Oncology Flashcards
What is Meig’s syndrome (3 things)?
What is the natural history?
- Benign ovarian tumour
- Ascites
- Pleural effusion
Fluids resolve if tumour is removed.
What gene mutation is commonly found in a large proportion of human cancers?
p53 gene mutation.
Cetuximab - what is the receptor target and what are the indications for this drug (3)?
EGFR receptor INHIBITOR
3 cancers:
- Metastatic colorectal cancer
- Metastatic NSCLC (non-small cell lung cancer)
- Head and neck cancer
What is an potential adverse effect of Bleomysin?
How often does this occur?
- Life-threatening Interstitial lung disease.
- 10% of patients that receive drug
Capecitabine is a oral pro-drug, what is it enzymatically converted into?
5-FU (5-fluorouracil)
What 2 cancers is Capecitabine used for?
Colorectal and Breast cancer
NB: off label use in Oesophageal and Gastric cancers.
What is the MOA of taxanes?
Which part of the cell cycle does it act?
- Disruption of microtubule action / mitotic inhibitors
- M-phase
Patient presents with subacute onset of ataxia, dizziness and vertigo on background of weight loss and B-symptoms. What to you suspect?
Paraneoplastic cerebeller degeneration - autoimmune reaction to purkinje cells
For the following panel done for work-up of paraneoplastic cerebellar degeneration what are the corresponding neoplasms:
Anti-Yo Anti-Hu Anti-Ri Anti-Tr Anti-CV2 Anti-Ma
Anti-Yo = ovary / breast Anti-Hu = SCLC Anti-Ri = SCLC / breast Anti-Tr = Hodgkin's lymphoma Anti-CV2 = SCLC Anti-Ma = Testicular
You suspect paraneoplastic syndrome in a patient with SCLC, what autoantibodies do you order (3)?
Anti-Hu
Anti- Ri
Anti- CV2
What is a SE of tacrolimus?
Diabetes mellitus
What is the MOA of anthracycline?
Inhibition of topisomerase
What feature of colonoscopy in a patient with IBD is a risk factor for colon cancer?
Colonic pseudopolyps
What are the side effect of Oxaliplatin?
Which is the most severe?
Less severe: marrow toxicity, gastrointestinal toxicity and sensory neuropathy
Severe: anaphylaxis
Regarding squamous cell carcinomas:
- What is the p16 stain?
- Where is are these cancers most likely to occur?
- Does the p16 stain confer good or poor prognosis?
- What is the p16 stain?
Surrogate for Human Papilloma Virus - Where is are these cancers most likely to occur?
Oropharaynx - Does the p16 stain confer good or poor prognosis?
Good prognosis
Which chemotherapy does NOT cause complete alopecia?
Cisplatin
Unlike (CoPED): Cyclophosphamide, Paclitaxel, Etoposide, Doxorubicin.
Describe what happens in the following 5 phases of the cell cycle: G0, G1, S, G2, M
G0 = resting phase
G1 = growth
S = DNA replication
G2 = growth and preparation for division
M = mitosis (division of the nucleus) and cytokinesis (division of the cytoplasm)
What are the 3 checkpoints within the cell cycle?
What are the conditions of ‘passing’ each checkpoint?
G1/S checkpoint:
- DNA undamaged
- cell size/nutrition/social signals adequate
S/G2 checkpoint:
- DNA undamaged
- Chromosome replication and activated MPF
M (metaphase) checkpoint:
- Chromosomes attached to spindle apparatus
Which 4 phases does the M-phase (mitotic phase) consist of in chronological order?
PMAT:
Prophase
Metaphase
Anaphase
Telophase
What types of cancers are the following genes associated with:
- BRCA1
- RET
- PTCH1
- CDH1
- VHL
- BRCA1 - triple negative breast cancer
- RET - papillary and non-medullary thyroid cancers
- PTCH1 - Basal cell carcinoma (BCC) of the skin
- CDH1 - Diffuse gastric cancer
- VHL - CNS haemangioblastoma
Inactivation or loss of function of the RET-proto-oncogene leads to which disorder?
Hirschsprung disease
Over-activation of the RET-proto-oncogene leads to which disorder?
MEN2 (PPH):
- Phaeochromocytoma
- Parathyroid tumour
- Medullary thyroid cancer
Somatic RET-proto-oncogene changes leads to which 2 types of thyroid carcinoma?
- Papillary thyroid cancer
- Non-familial medullary thyroid cancer
Which drug reduces the severity of chemotherapy-induced peripheral neuropathy?
Duloxetine
Trastuzumab (herceptin, HER2 receptor mAb) may induce reduction in LVEF.
Is this reversible?
Yes
Doxorubicin (anthracycline) may induce reduction in LVEF.
Is this reversible?
No.
T/F: Doxorubicin (anthracycline) related cardiomyopathy with usually declare itself within 1-3 years of administration of the chemotherapy.
False - often manifests >10 years post treatment.
What is a potential SE of Bevacizumab (anti-VEGF mAb)?
HTN
What is a potential cardiac complication of 5-FU?
coronary artery spasm
What is a potential cardiac complication of cisplatin
Premature CAD
Patient with good ECOG has stage II CRC that is node-negative.
When would adjuvant chemotherapy be offered?
Presence of high risk features e.g. presents with bowel perforation.
According to the Khorona score, which 2 types of cancer score the higher and increase the risk of VTE in cancer patients?
Gastric and Pancreatic Cancers
Patient has metastatic renal cell carcinoma.
What treatment is recommended?
What is a known SE of this drug?
Sunitinib (TKI) that may cause mucositis and diarrhoea.
Patient on Sunitinib for metastatic renal cell carcinoma presents with severe mucositis and diarrhoea. What is the recommendation in the following scenarios:
- Able to tolerate PO fluid
- Unable to tolerate PO fluid
- Able to tolerate PO fluid
Withold Sunitinib until mucositis and diarrhoea resolve, then recommence at same schedule at reduced dose. - Unaable to tolerate PO fluid
Admit for IVF and withold Sunitinib until mucositis and diarrhoea resolve, then recommence at same schedule at reduced dose.
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What drug classes do the following groups of drugs belong to:
- Gefitinib / Sorafenib
- Paclitaxel / Erlibulin
- Temozolomide
- Methotrexate
- Bleomycin / Doxorubicin / Mitomycin
- Gefitinib / Sorafenib = tyrosine kinase inhibitors
- Paclitaxel / Erlibulin = Anti-tubulin agent
- Temozolomide = Alkylating agent
- Methotrexate = Anti-metabolist
- Bleomycin / Doxorubicin / Mitomycin = Antibiotic
