ carcinogen

Alfatoxin (produced by aspergillus)

Answer 3

liver - HCC

Question 4

⚠️ carcinogen

Aniline dyes

Answer 4

bladder - TCC

Question 5

⚠️ carcinogen

Asbestos

Answer 5

mesothelioma

bronchial carcinoma

Question 6

Tumour marker

CA 125

Answer 6

ovarian

Question 7

Tumour marker

CA 19-9

Answer 7

pancreatic (9 looks like backwards P)

Question 8

Tumour marker

CA 15-3

Answer 8

breast (3 sideways looks like boobs)

Question 9

Tumour marker

PSA

Answer 9

prostate carcinoma

Question 10

Tumour marker

Alpha-feto protein (AFP)

Answer 10

HCC, teratoma

Question 11

Tumour marker

Carcinoembryonic antigen (CEA)

Answer 11

colorectal

Question 12

chemo N&V

1) for low risk patients
2) for high risk patients

Answer 12

1) metoclopramide

2) 5HT3 receptor antagonists e.g. ondansetron

Question 13

how do spinal metastases present?

Answer 13

unrelenting back pain
nocturnal
any thoracic/ cervical pain
worse on coughing/ sneezing 
tenderness

Question 14

T/F: patients with suspected spinal mets should have imagine of their whole spine conducted

Answer 14

True- whole spine MRI, pts commonly present with multi-level disease

Question 15

Ix for metastatic disease of unknown primary?

Answer 15

• FBC, U&E, LFT, calcium, urinalysis, LDH
• CXR
• CT CAP
• AFP and hCG

Question 16

most common site of bone metastases?

Answer 16

spine