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MRCP Part 1 > MRCP Oncology > Flashcards

MRCP Oncology Flashcards

1
Q

Thyroid cancer diagnosed by…

A

Fine needle aspiration of thyroid nodule

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2
Q

Small cell lung cancer paraneoplastic syndromes

A

SMAA

ADH
ACTH

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3
Q

Squamous cell lung ca paraneoplastic syndrome

A

PTH

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4
Q

Bronchial carcinoma paraneoplastic syndrome

A

Carcinoid syndrome

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5
Q

Which lung cancer is not associated with smoking

A

Adenocarcinoma

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6
Q

What is the most common deaths due to cancer in men top 3

A
  1. lung
  2. prostate
  3. colon
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7
Q

What is the most common deaths due to cancer in women top 3

A
  1. lung
  2. breast
  3. colon
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8
Q

Which rheumatological condition is associated with cancer

A

dermatomyositis

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9
Q

What is the management of bladder cancer

A

No metastasis (local no lymph node/muscle invasion)
- TURBT with single mytomicin C
- Follow up cystoscopy in 3 and 12 months

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10
Q

Which cancer is hep B/C associated with

A

HCC

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11
Q
A
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12
Q

facial swelling,
distended neck vein,
upper limb oedema,
distended veins in anterior chest wall

A

SVC obstruction due to lung cancer

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13
Q

What is MESNA (sodium 2-mercapto ethanesulfonate)

A

detoxify urotoxic chemotherapy
- ifosfamide
- cyclophosphamide

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14
Q

NF type 2 bilateral cancer…

A

acoustic neuroma

chr 22

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15
Q

Neutropenic sepsis

A

fever
low BP
tachycardia

urgent abx and cultures

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16
Q

Which leukaemia is assocaited with RAR alfa mutation on Chr 17

A
  • acute pro-myelocytic leukaemia (AML subtype)
  • translocation between chr 15 and 17
  • forms PML-RAR alfa –> block myeloid differentiation
  • treat with all trans retinoic acid (ATRA)
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17
Q

Virus and cancer associations

A

EBV- burkitt and hodgkins
Hep B- HCC
HHV-8 - kaposi
HPV 16,18 - cervical, anal, oropharyngeal
Human T lymphocyte - leukaemia

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18
Q

What mutation if papillary thyroid carcinoma associated with

A

RET prto-ongogene for tyrosine kinase mutation

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19
Q

testicular lump, CXR mass, raised beta hcg

A

testicular seminoma

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20
Q

Tumour lysis syndrome hallmarks

A

treatment of high grade lymphoma and leukaemia
triggered by R-CHOP combination
- breakdown of tumour cells –> release cell content –> high potassium high phosphate low calcium

Present: AKI, high phosphate, high uric acid

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21
Q

What medication lowers incidence of Tumour lysis syndrome

A

allopurinol

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22
Q

Lung cancer with back pain and bilateral leg weakness suddenly,…

A

spinal cord compression due to spinal mets

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23
Q

what are negative acute phase proteins
- decreases during inflammation

A

albumin
transferrin
antithrombin

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24
Q

Which cancers are tyrosine kinase inhibitors effective in?

A
  1. CML (philadelphia chromosome 9:22, BCR-ABL tyrosine kinase inhibitor)
  2. GIST - kit inhibitor

imatinib

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25
Myeloma blood test shows...
anaemia thrombocytopenia high IgG monoclonal bands on electrophoresis hypercalcaemia
26
Transitional cell tumours associated with...
smoking rubber/chemical industry phenacetin
27
Squamous cell carcinoma bladder cancer
schistosomiasis chronic inflammation
28
Courvoisier's law | malignant obstruction below level of cystic duct-> palpable distended GB
a painless, enlarged gallbladder with jaundice is unlikely to be caused by gallstones more likely to be caused by a malignant obstruction of the bile duct, such as pancreatic cancer or bile duct cancer
29
monoclonal ab against CD20 example
rituximab - used in CLL
30
itchy and tender acanthosis nigracans associated with...
malignancy
31
What is the action of imatinib
tyrosine kinase inhibitor in GIST- KIT inhibitor for stem cell
32
First line investigation for women >50 with ascites, palpable mass in iliac fossa and raised CA125
US abdo pelvis ---> CT staging and biopsy ?ovarian cancer
33
Ovarian cancer symptoms
abdo distension early satiety bloating frequent UTI weight loss palpable abdo mass
34
Thyroid cancer epidemiology
Papillary (80-85%) - papillary popular follicular (5-10%) - followed by... medullary rare anaplastic rare
35
Which thyroid cancer produced calcitonin
medullary
36
Which serum marker gives early detection of recurrent papillary and follicular thyroid cancer
thyroglobulin
37
Phase 1-4 of human trial
1- human toxicity 2- efficacy of drug 3- compare to current drug 4- long term toxicity
38
first line treatment for symptoms for carcinoid syndrome
octreotide somatostatin analogue blocks 5-HT
39
Bone mets blood film
leucoerythroblastic blood film - immature RBC
40
MSCC treatment
dexamethasone
41
Pancost tumour
pain in shoulder brachial plexus involved weakness and atrophy of hand Horner syndrome hoarsness T1-2 cord compression
42
Syringomyelia
weakness and wasting of upper limb loss of sensation of pain sparing touch and proprioception areflexia in arms spastic paraparesis cape pattern
43
Investigation for myeloma
First: - serum electrophoresis - urine electrophoresis (bence protein) - serum free light chains (paraprotein) Note: bone marrow biopsy needed if above -ve to confirm monoclonal plasma cells
44
Cryoglobinaemia hallmarks
raynauds in type 1 underlying lymphoma cryoglobulin precipitate when serum incubated at 4 degrees raynaud symptoms in cold due to precipitation
45
Osmotic fragility test...
hereditary spherocytosis
46
Cerebral mets with oedema management
dexamethasone +/- IV mannitol to reduce cerebral oedema
47
Best diagnostic test for CLL
flow cytometry - analyse cell surface markers on leukocytes aka B clonal cells - non invasive method
48
Common site of neuroendocrine tumour
ileum | carcinoid tumour --> serotonin
49
What is the most important thing about screening cancer method
clinically effective and cost effective method of early treatment
50
Febrile neutrophilia commonest organism
staph epidermidis strep viridans
51
Treatment of choice for SVCO
radiotherapy
52
Clear cell renal adenocarcinoma
hypernephroma causing left varicocele Triad: haematuria loin pain abdo mass
53
Why is left varicocele seen
compression of left renal vein (drains)
54
Platelet transfusion in unwell patient
aim plt above 20
55
Burkitt's lymphoma hallmarks
B cell lymphoma EBV related translocation (8;14) results in c-myc protooncogene transposition leading to dysregulated cell proliferation STARRY SKY appearance (macrophage phagocytosin cell debris and apoptotic cells scattered)
56
Anaplastic thryoid cancer sequelae
rarest cervical lymph node mets in 90% lung mets and tracheal deviation VERY POOR PROGNOSIS UPPER AIRWAY OBSTRUCTION
57
What is residual tumour classification for colon cancer
RX - cannot assess R0- no residual tumour R1- microscopic residual R2- macroscopic residual
58
TNM stands for
tumour size lymph node metastasis
59
Treatment for resectable oesophageal cancer
chemo preop then surgery | stent if dysphagic.
60
Cellcycle
G0 - rest G1- ready to divide S - DNA copied G2 - just before mitosis M - mitosis Note: chemotherapy does not affect G0 phase
61
Prolactinoma management
medical management with cabergoline/bromocriptine surgical if significant mass effect or refractory case
62
Most common cancers with bone mets
bronchial breast prostate
63
Which Tumour marker is sensitive to bronchial carcinoid
chromogranin A Note: neuron specific enolase also seen
64
65
Risk factors for oesophageal adenocarcinoma
GORD (strongest) Obesity Barrett's Smoking Poor Diet
66
Oesophageal cancer location
Adenocarcinoma: Lower third - near the gastroesophageal junction SCC: Upper two-thirds of the oesophagus
67
Risk factor for oesophageal SCC
smoking alcohol achalasia Plummer-Vinson syndrome diets rich in nitrosamines
68
SCC skin hallmarks
scaly crusty skin red inflamed base UV exposed areas areas of bowmen disease/chronic leg ulcer risk: immunosuppression/organ transplant metastasis via lymphatic channels
69
Anti yo associated with...
breast/ovarian/endometrial/fallopian ca - paraneoplastic cerebellar degeneration - tumour express protein triggering autoimmune rx - dysarthria, ataxia, nystagmus
70
Anti hu associated with...
small cell lung cancer
71
First line treatment for hodgkins lymphoma
combines chemo and radiotherapy - ABVD (adriamycin, bleomycin, vinblastine, decarbazine)
72
MEN 1 genetics
autosomal dominant - pituitary - parathyroid - pancreas
73
When is CEA useful
post op surveillance
74
HCC hallmarks
most common primary hepatic tumour more common in asia and africa due to hep B/C/aflotoxin AFP tumour marker
75
Most rapidly progressing lung cancer
small cell lung cancer
76
Mechanism of action of cisplatin
cross linking in DNA side effects: - nephrotoxic - neurotoxic - ototoxic - low Mg K Ca
77
HCC tumour size amenable to liver transplant
<5 CM <3 CM X 3 No extrahepatic or major vessel
78
Chemotherapy for colorectal cancer
FOLFOX and FOLFIRI folic flurouracil oxaliplatin
79
apple green bifringence under polarised light after congo red staining
myltiple myeloma
80
Small cell lung cancer chemotherapy
cisplatin etoposide
81
Non small cell lung cancer chemotherapy
Carboplatin paclitaxel
82
CA 153
Breast cancer
83
Renal tumour management
partial or total nephrectomy tumour <7cm - partial
84
Neurological paraneoplastic disease
encephalistis myelopathy neuropathy myopathy cerebellar degeneration eaton lambert syndrome
85
Paraneoplastic syndromes
Paraneoplastic neutrophilia SIADH dermatomyositis acanthosis nigracans polycythaemia PUO
86
Aromatic amines cause...
Bladder cancer
87
Best investigation for bone metastasuis
Bone scintigraphy
88
Reed steinburg is associated with..
Hodgkins disease
89
Dukes criteria for colorectal cancer
Stage A - confined to bowel Stage B - full thickness of bowel wall into serosa Stage C - spread to tumour to draining lymph nodes Stage D - distant spread primarily to liver
90
Colorectal stage D management
5-FU with folinic acid
91
HNPCC (lynch) sydrome associated with...
CEO colorectal endometrial ovarian

MRCP Part 1 (14 decks)

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