Oncology Flashcards
1
Q
Investigations pancreatic cancer
A
U/S shows ‘double duct’ dilatation
2
Q
Sx pancreatic cancer
A
Painless jaundice
Pale stools
Dark urine
Systemic sc
3
Q
Marker for pancreatic cancer
A
Ca19-9
4
Q
Genetic predisposition to pancreatic cancer
A
BRCA2 and KRAS
5
Q
Cause of pancreatic cancer
A
Decreased stercobilin
6
Q
Common type of cancer - pancreatic cancer
A
Adenocarcinoma - pancreatic head
7
Q
Management pancreatic cancer
A
Whipple’s and chemo
8
Q
Genetic predisposition bowel cancer
A
APC, KRAS, TP53
9
Q
Investigations for diagnosing bowel cancer
A
Colonoscopy
10
Q
Treatment bowel cancer
A
Surgery
11
Q
Colon cancer metastases
A
Liver
12
Q
Rectum cancer metastases
A
Lung
13
Q
Most common type and position of bowel cancer
A
Adenocarcinoma - l colon
14
Q
FH bowel cancer
A
FAP
Lynch syndrome - autosomal dominant condition causing aggressive tumours in proximal colon and endometrium
15
Q
Sx right sided bowel cancer
A
Iron def anaemia
Weight loss
Melena
Diarrhoea
16
Q
Sx left sided bowel cancer
A
Abnormal stools
Colicky pain
tenesmus
17
Q
Tumour marker colon cancer
A
CEA
18
Q
What is non-hodgkin’s lymphoma?
A
Lymphoma without Reed-Sternberg cells = better prognosis
19
Q
Cause of MALT lymphoma
A
H.pylori
20
Q
Most common non-hogkin’s lymphoma
A
Diffuse + large cell
21
Q
Burkitt’s lymphoma diagnosis
A
‘Starry sky’ appearance on biopsy
EB virus association
22
Q
Ix non-hodgkin’s lymphoma
A
Biopsy, FBC, Ig tests, HIV/hepatitis
23
Q
Symptoms non-hodgkin’s lymphoma
A
Same as HL + anaemias
24
Q
Treatment NHL
A
RCHOP
Rituximab
Cychophosphamide
Hydroxydaunorubicin
Oncovin
Prednisolone
25
S/e cyclophosphamide
Bleeding bladder - give mesna
26
Risk factor gastric cancer
H.pylori
27
Paraneoplastic syndrome with gastric cancer
Acanthosis nigricans
28
Symptoms gastric cancer
Abdo pain + dyspepsia
Weight loss and early satiety
N and V
Virchow's node
29
Tx gastric cancer
Roux-en-Y bypass
Gastrectomy
30
Most common type of gastric cancer
Adenocarcinoma
31
Diagnosing gastric cancer
Endoscopy and biopsy (gives signet ring cells)
HER2 testing
32
What is reactive lymphadenopathy?
Painful, enlarged LNs lasting less than 6 weeks
33
Treatment oesophageal cancer
Surgery + chemo/radio therapy
34
Risk factors for squamous cell oesophageal cancer
processed food and afro-caribbean heritage
35
Where are squamous cell oesophageal cancers located?
Upper 2/3 oesophagus
36
Risk factors for adenocarcinoma oesophageal cancers
Smoking and GORD
Barrett's oesophagus
37
Where are adenocarcinoma oesophageal cancers located?
Lower 1/3 of oesophagus
38
Early symptoms of oesophageal cancer
Asymptomatic
39
Diagnosing oesophageal cancer
Oeosphagastroduodenoscopy + biopsy
Apple core sign with barium (structure)
40
Late sx of oesophageal cancer
Weight loss, anaemia, dysphagia, coughing, haematemesis
41
What is Hodgkin's lymphoma?
B cell malignancy affecting younger people
42
Diagnosing HL
Reed-Sternberg cells on biopsy - CD15 and CD30 +ve
43
Type of HL with best prognosis
Lymphocyte dominant
44
Sx HL
Enlarged cervical LNs
Hepatosplenomegaly
B sx = night sweats and fever
45
Treatment HL
Adriamycin
Bleomycin
Vinblastin
Darcarbazine
46
Triple assessment breast cancer
Examination
Aspiration
Imaging
47
Main type of breast cancer
Adenocarcinoma
48
Ductal breast cancer
From epithelial lining of ducts - most common
49
How often are women screened in the UK for breast cancer?
3 years
50
Lobular breast cancer
From epithelial lining of terminal ducts
51
Risk factors breast cancer
Oestrogen
HRT
the Pill
BRCA 1/2
HER2
52
Symptoms breast cancer
Painless breast mass
+/-:
- Discharge
- Nipple changes
- Paget's nipple
53
Cancer marker breast cancer
CA-153
54
Surgical treatment for breast cancer
Excision if tumour small, LNs are negative and it is less than stage 2
Otherwise mastectomy
55
Treatment for breast cancer if HER2 +ve
Herceptin
56
Treatment for pre-menopausal women with breast cancer
Tanoxifen
57
Treatment for post-menopausal women with breast cancer
Anastrozole
58
Sx lung cancer
Cough
Haemoptysis
Dyspnoea
Wight loss and anorexia
Wheeze and clubbing
59
Treatment for lung cancer
Lobectomy +/- chemo
60
Ix lung cancer
CXR and biopsy
61
Where are small cell tumours located?
Centrally
62
Paraneoplastic syndromes with small cell lung cancer
Lambert-Eaton
ADH = hyponatraemia
ACTH = cushing's
63
Two types of non-small cell lung cancer
Squamous and adenocarcinoma
64
Most common type of lung cancer
Adenocarcinoma (non-small cell)
65
Where are adenocarcinomas in lung?
peripherally
66
Ix adenocarcinomas lungs
Mucin-producing cells
67
Sx adenocarcinoma lungs
Common in non-smokers, sx is gynaecomastai
68
Where are squamous lung cancers located?
Centrally
69
Which type of lung cancer causes hypercalcaemia?
Squamous cell through increased PTH
70
What is smouldering myeloma?
Transition from MGUS to multiple myeloma
71
Treatment smouldering myeloma
No treatment but monitor
72
Sx smouldering myeloma
Usually asymptomatic
73
Diagnosis of smouldering myeloma
Monoclonal protein >30
Plasma cells >10%
74
Symptoms of MGUS
Normally asymptomatic
75
Blood results for MGUS
Serum protein <30
Monoclonal plasma cells <10%
76
Treatment MGUS
None
77
What is MGUS
Pre-malignant condition before myeloma formation
78
Treatment multiple myeloma
Prevent infection and renal failure
Stem cell transplant
79
What is multiple myeloma
Neoplasm of bone marrow plasma cells
80
Investigations multiple myeloma
Monoclonal bands
Proteins (IgA or IgG) -> Bence-Jones proteins
Body MRI showing rain drop skull
81
Symptoms multiple myeloma
Bone disease + pain
Lethargy
Hypercalcaemia
Renal failure
Anaemia
(hyperCalcaemia, Renal failure, Anaemia, Bone pain)
= CRAB
82
Paraneoplastic syndrome with mesothelioma
Pulmonary osteoarthropathy
83
Mesothelioma cause
Asbestos
84
What is mesothelioma?
Cancer of lung pleura
85
Ix mesothelioma
CXR/CT shows plaques and thick pleura
86
Sx mesothelioma
Dyspnoea, chest pain, clubbing
87
What is Waldenstrom's macroglobulinaemia ?
Proliferation of immature B cells = lymphoma
88
Sx Waldenstrom's macroglobulinaemia
Tired and anorexic
Anaemia
Lymphadenopathy
Organosmegaly
89
Ix Waldenstrom's macroglobulinaemia
IgM
90
Treatment Waldenstrom's macroglobulinaemia
Watch and wait -> chemo
91
What is acute myeloid leukaemia
Cancer of WBCs
92
Ix acute myeloid leukaemia
Decreased Hb and platelets
AUER rods on film
93
Sx acute myeloid leukaemia
Anaemia
Neutropaenia
Thrombocytopenia
Splenomegaly
94
Treatment acute lymphoid leukaemia
Chemo and BM transplant
95
Age category acute lymphoid leukaemia
Children
96
Key sx acute lymphoid leukaemia
Lymphadenopathy
97
Sx acute lymphoid leukaemia
Bone/joint pain
No auer rods
Lymphoblast sin blood
Hepatosplenomegalty
98
genetic basis of chronic myeloid leukaemia
Mutation of Philadelphia chromosome 9 and 22 -> excess tyrosine kinase
BCR-ABL gene
99
Sx chronic myeloid leukaemia
Splenomegaly
Anaemia
Weight loss
Decreased ALP
100
Treatment chronic myeloid leukaemia
Imatinib = tyrosine kinase inhibitor
101
Chronic lymphoid leukaemia sx
Lymphadenopathy, splenomegaly, fever, SMUDGE cells
102
Treatment chronic lymphoid leukaemia
Rituximab and prednisolone
103
Chronic lymphoid leukaemia blood results
Increased WBCs
104
What type of lymphoma is indicated by translocation of heavy-chain immunoglobulin and cyclin D1?
t(11:14) = mantle cell lymphoma
105
What is mantle cell lymphoma?
NHL characterised by neoplastic proliferation of mature B cells - sx include B sx
106
Which type of HL has the best prognosis?
Classical lymphocyte predominant
107
Paraesthesia in glove and stocking distribution is caused by
vincristine
108
Nivolumab MOA
increase body T cell population
109
what is neoplastic spinal cord compression?
oncological emergency caused by vertebral metastases from lung/breast/prostate CA
110
sx neoplastic spinal cord compression
back pain, lower limb weakness
111
mx neoplastic spinal cord compression
immediate dexamethasone
urgent MRI
112
neutropenic sepsis
complication of chemo - normally 7-14 days (NADIR CURVE)
113
sx neutropenic sepsis
neutropenia <0.5, fever, sepsis sx
114
mx neutropenic sepsis
IV tazocin (piperacillin and tazobactam) immediately, don't wait for ix results
