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Hamilton 2020 Questions > Oncology > Flashcards

Oncology Flashcards

1
Q

Corey is a 2-year old boy who presents to the emergency department with abdominal distension and pain
Parents have noticed his belly being big for a couple of weeks, but no other symptoms
He complained of some discomfort today
On examination he was well but had a 10-cm mass
palpable in the upper right side of his abdomen
There are no other findings, and no lymphadenopathy
Which of these tumours is the LEAST likely diagnosis in this case?
a) Hepatoblastoma
b) Wilms tumour
c) Neuroblastoma
d) Burkitt’s lymphoma

A

d) Burkitt’s lymphoma

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2
Q

Which tumour is associated with the “claw sign” on CT scan?

  1. Hepatoblastoma
  2. Wilms tumour
  3. Neuroblastoma
  4. Burkitt’s lymphoma
A
  1. Wilms tumour
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3
Q

Which tumour diagnosis would be supported by a raised AFP level?

  1. Hepatoblastoma
  2. Wilms tumour
  3. Neuroblastoma
  4. Burkitt’s lymphoma
A
  1. Hepatoblastoma
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4
Q

Which tumour is most likely to occur at the metaphysis?

  1. Osteosarcoma
  2. Ewing sarcoma
  3. Chondrosarcoma
  4. Rhabdomyosarcoma
A
  1. Osteosarcoma
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5
Q

What is the most COMMON initial symptom of osteosarcoma?

  1. Swelling
  2. Pain at rest
  3. Pain with activity
  4. Pathological fracture
A
  1. Pain with activity
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6
Q

What is the commonest site for metastases in Osteosarcoma?

  1. Lymph nodes
  2. Adjacent bone (“skip lesions”)
  3. Brain
  4. Lung
A
  1. Lung
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7
Q

Which of these is NOT a short-term side effect of Doxorubicin

  1. Myelosuppression
  2. Hair loss
  3. Nausea/vomiting
  4. Haemorrhagic cystitis
A
  1. Haemorrhagic cystitis
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8
Q

Which of these is a long-term side effect of Cisplatin?

  1. Hepatic fibrosis
  2. Hearing loss
  3. Infertility
  4. Cardiomyopathy
A
  1. Hearing loss
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9
Q

Flow cytometry in a new oncology patient shows:
Positive CD19, Tdt, CD10
Negative CD3, CD33, Myeloperoxidase (MPO)
Which of these is the most likely diagnosis?
1. Acute Myeloid leukaemia
2. Pre B-cell Acute lymphoblastic leukaemia
3. T-cell Acute lymphoblastic leukaemia
4. Chronic myeloid leukaemia

A
  1. Pre B-cell Acute lymphoblastic leukaemia
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10
Q

Acute Lymphoblastic Leukaemia comprises what proportion of childhood cancer cases?

  1. 10%
  2. 15%
  3. 25%
  4. 40%
A
  1. 25%
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11
Q

Which of these features puts a patient into the “high risk” classification group for Pre-B ALL?

  1. Age = 12
  2. WBC = 35.6 x 109/L
  3. Male sex
  4. Trisomy 4
A
  1. Age = 12
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12
Q

Which of these drugs MUST NOT be given intrathecally?

  1. Hydrocortisone
  2. Vincristine
  3. Methtrexate
  4. Cytarabine
A
  1. Vincristine
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13
Q

Which of these is NOT a B-symptom?

  1. Drenching night sweats
  2. Persistent itch
  3. Weight loss >10%
  4. Fevers >38oC
A
  1. Persistent itch
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14
Q

What is the most IMPORTANT investigation to perform prior to biopsy of a concerning lymph node?

  1. CBC
  2. Electrolytes
  3. Pulse oximetry
  4. Chest X-ray
A
  1. Chest X-ray
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15
Q

What is the name given to the characteristic cell (arrowed) in Hodgkin’s Lymphoma?

  1. Reed-Sternberg cell
  2. Hodgkin cell
  3. Owl-face cell
  4. Snake-eye cell
A
  1. Reed-Sternberg cell
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16
Q

Patient presents unwell with fever 12 days after her first cycle of chemotherapy
Fever 39.2oC
BP 72/32 mmHg
HR 146/min
RR 32/min
Bloods: Hb 88g/L, WBC 0.4 x 109/L, Plt 32 x 109/L
What is the MOST APPROPRIATE management plan?
1. Blood culture, start IV broad spectrum antibiotics
2. Blood culture, start oral antibiotics
3. Blood culture, IV fluid bolus, start broad spectrum antibiotics
4. Blood culture, IV fluid infusion, start broad spectrum antibiotics

A
  1. Blood culture, IV fluid bolus, start broad spectrum antibiotics
17
Q

Which of these is UNLIKELY to be a long-term side effect of radiotherapy for lymphoma?

  1. Scoliosis
  2. Coronary artery disease
  3. Hypothyroidism
  4. Breast cancer
A
  1. Scoliosis
18
Q 
9-year old Matthew presents to his community ER with:
Headaches
Vomiting
Lethargy
Unsteadiness

Examination shows:
Papilloedema
Left inturning squint

You suspect he has a brain tumour

What IMMEDIATE treatment can be given to alleviate his symptoms, and potentially be life-saving?

  1. Dexamethasone
  2. Surgical resection of tumour
  3. Ventricular drainage
  4. Lumbar puncture
A

Dexamethasone

19
Q 
9-year old Matthew presents to his community ER with:
Headaches
Vomiting
Lethargy
Unsteadiness

Examination shows:
Papilloedema
Left inturning squint

You suspect he has a brain tumour

What do you think is the likely site of the tumour?

  1. Hypothalamus
  2. Thalamus
  3. Pineal gland
  4. Posterior fossa
A
  1. Posterior fossa
20
Q

On the family history of a patient with a posterior fossa tumour, you note that:
Multiple maternal relatives have basal cell carcinomas
Mother had cleft lip/palate
Aunt had multiple dental cysts removed

Which cancer predisposition syndrome would you suspect in Matthew’s family?

  1. Li Fraumeni syndrome
  2. Neurofibromatosis type 1
  3. Lynch syndrome
  4. Gorlin syndrome
A
  1. Gorlin syndrome

Hamilton 2020 Questions (29 decks)

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