Oncology

Question 1

Most common primary sources of secondary bone metastases

Answer 1

Breast (35%)
Prostate (30%)
Bronchus (10%)
Kidney (5%)
Thyroid (2%)

Question 2

Most common electrolyte abnormality in cancer

Answer 2

Hypercalcaemia

Question 3

Symptoms of hypercalcaemia (more practical than stones, moans, groans and bones)

Answer 3

Nausea, vomiting, CONFUSION

Question 4

Presentation of SIADH in cancer patients

Answer 4

Likely to be presentation of cancer, rather than develop after diagnosis already made
Insidious onset: drowsy, headache, muscle aches
(neuro symptoms after Na+ less than 115)

Question 5

Management of cancer-associated SIADH

Answer 5

Treat the tumour responsible.

Question 6

Metabolic complications of cancer

Answer 6

Hypercalcaemia
SIADH
Tumour lysis syndrome - AKI

Question 7

Structural complications of cancer

Answer 7

Spinal cord compression
Superior vena cava syndrome
Brain metastases

Question 8

Management of spinal cord compression in oncological patients

Answer 8

If no known reason for spinal cord compression, don’t give dexamethasone (will cause false negative histology results for lymphoma)
Otherwise, treat with TDS dexamethasone to reduce oedema and save the distal cord.
Investigate with Whole spine MRI

Question 9

Symptoms of superior vena cava syndrome

Answer 9

Shortness of breath
Facial/neck puffiness
Pemberton’s sign
Dilated veins in neck/face

Question 10

Most common cancer associated with superior vena cava syndrome

Answer 10

Lung cancer

Question 11

Management of SVC syndrome

Answer 11

Dexamethsone manages symptoms

Question 12

Does herceptin cross the blood-brain barrier

Answer 12

No - hence why you can be free of breast cancer below the head, and still have brain mets

(most other chemotherapies do not cross the BBB either)

Question 13

Treatment-related emergencies in medical oncology

Answer 13

Extravasation of chemotherapeutics
Coronary Artery Spasm
Laryngo-pharyngeal dysaesthesia

Question 14

Management of ChemoTx extravasation

Answer 14

Refer to plastics immediately
AVOID COMPRESSION
find out what chemotherapies have been administered (some have antidotes available)

Question 15

What chemotherapies are most commonly associated with coronary artery spasm

Answer 15

5FU and capecitabine

Question 16

What is laryngo-pharyngeal dysaesthesia

Answer 16

Lack of feeling of air passing through airways,
has patients very panicked, thinking they cannot breathe when really they just can’t feel that they are breathing.
Commonly caused after oxaliplatin (CTx) administration

Question 17

Which chemotherapy is known to cause laryngo-pharyngeal dysaesthesia

Answer 17

Oxaliplatin