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Finals > Oncology > Flashcards

Oncology Flashcards

1
Q

Causes of acute confusion?

A 
Sepsis
Hypercapnia
Hypercalcaemia
Ammonia
AKI 
Steroids
Brain mets
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2
Q

Mx of hypercalcaemia

A

Saline
Bisphosphonates

+/- calcitonin

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3
Q

SEs of bisphosphonates?

A

Oesophagitis
Gastritis
Osteonecrosis (jaw, fem head)

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4
Q

Mx of raised ammonia

A

Phosphate enema

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5
Q

How does AKI cause confusion in a patient on opiates?

A

Dehydration –> decrease opiate excretion –> increased opiate level –> confusion + sedation

mx = naloxone

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6
Q

Mechanism of steroid psychosis?

A

-> Reduced Na; therefore reduced water –> reduced BP

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7
Q

Drug causes of hyponatraemia?

A 
Steroids
PPI
SSRI
Carbamazepine
Fluids
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8
Q

Metastatic cascade?

A 
Detachment
Invasion
Intravasation
Evasion of host defence
Adherence
Extravasation
Angiogenesis
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9
Q

Indications for radiotherapy?

A 
Medically unfit for surgery
Anatomically unresectable
Neo-adjuvant
Adjuvant
Palliative (bone/brain mets/SCC)
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10
Q

Types of radiotherapy

A

External beam

Internal - brachytherapy

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11
Q

Comps of radiotherapy

A

Acute [fatigue, skin, GI, N+V+D, BM, lungs]

Chronic [infertility, lymphoedema, delayed healing, CV events, hypothyroid]

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12
Q

SEs of chemo

A 
Myelosuppression (usually worst 1 week after --> NEUTROPENIC SEPSIS!)
Alopecia
Infertility 
N+V+D
Fatigue
Teratogenicity
Mouth ulcers
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13
Q

Extravasation?

A

Problem with chemo -pain, redness and inflam –> may lead to skin necrosis + need for amputation

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14
Q

Mx of extravasation?

A

Topical agents

Debridement + grafting

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15
Q

Severe reaction to chemo?

A

Anaphylaxis

quite common

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16
Q

Ix in fever + recent chemo?

A

!!Neutropenic sepsis until proven otherwise!!

FBC, LFT, U+Es, CRP, lactate, Blood cultures, urine culture, NOT LP, swabs and cultures (from central line)

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17
Q

Spinal cord compression pres?

A

Pain
Sensory loss
Weakness
+/- incontinence

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18
Q

Ix in suspected SCC?

A

MRI whole spine

19
Q

Mx of SCC?

A

Dexamethasone, VTE prophylaxis, analgesia

Refer to neurosurgery/spinal

20
Q

Mx of painful spinal mets?

A

Analgesic ladder
Bisphosphonates
Palliative radio
Vertebroplasty

21
Q

Cause of hypercalcaemia in malignancy?

A

Osteolytic
Boney mets
Secretion of PTHrP

22
Q

Ix in hypercalcaemia?

A 
Total calcium 
Ionised calcium
Serum albumin
ECG
PTH
Skeletal survey
23
Q

Medications which worsen hypercalcaemia?

A

Thiazide
Calcitriol
Antacids
Lithium

24
Q

Mx of hypercalcaemia?

A

IV saline
+/- IV bisphosphonates
Furosemide

25
Q

Cause of SVCO?

A

Malignancy
75% lung Ca
15% lymphoma

26
Q

Pres of SVCO?

A

Oedema of face + upper extremities
Dyspnoea
Facial plethora
Cough

Fixed (non-pulsatile) + raised JVP

27
Q

Ix in SVCO?

A

CXR

CT thorax with contrast

28
Q

Mx of SVCO?

A

Secure airway + dexamethasone

+ radio / stent

29
Q

Tumour lysis syndrome?

Which cancers?

A

Metabolic and electrolyte abnormalities occurring spontaneously following initiation of cytotoxic treatment in patients with cancer
Lymphoma

30
Q

Ix in tumour lysis syndrome?

A

Hyperuricaemia
Hyperphosphataemia
Hyperkalaemia
Hypocalcaemia

31
Q

Pres of tumour lysis?

A

Arrhythmia (hyperK)
Muscle cramps/tetany (hypoCa)
AKI (uric acid nephropathy)

32
Q

LEMS?

Which cancer?

A

AI disorder of NM junction (Anti-VGCaC)

SCLC (often precedes cancer diagnosis by several years)

33
Q

Pres of LEMS?

A

Limb weakness (proximal)
Dry mouth
Dysarthria, ptosis, diplopia

Weakness improves on use

34
Q

Ix in LEMS?

A

Anti-VGCaC +ve
Anti-AChR -ve
NCS –> muscle action potential increases with exercise

35
Q

Mx of LEMS?

What if resp involvement?

A

Treat cause + amifampridine + pred

Intubation + ventilation + plasma exchange

36
Q

Pres of carcinoid syndrome?

A

Flushing + diarrhoea

due to serotonin from neuroendocrine tumour

37
Q

Dx of carcinoid?

A

Elevated urinary 5-hydroxyindoleacetic acid

38
Q

Mx of carcinoid

A

Octreotide + surgical resection of tumour

39
Q

Cancers that met to bone?

A 
Breast
Prostate
Bronchus
Myeloma
Thyroid
40
Q

What drug interacts with Tazocin?

Alternate abx?

A

If on MTX (both act on folic acid)

Give meropenem instead

41
Q

What can you give pts with high risk of neutopenic sepsis?

A

G-CSF [boosts bone marrow]

42
Q

What is bones, moans stones, psych overtones?

A

Bone pain
Abdo moans [N+V+D+ pain]
Kidney stones
Confusion, agitation

43
Q

Mx of TLS?

A

Allopurinol/rasburicase
Fluids

+/- dialysis

Finals (20 decks)

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