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Progress Test > OncoBreastObsGyn > Flashcards

OncoBreastObsGyn Flashcards

1
Q

What are the types of non small cell lung cancer?

A
  • Squamous cell
  • Adenocarcinoma
  • Large cell carcinoma
  • Carcinoid
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2
Q

What is squamous cell carcinoma?

A
  • Most common
  • Typically occurs centrally around main bronchus
  • Linked strongly with smoking
  • Associated with hypercalcaemia, clubbing, hypertrophic pulmonary osteoarthropathy, hyperthyroidism due to ectopic TSH
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3
Q

What is adenocarcinoma?

A
  • Typically occurs peripherally
  • Most common type of lung cancer in non-smokers
  • Associated with gynaecomastia, HPOA
  • Many are associated with EGFR mutations - responds to TKI inhibitors (gefitinib)
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4
Q

What is large cell carcinoma?

A
  • Anaplastic, poorly differentiated tumour
  • Carries a poor prognosis
  • Typically peripheral
  • May secrete B-HCG
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5
Q

What is carcinoid lung cancer?

A
  • Neuroendocrine tumour (5-HIAA found in urine)

- Presents with symptoms of hypotension, bronchospasm and flushing

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6
Q

What is small cell lung cancer?

A
  • Usually central
  • Not usually curative, poor survival
  • Anti-Hu Ab
  • Associated with paraneoplastic syndromes:
    1. SIADH: hyponatremia, excessive water retention
    2. ACTH: presents with HTN, hyperglycaemia, muscle weakness
    3. Lamberton Eaton syndrome: presents with limb girdle weakness, repeated muscle contractions, hyporeflexia, dry mouth
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7
Q

What are the investigations for lung cancer?

A
  • CXR
  • Bloods: thrombocytopenia, raised calcium
  • CT scan
  • Bronchoscopy with endobronchial US
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8
Q

What are key features of lung cancer?

A
  • Persistent cough
  • Haemoptysis
  • SOB
  • Weight loss/night sweats
  • Hoarse voice - Pancoast tumour, pressing on RLN
  • Stridor/difficulty swallowing
  • Clubbing
  • Fixed, monophonic wheeze
  • Supraclavicular lymphadenopathy
  • Hepatomegaly - metastases
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9
Q

What are blood results for colorectal cancer?

A
  • FBC - raised platelets, microcytic anaemia
  • U&E - urea raised in GI bleed
  • LFT - metastatic spread
  • Calcium - often raised in malignancies
  • TFT - can cause change in bowel habits
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10
Q

What investigations are done in colorectal cancer?

A
  • Stool cultures (rule out infection)
  • Faecal calprotectin (used to identify bowel inflammation - IBD)
  • Faecal immunochemical test (FIT)
  • Colonoscopy + biopsies/CT colonograohy if unable to tolerate
  • CT for staging
  • MRI
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11
Q

What resection would be done for location of cancer?

A
  • Caecum, ascending and proximal transverse colon: right hemicolectomy
  • Distal transverse and descending colon: left hemicolectomy
  • Sigmoid colon: high anterior resection
  • Rectum: anterior resection
  • Anal verge: abdomino-perineal excision of rectum
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12
Q

What is the presentation of pancreatic cancer?

A
  • Painless obstructive jaundice
  • Unintentional weight loss
  • Palpable mass in epigastric region
  • N&V
  • New onset diabetes or worsening of T2DM
  • Over 40 with jaundice - referred on 2WW
  • Over 60 with weight loss + diarrhoea, N+V, constipation, new onset diabetes, back + abdo pain - refer for CT abdomen
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13
Q

What are investigations and management for pancreatic cancer?

A
  • Staging CT scan
  • CA19-9
  • Biopsy
  • Management: surgery, but usually ERCP (stents to relieve biliary obstruction), surgery to improve symptoms, palliative chemo and radiotherapy
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14
Q

What is the presentation of endometrial cancer?

A
  • Post menopausal bleeding
  • Premenopausal intermenstrual bleeding/PCB
  • Pain/discharge/anaemia/haematuria/thrombocytopenia
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15
Q

What are the investigations and management for endometrial cancer?

A

Investigations:
- 1st line - trans animal USS (>4/5mm is concerning)
- Hysterectomy with pipeline endometrial biopsy
Management:
- Total abdominal hysterectomy with bilateral salpingo-oophorectomy
- +/- radiotherapy

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16
Q

What are the risk factors for endometrial cancer?

A
  • Unopposed oestrogen
  • Age
  • Obesity
  • Nulliparity
  • Early menarche
  • Late menopause
  • PCOS
  • Tamoxifen
  • Diabetes
  • Lynch syndrome
17
Q

What is the presentation of cervical cancer?

A
  • Discharge
  • PCB/IMB/PMB
  • Pelvic pain
18
Q

What is the screening for cervical cancer?

A

HPV first system

  • 3 yrly smears for all women aged >25 yrs
  • 5 yrs smears for women aged 50-64yrs
  • Women with HIV screened annually
  • Over 65 can request smears
  • Immunocompromised or previous CIN women may have additional screening
  • Pregnant women should wait 12 weeks postpartum
19
Q

What is the management for cervical cancer?

A

CIN: LLETZ or cone biopsy
Stage 1B-2A: radical hysterectomy and removal of local lymph nodes with chemo/RT
Stage 2B-4A: chemo/RT
Stage 4B: combo of surgery, RT, chemo and palliative care

20
Q

What is the presentation of ovarian cancer?

A
  • Abdominal distension
  • Bloating
  • Abdo pain
  • Urinary symptoms
  • Early satiety
  • Weight loss
  • Change in bowel habit
21
Q

What are the investigations for ovarian cancer?

A
  • Ca125
  • USS
  • Diagnostic laparotomy
22
Q

How does myeloma present?

A
  • Hypercalcaemia
  • Renal impairment
  • Anaemia
  • Bone pain
23
Q

What are the symptoms for breast cancer?

A
  • Discharge
  • Nipple changes
  • Skin tethering
  • Ulceration
  • Erythema
24
Q

What are the types of breast cancer?

A
  • Invasive dictaphone carcinoma
  • Invasive lobular carcinoma
  • Ductal carcinoma in situ
  • Lobular carcinoma in situ
  • Inflammatory
  • Rarer cancers = medullary, mucinous tubular etc.
25
Q

What is a fibroadenoma?

A
  • Small, mobile, smooth fibroepithelial lesions
  • Common in young
  • Hormone dependent
  • Can increase in pregnancy
  • Ix: US
26
Q

What is a cyst breast lump?

A
  • 30-60yrs

- Smooth, well circumscribed, often fixed, fluctuant lump

27
Q

What is a breast abscess?

A
  • Common cause staph aureus
  • Acute, bacterial infection, fever, pus discharge, local erythema, tenderness, oedema
  • RF: smoking, diabetes, immunocompromised, nipple piercing
  • Mx: flucloxacillin (safe when breastfeed), incision and drainage
28
Q

What are the causes of amenorrhea?

A
  • Pregnancy
  • Thyrotoxicosis
  • Contraceptives
  • Anorexia
  • PCOS
  • Stress
  • Turner syndrome (46XY)
29
Q

Describe PCOS

A
  • Irregular periods, overweight, hirsutism, sub fertility, acanthosis nigricans
  • Raised LH:FSH ratio, increased testosterone, sacs in ovaries seen on US
  • Mx: weight loss, contraceptives for regulating cycle, clomifene + metformin for infertility
30
Q

What are treatments for menorrhagia?

A
  1. IUS (mirena)
  2. Antifibrinolytics (tranexamic acid, mefenamic acid), NSAIDs, COCP
  3. Progestogens
31
Q

What are features of pre-eclampsia?

A

HTN, proteinuria and oedema

  • Headache
  • Visual disturbance or blurriness
  • N&V
  • Upper abdominal or epigastric pain (due to liver swelling)
  • Oedema
32
Q

What is the management of pre-eclampsia?

A
  • Labetolol
  • Nifedipine (modified release) second line
  • Methyldopa third line
  • IV hydralazine in severe pre- eclampsia or eclampsia
  • IV magnesium sulphate during labour and in 24 hours afterward to prevent seizures
  • Fluid restriction during labour to avoid fluid overload
  • Women are offered aspirin from 12 weeks gestation until birth if they have one high risk factor or more than one moderate risk factor

Progress Test (5 decks)

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