Oncology

Question 1

What is the treatment for nausea & vomiting caused by tumours that ↑ICP?

Ex.: Glioblastoma.

Answer 1

First line:
- Cyclizine (nausea only)

Second line:
- Dexamethasone (nausea & headache)

Question 2

What is the treatment for nausea & vomiting caused by Radiotheraphy?

Answer 2

1st line:
- Ondanserton

2nd line:
- Haloperidol

Question 3

What is the treatment for nausea & vomiting caused by Chemotherapy?

Answer 3

1st line:
- Ondanserton

2nd line:
- Metoclopramide

Question 4

What are the symptoms of neutropenic sepsis?

Complication of chemotherapy.

Answer 4

• Fever
• Neutrophils ⩽ 0.5 x 10⁹/L

Question 5

What is the management of neutropenic sepsis?

Answer 5

• Do not wait for WBC results!
• Empirical antibiotics.

➔ Tazobactam
➔ Piperacillin

Question 6

Describe the pain ladder meds.

Answer 6

1. First step:
➜ Simple analgesia
- Paracetamol
- NSAID

2. Second step:
➜ Weak opiates
- Codeine
- Dihydrocodeine
- Tramadol

3. Third step:
➜ Strong opiates
- Morphine
- Fentanyl
- Oxycodone
- Diamorphine

4. Fourth step:
- Epidural nerve block

➜ In pain caused by vertebral metastasis, ` all 3 steps at the same time

➜ Open surgery: Start with morphine and weane it off.

Question 7

Malignant brain tumour

When to choose between the following antiemetics:
- Cyclizine
- Dexamethasone

Answer 7

Dexamethasone
- Nausea;
- Headache;
- Other neurological symptom;

Cyclizine
- Just nausea.

Question 8

What is the Rx management in SVC obstruction?

Associated with lung cancer.

Answer 8

Immediate Rx:
- Dexamethasone
- O₂

Most appropriate:
- Endovascular stenting (of obstructed SVC).

Question 9

What is the labs analysis that must be requested on a thyroid cancer patient post thyroidectomy?

Answer 9

Thyroglobulin.

Should be undetectable.

Question 10

What is the medication used to treat several types of cancers with a side effect of severe diarrhoea?

Answer 10

Capecitabine.

Question 11

What type of cancers presents with thrombocytosis (⬆︎ PLT)?

Answer 11

• Lung
• Endometrial
• Gastric
• Oesophageal
• Colorectal

Question 12

Oncology

What are the investigations done in a case of Submandibular mass?

Answer 12

1st line: Ultrasound
2nd line: FNAC

Question 13

When suspecting spinal compression 2nd to metastasis how to perform the:
- Diagnose
- Rx

Answer 13

Diagnosis: Full spine MRI

Rx: High doses of corticosteroids (dexa).