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The One Deck To Rule Them All > Oncology > Flashcards

Oncology Flashcards

1
Q

Used to identify families with Lynch Syndrome (HNPCC)

A

Amsterdam Criteria

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2
Q

Criteria needed for a diagnosis in Amsterdam criteria

A

3+ members of family with colorectal cancer (1 = 1st degree)
2 successive affected generations
1+ member with colon cancer < 50 years old
Familial adenomatous polyposis has been excluded

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3
Q

Familial adenomatous colorectal polyposis (FAP)
Multiple chronic polyps
Retroperitoneal desmond tumours (15%)

Associated with:

  • skull osteoma
  • thyroid cancer
  • epidermoid cysts
A

Gardener’s Syndrome

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4
Q

Management of Gardener’s syndrome

A

Prophylactic colectomy to reduce risk

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5
Q

Gardener’s syndrome genetics

A

Autosomal dominant

  • mutation of APC gene
  • chromosome 5
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6
Q

Pheochromocytoma
RCC
Haemangioblastoma

A

Von-Hippel Lindau Disease

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7
Q

Sarcomas
Leukaemia
Breast cancer
Adrenal gland tumours

A

Li-Fraumeni Syndrome

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8
Q

Criteria to diagnose Li-Fraumeni syndrome

A

Sarcoma < 45 years old
1st degree relative has cancer < 45 year old
Another family member develops cancer < 45 year old

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9
Q

Genetics of Li-Fraumeni syndrome

A

Autosomal dominant

- germline mutations to p53 (tumour suppressor gene)

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10
Q

Genetics of BRCA 1

A

Chromosome 17

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11
Q

Genetics of BRCA 2

A

Chromosome 13

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12
Q

What cancers are associated with BRCA genes

A 
Breast cancer ( both 60% risk) 
Ovarian cancer
 - BRCA 1 (55%)
 - BRCA 2 (25%)
Prostate cancer (BRCA 2)
Pancreatic 
Melanoma
Young-onset colorectal cancer (BRCA 1)
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13
Q

Uses flurodeoxyglucose as a tracer

Shows 3d metabolic activity

A

Positive emission tomography (PET Scan)

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14
Q

Neutropenic sepsis is common in

- presents with fever

A

Adjuvant therapy (curative regimes)

  • Breast cancer
  • Germ cell cancers
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15
Q

Management of neutropenic sepsis

A
  1. Tazocin
    - Teicoplanin/ Aztreonam (if Penicillin allergic)
  2. Vancomycin
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16
Q

What are tumour markers

A

Monoclonal antibodies
Tumour antigens
Enzymes
Hormones

  • Low specificity
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17
Q

Ovarian + testicular cancers drain to the

A

Para-aortic lymph nodes (via gonadal vessels)

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18
Q

Breast cancer drains to the

A

Axillary lymph nodes

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19
Q

Vulval, penile + anal cancers drain to the

A

Inguinal lymph nodes

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20
Q

Colon cancers drain to the

A

Mesenteric lymph nodes

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21
Q

Thoracic, breast + gastric cancers drain to the

A

Supraclavicular nodes

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22
Q 
Oliguria (decreased urine output)
Cardiac arrhythmia 
Seizure
Confusion 
Hx of lymphoma/ germ cell cancer
A

Tumour lysis syndrome

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23
Q

Cancers associated with tumour lysis syndrome

A

Lymphoma

Germ cell cancer

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24
Q

Biochemistry in tumour lysis syndrome

A

Increased Potassium

Increased Phosphate

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25
Management for tumour lysis syndrome
``` Calcium gluconate (cardio protection from potassium) Fluids ```
26
Most common causes of brain mets
``` Lung Breast Bowel Skin (Melanoma) Kidney ```
27
Most common causes of bone mets
BLT + Kosher pickle ``` Breast Lung Thyroid Kidney Prostate ```
28
Most common site of bone mets
``` Spine Pelvis Ribs Skull Long bones ```
29
Biochemistry in bone mets
Hypercalcaemia | Increased ALP
30
Investigations for bone mets
1st line: MRI | DEXA Scan: picks up lytic mets better then XR
31
Management for bone mets
Radiotherapy can be used as pain relief
32
``` Bone pain - worse with straining/ coughing - nocturnal - tender Pathological fractures - vertebral wedge compression ```
Bone metastasis
33
``` Back pain - worse when lying down + coughing Lower limb weakness Sensory changes (numbness) Disturbed bowel function Disturbed bladder function ```
Neoplastic spinal cord compression - Oncological emergency - 5 % of cancer patients
34
In neoplastic spinal cord compression lesions above L1 exhibit
UMN signs in the legs
35
In neoplastic spinal cord compression lesions below L1 exhibit
LMN signs in the legs + perianal numbness
36
In neoplastic spinal cord compression tendon reflexes are
increased below the level of the lesion | absent at the level of the lesion
37
Investigations for neoplastic spinal cord compression
Urgent MRI (whole spine) < 24 hours
38
Management for neoplastic spinal cord compression
Oral dexamethasone (high dose) - reduce oedema Consider radiotherapy/surgery
39
Causes of superior vena cava obstruction
``` Small cell lung cancer (right lobe) Lymphoma Metastatic seminoma Kaposi sarcoma Breast cancer Vein occlusion ```
40
``` Dyspnoea Swelling of face, neck + arms Eyes (conjunctival + peri-orbital oedema) Headache (worse in mornings) Visual disturbance Pulseless JVP distension ```
Superior vena cava obstruction
41
Tests for superior vena cava obstruction
Pemberton's sign: positive | - Raise arms above head to exacerbate SVCO symptoms
42
Management for superior vena cava obstruction
Dexamethasone Balloon venoplasty/ stenting Radiotherapy/ surgery
43
Tumour marker for colorectal cancer
Carcinoembryonic antigen (CEA)
44
Tumour marker fo prostate cancer
Prostate specific antigen (PSA)
45
Tumour marker for ovarian cancer
CA 125 (monoclonal antibody)
46
Tumour marker for pancreatic cancer
CA 19-9
47
Tumour marker for HCC
Alpha-feto protein (AFP)
48
Tumour marker for testicular teratoma
Alpha-feto protein (AFP) | Beta hCG
49
Tumour marker for melanoma
S-100 (tumour antigen)
50
Tumour marker for gastric cancer
Bombesin (tumour antigen)
51
Tumour marker for schwannomas
S-100 (tumour antigen)
52
Tumour marker for neuroblastoma
S-100 (tumour antigen)
53
Familial causes of colorectal cancer
5% - Hereditary Non-polyposis colorectal carcinoma (HNPCC) | 1 % - Familial adenomatous polyposis (FAP)
54
Familial causes of endometrial cancer
5% - Hereditary Non-polyposis colorectal carcinoma (HNPCC)
55
Cause of Kaposi's sarcoma
Causes by Herpes Virus 8 | - common in HIV
56
Purple papules on skin Plaques on shin/ mucosa Hx of HIV
Kaposi's sarcoma
57
Management of kaposi's sarcoma
Radiotherapy | Surgical resection
58
Chemo for bladder cancer
CMV Cisplatin Methotrexate Vinblastine
59
Chemo for high-grade non-hodgkins lymphoma
R-CHOP Cyclophosphamide Hydroxydaunorubicin (doxorubicin) Vincristine (Oncovin) Prednisolone
60
Chemo for colorectal cancer
FOLFOX 5-FU Leucovorin (colonic acid) Oxaliplatin
61
Chemo for breast cancer
FEC 5-FU Epirubicin Cyclophosphamide
62
Chemo for hodgkins lymphoma
ABVD Adriamycin (doxorubicin) Bleomycin Vinblastine Dacarbazine
63
No red reflex | Age 18 months
Retinoblastoma
64
Retinoblastoma genetics
Autosomal dominant 10% hereditary caused by loss of function of tumour suppressor gene on chromosome 13
65
Management of Retinoblastoma
External beam radiation Chemo Photocoagulation Enucleation 90% survive

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