Oncology

Question 1

When increasing dose of opiates how much do you increase by?

Answer 1

30-50%

Question 1

What can be used for bone met pain in palliative care?

Answer 1

Strong opioids
Bisphosphonates
Radiotherapy.

Question 2

Ca 15-3

Answer 2

Breast ca

Question 3

Ca 125

Answer 3

Ovarian

Question 4

When can AFP be raised

Answer 4

Liver ca
Teratomas

Question 5

What tumour markers may be elevated in testicular ca in what situations

Answer 5

Seminomas: hCG may be elevated in around 20%

Non-seminomas: AFP and/or beta-hCG are elevated in 80-85%

LDH is elevated in around 40% of germ cell tumours

Question 6

What are the types of testicualr ca?

Answer 6

Germ cell = most common (95%)
These can be further split into:
Seminoma

Non-seminoma - embryonal, yolk sac, teratoma and choriocarcinoma

Non-germ cell tumours include Leydig cell tumours and sarcomas.

Question 7

CEA

Answer 7

colorectal ca

Question 8

s-100

Answer 8

melanoma/schwannoma

Question 9

Bombesin

Answer 9

Small cell lung carcinoma, gastric cancer, neuroblastoma

Question 10

Cyclophosphamide SEs

Answer 10

Haemorrhagic cystitis, TCC

Question 11

Bleomycin SE’s

Answer 11

Pulmonary fibrosis

Question 12

Anthracyclines example and SE

Answer 12

Doxorubicin
Cardiotoxicity

Question 13

Cisplatin SE’s

Answer 13

Ototoxicity, nephrotoxicity, peripheral neuropathy, low mg

Question 14

Vincristine SE’s

Answer 14

Peripheral neuropathy

Question 15

Asparagine SEs

Answer 15

Neurotoxicity

Question 16

Codeine to morphine conversion

Answer 16

divide by 10

Question 17

How to get from
1) Oral morph to s/c morph
2) Oral morph to s/c diamorph

Answer 17

1) divide by 2
2) divide by 3

Question 18

First line drug for confusion in palliative care

Answer 18

Haloperidol

Question 19

What antiemetic for chemical stuff e.g. chemo/opiates

Answer 19

Ondansetron/haloperidol/levo

Question 20

what antiemetic for mechanical obstruction

Answer 20

Metoclopromide

Question 21

What antiemetic for raised ICP

Answer 21

Cyclizine

Question 22

Which 2 main chemo agents cause peripheral neuropathy and when would each be used?

Answer 22

Vincristine - Lymphoma
Cisplatin

Question 23

Methotrexate SEs

Answer 23

Myelosuppression, liver fibrosis and oral mucositis

Question 24

What opiate would you use in severe CKD?

Answer 24

alfentanil, buprenorphine and fentanyl

(mild-mod CKS would use oxycodone)

Question 25

How to treat hiccups in palliative care

Answer 25

chlorpromazine or haloperidol

Question 26

Calcitonin tutor marker association

Answer 26

Medullary thyroid ca

Question 27

What is BRCA2 associated with in men

Answer 27

Prostate ca

Question 28

Which testicular ca are not radiosensitive

Answer 28

teratoma (seminoma are).