Oncology Flashcards by Adam Darnley

What is CA 19-9 a tumour marker for

Pancreatic cancer

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What is CA 15-3 a tumour marker for

Breast cancer

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What tumour marker is useful for teratomas

Alpha-feto protein

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Which cancers is S-100 a tumour marker for

Melanoma, schwannoma

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What is the screening programme for colorectal cancer

FIT testing every 2 years between 60-74 years old, abnormal result will be offered colonoscopy

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After positive FIT test, how many patients will have colorectal ca on colonoscopy

10%

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What are the risk factors for bladder cancer

Smoking, aniline dyes/aromatic amines (rubber manufacturing), schistosomiasis, cyclophosphamide

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Which blood group has increased risk of gastric cancer

Blood group A

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What does gastric adenocarcinoma show on biopsy

Signet ring cells

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What conditions are thymomas associated with

MG, red cell aplasia, dermatomyositis, SLE, SIADH

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Which malignancy is most commonly associated with SVC obstruction

Lung cancer (SCLC)

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What is the immediate management of SVC obstruction

IV dexamethasone and LMWH

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What is the MOA of cyclophosphamide

Alkylating agent - causes cross-linking in DNA

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What are the side effects of cyclophosphamide

Haemorrhagic cystitis, transitional cell carcinoma, myelosuppression

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What is the main side effect of doxorubicin

Dilated cardiomyopathy

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What is the MOA of 5-FU (fluorouracil)

Pyramidine analogue - induces cell cycle arrest during S phase

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What is the MOA of vincristine

Mitosis inhibitor (M stage of cell cycle)

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What is the MOA of docetaxel

Taxane - prevents microtubule dissasembly

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What is the main side effect of vincristine

Peripheral neuropathy

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What is the MOA of cisplatin

Causes cross-linking in DNA

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What are the main side effects of cisplatin

Ototoxicity, peripheral neuropathy, hypomagnesaemia

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What is the MOA of hydroxycarbamide

Inhibits ribonucleotide reductase- decreasing DNA synthesis

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What disorder is characterised by lethargy and clumsiness around 11-21 or 31-35 days after cranial radiotherapy

Post cranial irradiation somnolesnce syndrome

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Which condition occurs within 2 weeks of a BM transplant and shows centrilobular necrosis on liver biopsy

Hepatic veno-occulsive disease (sinusoidal obstruction syndrome)

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What is cetuximab

EGFR antagonist - used in mCRC and head+neck ca

What is alemtuzumab

Anti-CD52 - used in CLL

Which conditions is INF-alpha useful in

HBV, HCV, kaposi’s sarcoma, metastatic renal cell cancer, PRV, CML, hairy cell leukaemia

What are the causes of gingival hyperplasia

Phenytoin, cyclosporine, CCBs (nifedipine), AML

What is the most common malignancy in men aged 15-35 years old

Testicular seminoma (germ cell tumour)

What is the investigation of choice for testicular seminoma

Scrotal USS - hypoechoic mass with areas of calcifications

What is the most specific tumour marker for testicular seminomas

Beta-HCG

What are poor prognostic factors for Ewing’s sarcoma

Male, >12 years, raised LDH, anaemia

What is the MOA of letrozole

Aromatase inhibitor - reduces peripheral oestrogen synthesis

What is the MOA of tamoxifen

Selective oestrogen receptor antagonist

What investigation should be performed when starting letrozole

DEXA scan

What is the MOA of anthracyclines (e.g. doxorubicin)

Stabilises DNA-topoisomerase II complex - inhibits DNA and RNA synthesis

What is the MOA of bleomycin

Degrades preformed DNA

What is the MOA of 6-mercaptopurine

Decreases purine synthesis

What is the MOA of cytarabine

Pyramidine antagonist - interferes with DNA synthesis at the S-phase

What is the MOA of docetaxel

Prevents microtubule deploymerisation and disassembly

What is the MOA of vincristine

Inhibits formation of microtubules

What is the MOA of irinotecan

Inhibits topoisomerase I which prevents relaxation of supercoiled DNA

Which cytotoxic drug can cause mucositis and dermatitis

5-Fluorouracil

Which antiemetic blocks the neurokinin 1 (NK1) receptor

Aprepitant

Which chemotherapy is associated with hypomagnesaemia

Cisplatin

What cancer is at increased risk with Aflatoxin exposure (produced by aspergillus)

Liver - HCC

What cancers are at increased risk of developing with nitrosamine exposure

Oesophageal and gastric cancer

Exposure to benzene is a risk factor for which cancer

Leukaemia

What is the strongest risk factor for cervical cancer

Having multiple sexual partners which greatly increases the chance of being infected with HPV 16&18

What is the mechanism of HPV causing cervical cancer

HPV 16&18 produces oncoproteins which causes inhibition of tumour suppressor genes (p53 and RB)

Which cancers does asbestos increase risk of

Mesothelioma, bronchial carcinoma, laryngeal cancer, ovarian cancer

What is 0 on the WHO performance scale

Asymptomatic

What is 3 on the WHO performance scale

In bed >50% of the day (unable to care for self)

What is the post op treatment of glioblastoma in fit patients

Radiotherapy 60 Gy in 30 fractions with concomitant temozolomide, followed by up to 6 cycles of adjuvant temozolomide

What risk factors are associated with ovarian cancer

Early menarche, late menopause, nulliparity

How does Cowden syndrome present

Facial papules, acral keratoses, FHx of endometrial and RCC Mutation in PTEN gene Breast ca is most common malignancy

Which gene is commonly the first hit in adenoma-to-carcinoma sequence of the bowel

Somatic APC mutation

What is the most common side effect of rituximab

Flu-like symptoms - temperature, chills, aches

What is the treatment of adrenal corctical adenocarcinoma

Mitotane

Which gene mutation is responsible for familiar clusters of malignant melanoma and breast cancer

CDKN2A

What should be done if doxorubicin or danorubicin infusions extravasate

Consult with a plastic surgeon

What is the treatment of severe colitis secondary to immunotherapy-related colitis

IV methylprednisolone + urgent oncology and gastro review

What is checked prior to chemo to identify patients high risk for tumour lysis syndrome

LDH

What is first line adjuvant chemo for ovarian cancer

Paclitaxel and carboplatin

Which inherited condition causes multiple hamartomatous polyps and thyroid dysfunction

Cowden syndrome

What is the conversion of oral codeine to oral morphine

Divide by 10

What is the conversion of oral morphine to oral oxycodone

Divide by 1.5-2

What is the conversion of oral morphine to SC morphine

Divide by 2

What is the conversion of oral morphine to SC diamorphine

Divide by 3

What is the oral opiate of choice in significant renal impairment

Buprenorphine