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4th Year Finals Revision > Oncology > Flashcards

Oncology Flashcards

1
Q

What is the chemotherapy regime of choice for Hodgkin’s Lymphoma?

A

ABVD

Adriamyacin (aka doxorubicin), Bleomycin, Vinblastine and Dacarbazine.

If this were to fail, the next treatment would be bone marrow transplant

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2
Q

What system is used to stage Hodgkin’s Lymphoma?

A

The Ann Arbor System

Stage I - involvement of a single lymph node region or a single extra-nodal site

Stage II - two or more lymph node regions on the same side of the diaphragm, or of one lymph node region and a contiguous extra-nodal site

Stage III - involvement of lymph node regions on both sides of the diaphragm which may include the spleen and/or limited contiguous extra-nodal site or organ

Stage IV - disseminated involvement of one or more of the extralymphatic organs

ABES

A - asymptomatic

B - presence of B symptoms

E - localised extra-nodal extension

S - spleen involved

Stage IV

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3
Q

What is the chemotherapy regime of choice for Non-Hodgkin’s Lymphoma?

A

R-CHOP

Cyclophosphamide, Hydroxydaunorubicin (doxorubicin), Vincristine (Oncovin), Prednisone

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4
Q

Hypercalcaemia is a common symptom seen in patients with various cancers. How is it treated?

A

Rehydration is key with IV 0.9% Saline

Bisphosphonates can also be given to prevent bone breakdown

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5
Q

What tumour marker is associated with Hepatocellular Carcinoma?

A

Alpha Fetoprotein (AFP)

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6
Q

What tumour marker is associated with pancreatic cancer?

A

Ca-19-9

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7
Q

What tumour marker is associated with testicular cancer?

A

Human chorionic gonadotrophin (HCG)

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8
Q

What tumour marker is associated with ovarian cancer?

A

Ca-125

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9
Q

What mutation is associated with an increased risk of breast cancer?

Does it increase the risk of any other cancers?

What % chance does a child have of inheriting this gene mutation?

A

BRCA1 and BRCA2 (the former making breast ca 72% more likely, and the latter making it 69% more likely)

The BRCA genes are also associated with an increased risk of ovarian cancer, pancreatic cancer, prostate cancer and melanoma

There is a 50% chance that mutations in this gene are passed on

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10
Q

What tumour marker is associated with colon and stomach cancers?

A

CEA

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11
Q

What marker might you see raised in the bloods of someone with multiple myeloma?

A

Immunoglobulins - IgA, IgG etc.

Also low RBC count

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12
Q

What type of cancer do patients with pernicious anaemia have a 2-3 fold increase in getting?

A

Gastric adenocarcinoma

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13
Q

Classically, what type of malignancy is Coeliac disease associated with?

A

Lymphoma

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14
Q

What is Plummer-Vinson syndrome?

What type of malignancy is it associated with?

A

Rare condition resulting in oesophageal structuring/webs, atrophic glottitis and iron deficiency anaemia

Patients present with painless dysphagia

Associated with oesophageal squamous cell cancer

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15
Q

What classic histological signs are seen when performing microscopy on a sample from a yolk sac tumour?

What tumour marker is raised in yolk sac tumours?

A

Schiller-Duvalle bodies are seen that represent glomeruli

AFP is raised in yolk sac tumours

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16
Q

What are the most common to least common types of thyroid cancers?

A

PFMA

Papillary - 75%

Follicular - 10%

Medullary - 8%

Anaplastic - approx. 2%

NB - as the tumour type becomes less common, the prognosis also becomes worse

17
Q

What tumour marker is used for the surveillance of papillary and follicular thryoid cancers?

A

Thyroglobulin, which is secreted by the thyroid follicular cells

18
Q

What is the tumour marker that tends to be raised in medullary thyroid carcinomas?

What cells in the thyroid produce this marker?

A

Calcitonin

Calcitonin is secreted by the parafollicular cells of the thyroid

19
Q

What is the classic symptom experienced by patients with spinal cord compression due to cancer?

How does this symptom present?

A

Classic symptom is pain

Majority of patients feel it in the spine and state that it is worse on coughing

Pain is also radicular in distribution

20
Q

As a junior doctor, how should you manage a patient presenting acutely with spinal cord compression?

A

Urgent MRI of spine

Give dexamethasone, 16mg IV first then 8mg orally

Purpose of giving dexamethasone is to reduce vasogenic oedema

21
Q

Regarding further management of spinal cord compression, what is the mainstay of treatment?

A

Surgery

Surgery can be considered if…

  • A single vertebral region of involvement
  • No evidence of widespread metastasis
  • A radio-resistant primary tumour (e.g. renal)
  • Previous radiotherapy to the site that has not been sufficient
  • Unknown primary tumour – in this case the purpose of the surgery is to get a tissue sample

Chemotherapy can also be used in theory for sensitive tumours such as lymphomas and small cell lung cancers

4th Year Finals Revision (13 decks)

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