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Year 4 > Oncology > Flashcards

Oncology Flashcards

1
Q

Purine Analogues

A 
Fludarabine 
Cladribine 
Pentostatin 
Clofarabine 
Nelarabine 
Azathioprine
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2
Q

R-CHOP chemotherapy components

A 
Rituximab 
Cyclophosphamide 
Doxorubicin 
Vincristine 
Prednisolone
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3
Q

ABVD chemotherapy components

A

Adriamycin
Bleomycin
Vinblastine
Dacarbazine

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4
Q

Who needs irradiated blood?

A

Any Hodgkins Lymphoma
Any Purine Analogue Chemotherapy
Immunosuppressed

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5
Q

Who needs CMV negative blood?

A

Pregnant women - not essential at delivery

Neonates

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6
Q

SIRS Criteria

A

Fever >38 or hypothermia <36
RR > 20
HR > 90 beats/minute
WBC >12

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7
Q

Neutropaenic Sepsis =

A

Sepsis and neutrophil count <0.5

If chemotherapy within last 21 days, then neutrophil count <1

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8
Q

Definition of standard risk of neutropaenic sepsis

A

Neutropaenia
Sepsis
NEWS < 6

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9
Q

Definition of high risk of neutropaenic sepsis

A

Neutropaenia
Septic shock
NEWS > 7

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10
Q

Management of standard risk neutropaenic sepsis

A

Piperacillin or Tazobactam

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11
Q

Management of standard risk neutropaenic sepsis

Penicillin Allergic

A

Teicoplanin + Aztreonam

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12
Q

Management of high risk neutropaenic sepsis

A

Piperacillin/Tazobactam
+
Gentamicin

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13
Q

Management of high risk neutropaenic sepsis

Penicillin Allergic

A

Teicoplanin + Aztreonam + Gentamicin

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14
Q

Chemotherapy and Gentamicin

A

Get advice if on cisplatin chemotherapy

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15
Q

Neutropaenic Sepsis and Previous ESBL Management

A

Meropenem

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16
Q

When should antibiotic therapy be reviewed in neutropaenic sepsis?

A

48-72 hours
If afebrile consider converting to oral antibiotics
If persistent consider switching to meropenem

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17
Q

Types of non-small cell lung cancer

A

Adenocarcinoma
Squamous cell
Large cell
Mixed/Undifferentiated

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18
Q

ABVD chemotherapy is used in

A

Hodgkins Lymphoma

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19
Q

CHOP/R-CHOP is used in

A

Non-Hodgkins Lymphoma

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20
Q

MVAC chemotherapy is used in

A

Advanced bladder cancer

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21
Q

Types of bladder cancer

A

Transitional cell carcinoma

Squamous cell carcinoma

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22
Q

Association with transitional cell carcinoma

A

Smoking
Aniline dyes
Rubber manufacture

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23
Q

Associations with squamous cell carcinoma of the bladder

A

Schistomiasis

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24
Q

Adjuvant VS Neo-Adjuvant

A 
Adjuvant = to reduce cancer recurrence 
Neo-Adjuvant = to down-stage the tumour prior to tumour
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25
Q

Bone Marrow Suppression in Chemo (3)

A

Neutropaenia
Anaemia
Thrombocytopaenia

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26
Q

GI Toxicitiy in Chemo (2)

A

Nausea/vomiting

Mucositis

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27
Q

Neurotoxicity in Chemo (2)

A

Peripheral Neuropathy

Ototoxicity

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28
Q

Cardiac Toxicity in Chemo (2)

A

Reduced ejection fraction

Coronary vasospasm

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29
Q

Bladder Toxicity in Chemo

A

Haemorrhagic Cystitis

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30
Q

MOA of Anti-Metabolite Chemotherapy

A

Inhibit folic acid synthesis
OR
Inhibit purine/pyramidine synthesis

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31
Q

Examples of Anti-Metabolites (4)

A

5FU
Azathioprine
Fludarabine
Methotrexate

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32
Q

MOA of Anti-Microtubule Agents

A

Prevent microtubule function

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33
Q

Examples of Anti-Microtubule Agents (3)

A

Paclitaxel
Vincristine
Vinblastine

34
Q

Types of Alkylating Agents

A

Platinum Drugs
Nitroureas
Cyclophosphamide, Dacarbazine

35
Q

Cetuximab target

36
Q

Rituximab target

37
Q

Describing the dose of radiotherapy

A

Measured in Gray (Gy)
A fraction describes a single treatment
e.g. Radiation at 60Gy in 30 fractions (2Gy per fraction)

38
Q

Short Term/Temporary Effects of Radiotherapy (5)

A 
SOB 
Cough 
Oesophagitis 
Headaches 
Skin changes
39
Q

Long Term/Permanent Effects of Radiotherapy (2)

A

Fibrosis

Memory changes

40
Q

What is SABR?
What is it used for?
What are the side effects?

A

Sterotactic ablative body radiotherapy
= more accurate delivery of external beam radiotherapy: use higher doses/fraction
Lung cancer
S/E: rib fractures, myelopathy

41
Q

What is Bracytherapy?

What is it used for?

A

= small radiotherapy sources into or next to the tumour

Uses: cervical cancer, endometrial cancer, prostate cancer

42
Q

Management of Chemotherapy Induced Nausea and Vomiting

A

Dexamethasone
NK1 Antagonist
5HT3 Antagonist

43
Q

Benefit of the 5HT3 Antagonist in CINV

A

Effective for acute events

44
Q

Benefit of the NK1 Antagonist in CINV

A

Effective for delayed events

45
Q

Acute CINV =

A

Within 24 hours of chemotherapy

46
Q

Delayed CINV =

A

24 hours - 7 days post chemotherapy

47
Q

Example of NK1 Antagonist

A

Aprepitant

48
Q

Examples of 5HT3 Antagonist (2)

A

Ondansetron

Granisetron

49
Q

Management of anticipatory nausea and vomiting

50
Q

Metoclopramide

Contraindications

A

Cannot be used in Parkinson’s Disease

51
Q

Extra-thoracic presentations of lung cancer (3)

A

Liver - painful due to the stretching of the liver capsule
Bone - lytic lesions. May also result in cord compression
Brain - mass effect may result in headaches, vomiting, visual loss or seizure

52
Q

Paraneoplastic syndromes associated with lung cancer (4)

A

Hypercalcaemia
SIADH secretion
Cushing’s syndrome
Hypertrophic osteoarthropathy

53
Q

Curative radiotherapy dose in lung cancer

A

55Gy in 20 fractions

54
Q

Radiotherapy offered in small cell lung cancer

A

Offer prophylactic irradiation of the brain (mets)

55
Q

Two main groups of ovarian tumour

A

Epithelial cell tumours

Germ cell tumours

56
Q

Types of epithelial ovarian tumour (4)

A

Serous
Mucinous
Endometriod
Clear cell

57
Q

Stage 1A vs Stage 1B Endometrial Carcinoma

A

1A - contained within the endometrium

1B - spread into the myometrium

58
Q

When to use Trastuzumab in Breast Cancer

A

HER2 Positive

59
Q

Most common area for BPH to develop

A

Transitional zone of the prostate

60
Q

Most common area for prostate cancer to develop

A

Peripheral zone of the prostate

61
Q

Grading system used in prostate cancer

A

Gleason System

62
Q

When would radical prostectomy be considered?

2 conditions

A

Lifespan >10 years

T1-3 stage tumour

63
Q

Which lymph nodes drain the prostate?

A

Internal iliac nodes

64
Q

Management of oedema in brain tumours

65
Q

Initial investigation of choice in suspected brain tumour

66
Q

Benign brain tumours (5)

A 
Pituitary adenoma 
Cranio-pharyngioma 
Meningioma
Acoustic neuroma 
Dermoid tumour
67
Q

Malignant brain tumours (5)

A 
Glioma 
Pineoblastoma 
Primary Cerebral Lymphoma 
Medulloblastoma 
Germinoma
68
Q

Association with Primary Cerebral Lymphoma

69
Q

Grading of Glioma

A

I - fibrillary astrocytoma
II - astrocytoma or oligodendroglioma
III - anaplastic astrocytoma OR oligodendroglioma
IV - glioblastoma multiforme

70
Q

Management of malignant brain tumours

A

Radiotherapy - 60Gy in 30 fractions

Temozolamide chemotherapy

71
Q

Presentation of pain in spinal cord compression

A

Radicular pain = band around the middle, burning pain

72
Q

Investigation of suspected spinal cord compression

A

Urgent MRI of spine

73
Q

Management of spinal cord compression

A

Radiotherapy

74
Q

Causes of hypercalcaemia in malignancy (3)

A

Release of PTH-related protein
Local destruction of bone
Tumour produces vitamin D analogues

75
Q

Management of hypercalcaemia

A

Rehydration - lots of saline
Bisphosphonates - IV pamidronate (can cause renal failure so checking U&Es important)
Systemic management of the malignancy

76
Q

Pathophysiology of pericardial tamponade

A

Pericardial effusion develops
Compresses the ventricle, reducing cardiac output
Collapses the right atrium increasing venous back pressure

77
Q

Beck’s Triad

  • What an indication of?
  • Components?
A

= pericardial effusion

  1. Jugular venous distension
  2. Muffled heart sounds
  3. Hypotension with narrowed pulse pressure
78
Q

Investigation of choice in suspected PE

79
Q

Lung cancer associated with hypercalcaemia

A

Squamous cell carcinoma

80
Q

Potential complication of cervical cancer

A

Ureteric obstruction

81
Q

Chemo drug associated with cardiomyopathy

A

Doxorubicin

82
Q

How does chemotherapy result in a proteinuria?

A

Causes direct renal tubular damage = proteinuria

Year 4 (27 decks)

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