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500 SBA's > ONCOLOGY > Flashcards

ONCOLOGY Flashcards

1
Q

What is the treatment of acute hypercalcaemia?

A

saline
saline
saline
saline

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2
Q

Which cancers have a high tendency to metastasize to the bones?

A 
Breast
Prostate
Lung
Thyroid
Renal
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3
Q

Whats the PC of colorectal cancer

A

Change in bowel habit
Blood + Mucous MIXED in stool
Weight loss
Tenesmus

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4
Q

What is the PC of oesophageal cancer?

A

Progressive dysphagia
Regurg, Cough, Choking on food
Weight loss

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5
Q

What are the findings on endoscopy of oseophageal adenocarcinoma and oesophageal squamous cell cancer

A

adenocarcinoma - lower third

squamous cell cancer - upper 2/3rd’s

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6
Q

What is the most common oesophageal cancer type

A

adenocarcinoma

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7
Q

What is oesophageal adenocarcinoma strongly associated with?

A

GORD

Barret’s

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8
Q

What is the most common skin cancer?

A

basal cell carcinoma

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9
Q

Describe the appearance of a standard BCC

A

Usually on FACE*, scalp, ears trunk.

Small glistening, translucent skin
Pearly edges with central ulcer
Rolled edges
Fine telangiectasia on tumour.

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10
Q

Which cancers commonly cause SIADH?

A 
Small cell lung cancer
Prostate
Thymus
Pancreatic cancers
Lymphomas
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11
Q

What are the results for SIAD of serum and urine osmolality?

A

Low serum osmolality
High urine osmolality

Low serum Na+ = present with confusion

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12
Q

How does SIADH present?

A

Hyponatraemia
Confusion

  • Headache
  • Nausea/vomiting
  • Muscle cramp/weakness
  • Irritability
  • Confusion
  • Drowsiness
  • Convulsions
  • Coma
  • Symptoms of underlying cause
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13
Q

Generate a management plan for SIADH

A
  • Treat underlying cause
  • Fluid restriction
  • Vasopressin receptor antagonists (e.g. tolvaptan)
  • In SEVERE cases - slow IV hypertonic saline and furosemide with close monitoring
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14
Q

Whats the very first thing you do for hyponatremia?

A

Fluid restriction + Mx of underlying cause

If sodium levels dont seem to increase you then turn to medical mx: VP receptor antagonists

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15
Q

Pt with gastric cancer presents with a weird nodule on his belly button
What is this

A

Sister mary Joseph nodule

Associated with gastric or gynaecological cancer

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16
Q

Lung cancer patient presents with sudden onset SOB, hand and arm sweelling
His face is plethoric
What is this?

A

Superior vena cava obstruction

Commonly associated with lung cancer and other mediastinal masses (germ cell tumours, lymphomas, goitres, thrombotic disorders)

PC: dyspnoea, swollen face and upper limbs, plethora, headache.
Pemberton’s sign = raise hands above head and face flushes.

17
Q

What is carcinoid syndrome

A

• Carcinoid tumours which slow-growing neuroendocrine tumours
• Mostly derived from serotonin-producing enterochromaffin cells
• They produce secretory products like SEROTONIN, histamine, tachykinins, kallikrein and
prostaglandins

  • 75-80% of patients with carcinoid syndrome have small bowel carcinoids
  • NOTE: hormones released into the portal circulation will be metabolised by the liver so symptoms don’t tend to appear until there are hepatic metastases** or release into the systemic circulation from bronchial or extensive retroperitoneal tumours
18
Q

Recognise the presenting symptoms of carcinoid syndrome

A
  • Paroxysmal FLUSHING *
  • Diarrhoea *
  • Crampy abdominal pain
  • Wheeze
  • Sweating
  • Palpitations
19
Q

Recognise the signs of carcinoid syndrome on physical examination

A
  • Facial flushing
  • Telangiectasia
  • Wheeze
  • Right-sided murmurs (tricuspid stenosis/regurgitation or pulmonary stenosis)
  • Nodular hepatomegaly in cases of metastatic disease
20
Q

Carcinoid Crisis Signs:

A

o Profound flushing
o Bronchospasm
o Tachycardia
o Fluctuating blood pressure

21
Q

Identify appropriate investigations for carcinoid syndrome

A

• 24 hours urine collection
o Check 5-HIAA levels (metabolite of serotonin)

• Blood
o Plasma chromogranin A and B
o Fasting gut hormones

• CT or MRI Scan
o To localise the tumour

• Radioisotope Scan
o Radiolabelled somatostatin analogue helps localise the tumour

• Investigations for MEN-1 (associated with carcinoid tumours)

500 SBA's (12 decks)

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