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Oncology Flashcards

1
Q

Most common site of spread of ER+ve Breast Ca

A

Bone

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2
Q

What is the commonest targetable in non-squamous NSCLC

A

EGFR > ALK > ROS1

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3
Q

General mgmt of pancoast tumour

A

Neoadjuvant Chemo/RTx followed by resection to get the tumour away from the nerve bundle

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4
Q

Standard rx for mgmt of Stage III unresectable NSCLC

A

chemoradiotherapy + adjuvant Durvalumab

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5
Q

Clinical Trial Phase 1:

A

dose ranging on healthy volunteers for safety; find PK/PD

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6
Q

Clinical Trial Phase 2

A

Assess efficacy and side effects

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7
Q

Trial Phase 3

A

intervention to current gold standard

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8
Q

Cell cycle: G0 is

A

cell is chilling

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9
Q

Cell cycle, G1 is:

A

replicating contents but not chromosomes

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10
Q

Cycle cycle, S is:

A

chromosomes duplicating

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11
Q

Helicase function

A

splits dsDNA

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12
Q

Topoisomerase function

A

unwinds DNA

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13
Q

DNA polymerase function

A

matches base pairs -> purine and pyramidine analogues

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14
Q

Ligase function

A

joins fragments

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15
Q

Cell cycle, G2 is

A

double checking chromosomes

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16
Q

Cell cycle, mitosis is

A

Mitotic spindles pulling apart

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17
Q

Alkylating agents MOA

A

alkylate guanine -> disorts structure directly and cross links so helicase can no longer unwind

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18
Q

examples of alkylating agents

A

cyclophosphamide, melphalan, dacarbazine, cyclosporin, temozolomide, chlorambucil; and platinums

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19
Q

anti-metabolites MOA

A

anti-folates: prevent all NS/NT formation

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20
Q

anti-metabolits examples

A

MTX, permetrexed; purine analogues- fludarabine, 6-MP,; pyrimidine analogues- 5FU, Capecitabine, gemcitabine

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21
Q

Deficiency of what can make 5-FU fatal?

A

dihydro pyramidine dehydrogenase (breaks down 5-FU)

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22
Q

Alkaloids MOA

A

microtubule poisons- bind tubulin and stop microtubule formation

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23
Q

Alkaloids examples

A

Vinca alkaloids (vincristine, vinblastine, vinorelbine); taxanes; topoisomerase poisons- etoposide, irinotecan

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24
Q

Anthracyclines act on which part of cell cycle?

A

not cell cycle specific

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25
Q

Platinums side effects

A

neuropathy and nausea esp. cisplatin

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26
Q

High emetogenicity chemo

A

Cisplatin > anthracyclines + cyc, cyc alone

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27
Q

Medium emetogenicity chemo

A

other platinums, irinotecan

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28
Q

Cancers with highest somatic mutation burden

A

melanoma >SqCC lung > adeno lung >bladder> small cell lung

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29
Q

Lynch mutations

A

MSH2 >MLH1 > PMS2, MSH6

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30
Q

Lynch mechanism of inheritance

A

AD

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31
Q

Which Lynch MSI mutations go together?

A

MLH1 and PMS2; and MSH2 with MSH6

32
Q

Lynch Amsterdam criteria:

A

3 cases, 2 generations, 1 <50

33
Q

Which BRCA gives you a higher risk of ovarian cancer?

A

1 = 44% vs. 17% for 2

34
Q

histology of BRCA breast cancers

A

majority are ductal carcinomas of no specific type; atypical medullary carcinomas more common in BRCA 1

35
Q

What histology ovarian cancer is NOT assoc. w. BRCA?

A

mucinous histology

36
Q

what else can cause loss of expression of MLH1 coupled with PMS2

A

not just germline mutation; but MLH1 methylation or somatic mutation- V600E BRAF

37
Q

Is BRCA 1 or 2 worse for females/males?

A

1 worse for females w. higher cancer rates and more aggressive; 2 worse for males

38
Q

receptor status of BRCA 1/2 breast cancers

A

1 = triple -ve; 2 = ER/PR +ve

39
Q

BRCA test if:

A

any BRCA cancer and <40yrs, triple -ve breast, male breast, Jewish, 2 primary breast Cas, 2 BRCA assoc. cancers

40
Q

BRCA mgmt

A

bilateral proph mastect or RRSO; or annual MRI +/- USS from 30 y.o; bilateral SPO by 35 but no ovarian screening

41
Q

Most important prognostic factor for early breast ca

A

axillary LN involvement

42
Q

When to perform axillary dissection? I’m breast ca

A

> 2 sentinel nodes

43
Q

Who receives adjuvant rx in early breast ca?

A

high risk = nodes, HR -ve, size

44
Q

Adjuvant chemo regime for breast cancer

A

anthracycline + taxane

45
Q

Tamoxifen side effects

A

VTE, endometrial cancer, hot flushes

46
Q

Who gets CDK4/6 inhibitors?

A

ER +ve, 1st line metastatic

47
Q

Are SERMs agonists or antagonists?

A

depends on the organ, diff tissues have diff co-stimulators with which it combines -> Breast = ER antagonist, endometrial/bone = ER partial agonist

48
Q

Fulvestrant MOA

A

selective oestrogen receptor down regulator

49
Q

Fulvestrant place

A

superior to AI in pts. w. met HR+ve BC WITHOUT visceral mets i.e. bony disease

50
Q

Example CKD 4/6 inhibitor

A

Palbociclib, Ribociclib

51
Q

Lapatinib MOA

A

Dual EGFR/HER2 TKI

52
Q

In bowel ca screening, FIT binds to

A

Human Globin

53
Q

Does FIT detect digested blood?

54
Q

HNPCC screening guidelines

A

1-2 yearly scopes from age 25 OR 5 yrs before youngest relative

55
Q

GIST appearance

A

spindle shaped cells

56
Q

molecular finding of GIST

A

c-kit / CD117 positive

57
Q

Rx of GIST

A

TKIs, escalate dose if progressing

58
Q

HCC Milan criteria

A

single lesion <5cm, 3x <3xm each

59
Q

which testicular cancer does better/ responds better to rx?

A

seminomatous better than non sem

60
Q

Which testicular cancer type produces what tumour marker?

A

seminomatous- HCG; Non- AFP and HCG

61
Q

seminomatous/Nonseminom rx

A

carboplatin/BEP. almost always resect.

62
Q

long-term cisplatin risks in men

A

metabolic syndrome, hearing loss, hypogonadism

63
Q

EGFR TKIs inhibitors

A

Ertlotinib, Gefitinib, afatanib

64
Q

EGFR TKI against T790M

A

Osimertinib

65
Q

ALK TKI

A

Alectinib, Crizotinib

66
Q

ROS1 TKI

A

Crizotinib

67
Q

TKI side effects

A

acne, diarrhoea, nausea, ILD

68
Q

Which TKIs cross the BBB?

A

Osimertinib, alectinib

69
Q

IHC of small cell/ SqCC/ Adeno

A

chromogranin + synaptophysin/ p40/ TTF1

70
Q

DNA repair of single strand breaks via

A

base excision repair

71
Q

DNA repair of double strand breaks via

A

homologous recombination or non-homologous end joining

72
Q

Cetuximab doesn’t work if

A

KRAS mutant

73
Q

MEN2 is due to which gene

A

RET gain of function

74
Q

What is the usual mechanism of de novo AD conditions?

A

gonadal mosaicism

75
Q

What risk do siblings have in de novo AD conditions?

76
Q

Uveal melanoma most commonly metastasises to…

BPT Written (21 decks)

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