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Medicine > Oncology > Flashcards

Oncology Flashcards

1
Q

What type of agent is cyclophosphamide?

A

Cyclophosphamide is an akylating agent. It causes cross linking in DNA.

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2
Q

What are the main side effects from cyclophosphamide?

A

cyclophosphamide causes heamorrhagic cystitis, myelosuppression, and transitional cell carcinoma.

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3
Q

What are the two main cytotoxic antibiotics that are use in chemotherapy?

A

The two main cytotoxic antibiotics that are used in chemotherapy include bleomycin and doxorubicin.

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4
Q

What is the difference between the actions of bleomycin and doxorubicin? What are their main side effects?

A

Bleomycin degrades pre-formed DNA. Doxorubicin stabilises DNA topoisomerase preventing the synthesis of DNA and RNA. Bleomycin causes fibrosis of the lungs, Doxorubicin causes cardiomyopathy.

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5
Q

What are the main antimetabolite drugs that are used for chemotherapy?

A

Methotrexate (MTX), Flourouracil (5FU), Cytarabine, 6-mercaptopurine.

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6
Q

How does methotrexate work? What is its main side effects?

A

Methotrexate inhibits dihydrofolate reductase and dithymidylate synthesis. Methotrexate causes myelosupression, mucositis, liver fibrosis, and lung fibrosis.

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7
Q

Which anticancer drug is most likely to cause ototoxicity?

A

Most likely to be caused by cisplatin. Cisplatin is a cytotoxic drug that causes cross linking of DNA. As well as ototoxicity it causes peripheral neuropathy and hypomagnesia.

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8
Q

Which anti-cancer drugs act on microtubules?

A

Vincristine/Vinblastine and docetacel act upon the microtubules.

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9
Q

What are the four different categories of tumour markers?

A

Tumour markers can be divided into four braod categories:

  • Antibodies against tumour proteins (CA19.9, CA125, CA15.3)
  • Tumour Antigens (PSA, Alpha fetaprotein, CEA, S100, bombesin)
  • Enzymes (Alk phosphatase, neurone specific enolase)
  • Hormones (calcitonin, ADH)
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10
Q

What are the tumour markers for breast cancer?

A

CA15.3

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11
Q

What is the tumour marker for pancreatic cancer?

A

CA 19.9

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12
Q

What is the tumour marker for ovarian cancer?

A

CA125

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13
Q

What is the tumour marker for prostate cancer?

A

PSA (prostate specific antigen)

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14
Q

What is the tumour marker for colorectal cancer?

A

CEA - carcinoembryonic antigen

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15
Q

What is the tumour marker for hepatocellular carcinoma?

A

Alpha feta protein is the tumour marker for hepatocellular carcinoma. It is also a tumour marker for teratomas.

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16
Q

What is the tumour marker for melanomas and schwanomas?

A

The tumour marker for melanomas and schwanomas is S100

17
Q

What is bombesin?

A

Bombesin is a tumour marker for small cell lung cancer, gastric cancer, and neuroblastoma.

18
Q

What are the clinical features of ovarian cancer?

A 
Usually presents around 60 years of age. Clinical symptoms are notoriously vague. They include:
-Abdominal distension and bloating
-Abdominal and pelvic pain
-Urinary symptoms eg. urgency
-Early satiety
-Diarrhoea
-FHx of BRCA1 and BRCA2 mutations.
Dignosis is usually made by a diagnostic laparotomy.
19
Q

What are the paraneoplastic features associated with squamous cell carcinoma of the lung?

A

Squamous cell carcinoma of the lung is associated with PTH related peptide secretion, clubbing, and HPOA.

20
Q

What are the paraneoplastic features associated with small cell lung cancer?

A

Excess ADH (leading to hyponatreamia), Cushing’s syndrome (excess ACTH), and Lambert-Eaton syndrome. NB: small cell luncer is usually centrally located and is associated with a bad prognosis.

21
Q

What are the most common types of tumours that mestatasize to bone?

A

Prostate> Breast> Lung>

22
Q

What are the bones that are most likely to have bony mets?

A

spine>pelvis>ribs>skull>long bones

23
Q

What is superior vena cava syndrome?

A

SVC syndrome is an oncological emergency most commonly associated with lung cancers. The most common symptom is dyspnoea. Other symptoms include swelling of the neck, face and arms (conjunctiva and periorbital oedema may be seen), headache, visual disturbances, and pulseless JVP distension. May also be caused by goitre, mediastinal fibrosis, Aortic aneurysm, SVC thrombosis.

24
Q

What type of oesophageal cancer is associated with GORD? What is the other type of commonly occuring cancer?

A

Adenocarcinoma associated with GORD.

Squamous cell carcinoma is still the most commonly occuring in third world countries.

25
Q

What is tamoxifen?

A

Tamoxifen is a selective estrogen receptor modulator (SERM) which acts as an oestrogen receptor antagonist and partial agonist. It is used in the management of oestrogen receptor positive breast cancer
Adverse effects
•menstrual disturbance: vaginal bleeding, amenorrhoea
•hot flushes
•venous thromboembolism
•endometrial cancer
Tamoxifen is typically used for 5 years following removal of the tumour.
Raloxifene is a pure oestrogen receptor antagonist, and carries a lower risk of endometrial cancer

26
Q

What are the common types of testicular cancer?

A

Testicular cancer is the most common malignancy in men aged 20-30 years. Around 95% of cases of testicular cancer are germ-cell tumours. Germ cell tumours may essentially be divided into:
•seminomas
•teratomas
Seminomas peak incidence is 35 years, they have a better prognosis that teratomas whose peak incidence is at 25 years.
Other type of germ cell tumours include yolk sac tumours. Non-germ cell tumours include Leydig cell tumours and sarcomas.

27
Q

What are the presenting features of Testicular cancer?

A

Features
•a painless lump is the most common presenting symptom
•pain may also be present in a minority of men
•other possible features include hydrocele, gynaecomastia

28
Q

What are the risk factors for testicular cancer?

A
  • cryptorchidism
  • infertility
  • family history
  • Klinefelter’s syndrome
  • mumps orchitis

Medicine (16 decks)

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