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Progress test packs > Oncology > Flashcards

Oncology Flashcards

1
Q

Most common cancers

A 
BREAST (1 in 8 w)
LUNG (1 in 16)
CRC (1 in 17)
PROSTATE (1 in 14 m)
--
Bladder
NH Lymphoma
Melanoma
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2
Q

Most cancer deaths

A 
LUNG
CRC
BREAST
PROSTATE
--
Pancreas
Oesoph
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3
Q

4 cancer assoc w obesity

A

colon
renal
endometrial } think oestrogen
breast }

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4
Q

Infections linked to cancer

A 
HPV - cervical, head and neck
HBV - liver flukes
EBV - nasopharyngeal, burkitts,
H Pylori - gastric, MALT
Schistosomiasis - SCC of bladder (not transitional)

HIV/AIDS linked
- cervical, lymphoma, Kaposi (HHV8)

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5
Q

Occupational cancer causes

A 
asbestos - mesothelioma
dyes - bladder
UV - skin
benzene - lymphoma
radon - lung
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6
Q

TNM staging

A

T1 - small
T2 - larger
T3 - to capsule
T4 - adjacent organs

N1 - small
N2 - larger
N3 multiple

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7
Q

Histology of cancers

A

Anal - SCC

CRC, stomach - adenocarcinoma
Prostate - adenocarcinoma
Breast - adenocarcinoma

Kidney - renal cell carcinoma
Bladder - transitional cell

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8
Q

Radiotherapy SE

A

First show in adjacent tissues w fast turnover

  • skin, hair,
  • bowel
  • bone marrow

Delayed SE in organs w slower turnover
- CNS, kidney, lung

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9
Q

Spinal cord compression

A

first see

  • back pain
  • leg weakness
  • sensory distrub

—> do MRI

if above L1 - get UMN signs in legs w sensory level

if below L2 - get LMN signs w saddle anaesthesia

Mx: DEXAMETHASONE 10mg IV stat
SURGERY OR RADIOTHRAPY

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10
Q

SVC obstruction

A

sob, swelling of face, haeadache,
visual distrubance
venous engorgement

seen w SCLC, lymphoma, squamous cell

Mx:
ABC - sit upright
DEXAMETHASONE 4mg po
STENT/ BALLOON

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11
Q

4 Common Palliative Care drugs

A 
Morphine 5-10mg hourly prn
Midazolam 5mg sc
Hyoscine hydrobromide 400mcg sc
Cyclizine 50mg tds sc
- central, anticholinergic
- but can used more specific approach to nausea
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12
Q

Targeted treatment of nausea

A

stomach, partial GI obs - metoclopramide 10mg tds

total bowel obstruc

  • hyoscine butylbromide
  • cyclizine 50mg tds
  • ng tube

blood chemistry eg ca - haoperidol 1-5mg per 24hrs

raised ICP - cyclizine 50mg tds
also steroids - good adjuvant in many cause

motion sickness - antihistamine - cinnarizine, promethazine

vertigo - phenothiazines - prochlorpromazine

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13
Q

Opiate conversions

A

breakthrough = 1/6 of 24hr

increasing uncontrolled pain - by 30-50%

codeine <1/6 stength of morphine
ie 30mg cod = 4.5 mg morph

fentanyl 25mcg/hr patch = 120mg over 24hr morphine

10mg oxycodone = 20mg morphine

10mg diamorphine sc = 30mg morphine

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14
Q

Cancers linked to smoking

A

head and neck (mouth, pharyng, oesoph)
lung
bladder
pancreas

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15
Q

Cancers linked to booze

A

head and neck (mouth, pharyng, oesoph)
CRC
liver

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16
Q

Chemo side effects

Bleomycin
Doxorubicin
Cyclophosphamide

A

Bleomycin - lung fibrosis
Doxorubicin - cardiomyop

Cyclophosphamide

  • hemorrahgic cystitis
  • myelosuppression
  • TCC (kidney/bladder)
17
Q

Chemo SE

methotrexate
5 FU

vincristine

cisplatin

A

methotrexate

  • myelosup
  • mucositis
  • lung and liver fibrosis

5 FU

  • myelosup
  • mucositis
  • dermatitis

vincristine - nerves

cisplatin

  • ototoxic
  • periph nerves
  • renal toxicity
18
Q

Screening breast

A

47 - 73 mammo every 3 yrs

  • stong FH - start at 40, offer MRI
  • yearly mammo surveillance if prev breast cancer
19
Q

Screening

A

60 - 69 every 2 years
foecal occult blood test

  • annually for high risk (offer colonoscopy)
  • – FPC, HNPCC, UC
20
Q

Cervical ca screening

A

25 - 49 3 yearlys

50 - 64 5 yearly

21
Q

Breast cancer

A

BRCA accounts for 5% of all but over 50% of those under 40yrs

25% express HER-2

  • worse prognosis
  • but can use HERCEPTIN

DCIS - ductal carcinoma in situ

Pagets - eczema of nipple

Tx - surgery, inc test sentinel nodes

  • radio adjuvant
  • systemic adjuvant

systemic treat

  • chemo - anthracycline
  • hormonal - tamoxifen (pre meno) or aromatase inhib (anastrozole - post meno)
  • targetted - herceptin
22
Q

Prostate

A

TNM staging
Gleason scoring 1 - 5(poorly diff)

PSA normally under 4 over 10 is suspicious
do TRUS
do TR biopsy
follow w cxr, ct stage, bone scan, renal us (look for 2dry)

T

  • wait
  • surgery - turp or radical
  • radio or brachytherapy
  • if metastasized use antiandrogen - eg GOSERELIN (gnrh analogue)
23
Q

Lung cancers

A

Squamous cell 40-60%

  • central large airway
  • slow growth/slow met
  • cavitating
  • PTH - hypercalcaemia

Adeno 10-20%

  • peripheral
  • non smokers
  • slow growth

Large cell 5-15%

SMALL CELL LUNG CANCER

  • poor prog - inoperable -> chemo
  • central
  • rapid growth and metastasis - often disseminated
  • SIADH
  • ACTH
  • Lambert Eaton (like MG)
24
Q

Colorectal cancer

A

familial

  • FAP (apc gene) - prophylactic colectomy age 20
  • HNPCC (mlh, msh gene) - aut dom, annual surveil
dukes staging
A submucosa
B serosa
C lympho nodes
D metastasized
25
Q

Neutropeonic sepsis

A

comp of chemotherapy
seen between day 10-14 post chemo

neutrophils 0.5 or lower
temp over 38

aggressive IV abx

26
Q

Testicular cancer

A

most common cancer in men aged 20-30
- PAINLESS LUMP

semanoma or teratoma

teratoma - 20-30, germ cell (afp, bhcg)
semanoma - 30-40

risk - mumps orchitis, orchidopexy (undescended), cryptoorchidism, infertility, klinfelters

27
Q

sclc

A

not tnm - use ‘limited’ or ‘extensive’

limited ~2y surv, extensive ~1y surv (with treatment)

is chemo and radiosensitive

28
Q

nsclc

A

use tnm staging

and also stage 1 - 4 (4= chemo only)

29
Q

Carotid body tumour

A

May be functional (rare) or non functional

Functional - behave like phaeochromocytoma
- palps sweat etc

29
Q

performance status

A

important in deciding treatment for lung cancer

0 = fully active
1 = ambulatory, light work
2 = amb, self care, up and about >50%
3 = bed/chair > 50% of time, limited self care
4 = needs care
5 = dead

avoid chemo if PS 4

Progress test packs (16 decks)

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