Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Final > Oncology > Flashcards

Oncology Flashcards

1
Q

Hypertrophy Vs Hyperplasia

A

Inc size Vs Inc number

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Metaplasia

A

Transformation of one terminally differentiated cell into another (e.g. Barretts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dysplasia

A

Cellular atypia and decreased differentiation
Changes are pre-malignant and reversible

End stage of spectrum = anaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Apoptosis Vs Necrosis

A

Apoptosis = Programmed cell death of unwanted individual cells. monitored by p53

Necrosis is cell death from ischaemia, metabolic or traumatic cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens to cell in apoptosis Vs Necrosis

A

Cell shrinkage and fragmentation (blobbing) for phagocytosis.
Dense chromatin

Cell swelling and lysis with spilling out of DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Carcinogenensis def

A

Normal -> neoplastic cell transformation through permanent genetic mutations
Inc growth and dec cell death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Carcinogen def

A

Mutagenic (Chemical, viral, radiation - melanoma, hormones - breast/prostate, parasite - schist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Neoplasm def

A

a new lesion from autonomous abnormal growth of cells which persists after initiating stimulus is removed (benign or malignant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Benign Vs malignant features

A

Bening:
Localised, non-invasive, well differentiated, encapsulated, normal morphology, necrosis/ulceration (rare - doesn’t outgrowth blood supply that fast)
Growth up and out

Malignant:
Invasive, metastatic, rapid growth (ulceration and necrosis), Poorly differentiated cells, inc mitotic activity, growth down and in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Benign tumour morbidity

A

Pressure on adjacent
Flow obstruction
Hormone production
Malignant transformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Malignant tumour morbidity

A 
Destroy surrounding tissue, 
Metastasise, 
Flow obstruction, 
Hormone production
Paraneoplastic features
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Papilloma
Adenoma

Carcinoma
Adenocarcinoma

Lipoma/Osteoma/Angioma for e.g.

Sarcoma

A

benign epithelial neoplasm

Benign secretory epithelial neoplasm

Malignant epithelial tumour

Malignant secretory epithelial neoplasm

Benign connective tissue tumour

Malignant connective tissue tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Metastatic cascade

A

1) detachment
2) invasion
3) Intravasation (blood/lymph)
4) Evades host immune system
5) Adherence
6) Extravasation
7) Angiogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Forms of metastatic spread

Mets are the main cause of cancer death

A

Lymphatic (to LNs)

Haematogenous (Organs, bone)

Transcoelomic (within body cavity e.g. pleural, peritoneal mets)

Iatrogenic (e.g. needle tracking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cancer grading:

  • Low Vs High grade
  • Relevance
A

Low = well differentiated

High = poorly differentiated

Degree of differentiation correlated with outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

TNM

A

Tumour (extent of main tumour)

Nodes (Presence and extent of LN spread)

Metastasis

X after any = can’t be measured.
0 = none can be found

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cancer treatment methodologies

A

Surgery (curative)
Radiotherapy (curative)
Chemotherapy
Immunotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Important factors when deciding Tx

A

Patient factors (Kornofsky state of health score: 0-100% full health)

Cancer Stage/Grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Radiotherapy

  • Purpose
  • What is it
  • How it is used
  • Typical Regimen
A

Curative and palliative use

High energy x-ray beams precisely delivered cause DNA damage

Sole Tx or with surgery/chemo

  • Neoadjuvant: before
  • Adjuvant: post

Daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Radiotherapy indications

A

Neoadjuvant - Shrink structure to make it resectable (if close to vital structures)

Adjuvant - decrease recurrence

Palliative for bone/brain mets and spinal compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Types of radiotherapy

A

External beam (CT/MRI targeted)

Internal radiation (Brachytherapy) source placed close to tumour

Stereotactic: very accurate directed Tx good for small elsions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Radiotherapy SE/Complications

  • Acute
  • Chronic
A

Acute: Fatigue, Skin (erythema, desquamation, irritation), GI (loss of taste, oil mucositis, D&V), BM-Pancytopenia
Lung - pneumonitis, fever, cough, dyspnoea

Infertility, Lymphoedema, delayed healing, inc risk CV disease/stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Chemotherapy

  • When is the only time curative
  • How used
  • Example of regimen
  • What cell affected
A

In leukaemia, lymphomas

Neo-adjuvant (before surgery), adjuvant (post surgery - curative aim), Palliative - often with radiotherapy

e.g. 3 weekly cycles to allow normal cell recovery

Fast replicating cells (gut mucosa, hair, bone, BM)

24
Q

Routes of chemo

A 
Oral
IM
IV
Intrathecal
Topical
25
Types of Chemo: - Alkylating - Cytotoxic - Antimetabolite - Topoisomerase inhib - Mitotic inhib - Platinum compounds
- Alkylating Chlorambuclin, Darcarbazine - Cytotoxic Doxorubicin, Bleomycin - Antimetabolite 5-FU, MTX - Topoisomerase inhib Etoposide - Mitotic inhib Vincristine, Paclitaxel - Platinum compounds Cisplatin
26
Chemotherapy side effects
Myelosuppression (anaemia, infection, bleeding) Alopecia Infertility N&V&D (domperidone, metoclopramide) Fatigue Mouth ulcers Peripheral neuropathy Teratogenicity
27
Immunological therapies: Monoclonal antibodies (main form): How it works and E.G.
Antibody produced by single clone of cells Bind specific target e.g. cancer specific antigens, stop blood vessels, block proteins that down reg immune surveillance by cancer Trstuzumab/herceptin - against Her-2 Pembrolizumab - blocks programmed cell death protein 1 on lymphocytes Cetuximab - block VEGF prod through TK inhibition
28
Immediate risk factor in administering chemo Management Beware of?
Anaphylaxis Stop drug ABCDE, IM adrenaline (0.5mg), IV hydrocortisone + Chlorphenamine May recur at 4-12hrs
29
Neutropenis sepsis + chemo - why happens - definition - when to suspect + why difficult - Ix + Tx
Myelosuppression in chemo Neutrophil count less than 1 per high power field Suspect in anyone with fever who has had chemo in last 6 weeks (May not get fever - atypical pres) BUFALO, sam central lines Abx- IV Piperacillin and tazobactam (Tazocin) or Gentamycin. May also add fluconazole (thrush) acyclovir (varicella zoster - shingles)
30
Spinal cord compression - When - Pres - Site - Ix & Tx
3-5% cancer, 10% spinal mets Pain ± sensory loss/weakness below level ± lost continence 70% thoracic, 20% lumbosacral (below L1/2 think cauda equina) MRI spine, neuro/spinal surgical referral, IV DEXAMETHASONE
31
Spinal mets Tx
Analgesia (NSAID, Para, Opiates) Bisphosphonates (lytic lesions: breast, myeloma) Palliative radiotherapy Vertebroplasty
32
DVT/PE in Ca - why - mech
Cancer and treatment are prothrombotic (higher PT and clotting factors) Surgery and chemo damage vessel walls (inc clots) Patients tend to be less active
33
DVT Tx
Immediate LMWH Long term - 3 - 6 month Warfarin + - NOAC 3 month (Rivaroxoban)
34
Haemorrhage in cancer/chemo - Mechanisms - Tx
Both chemotherapy and disease process may lead to low platelets Cancer may cause direct erosion of blood vessels (n.b. major blood vessel = fatal) Decreased clotting factors with liver metastasis or chemotherapy NSAIDs for pain, topical tranexamic acids/adrenaline soaks, oral tranexamic acid
35
Hypercalcaemia in malignancy - Mechanisms (3) - % of malignancies
PTH related peptide secretion by tumour (humoral hypercalcaemia) - renal, ovarian, breast, SCC Local osteolytic hypercalcaemia - Mets in breast, myeloma etc Calcitriol prod by lymphoma (over prod of active Vit D) 10% of malignancies 20% of hypercalcemias
36
Hypercalcaemia of malignancy | - Symptoms
Bones (pain) Stones Abdo moans (nausea, loss of appetite, constipation) Thrones (polyuria, polydipsia) Psychic Overtones (confusion, fatigue)
37
Investigations hypercalcaemia of malignancy
Total calcium Serum PTHrP (humoral) Serum Calcitrol (Lymphoma) Resting ECG
38
Treatment hypercalcaemia of malignancy
Treat underlying malignancy Avoid meds that worsen (Thiazides, calcium sups, antacids, lithium) IV normal saline, Bisphosphonates (Zoledronic acid - block osteoclast resorption_ Furosemide avoid fluid overload
39
SVC obstruction - Most commonly caused by what disease? - Mechansim of obstruction (2) - Specific causes
Most common cause is cancer Intraluminal obstruction / external compression blocks venous return from head/thorax/upper extremities 75% lung cancer 15% Non-hodgkin lymphoma 10%metastasis from breast/colon/oesophaguis Rest obstruction from other mediastinal cancer( Thymoma, germ cell etc)
40
SVC obstruction symptoms
``` Oedema of face & upper extremities Dyspnoea Facial plethora (venous engorgement) Cough Distended neck veins/Chest veins Hoarse voice Raised JVP (Fixed, non-pulsatile) ```
41
Investigations SVC obstruction
CXR (Widenened mediastinum or mass in lung) CT thorax USS upper extremities (dilated SVC, thrombus)
42
Complication of SVC obstruction + what must be done..
Acute airway obstruction Secure airway
43
SVC obstruction Tx
Treat malignancy Local radiotherapy and Dexamethasone (IV)
44
Tumour lysis syndrome - Def - Common cause - Diagnosis (Lab + Clinical)
Metabolic/Electrolyte abnormalities occurring following initiation of cytotoxic Tx in cancer. Due to excessive cell lysis. Highly proliferative chemosesnitive malignancies e.g. lymphoma & leukaemia Lab TLS: (2 of) hyperuricaemia, hyperphosphataemia, hyperkalaemia, HYPOcalcaemia Clinical TLS: Inc serum creatinine, arrhythmia (K+, hypoCa, PO4), Seizure (hypoCa - muscle cramps, tetany
45
TLS pathophys - AKI - HypoCa - HyperK+
High turnover of tumour cells/destruction by chemo = nucleic acid products )uric acid) + phosphate Uric acid/Phosphate crystals cause renal tubular obstruction -> AKI Hyperphosphataemia causes secondary hypercalcaemia (Calcium bound to form calcium phosphate) Cell degradation = high K+
46
Tumour lysis syndrome - RF - Pres - Ix
Haematological malignancy, chemosensitive, renal impairment, dehydration Syncope, chest pain, seizure, N&V, diarrhoea, muscle cramps/weakness Serum: high potassium, uric acid and phosphate, low calcium Elevated lactate dehydrogenase and serum urea ECG - electrolyte disturbance
47
Acute TLS Tx
Glucose+Insulin and salbutamol for hyperkalaemia Intense fluid resus Phosphate binder Rasburicase (uric acid binder in blood)
48
Preventing TLS
Prechemo IV hydration Regular monitoring (bloods, ECG) Phosphate binder Uric acid binder (Rasburicase)
49
Paraneoplastic syndrome - what - common with
This syndrome is consequence of cancer in body but not due to local presence of cancer cells mediated by humoral factors (hormones, cytokines) secreted by cancer cells or by immune response to tumour. Breast, lung, ovary, lymphomas
50
Lung small cell paraneoplastic syndromes
Hyponatraemia (dilutional): inappropriate ADH secretion Cushings: ACTH-like substance
51
Squamous cell lung cancer paraneoplastic syndrome
Hypercalcaemia due to parathyroid like substance
52
Carcinoid paraneoplastic syndrome - pres - cause - Ix - Tx
Flushing, diarrhoea, palpitations Serotonin release from neuroendocrine tumours. Often seen when mets to Liver 24 hr urinary 5HIAA Ocretoide (somatostatin analogue - inhibits secretion of many hormones) Surgical resection
53
Which cancers mets to bone? | What type of lesion
Breast - Lytic or sclerotic Prostate- sclerotic Lung - lytic Thyroid - lytic Myeloma -lytic
54
Familial cancer syndromes
``` MEN NF Retinoblastoma (assoc with sarcoma) Ataxia telangiectasia HNPCC/Lynch syndrome FAP VHL (Loss of HIF1-a degradation) ```
55
Sanctuary sites for cancers
These are areas chemotherapy does not reach well | e.g. Brain and scrotum
56
E.G of - Viral Carcinogen - Chemical Carcinogen - Hormonal Carcinogen - Parasitic Carcinogen - Exposural Carcinogen
Hep B, HHV-8, HPV-16/18 All, Smoking, Nitrosamines (pickled food) Oestrogen (breast), Testosterone (Prostate) Schistosomiasis Asbestos, dyes/rubber industry

Final (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions