oncology

Question 1

Types of cancers

Answer 1

Leukemias
lymphomas
CNS tumours
Neuroblastoma etc

0-4 age group

Question 2

who to be worried about

Answer 2

immediate refferal
0unexplained petechiae, hepatosplenomegaly

urgent referral

• repeat attendance, same problem, no clear diagnosis
• new neuro symptoms, abdo mass

Refer
-rest pain, back pain and unexplained lump
lymphadenopathy
hard, mobile, increasing in size

Question 3

what to do

Answer 3

scans
biopsy/ pathology
tumour markers
pet scan

where it is?
staging, bone marrow

Question 4

risk of treatment

Answer 4

acute
hair loss
nausea and vomiting
mucositis
diarrhoea/ constipation
bone marrow suppresion

Chronic- organ impairment- kidneys heart, nerves, ears
reduced fertility
second cancer

radiotherapy:
lethargy
skin irritation
swelling
organ inflammation- bowel, lungs

chronic
fibrosis/scarring
second cancer
reduced fertility

Question 5

oncological emergencies

Answer 5

febrile neutropenia
-infection major cause of morbidity

Risks
neutrophil count <0.5
indwelling catheter
mucosal inflammation
high dose chemo/SCT
psedomonas aeruginosa
enterobacteria E coli

Question 6

presentation

Answer 6

fever (or low temp)
rigors
drowsiness
chock

tachycardia
tachypnoea
hypotention, prolonged capillary refill time
reduced UO metabolic acidoses

Question 7

management

Answer 7

IV access
blood culture, FBC, coag, UE LFTs, CRP, Lactate
CXR
other
urine microscopy
throat swab
sputum culture/ BAL
LP
Viral PCRs
CT/USS
ABC

Question 8

spinal cord compression

Answer 8

-possible complication
-urgent MRI
start dexamethasone urgently to reduce peritumour oedema
surgery and radiotherapy are other options
outcome depdns on severity of impairment