Oncology

Question 1

Carcinoma means a cancer of what cell type?

Answer 1

Epithelial

Question 2

Impaired fasting glucose levels and impaired glucose tolerance levels are what range?

Answer 2

fasting glu: 6.1-6.9 (IFG)
OGTT2h: 7.8-11.0 (IGT)

Question 3

What cancers causes SVCO?

Answer 3

Lung cancer and Non-Hodgkins lymphoma

Question 4

What abx is given for neutropenic sepsis?

Answer 4

Pipperacillin + Tazobactam = IV Tazocin

Question 5

MEN Type 1 includes what cancers?

Answer 5

Parathyroid, pituitary and pancreatic.

Question 6

1st line to treat breathlessness in end of life care?

Answer 6

Subcutaneous morphine sulphate

Question 7

A sarcoma is derived from what cell of origin?

Answer 7

Mesenchymal

Question 8

CDX2 and CK7 = an adenocarcinoma from where?

Answer 8

Upper GI

Question 9

CDX2 and CK20 = an adenocarcinoma from where?

Answer 9

Lower GI

Question 10

PAX8 and CK7 = an adenocarcinoma from where?

Answer 10

Ovary (non-mucinous)

Question 11

Define neutropenic sepsis:

Answer 11

It may be defined as a neutrophil count of < 0.5 * 10^9. in a patient who is having anticancer treatment and has one of the following:

• A temperature higher than 38ºC or
• Other signs or symptoms consistent with clinically significant sepsis

Question 12

Most common pathogen that causes neutropenic sepsis:

Answer 12

Staphylococcus epidermidis

This is probably due to the use of indwelling lines in patients with cancer.

Question 13

What prophylaxis should be given for neutropenia?

Answer 13

Fluoroquinolone

Question 14

1st line abx for neutropenic sepsis:

Answer 14

Piperacillin with tazobactam (Tazocin)immediately

Question 15

2nd line for neutropenic sepsis if patients are still unwell in 48hrs?

Answer 15

If patients are still febrile and unwell after 48 hours an alternative antibiotic such as meropenem is often prescribed +/- vancomycin

Question 16

Features of SVCO:

Answer 16

• Dyspnoea is the most common symptom
• Swelling of the face, neck and arms - conjunctival and periorbital oedema may be seen
• Headache: often worse in the mornings
• Visual disturbance
• Pulseless jugular venous distension

Question 17

Management of SVCO:

Answer 17

A-E. Then SOS.

Sit up!

Oxygen!

Steroids (dexamethasone).

If a thrombus then LMWH.

Question 18

Definitive treatment for SVCO:

Answer 18

• Vascular stenting
• Chemotherapy, radiotherapy (depending on primary tumour).

Question 19

BRCA2 increases risk of what cancers in men?

Answer 19

Prostate and breast

Question 20

Raindrop skull and lytic lesions on X-ray =

Answer 20

Myeloma

Question 21

Raindrop skull and lytic lesions on X-ray =

Answer 21

Myeloma