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Finals > Oncology > Flashcards

Oncology Flashcards

1
Q

What cancers have screening programmes ?

A

Breast
Cervix
Bowel

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2
Q

What are the 6systemic red flags symptoms of cancer ?

A
  • Unexplained weight loss
  • Loss of appetite
  • Fatigue
  • Back pain
  • Night sweats
  • Unexplained anaemia
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3
Q

what is the WHO performance status ?

A
  • 0 = fully active
  • 1 = Restricted in physical strenuous activity but ambulatory and able to carry out light work.
  • 2 = Ambulatory and capable of all self care. No work activities. Awake for >50% of waking hours.
  • 3 = Confined to bed / chair >50% of working hours
  • 4 = bed bound.
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4
Q

What are the 4 types of treatment in regards to non surgical oncology

A
  • Curative / radical = aims to cure
  • Neoadjuvant = therapy before surgery / radiotherapy with aim to shrink cancer
  • Adjuvant = aims to reduce risk of local or distant recurrence by treating metastatic disease. After surgery.
  • Palliative = not curative but aimed at improving quality of life and survival
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5
Q

What is neutropenic sepsis ?

A
  • Complication of cancer therapy, usually occurring 7-14 days after treatment
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6
Q

How is neutropenic sepsis defined ?

A
  • Neutrophil count of <1*10^9 + either :
  • Temp of higher than 38
  • Other signs / symptoms consistent with clinically significant sepsis
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7
Q

what is the most common cause of neutropenic sepsis ?

A
  • Staphylococcus epidermidis
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8
Q

What can be given as prophylaxis to neutropenic sepsis ?

A
  • Fluoroquinolone
  • Antifungals
  • Granulocyte colony-stimulating factor (G-CSF)
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9
Q

How is neutropenic sepsis managed ?

A
  • Immediate empirical therapy ( IVTazocin = piperacillin + tazobactam)
  • DO NOT wait for FBC, aim to give within an hr of presentation.
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10
Q

What 5 cancers most commonly spread to bone ?

A
  1. Prostate
  2. Breast
  3. Lung
  • Kidney
  • Thyroid

BLT ketchup please

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11
Q

How is malignancy spinal cord compression managed ?

A
  • Same day whole spine MRI.
  • High dose steroids = dexamethasone 8mg BD with PPI and monitor BMs)
  • Urgent discussion with oncology and spinal surgeons.
  • Surgical decompression / stabilisation vs radiotherapy
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12
Q

How can malignant spinal cord compression present ?

A
  • WORSENING back pain -> worse on lying / coughing
  • Lower limb weakness
  • Sensory loss / changes
  • Bowel or bladder dysfunction
  • Radicular pain
  • Abnormal neurological examination
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13
Q

Where are the neurological signs seen dependent on the level of spinal cord compression ?

A
  • Lesion above L1 = UMN signs in legs and a sensory level
  • Lesion below L1 = LMN signs in the legs and perianal numbness.
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14
Q

Other than bone pain, what features are seen in bone metastases ?

A
  • Pathological fractures
  • Hypercalcaemia
  • Raised ALP
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15
Q

What can cause malignant hypercalcaemia ?

A
  • Bone metastases = osteolysis
  • Humoral = PTHrP in squamous cell lung cancer
  • Dehydration
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16
Q

How does hypercalcaemia present ?

A
  • Kidney stones
  • Bone pain
  • GI : abdo pain, vomiting, constipation
  • Psych : depression
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17
Q

How is malignant hypercalcaemia managed ?

A
  • Correct dehydration : 0.9% saline 3-4L
  • Following rehydration : IV bisphosphonates (Zolendronic acid)
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18
Q

Why are IV bisphosphonates used in hypercalcaemia and what are their SE ?

A
  • They inhibit osteoclasts.
  • Se : flu like symptoms, bone pain, myalgia, reduced phosphate levels, N&V, headache
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19
Q

what cancer most commonly causes SVC obstruction

A
  • Lung cancer
  • Lymphoma
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20
Q

6 Features of SVC obstruction

A
  • Dyspnoea = most common symptom
  • Swelling of the face, neck and arms
  • Conjunctival and periorbital oedema
  • Headache: often worse in the mornings
  • Visual disturbance
  • Pulseless jugular venous distension
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21
Q

How is SVC obstruction diagnosed ?

A
  • CXR + widened mediastinum
  • CT scan
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22
Q

How is SVC obstruction managed ?

A
  • Elevation of head and O2 for symptomatic relief
  • High dose steroids
  • Endovascular stenting
  • Further radio/chemotherapy depends on the type of cancer
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23
Q

what carcinogens are associated with what cancers ?

A
  1. Aflatoxin = hepatocellular carcinoma
  2. Aniline dyes = bladder (transitional cell carcinoma)
  3. Asbestos = mesothelioma and bronchial carcinoma
  4. Nitrosamines = oesophageal and gastric
  5. Vinyl chloride = hepatic angiosarcoma
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24
Q

Common SE of chemotherapy

A
  • N&V
  • Fatigue
  • Sepsis
  • Myelosuppression
  • Impact on renal liver function
  • Alopecia
  • Blood clots
  • Infertility
  • Allergic reactions
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25
Q

what kind of chemotherapy is cyclophosphamide ?

A
  • Alkylating agent = causes cross-linking of DNA
26
Q

Give 3 adverse effects of cyclophosphamide

A

-> Haemorrhagic cystitis (mesna used to prevent)
-> Myelosupression
-> Transitional cell; carcinoma

27
Q

CA 125

A
  • CA 125 = ovarian
28
Q

What tumour antigens are associated with what cancers ?

A
  • PSA = prostatic carcinoma
  • AFT = hepatocellular carcinoma, teratoma
  • Carcinoembryonic (CEA) = colorectal
  • S-100 = melanoma, schwannomas
  • Bombesin = SCLC, gastric and neuroblastoma
29
Q

Give an example of an anthracycline cytotoxic agent, how it works and an adverse effect

A
  • Doxorubicin
  • Inhibits DNA & RNA synthesis
  • Cardiomyopathy
30
Q

Give an example of an antimetabolite cytotoxic agent and its advertse effcets

A
  • Methotrexate
  • Myelosuppression, mucositis, liver fibrosis and lung fibrosis
31
Q

How does Docetaxel work and what is an adverse effect ?

A
  • Prevents microtubule depolymerisation
  • Neutropenia
32
Q

Tumour markers for recurrence of testicular teratoma

A

Alpha-fetoprotein
Beta-HCG

33
Q

Tumour marker for breast cancers

A

CA 15-3

34
Q

Tumour marker for pancreatic cancer

A

CA 19-9

35
Q

Tumour marker for hepatocellular carcinoma

A

Alpha-fetoprotein

36
Q

what does a PET scan demonstrate

A

Glucose uptake

37
Q

what is the BRCA2 mutation associated with in men

A

Prostate cancer

38
Q

Medication to help with N&V caused by intracranial masses

A

Dexamethasone

39
Q

Action of cyclophophamide and 3 adverse effects

A
  • Alkylating agent
  • Haemorrhagic cystitis, myelosuppression, transitional cell carcinoma
40
Q

Adverse effect of bleomycin

A

Lung fibrosis

41
Q

Adverse effect of anthracyclines (e.g. doxorubicin)

A

Cardiomyopathy

42
Q

4 SE of methotrexate

A

Myelosuppression
Mucositis
Liver fibrosis
Lung fibrosis

43
Q

3 SE of fluorouracil

A

Myelosupression
Mucositis
Dermatitis

44
Q

most common lung cancer in non smockers

A

Adenocarcinoma

45
Q

Lung cancer most strongly associated with smoking

A

squamous cell cancer

46
Q

SE of 6-mercaptopurine

A

Myelosuppresion

47
Q

2 SE of cytarabine

A

Myelosuprresion, ataxia

48
Q

2 Adverse effect of vincristine

A

Peripheral neuropathy
Paralytic ileus

49
Q

se of docetaxel

A

Neutropenia

50
Q

3 SE of Cisplatin

A

Hypomagnesaemia
Ototoxicity
Peripheral neuropathy

51
Q

SE of hydroxycarbamide

A

Myelosupression

52
Q

CA 19-9

A

pancreatic cancer

53
Q

CA 15-3

A

breast cancer

54
Q

Alpha-feto protein

A

Hepatocellular carcinoma
Teratome

55
Q

Carcinoembryonic antigen

A

Colorectal cancer

56
Q

S-100

A

Melanoma
Schwannomas

57
Q

Bombesin

A

SSLC
Gastric cancer
Neuroblastoma

58
Q

Calcitonin

A

Medullary thyroid cancer

59
Q

HPV strains associated with cervical cancer

A

16,18 and 33

60
Q
A

Finals (92 decks)

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