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CCC > Oncology > Flashcards

Oncology Flashcards

1
Q

What are the known causes of:
Lung cancer
Burkitt’s lymphoma
Leukaemias

A

Lung: cigarette smoking
Burkitt’s: EBV
Leuk: Radiation

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2
Q

What are the classes of aetiological agents?

A 
Inherited
Chemical
Physical
Diet
Drugs
Infective
Immune deficiencies
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3
Q

What are the currently known gene mutations that cause types of cancer?

A

BRCA1 & BRCA2
NAPC
Von-Hippel Lindau syndrome
p53

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4
Q

What types of chemicals cause certain cancers?

A 
Cigarette smoke: Lung cancer
Aromatic amines: Bladder cancer
Benzene: Leukaemia
Wood dust: Nasal adenocarcinoma
Vinyl Chloride: Angiosarcomas
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5
Q

How do chemicals cause cancer

A

Damage cellular DNA

Induce mutations in oncogenes & tumour suppressor genes

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6
Q

How does smoking cause cancer?

A

Cause specific mutations in the p53 tumour suppressor gene.

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7
Q

How does radiation exposure cause cancer?

A

Increasing DNA damage leading to the accumulation of mutations in tumour-suppressor genes and oncogenes.

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8
Q

In radiation exposure, what is the risk of tumour development associated with?

A
  • Level of exposure: Dose dependant, accumulation of an isotope in a tissue may lead to tumour formation (e.g iodine & thyroid)
  • Radiation source: High energy radiation (electrons/photons) more carcinogenic than x-rays. UV light damages the skin (malignant melanoma)
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9
Q

How does a low fibre diet cause cancer?

A

A decrease of transit time through the bowel thereby increasing exposure to carcinogenic substances.

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10
Q

How do drugs cause cancer?

A

Cytotoxic drugs induce DNA damage and are associated with an increased risk of malignancy. The effect is dose dependent.
(e.g topoisomerase inhibitors & acute leukaemia)

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11
Q

What infections can lead to cancer?

A
  • HPV: Cervical & anal cancers
  • EBV: Non-Hodgkin’s lymphoma
  • Hep B: Hepatocellular cancer
  • Retrovirus: T-cell lymphomas
  • H.Pylori: MALT tumours
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12
Q

How does HPV cause cancer?

A

E6 protein produced by HPV16 bids to & inactivates p53 protein.
Dysregulation of cell cycle & apoptotic pathways
Malignant transformation of epithelial cells infected

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13
Q

How does EBV cause cancer?

A

Most common caused by EBNA
14:8 translocation- proto-oncogene ‘c-myc’ on Chr8 is transcriptionally controlled by control elements of immunoglobulin genes on Chr14

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14
Q

How does Retrovirus cause cancer?

A

Integration into cellular genome

Causes abnormal overexertion of oncogenes

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15
Q

What tests need to be done to diagnose cancer and then confirm the diagnosis?

A

BIOPSY: Either of a superficial mass or by endoscopic techniques
HISTOLOGY: Needed to treat a cancer radically

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16
Q

How is cancer staged?

A

TNM staging
Tx: Primary tumour cannot be assessed
T0: No evidence of primary tumour
Tis: Carcinoma in situ
T1/2/3/4: Increasing size and/or local extent of the primary tumour
NX: Regional cannot be assessed
N0: No regional lymph node mets
N1/2/3: Increasing involvement of regional lymph nodes
MX: Presence of distant mets cannot be assessed
M0: No distant mets
M1: Distant mets

17
Q

How are tumours graded?

A

Histologically done
GX: Grade of differentiation cannot be assessed
G1: Well differentiated: Similarities remain to normal tissue of the organ of origin
G2: Moderately differentiated
G3: Poorly differentiated- bizarre cells

18
Q

How can imaging be used in cancer medicine?

A 
Diagnosis
Staging (CT= chest & abdo malignancies, MRI= bone & soft tissue)
Response assessment
Follow-up
Screening (mammography)
19
Q

How is the RECIST system defined?

A

Response to treatment
Complete response: No disease detectable radiologically
Partical response: All lesions shrunk by at least 30% but disease still present
Stable disease: <20% inc in size or <30% dec in size
Progressive disease: New lesions/lesions inc >20%

20
Q

What are the risks associated with CT?

A

-Radiation exposure: risk of inducing malignancies

21
Q

What is MRI the gold standard of imaging tumours for?

A

Neurospinal
Rectal
Prostate
Musculoskeletal

22
Q

What are contraindications for MRI scanning?

A

Pacemakers, implantable cardiac defibs
Metallic foreign bodies (eye or brain)
Vascular clips, surgical staples

23
Q

What tumours can USS detect?

A

Metastases in solid ‘visceral’ abdominal organs

24
Q

What tumours can be detected through nuclear medicine?

A

Bone scintography: Principle investigation for bone mets
Technetium
Radioiodine

25
Q

What investigations should be done in metastatic disease of unknown primary?

A 
Bloods: FBC,U&amp;E, LFT, Ca, LDH
Tumour markers: aFP, bHCG
Urinalysis
CXR
CT: Chest, abdo, pelvis
26
Q

What specific investigations can be done in patients with cancer?

A 
Myeloma screen = lytic bone lesions
Endoscopy= Direct towards symptoms
PSA= Men
Ca125= Women w/peritoneal malignancy/ascites
Testicular USS= Men w/germ cell tumours
Mammogram= Women w/signs of breast Ca

CCC (21 decks)

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