Oncology Flashcards
What is CA 19-9 a tumour marker for
Pancreatic cancer
What is CA 15-3 a tumour marker for
Breast cancer
What tumour marker is useful for teratomas
Alpha-feto protein
Which cancers is S-100 a tumour marker for
Melanoma, schwannoma
What is the screening programme for colorectal cancer
FIT testing every 2 years between 60-74 years old, abnormal result will be offered colonoscopy
After positive FIT test, how many patients will have colorectal ca on colonoscopy
10%
What are the risk factors for bladder cancer
Smoking, aniline dyes/aromatic amines (rubber manufacturing), schistosomiasis, cyclophosphamide
Which blood group has increased risk of gastric cancer
Blood group A
What does gastric adenocarcinoma show on biopsy
Signet ring cells
What conditions are thymomas associated with
MG, red cell aplasia, dermatomyositis, SLE, SIADH
Which malignancy is most commonly associated with SVC obstruction
Lung cancer (SCLC)
What is the immediate management of SVC obstruction
IV dexamethasone and LMWH
What is the MOA of cyclophosphamide
Alkylating agent - causes cross-linking in DNA
What are the side effects of cyclophosphamide
Haemorrhagic cystitis, transitional cell carcinoma, myelosuppression
What is the main side effect of doxorubicin
Dilated cardiomyopathy
What is the MOA of 5-FU (fluorouracil)
Pyramidine analogue - induces cell cycle arrest during S phase
What is the MOA of vincristine
Mitosis inhibitor (M stage of cell cycle)
What is the MOA of docetaxel
Taxane - prevents microtubule dissasembly
What is the main side effect of vincristine
Peripheral neuropathy
What is the MOA of cisplatin
Causes cross-linking in DNA
What are the main side effects of cisplatin
Ototoxicity, peripheral neuropathy, hypomagnesaemia
What is the MOA of hydroxycarbamide
Inhibits ribonucleotide reductase- decreasing DNA synthesis
What disorder is characterised by lethargy and clumsiness around 11-21 or 31-35 days after cranial radiotherapy
Post cranial irradiation somnolesnce syndrome
Which condition occurs within 2 weeks of a BM transplant and shows centrilobular necrosis on liver biopsy
Hepatic veno-occulsive disease (sinusoidal obstruction syndrome)
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