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POS - Clinical Practice > Oncology > Flashcards

Oncology Flashcards

0
Q

How can viruses promote cancer?

A

Some express oncogenes that induce malignancy on infection

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1
Q

What is an oncogene?

A

When activated forms tumour, regulation lost by mutation

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2
Q

What is a photo-oncogene?

A

Regulate proliferation, differentiation and apoptosis

Mutations promote unregulation so can become an oncogene

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3
Q

What are tumour suppressor genes?

A

Rb, P53 - produce proteins that prevent proliferation

When both gene copies are mutated ➡️ loss of function

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4
Q

How many mutations does it take to progress to a tumour?

A

10-12

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5
Q

What are the six ways mutations on cells result in tumour?

A 
Sustained proliferative signalling
Evading growth suppressors
Resisting cell death
Enabling replicative immortality
Inducing angiogenesis
Activation of invasion and metastasis
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6
Q

What are the characteristics of sustained proliferative signalling? (3)

A

Uncontrolled secretion of endogenous GF
GF receptor mutation - over expression or activation without ligand
Intracellular signalling - mutation of proto onc Ras/Raf ➡️ MAPK path

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7
Q

What is the characteristic of evading growth suppressors?

A

Rb and P53 regulate cell cycle ➡️ mutation ➡️ proliferation

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8
Q

What are the characteristics of resisting cell death? (2)

A

Extrinsic pathway - process signals
Intrinsic - sensing, integrating signals ➡️ caspase cascade ➡️ apoptosis
- mutation ➡️ imbalance ➡️ resist apoptosis, ⬇️ regulate death rec

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9
Q

What are the characteristics of enabling replicative immortality? (2)

A

Normal cells replicate definite number of times - telomeres

Malignant cells up regulate telomerase adding segments

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10
Q

What is the characteristic of inducing angiogenesis?

A

Secrete angiogenic factors VEGF to stimulate new blood vessels

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11
Q

What are the characteristics of activating invasion and metastasis? (4)

A

Local invasion - lymph node, blood vessels ➡️ tissues ➡️ lesion
Tumour cells produce enzymes to to disrupt tissue
Adhesion molecules produced to attach to other cells and ECM
Lose E-cadherin to allow detachment and metastasis

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12
Q

How do we grade tumours?

A

Low
Intermediate
High

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13
Q

What is TNM?

A

Tumour - 123
Node - 01
Metastasis - 01

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14
Q

How do we stage lymphoma according the the WHO?

A

I - V
Sub-stage a without systemic signs
b with systemic signs

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15
Q

What is paraneoplastic syndrome?

A

Tumour effects distant through hormones, enzymes, cytokines

16
Q

What are the baseline tests for in oncology? (4)

A

Haematology
Biochemistry
Urinalysis
Coagulation parameters

17
Q

Name some paraneoplastic effects? (11)

A 
Hypercalcaemia
Hypoglycaemia
Hyperviscosity
Gastric ulceration
Vomiting
Endocrine - adreno, thyroid
Pyrexia
IMD
Hypertrophic osteopathy
Dermatological
Cancer cachexia
18
Q

How does chemotherapy work?

A

Cytotoxic drugs that interfere with cell growth, division

19
Q

When is chemo a primary treatment? (5)

A 
Lymphoma
Myeloma
Leukemia
Disseminated MCT
Disseminated histiocytic sarcoma
20
Q

When is adjuvant therapy used?

A

After surgery for highly metastatic tumours

Osteosarcoma, haemangiosarcoma, high grade soft tissue tumours, grade 3 MCT

21
Q

What does neo-adjuvant chemo do?

A

Shrinks tumours prior to surgery

22
Q

What routes of administration are there for chemotherapy? (5)

A 
IV
SC
PO
Intracavitary
Intralesional
23
Q

What does the cell kill hypothesis state?

A

Drug kills percentage of cells, never complete removal

24
Q

What is normal chemo dosing method?

A

Surface area of animals >10kg

Mg/m2

25
Q

Adverse effects of chemo? (4)

A

Myelosuppression
GIT toxicity
Poor hair growth
Drug extravasation

26
Q

Name the five common chemo drugs?

A 
Doxorubin
Cyclophosphamide
Vincristine
Lomustine
Platinum drugs
27
Q

What are the five mechanisms of chemo drugs?

A 
Alkykating
Mitotic spindle inhibitors
Anti-metabolites
Anti- tumour ABs
Platinum compounds
28
Q

How does alkylation work?

A

Swap alkyl group for H+ ➡️ breaks DNA strands

29
Q

How do mitotic spindle inhibitors work?

A

Bind to tubulin and inhibit micro tubule assembly

30
Q

How do anti-metabolite chemo drugs work?

A

Inhibit enzymes, producing non-functional molecules

31
Q

How do anti-tumour antibiotics work?

A

Inhibit topoisomerase II which breaks DNA x-link in base pairs

32
Q

How do platinum compounds work?

A

Causes intra/inter strand x-links which ⬇️ synthesis and transcription

33
Q

How does radiotherapy work?

A

Delays mitosis
Cells cannot divide
Intermitotic death
Die after 1-2 days

34
Q

What are the four Rs in radiotherapy?

A

Repair
Repopulation
Reoxygenate
Redistribution

POS - Clinical Practice (4 decks)

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