Oncology Flashcards

1
Q

Types of cytotoxic agents?

A

ACAMTO
1. Alkylating agents
2. Cytotoxic antibiotics
3. Antimetabolites
4. Microtubule inhibitors
5. Topoisomerase inhibitors
6. Other

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2
Q

Alkylating agent example?

A

Cyclophosphamide

Others:
Cisplatin
Chlorambucil
Busulfan
Melphalan

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3
Q

Cyclophosphamide MOA?

A

Alkylating agent - causes cross-linking in DNA

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4
Q

Cyclophosphamide s/e?

A

MHT

  1. Haemorrhagic cystitis
  2. Myelosuppression
  3. Transitional cell carcinoma
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5
Q

Cytotoxic Abx examples?

A
  1. Bleomycin
  2. Doxorubicin
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6
Q

Bleomycin MOA?

A

Degrades preformed DNA

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7
Q

Doxorubicin MOA?

A

Stabilizes DNA-topoisomerase II complex inhibits DNA & RNA synthesis

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8
Q

Bleomycin s/e?

A

Lung fibrosis

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9
Q

Doxorubicin s/e?

A

Cardiomyopathy

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10
Q

Antimetabolite examples?

A
  1. Methotrexate
  2. 5-FU (pyrimidine analogue)
  3. 6-MP (purine analogue)
  4. Cytarabine
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11
Q

Antimetabolite main s/e?

A

Myelosuppression

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12
Q

Methotrexate s/e?

A
  1. Mucositis
  2. Liver fibrosis
  3. Lung fibrosis
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13
Q

5-FU s/e?

A
  1. Mucositis
  2. Dermatitis
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14
Q

Cytarabine s/e?

A

Ataxia

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15
Q

Microtubule inhibitor examples?

A
  1. Vincristine, vinblastine
  2. Docetaxel
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16
Q

Vincristine s/e?

A
  1. Peripheral neuropathy (reversible)
  2. Paralytic ileus
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17
Q

Docetaxel s/e?

A

Neutropenia

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18
Q

Topoisomerase inhibitor example?

A

Irinotexan

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19
Q

Irinotecan s/e?

A

Myelosuppression

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20
Q

Cisplatin s/e?

A
  1. Ototoxicity
  2. Peripheral neuropathy
  3. Hypomagnesaemia
21
Q

Hydroxyurea (hydroxycarbamide) s/e?

A

Myelosuppression

22
Q

Which chemo causes hypomagnesaemia?

A

Cisplatin

23
Q

Bleomycin s/e?

A

Lung fibrosis

24
Q

Haemorrhagic cystitis chemo cause?

A

Cyclophosphamide

25
Q

Peripheral neuropathy chemo cause?

A

Vincristine

26
Q

Li-Fraumeni syndrome?

A
  1. AD
  2. Germline mutations to p53 TS gene
  3. High incidence of malignancies particularly sarcomas and leukaemias
  4. Diagnosed when: Individual develops sarcoma under 45 years, First degree relative diagnosed with any cancer below age 45 years and another family member develops malignancy under 45 years or sarcoma at any age
27
Q

BRCA 1 chromosome?

A

17

28
Q

BRCA 2 chromosome?

A

13

29
Q

BRCA 1 & 2 breast cancer risk?

A

60%

30
Q

What other cancers are associated with BRCA 1 and 2?

A
  1. Ovarian cancer (55% with BRCA 1 and 25% with BRCA 2)
  2. BRCA2 mutation associated with prostate cancer in men
31
Q

Lynch syndrome (HNPCC) ?

A
  1. AD
  2. Colonic and endometrial cancer at young age
  3. 80% of affected individuals will get colonic and/or endometrial cancer
  4. High risk individuals ID using the Amsterdam criteria
32
Q

Amsterdam criteria for Lynch syndrome?

A
  1. Three or more family members with a confirmed diagnosis of colorectal cancer, one of whom is a first degree (parent, child, sibling) relative of the other two.
  2. Two successive affected generations.
  3. One or more colon cancers diagnosed under age 50 years.
  4. Familial adenomatous polyposis (FAP) has been excluded.
33
Q

Gardner’s syndrome?

A
  1. AD, considered a variant of FAP
  2. Multiple colonic polyps
  3. Extra colonic diseases include: skull osteoma, thyroid cancer and epidermoid cysts
  4. Desmoid tumours are seen in 15%
  5. Mutation of APC gene located on chromosome 5
  6. Due to colonic polyps most patients will undergo colectomy to reduce risk of colorectal cancer
34
Q

Ovarian cancer marker?

A

Ca 125

35
Q

Pancreatic cancer marker?

A

Ca 19-9

36
Q

Breast cancer marker?

A

Ca 15-3

37
Q

Prostate ca marker?

A

PSA

38
Q

HCC and teratoma marker?

A

ADP

39
Q

Colorectal cancer marker?

A

CEA

40
Q

Melanoma, Schwannoma marker?

A

S100

41
Q

SCLC, Gastric cancer, neuroblastoma marker?

A

Bombesin

42
Q

Medullary thyroid carcinoma marker?

A

Calcitonin (as MTC arises from parafollicular cells)

43
Q

Most common UK cancers?

A
  1. Breast
  2. Lung
  3. Colorectal
  4. Prostate
  5. Bladder
44
Q

Most common cancers that cause deaths in UKK?

A
  1. Lung
  2. Colorectal
  3. Breast
  4. Prostate
  5. Pancreas
45
Q

Neoplastic spinal cord compression features?

A
  1. Back pain, worse on lying down and coughing
  2. Lower limb weakness
  3. Sensory changes: sensory loss and numbness.
  4. Neurological signs depend on the level of the lesion. Lesions above L1 usually result in upper motor neuron signs in the legs and a sensory level. Lesions below L1 usually cause lower motor neuron signs in the legs and perianal numbness. Tendon reflexes tend to be increased below the level of the lesion and absent at the level of the lesion
46
Q

Neoplastic spinal cord compression Ix?

A

Urgent Whole MRI spine within 24 hours of presentation

47
Q

Neoplastic spinal cord compression Rx?

A
  1. High dose oral dexamethasone
  2. Urgent oncological assessment for consideration of radiotherapy or surgery
48
Q

Raised bHCG and raised AFP

A

Non-seminomatous testicular cancer

49
Q

Amsterdam criteria for Lynch syndrome?

A
  1. Three or more family members with a confirmed diagnosis of colorectal cancer, one of whom is a first degree (parent, child, sibling) relative of the other two.
  2. Two successive affected generations.
  3. One or more colon cancers diagnosed under age 50 years.
  4. Familial adenomatous polyposis (FAP) has been excluded.