Oncology Flashcards
Paget’s disease of the bone
Excessive osteoclastic activity followed by osteoblastic activity –> increased rate of bone
turnover –> mosaic lamellar bone pattern
Suspected testicular cancer. Ultrasound shows a hypoechoic intratesticular mass. Which investigation would be most appropriate to confirm the diagnosis?
a) Serial AFP (alpha feto-protein)
b) testicular core biopsy
c) testicular open biopsy
d) Inguinal orchidectomy
e) Review later
f) Surgical exploration
CONFIRM DIAGNOSIS?
AFP is a marker doesn’t really diagnose..
Think orchidectomy
20 year old man with anechoic testicular mass with raised B-hCG. What type?
a) Choriocarcinoma
b) Seminoma
c) Ledig cell tumor
d) Sertoli tumour lol
VERY RAISED = choriocarcinoma
If just raised up to about ~50, this could be a seminoma
Testicular mass. What investigation first?
a) Serial AFP (alpha feto-protein)
b) Testicular biopsy
c) USS
d) Inguinal orchidectomy
Umm, I think USS first.
Guy with low back pain sore to touch with red flags like pain at night and at rest. Paracetamol and NSAIDs didn’t relieve it. Bloods: PSA <2, slightly raised total protein, raised Ca and poor renal function. Dx?
a) Multiple myeloma
b) Prostate cancer mets
c) Inflammatory arthritis
d) OA
e) Osteoporotic vertebral crush fracture
Multiple myeloma
- total protein up
Raised Ca due to breakdown of brown
Bence-Jones collecting in nephron –> poor renal function
Person with back pain, waking at night. Bloods show anaemia, mildly high protein, high urea, high calcium and creatinine, reduced vit D. Dx?
a) Multiple myeloma
b) Osteoporotic crush fractures
c) Metastatic prostate cancer
Multiple myeloma
Man with squamous cell lung cancer causing hypercalcaemia. Why?
a) PTHrP
b) Osteolytic bony metastasis
c) Calcitriol
Squamous cell carcinomas can cause PTHrP
Osteolysis mostly breast, multiple myeloma
Calcitriol in Hodgkins lymphoma
Testicular cancer metastasises to which lymph nodes?
Paraaortic
Kid with solid tumor arising from inside testicle, what do you do to diagnose it?
a) Inguinal orchidectomy
b) Scrotal approach biopsy
c) FNA
We do not use biopsy for testicles
INGUINAL ORCHIDECTOMY
Old woman with trouble swallowing, originally to solids now to liquids as well. 15kg weight loss, LL neuro sx (areflexia both ankles, some sensory loss). Diagnosis?
a) Bulbar Palsy
b) Achalasia
c) GERD
d) Oesophageal Cancer
Oesophageal Cancer with spinal compression
Dude with small cell lung cancer had a calcium of 3.2. What is this due to?
a) Bone mets
b) PTHrP
Bone mets
Small cell cx hypercalcaemia – bone mets
Squamous cell cx hypercalcaemia – PTHrP
Lady with Non-Hodgkin’s lymphoma, bulky abdomen and hilar disease before treatment. Day 3 post 1st round of chemo. Now presenting with non-specific malaise. Blood results: low Hb and WCC, high urate, K+, phosphate and creatinine. Diagnosis?
a) Tumour lysis syndrome
b) Neutropenic sepsis/gram negative septicaemia
c) Aplastic crisis
d) Dehydration
e) Urate nephropathy
This is tumour lysis syndrome, where the tumour breaks down and all its contents are released (K+, urate, phosphate)
Dude a) b) c) d)
with metastatic prostate cancer presents with back pain. First treatment? Anti-androgen therapy
Bisphosphates
External beam radiation therapy
Corticosteroids
I think anti-androgen
Pathologist determines features of cancer using microscope. What is this called?
a) Grading
b) Staging
Grade = appearance of cells related to tissue of origin
Male with colonic cancer. Best prognostic indicator?
a) Stage
b) Grade
c) CEA level
d) MSI mutations
Stage
Patient with SOB, bilateral non-pulsatile (no wave) raised JVP up to 8cm (R >L) and mediastinal enlargement. Diagnosis?
SVCO
Non-pulsatile engorged veins
Prob give dexamethasome unless lymphoma
65 year old man with palpable supraclavicular mass. Dx?
a) Gastric cancer
b) Lung cancer
This is Virchows node, suggestive of abdominal malignancy –> Gastric cancer
Score used for prostate cancer staging. a) Gleason
b) Bethesda
c) Manchester
Gleason
Which is not a risk factor for gastric cancer?
a) H pylori infection
b) Smoking
c) Older age
d) FHx
e) Pernicious anaemia
f) Male
g) Low salt diet
The pooled ORs showed a significantly positive association between high salt intake and gastric cancer compared with low salt intake
Most likely investigation to confirm a diagnosis of prostate cancer?
a) Transurethral resection of prostate (TURP)
b) PSA
c) MRI prostate
d) Trans-rectal ultrasound (TRUS) needle biopsy
e) DRE
Do a TRUS for prostate cancer diagnosis
TURP is for treatment of BPH + diagnosis
