oncology (2)

Question 1

spinal cord compression (on background of prostate cancer (mx):

Answer 1

• Refer for: urgent MRI (whole spine, not just lumbar spine) + high dose dexamethasone

Question 2

2 cancers that BRCA2 mutation is associated in MEN?

Answer 2

• Breast cancer (and ovarian cancer in women)
  also:
• Prostate cancer

Question 3

Presentation of spinal cord compression (neoplastic)?

Answer 3

• back pain: may be worse on lying down/coughing
• lower limb weakness
• sensory changes: sensory loss and numbness
• relevant neurological signs

Inv: urgent MRI within 24 hours of presentation

Mx: high dose oral dexamethasone
also: urgent oncological assessment for consideration of radiotherapy or surgery

Question 4

which cytotoxic chemo drug has peripheral neuropathy and urinary hesitancy as a side effect?

Answer 4

Vincristine
other side effects: hyponatraemia, alopecia, constipation

Question 5

side effect of Cyclophosphamide?

Answer 5

haemorrhagic cystitis, myelosuppresion, transitional cell carcinoma (renal)

Question 6

side effect of BLeomycin?

Answer 6

lung fibrosis (lung)

Question 7

Side effect of DoxorubiCin (Anthracyclines)?

Answer 7

Cardiomyopathy

Question 8

side effects of Antimetabolites? (methotrexate, fluorouracil, 6-mercaptopurine, cytarabine)

Answer 8

Myelosuppression

Question 9

side effect of irinotecan?

Answer 9

Also Myelosuppresion

Question 10

side effect of Cisplatin?

Answer 10

• Ototoxicity
• Neuropathy
• Hypomagnesiumia

Question 11

side effect of Hydroxyurea (hydroxycarbamide)?

Answer 11

Myelosuppresion

Question 12

Superior Vena Cava Obstruction?

Answer 12

• Presentation: SOB, swelling of face, headache worse in morning, visual disturbance, pulseless jugular venous distension
• Associated with: Small cell Lung cancer
• Mx: Endovascular stenting: for symptomatic relief, if other underlying cause: radical chemo/chemo-radiotherapy

Question 13

what medication is used to suppress nausea and vomiting in intracranial tumours?

Answer 13

Dexamethasone

ddx: if nausea+vomiting is caused by chemo: give Ondansetron

Question 14

4 types of thyroid cancers?

Answer 14

1) Anaplastic
2) Follicular
3) Medullary: Calcitonin: is a tumour marker: levels will be raised= originates in parafollicular cells= which produce calcitonin
4) Papillary

Question 15

Which lung cancer has the strongest association to smoking?

Answer 15

Squamous cell lung cancer

Question 16

Which cancer is least likely to be inherited?

Answer 16

Gastric cancer

Question 17

bony metastases most common initial location in women?

Answer 17

1st) Breast
2nd) lung

NB: spine= is most common site of metastases (bone related spread)