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AMK > Oncology > Flashcards

Oncology Flashcards

1
Q

Investigations pancreatic cancer

A

U/S shows ‘double duct’ dilatation

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2
Q

Sx pancreatic cancer

A

Painless jaundice
Pale stools
Dark urine
Systemic sc

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3
Q

Marker for pancreatic cancer

A

Ca19-9

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4
Q

Genetic predisposition to pancreatic cancer

A

BRCA2 and KRAS

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5
Q

Cause of pancreatic cancer

A

Decreased stercobilin

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6
Q

Common type of cancer - pancreatic cancer

A

Adenocarcinoma - pancreatic head

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7
Q

Management pancreatic cancer

A

Whipple’s and chemo

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8
Q

Genetic predisposition bowel cancer

A

APC, KRAS, TP53

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9
Q

Investigations for diagnosing bowel cancer

A

Colonoscopy

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10
Q

Treatment bowel cancer

A

Surgery

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11
Q

Colon cancer metastases

A

Liver

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12
Q

Rectum cancer metastases

A

Lung

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13
Q

Most common type and position of bowel cancer

A

Adenocarcinoma - l colon

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14
Q

FH bowel cancer

A

FAP
Lynch syndrome - autosomal dominant condition causing aggressive tumours in proximal colon and endometrium

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15
Q

Sx right sided bowel cancer

A

Iron def anaemia
Weight loss
Melena
Diarrhoea

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16
Q

Sx left sided bowel cancer

A

Abnormal stools
Colicky pain
tenesmus

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17
Q

Tumour marker colon cancer

A

CEA

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18
Q

What is non-hodgkin’s lymphoma?

A

Lymphoma without Reed-Sternberg cells = better prognosis

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19
Q

Cause of MALT lymphoma

A

H.pylori

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20
Q

Most common non-hogkin’s lymphoma

A

Diffuse + large cell

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21
Q

Burkitt’s lymphoma diagnosis

A

‘Starry sky’ appearance on biopsy
EB virus association

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22
Q

Ix non-hodgkin’s lymphoma

A

Biopsy, FBC, Ig tests, HIV/hepatitis

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23
Q

Symptoms non-hodgkin’s lymphoma

A

Same as HL + anaemias

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24
Q

Treatment NHL

A

RCHOP
Rituximab
Cychophosphamide
Hydroxydaunorubicin
Oncovin
Prednisolone

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25
Q

S/e cyclophosphamide

A

Bleeding bladder - give mesna

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26
Q

Risk factor gastric cancer

A

H.pylori

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27
Q

Paraneoplastic syndrome with gastric cancer

A

Acanthosis nigricans

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28
Q

Symptoms gastric cancer

A

Abdo pain + dyspepsia
Weight loss and early satiety
N and V
Virchow’s node

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29
Q

Tx gastric cancer

A

Roux-en-Y bypass
Gastrectomy

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30
Q

Most common type of gastric cancer

A

Adenocarcinoma

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31
Q

Diagnosing gastric cancer

A

Endoscopy and biopsy (gives signet ring cells)
HER2 testing

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32
Q

What is reactive lymphadenopathy?

A

Painful, enlarged LNs lasting less than 6 weeks

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33
Q

Treatment oesophageal cancer

A

Surgery + chemo/radio therapy

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34
Q

Risk factors for squamous cell oesophageal cancer

A

processed food and afro-caribbean heritage

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35
Q

Where are squamous cell oesophageal cancers located?

A

Upper 2/3 oesophagus

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36
Q

Risk factors for adenocarcinoma oesophageal cancers

A

Smoking and GORD
Barrett’s oesophagus

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37
Q

Where are adenocarcinoma oesophageal cancers located?

A

Lower 1/3 of oesophagus

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38
Q

Early symptoms of oesophageal cancer

A

Asymptomatic

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39
Q

Diagnosing oesophageal cancer

A

Oeosphagastroduodenoscopy + biopsy
Apple core sign with barium (structure)

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40
Q

Late sx of oesophageal cancer

A

Weight loss, anaemia, dysphagia, coughing, haematemesis

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41
Q

What is Hodgkin’s lymphoma?

A

B cell malignancy affecting younger people

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42
Q

Diagnosing HL

A

Reed-Sternberg cells on biopsy - CD15 and CD30 +ve

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43
Q

Type of HL with best prognosis

A

Lymphocyte dominant

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44
Q

Sx HL

A

Enlarged cervical LNs
Hepatosplenomegaly
B sx = night sweats and fever

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45
Q

Treatment HL

A

Adriamycin
Bleomycin
Vinblastin
Darcarbazine

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46
Q

Triple assessment breast cancer

A

Examination
Aspiration
Imaging

47
Q

Main type of breast cancer

A

Adenocarcinoma

48
Q

Ductal breast cancer

A

From epithelial lining of ducts - most common

49
Q

How often are women screened in the UK for breast cancer?

A

3 years

50
Q

Lobular breast cancer

A

From epithelial lining of terminal ducts

51
Q

Risk factors breast cancer

A

Oestrogen
HRT
the Pill
BRCA 1/2
HER2

52
Q

Symptoms breast cancer

A

Painless breast mass
+/-:
- Discharge
- Nipple changes
- Paget’s nipple

53
Q

Cancer marker breast cancer

A

CA-153

54
Q

Surgical treatment for breast cancer

A

Excision if tumour small, LNs are negative and it is less than stage 2
Otherwise mastectomy

55
Q

Treatment for breast cancer if HER2 +ve

A

Herceptin

56
Q

Treatment for pre-menopausal women with breast cancer

A

Tanoxifen

57
Q

Treatment for post-menopausal women with breast cancer

A

Anastrozole

58
Q

Sx lung cancer

A

Cough
Haemoptysis
Dyspnoea
Wight loss and anorexia
Wheeze and clubbing

59
Q

Treatment for lung cancer

A

Lobectomy +/- chemo

60
Q

Ix lung cancer

A

CXR and biopsy

61
Q

Where are small cell tumours located?

A

Centrally

62
Q

Paraneoplastic syndromes with small cell lung cancer

A

Lambert-Eaton
ADH = hyponatraemia
ACTH = cushing’s

63
Q

Two types of non-small cell lung cancer

A

Squamous and adenocarcinoma

64
Q

Most common type of lung cancer

A

Adenocarcinoma (non-small cell)

65
Q

Where are adenocarcinomas in lung?

A

peripherally

66
Q

Ix adenocarcinomas lungs

A

Mucin-producing cells

67
Q

Sx adenocarcinoma lungs

A

Common in non-smokers, sx is gynaecomastai

68
Q

Where are squamous lung cancers located?

A

Centrally

69
Q

Which type of lung cancer causes hypercalcaemia?

A

Squamous cell through increased PTH

70
Q

What is smouldering myeloma?

A

Transition from MGUS to multiple myeloma

71
Q

Treatment smouldering myeloma

A

No treatment but monitor

72
Q

Sx smouldering myeloma

A

Usually asymptomatic

73
Q

Diagnosis of smouldering myeloma

A

Monoclonal protein >30
Plasma cells >10%

74
Q

Symptoms of MGUS

A

Normally asymptomatic

75
Q

Blood results for MGUS

A

Serum protein <30
Monoclonal plasma cells <10%

76
Q

Treatment MGUS

A

None

77
Q

What is MGUS

A

Pre-malignant condition before myeloma formation

78
Q

Treatment multiple myeloma

A

Prevent infection and renal failure
Stem cell transplant

79
Q

What is multiple myeloma

A

Neoplasm of bone marrow plasma cells

80
Q

Investigations multiple myeloma

A

Monoclonal bands
Proteins (IgA or IgG) -> Bence-Jones proteins
Body MRI showing rain drop skull

81
Q

Symptoms multiple myeloma

A

Bone disease + pain
Lethargy
Hypercalcaemia
Renal failure
Anaemia
(hyperCalcaemia, Renal failure, Anaemia, Bone pain)
= CRAB

82
Q

Paraneoplastic syndrome with mesothelioma

A

Pulmonary osteoarthropathy

83
Q

Mesothelioma cause

A

Asbestos

84
Q

What is mesothelioma?

A

Cancer of lung pleura

85
Q

Ix mesothelioma

A

CXR/CT shows plaques and thick pleura

86
Q

Sx mesothelioma

A

Dyspnoea, chest pain, clubbing

87
Q

What is Waldenstrom’s macroglobulinaemia ?

A

Proliferation of immature B cells = lymphoma

88
Q

Sx Waldenstrom’s macroglobulinaemia

A

Tired and anorexic
Anaemia
Lymphadenopathy
Organosmegaly

89
Q

Ix Waldenstrom’s macroglobulinaemia

A

IgM

90
Q

Treatment Waldenstrom’s macroglobulinaemia

A

Watch and wait -> chemo

91
Q

What is acute myeloid leukaemia

A

Cancer of WBCs

92
Q

Ix acute myeloid leukaemia

A

Decreased Hb and platelets
AUER rods on film

93
Q

Sx acute myeloid leukaemia

A

Anaemia
Neutropaenia
Thrombocytopenia
Splenomegaly

94
Q

Treatment acute lymphoid leukaemia

A

Chemo and BM transplant

95
Q

Age category acute lymphoid leukaemia

A

Children

96
Q

Key sx acute lymphoid leukaemia

A

Lymphadenopathy

97
Q

Sx acute lymphoid leukaemia

A

Bone/joint pain
No auer rods
Lymphoblast sin blood
Hepatosplenomegalty

98
Q

genetic basis of chronic myeloid leukaemia

A

Mutation of Philadelphia chromosome 9 and 22 -> excess tyrosine kinase
BCR-ABL gene

99
Q

Sx chronic myeloid leukaemia

A

Splenomegaly
Anaemia
Weight loss
Decreased ALP

100
Q

Treatment chronic myeloid leukaemia

A

Imatinib = tyrosine kinase inhibitor

101
Q

Chronic lymphoid leukaemia sx

A

Lymphadenopathy, splenomegaly, fever, SMUDGE cells

102
Q

Treatment chronic lymphoid leukaemia

A

Rituximab and prednisolone

103
Q

Chronic lymphoid leukaemia blood results

A

Increased WBCs

104
Q

What type of lymphoma is indicated by translocation of heavy-chain immunoglobulin and cyclin D1?

A

t(11:14) = mantle cell lymphoma

105
Q

What is mantle cell lymphoma?

A

NHL characterised by neoplastic proliferation of mature B cells - sx include B sx

106
Q

Which type of HL has the best prognosis?

A

Classical lymphocyte predominant

107
Q

Paraesthesia in glove and stocking distribution is caused by

A

vincristine

108
Q

Nivolumab MOA

A

increase body T cell population

109
Q

what is neoplastic spinal cord compression?

A

oncological emergency caused by vertebral metastases from lung/breast/prostate CA

110
Q

sx neoplastic spinal cord compression

A

back pain, lower limb weakness

111
Q

mx neoplastic spinal cord compression

A

immediate dexamethasone
urgent MRI

112
Q

neutropenic sepsis

A

complication of chemo - normally 7-14 days (NADIR CURVE)

113
Q

sx neutropenic sepsis

A

neutropenia <0.5, fever, sepsis sx

114
Q

mx neutropenic sepsis

A

IV tazocin (piperacillin and tazobactam) immediately, don’t wait for ix results

AMK (33 decks)

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