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YEAR 4 > Oncology > Flashcards

Oncology Flashcards

1
Q

Small cell and adenocarcinoma are two types of lung cancer, name 4 more.

A

Large cell
Alveolar cell carcinoma
Squamous cell carcinoma
Bronchial adenoma

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2
Q

Persistent cough, haemoptysis and dyspnoea are three features seen in lung cancer, name 4 more.

A

Weight loss
Hoarse voice
Chest pain
SVCO

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3
Q

Clubbing and a monophasic wheeze are two examination findings for a patient with lung cancer, name one more.

A

Supraclavicular lymphadenopathy
OR
Persistent cervical lymphadenopathy

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4
Q

What are the paraneoplastic features associated with small cell lung cancer?

A

ADH - SIADH
ACTH - Cushings or Addisons
Lambert-Eaton syndrome
Metastases common

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5
Q

What are the paraneoplastic features associated with squamous cell carcinoma of the lung?

A

PTH-rp - Hypercalcaemia
Clubbing
Hypertrophic Pulmonary Osteoarthropathy
TSH - hyperthyroidism

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6
Q

What are the paraneoplastic features associated with adenocarcinoma of the lung?

A

Gynaecomastia
Hypertrophic Pulmonary Osteoarthropathy

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7
Q

What is the investigation pathway for lung cancer?

A

CXR
CT
Bronchoscopy
PET CT (usually non-small cell for management guidance).

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8
Q

What are the features of adenocarcinoma lung cancer?

A

Typically peripheral
Most common type of lung cancer in non-smokers (majority still smokers).
Late metastases.

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9
Q

What are the features of large cell carcinoma of the lung?

A

Typically peripheral
Anaplastic lymphoma - poorly differentiated tumours with poor prognosis.
May secrete beta-hCG.

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10
Q

When should a patient be referred on a 2-week wait referral for lung cancer?

A

Xray changes that are of suggestive of cancer
40 or over with unexplained haemoptysis.

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11
Q

When should a patient be offered an urgent CXR (within 2 weeks)?

A

40 or over with two or more of:
- cough
- fatigue
- shortness of breath
- chest pain
- weight loss
- appetite loss
OR
if they have ever smoked and have one or more of those sx.

OR

In anyone 40 or over with any of the following:
- persistent or recurrent chest infection
- finger clubbing
- supraclavicular or cervical lymphadenopathy
- chest signs consistent with lung cancer
- thrombocytosis

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12
Q

What ages does breast cancer screening start and end? What is the frequency of screening?

A

50-71
Every 3 years.

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13
Q

When should patients be referred for 2WW for breast cancer?

A

Aged 30 and over with an unexplained breast lump with or without pain.
Aged 50 and over with any of the following in one nipple only:
- discharge
- retraction
- other changes of concern (bleeding, padgets).

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14
Q

When should patients be considered for a 2WW for breast cancer?

A

Skin changes that suggest breast cancer (peau d’orange)
Aged 30 or over with an unexplained lump in the axilla.

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15
Q

When should a patient be considered for a non-urgent referral for breast cancer?

A

30 and under with an unexplained breast lump with or without pain.

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16
Q

Nulliparity, early menarche, late menopause, past hx and obesity are 5 risk factors for the development of breast cancer, name 8 more.

A

BRCA gene mutations
1st degree relative with perimenopausal breast cancer
First child over 30
COCP and HRT (combined)
Not breastfeeding
Ionising radiation
p53 gene mutations
Previous surgery for benign breast lump

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17
Q

What are the 4 common types of breast cancer?

A

Invasive ductal carcinoma
Invasive lobular carcinoma
Ductal carcinoma in-situ
Lobular carcinoma in-situ

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18
Q

Medullary, tubular and mucinous are 3 types of rarer breast cancers, name 4 more.

A

Padgets disease (may be associated with other underlying breast cancer if there is an associated lump)
Inflammatory breast cancer
Adenoid cystic
Lymphoma
Metaplastic
Basal type

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19
Q

Surgery and radiotherapy are two of the management options for breast cancer, name 3 more.

A

Hormone therapy
Biologival therapy
Chemotherapy

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20
Q

Multifocal tumour and central tumour are two of the indications for mastectomy, name 2 more.

A

Large lesion in small breast
DCIS >4cm

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21
Q

Peripheral tumour and small lesion in large breast are two of the indications for a wide local excision, name two more.

A

DCIS <4cm
Solitary lesion

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22
Q

What can be used to manage metastatic bone pain?

A

Analgesia
Bisphosphonates
Radiotherapy

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23
Q

What is the mechanism of action of the drug most likely to be given to a premenopausal woman with an oestrogen-receptor positive breast cancer?

A

Oestrogen-receptor selective antagonism (tamoxifen)

24
Q

Nulliparity, early menarche, late menopause, unopposed oestrogen are 4 risk factors for endometrial cancer, name 7 more.

A

Obesity
Diabetes
PCOS
Tamoxifen
Hereditary non-polyposis colorectal carcinoma
Polyps
BRCA - previous breast or ovarian cancer

25
Q

The COCP is protective against endometrial cancer, name 3 more protective factors.

A

Multiparity
Smoking
Continuos HRT

26
Q

What is the indication for referral for 2WW with endometrial cancer, and what investigations are done?

A

55 and over who present with postmenopausal bleeding.
TVUS
Hysteroscopy with endometrial biopsy.

27
Q

What surgery is suitable for endometrial cancer?

A

Total abdominal hysterectomy with bilateral salpingo-oophorectomy.

28
Q

What are the 3 most common cancers that cause bone mets?

A

Prostate
Breast
Lung

29
Q

The spine is the most common site for bone metastases, name 4 other common sites.

A

Pelvis
Ribs
Skull
Long bones

30
Q

What are the management options for bone pain caused by bone mets?

A

Strong opioids
Bisphosphonates
Radiotherapy

31
Q

Best to worst prognosis for lung cancer?

A

Squamous cell
Adenocarcinoma
Large cell
Small cell

31
Q

What is the most common type of breast cancer?

A

Invasive ductal carcinoma

32
Q

What are the symptoms of hypercalcaemia?

A

More frequent urination and thirst.
Fatigue.
Bone pain.
Headaches.
Nausea and vomiting.
Constipation.
Decrease in appetite.
Forgetfulness, depression or irritability.
Muscle aches, weakness, cramping and/or twitches.

33
Q

What is the investigation for SVCO?

A

CT Thorax with contrast looking at the venous phase (venogram)
CXR
ABG

34
Q

What is the management for SVCO?

A

Sit them up
Oxygen
Dexamethasone Oral

35
Q

What are the symptoms of TLS?

A

Nausea and vomiting
Confusion
Muscle cramps and tetany
Diarrhoea
Lethargy
Reduced urine output
Syncope
Chest pain
Palpitations

36
Q

What drug is given for the treatment of TLS?

A

Rasburicase

37
Q

What is the treatment for immune colitis?

A

Prednisolone
Fluids

37
Q

At what size should surgical excision be suggested for a fibroadenoma?

A

> 3cm

38
Q

At what size should surgical excision be suggested for a fibroadenoma?

A

> 3cm

39
Q

What type of breast lump exhibits a halo sign on a mammogram?

A

Breast cyst.

40
Q

A 55-year-old lady has undergone a wide local excision and sentinel lymph node biopsy for breast cancer. The histology report shows a completely excised 1.3cm grade 1 invasive ductal carcinoma. The sentinel node contained no evidence of metastatic disease. The tumour is oestrogen receptor negative. What is the next step?

A

Radiotherapy
This is done following all breast conserving procedures.
Recurrence rate is 40%

41
Q

What are the stages for ovarian cancer spread?

A

Stage 1 Tumour confined to ovary
Stage 2 Tumour outside ovary but within pelvis
Stage 3 Tumour outside pelvic but within abdomen
Stage 4 Distant metastasis

42
Q

When should a trans female who is taking female hormones have breast screening?

A

After they have been taking the hormones for more than 2 years

43
Q

What is the most common type of endometrial cancer? What are the other types?

A

Adenocarcinoma
Clear cell
Papillary Serous
Carcinoscarcoma

44
Q

What are some risk factors for cervical cancer?

A

Immunosuppression
High parity
Smoking
COCP over 5 years
HPV

45
Q

How do the 16 and 18 cause cervical cancer?

A

E6 and 7 which suppress the products of p53 tumour suppressor gene in keratinocytes and dysplasia and infection usually lasts 8 months.

46
Q

How is CIN treated? When do you follow up?

A

Large loop excision of TZ
Cone biopsy (preserve fertility)
6-12 months

47
Q

What is the topical treatment for VIN?

A

Imiquimod

48
Q

What are the views for mammogram? When should mammogram be chosen over USS?

A

Caudo-cranial and mediolateral.
>35

49
Q

What is the difference between the FNA and core biopsy?

A

FNA - just cytology, quick less, painful.
Core - removes tissue, receptor status and grade, high morbidity.

50
Q

What do SERMs increase the risk of?

A

Endometrial cancer
VTE

51
Q

What is the staging score for prostrate?

A

Gleasons

52
Q

What are the investigations for prostate cancer?

A

Multiparametric MRI
bone profile

53
Q

What are the potential treatments for prostate cancer?

A

Radical prostatectomy
Brachytherpay
GnRH ananolugues
Androgen deprivation therapy for metastatic disease.

54
Q
A

YEAR 4 (11 decks)

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