Oncology Flashcards
What is Filgrastim and what is it used for?
Used in the treatment for Neutropenic sepsis.
Is a Recombinant granulocyte-colony stimulating factor (G-CSF) and works by stimulating the bone marrow
What is Marjolin’s ulcer?
A rare disease that involves the development of an SCC within the site of a scar or an ulcer.
What increases risk of Ovarian Cancer?
- The higher the number of ovulation cycles in a woman’s lifetime, the higher the risk of ovarian cancer
- COCP use
- Multiparity
- Breastfeeding
What are risk factors for breast cancer?
Uninterrupted oestrogen exposure
- Early menarche, late menopause or nulliparity
- First pregnancy after age 35
- Not breastfeeding
- Obesity
- COCP use
- HRT use
What tumour marker can be used to assess response to treatment in Breast cancer?
Ca 15-3
What can raise your PSA levels?
- UTI
- Prostate biopsy
- DRE
- Urinary catheterisation
- Ejaculation within the last 48 hours
- Anal sexual intercourse
- Vigorous exercise
When are symptoms of SVC obstruction worse?
Worse on bending over, lying flat or lifting the arms above the head
What is the investigation of choice for metastatic cord compression?
MRI whole spine
What is tumour lysis syndrome?
Severe metabolic disturbance caused by the sudden release of large quantities of cellular components into the blood following the rapid lysis of malignant cells.
Which patients are at high risk of neutropenic sepsis?
- Have sustained, significant neutropenia that is expected to last more than 7 days
- Are clinically unstable
- Have an underlying malignancy and are being treated with high-intensity chemotherapy
- Have significant comorbidities
What are the main aetiological factors for head and neck cancers?
- Tobacco use
- Alcohol consumption
- HPV
- EBV
What are the biochemical findings in tumour lysis syndrome?
Hyperuricaemia, hyperphosphataemia, Hyperkalaemia and hypocalcaemia
What are some signs and symptoms of tumour lysis syndrome?
Related to electrolyte abnormalities:
- Dysuria or oliguria
- Weakness
- Nausea or vomiting
- Muscle cramps
- Seizures
- Cardiac Arrhythmias
- Gout/joint swelling
What is the management of tumour lysis syndrome?
- Correction of electrolyte imbalances: This may require dialysis in severe cases
- IV fluids
- Medications: Allopurinol or rasburicase may be given to prevent or treat hyperuricaemia
What are some strong risk factors for Bowel cancer?
- Increasing age
- Hereditary syndromes
- Increased alcohol intake
- Smoking tobacco
- Processed meat
- Obesity
- Previous exposure to radiation
- IBD
What is the current screening programme for bowel cancer?
- FIT every 2 years for men and women age 60-74. If positive patients are referred for colonoscopy
What initial blood tests could you do for bowel malignancy?
FBC, Iron studies and Carcinoembryonic antigen (CEA)
What is the likelihood of developing colorectal cancer in familial adenomatous polyposis?
Virtually guaranteed by 20s unless they undergo prophylactic proctocolectomy
What is HNPCC caused by?
Is caused by a mutation in the mismatch repair genes MLH1/MSH2 and has an autosomal dominant inheritance pattern.
What is Peutz-Jeghers syndrome?
Is caused by a mutation in the STK11 gene and has an autosomal dominant inheritance pattern.
Patients typically present in their teens with mucocutaneous pigmentaiton and hamartomatous polyps.
What is the first-line opioid of choice in patients with stage 4 or 5 chronic kidney disease?
Alfentanil
What is Li Fraumeni Syndrome?
A rare autosomal dominant disorder. It is the result of germ line mutation of the p53 tumour suppressor gene. It leads to an increased risk of sarcoma and cancer of the breast, brain and adrenal glands.
What test can help to diagnose medullary thyroid cancer?
Calcitonin
How do you characterise neutropaenic sepsis?
Temperature >38.5 °C, or two consecutive readings >38 °C, in a patient with a neutrophil count of <0.5 × 109/l (or expected to fall below this level in the next 48 hours).
What is the most common type of ovarian cancer?
- Epithelial ovarian cancer
What are some late side effects of radiotherapy?
- Skin pigmentation changes
- Pulmonary fibrosis
- Infertility
- Secondary cancers
- Constrictive pericarditis
- Dysphagia
How does Spinal cord compression present?
- UMN Signs: Hyperreflexia, spasticity, and a positive Babinski’s signs
- Sesnory disturbance: Typically below the level of the lesion
- Deep and localised back pain
- Radicular senory disturbance: A stabbing sesnation at the level of the lesion
- Bladder and bowel involvement
What cancers commonly cause superior vena cava obstruction?
Non-small cell lung cancer, small cell lung cancer and lymphoma
What is a positive Pemberton’s test and what does it indicated?
Involves lifting the arms over the head for more than 1 minute; this will precipitate facial plethora and cyanosis.
Indicates Superior vena cava obstruction
How do you diagnose SVCO?
CT scan of the thorax
What is the management of SVCO?
- Oral dexamethasone 8mg BD
What is the most common route of metastasis?
Haematogenous spread
