Oncology

Question 1

What is the philadelphia chromosome translocation?

What is it associated with?

What condition does it predict poor outcomes for?

Answer 1

t(9;22)

CML

ALL

Question 2

Cisplatin mechanism

Answer 2

Prevents cross linking of DNA (remember like hair plaits)

Question 3

First line treatment for CML?

Answer 3

Imatinib (tyrosine kinase inhibitor)

Question 4

How to prevent haemorrhagic cystitis with cyclophosphamide?

Answer 4

MESNA (detoxifies acrolein, a urotoxic metabolite of cyclophosphamide that accumulates in the bladder)

Question 5

Give an example of an aromatase inhibitor + when used?

Answer 5

Anastrazole or Letrozole - iused in Eostrogen receptor +ve breast cancer (if unable to use tamoxifen CI’ed)

OSTEOPOROSIS
hot flushes, insomnia, myalgia

Question 6

What are the complications of tamoxifen + aromatase inhibotprs

Answer 6

tamoxifen: VTE + endometrial cancer

aromatase inhibitors: OP

Question 7

What are some side effects of tamoxifen?

Answer 7

Abnromal vaginal bleeding, amenorrhoea, hot flushes

Question 8

Increased and decreased cancer risks in using COCP?

Answer 8

Increased: cervical + breast

Decreased: ovarian + endometrial

Question 9

What CTx drug is associated with hypomagnasaemia?

Answer 9

Cisplatin

Question 10

What vitamin reduces risk of colon cancer?

Answer 10

Vitamin D

Question 11

Treatment of multiple myeloma 1st line? If contraindicated or not tolerated what do you use?

Answer 11

THALIDOMIDE

Bortezomib

Question 12

poor prognosis factors in ALL

Answer 12

Older
Male
WCC >50

(In children: pholaelphia chromosome is poor prognosis – > however in Ph +ve CML it is a better prognosis)

Question 13

What is the most useful marker of prognosis in myeloma?

Answer 13

b2-microglobulin