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Finals > Oncology > Flashcards

Oncology Flashcards

1
Q

ca125

A

ovarian cancer

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2
Q

ca19-9

A

pancreatic cancer

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3
Q

ca15-3

A

breast cancer

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4
Q

AFP

A

Hepatocellular cancer, teratoma

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5
Q

CEA

A

colorectal cancer

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6
Q

s-100

A

Melanoma, schwannomas

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7
Q

bombesin

A

Small cell lung carcinoma, gastric cancer, neuroblastoma

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8
Q

raised AFP excludes what

A

seminomas

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9
Q

features of gardner’s syndrome

A
  • Autosomal dominant familial colorectal polyposis
  • Multiple colonic polyps
  • Extra colonic diseases include: skull osteoma, thyroid cancer and epidermoid cysts
  • Desmoid tumours are seen in 15%
  • Mutation of APC gene Chr5
  • Patients undergo colectomy to reduce risk of colorectal cancer
  • Variant of familial adenomatous polyposis coli
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10
Q

Features of Li-Fraumeni Syndrome

A
  • Autosomal dominant
  • Germline mutations to p53 tumour suppressor gene
  • High incidence of malignancies particularly sarcomas and leukaemias
    Diagnosed when: pt < 45, and 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
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11
Q

features of BRCA 1 and 2

A
  • Chr 17 (BRCA 1) and Chr 13 (BRCA 2)
  • Linked to breast cancer (60%) risk.
  • Risk of developing ovarian cancer (55% with BRCA 1 and 25% with BRCA 2).
  • BRCA2 mutation is associated with prostate cancer in men
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12
Q

Features of Lynch syndrome (HNPCC)

A
  • Autosomal dominant
  • Develop colonic cancer and endometrial cancer at young age
  • 80% of affected individuals will get colonic and/ or endometrial cancer
  • High risk individuals may be identified using the Amsterdam criteria
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13
Q

What is the amsterdam criteria

A
  • 3 or more family members with a diagnosis of colorectal cancer, one of whom is a first degree (parent, child, sibling) relative of the other two.
  • Two successive affected generations.
  • One or more colon cancers diagnosed under age 50 years.
  • Familial adenomatous polyposis (FAP) has been excluded.
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14
Q

How does a PET scan work

A

shows glucose uptake (cancer more metabolically active = use more glucose)

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15
Q

use of bleomycin

A

cytotoxic drug against lymphoma, metastatic germ cell cancer, squamous cell carcinoma and in some regimes non-Hodgkin’s lymphoma

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16
Q

adverse effect of bleomycin

A

pulmonary fibrosis

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17
Q

use of Cyclophosphamide

A

against lymphoma

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18
Q

adverse effect of Cyclophosphamide

A
  • haemorrhagic cystitis
  • myelosuppression
  • transitional cell carcinoma
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19
Q

use of Anthracyclines (e.g. doxorubicin)

A

against lymphoma

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20
Q

adverse effects of Anthracyclines (e.g. doxorubicin)

A

cardiomyopathy (heart failure)

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21
Q

use of Docetaxel

A

against breast and lung cancer

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22
Q

adverse effect of Docetaxel

A

neutropenia

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23
Q

adverse effect of vincristine

A

peripheral neuropathy

24
Q

what is vincristine used against

A

lymphoma

25
Q

adverse effects of methotrexate

A
  • Myelosuppression
  • mucositis
  • liver fibrosis
  • lung fibrosis
26
Q

adverse effect of cisplatin

A
  • Nephrotoxicity (the primary dose-limiting side effect)
  • Ototoxicity
  • peripheral neuropathy
  • hypomagnesaemia

cisplatin not used for lymphoma

27
Q

common cause of lytic bone metastases in women

A
  • most common= breast cancer
  • 2nd most common= lung cancer
28
Q

Most common tumour causing bone metastases (in descending order)

A

prostate
breast
lung

29
Q

most common sites of metastases (descending order)

A

spine
pelvis
ribs
skull
long bones

30
Q

Other than bone pain, features of metastases include:

A

pathological fractures
hypercalcaemia
raised ALP

31
Q

most common cause of superior vena cava obstruction

A

lung cancer (small cell lung cancer, especially in the right upper lobe)

32
Q

features of SVCO

A
  • dyspnoea MC
  • swelling of the face, neck and arms: conjunctival and periorbital oedema may be seen
  • headache: worse in the mornings
  • visual disturbance
  • pulseless jugular venous distension
  • stridor
33
Q

mx of SVCO

A

EMERGENCY
- dexamethasone
- endovascular stenting provides symptom relief
- certain malignancies such as lymphoma, small cell lung cancer may benefit from radical chemotherapy or chemo-radiotherapy rather than stenting

34
Q

HPV assoc with cervical cancer

A

16 + 18

35
Q

HPV assoc with genital warts

A

6 + 11

36
Q

tumour marker in medullary thyroid cancer

A

calcitonin
(MT originates from the parafollicular cells, which produce calcitonin)

37
Q

lung cancer that has the strongest association with smoking

A

squamous cell lung cancer

38
Q

features of squamous cell lung cancer

A
  • SMOKING
  • Central near large airways
  • M > F
  • associated with parathyroid hormone-related protein (PTHrP) secretion → hypercalcaemia
  • strongly associated with finger clubbing
  • cavitating lesions are more common than other types
  • hypertrophic pulmonary osteoarthropathy (HPOA)
39
Q

features of adenocarcinoma of the lung

A
  • peripheral
  • women
  • MC type in non smoking although majority that develop do smoke
40
Q

features of small cell lung cancer

A
  • near large airways
41
Q

features of large cell lung cancer

A
  • typically peripheral
  • anaplastic, poorly differentiated tumours with a poor prognosis
  • may secrete β-hCG
42
Q

what is Kartagener’s syndrome

A

situs invertus + immotile cilia syndrome

43
Q

which condition is thyroid medullary carcinoma associated with

A

Multiple endocrine neoplasia type II

44
Q

organisms causing neutropenic sepsis

A

staph aureus
enterococcus
streptococcus
e-coli

45
Q

Mx of neutropenic sepsis

A

Immediate assessment and vigorous resuscitation
Blood cultures
Septic screen
Empirical antibiotics urgently
Discuss with oncology re GCSF

46
Q

Abx for neutropenic sepsis

A

1st: piperacillin/tazobactam + amikacin

if penicillin allergy: meropenem

47
Q

how to prevent neutropenic sepsis

A
  • reduce chemo dose
  • prophylactic GCSF
  • prophylactic abx
48
Q

Mx of metastatic cord compression

A

high dose dexamethasone
MRI spine
surgical decompression
radiotherapy

49
Q

causes of hypercalcaemia of malignancy

A
  • 80% tumour production PTHrP
  • 20% Osteolytic bone mets
  • 1% ectopic PTH secretion, Vit D secreting lymphomas
50
Q

presentation of of hypercalcaemia of malignancy

A
  • Fatigue
  • Anorexia
  • muscle weakness
  • Nausea
  • abdo pain
  • Constipation
  • confusion
51
Q

Mx of hypercalcaemia of malignancy

A
  • rehydration
  • stop thiazides and Ca supplements
  • bisphosphonates
52
Q

side effects of bisphosphonates

A

common
- Transient flu like syndrome with aches, fevers and chills.
- Bone and joint pain
- Nausea
- Electrolyte imbalance

Rare
- Osteonecrosis of the jaw (advise patients about dental work)
- Acute renal failure

53
Q

what is tumour lysis syndrome

A

group of metabolic abnormalities that can occur as a complication during the treatment of cancer, where large amounts of tumour cells are killed off (lysed) at the same time by the treatment, releasing their contents into the bloodstream.

54
Q

features of TLS

A

↑ PO4
↑K
↓Ca2+
↑Urate
Acidosis
Resulting in AKI/potential for cardiac arrhythmias/seizures

55
Q

Mx of TLS

A
  • Fluids
  • ↑ PO4 - Phosphate binder, furosemide, mannitol
  • ↑K - Insulin/glucose, Ca gluconate
  • ↓Ca2+ - Correct phosphate
  • ↑Urate - Allopurinol or rasburicase
  • Early discussion regarding dialysis/renal replacement therapy
56
Q
A

Finals (10 decks)

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