Oncology

Question 1

Define oncology

Answer 1

The study of tumours

Question 2

Define tumour

Answer 2

An abnormal mass of tissue, the growth of which is

virtually autonomous and exceeds that of normal tissues

Question 3

How are tumours different from non-neoplastic proliferations?

Answer 3

Unlike non-neoplastic proliferations, growth of tumours persists after cessation of the stimuli that initiated change

Question 4

What are the two components of tumours?

Answer 4

• Neoplastic cells
• Supporting stroma
  (i. e. CT, blood vessels)

Question 5

Give some examples of benign tumours

Answer 5

• Lipoma
• Fibroma
• Osteoma
• Leiomyoma
• Adenoma
• Papilloma

Question 6

What do carcinomas affect?

Give 2 examples of these

Answer 6

• Epithelial tissue
• Oral squamous cell carcinoma
• Adenocarcinoma

Question 7

What do sarcomas affect?

Give 2 examples of these

Answer 7

• Mesenchymal tissue
• Osteosarcoma
• Liposarcoma

Question 8

Distinction of malignant tumours are based on appearance and behaviours

What behaviours of tumours suggest that they are malignant? (4)

Answer 8

• Altered differentiation and anaplasia
• Rate of growth
• Metastases
• Local invasion
  (eg OSCC invasion through basement membrane into underlying connective tissue)

Question 9

All malignant tissues metastasise except for? (2)

Answer 9

• Tumours of the brain

- Basal cell carcinoma

Question 10

Where do tumours spread via? (3)

Answer 10

• Body cavities
• Lymphatics
• Blood vessels (haematogenous)

Question 11

Bone and soft tissue tumours (sarcomas) spread primarily through what?

Answer 11

Blood system

Question 12

Melanoma, breast, lung and gastrointestinal tumours spread through what?

Answer 12

Lymphatic system

Question 13

What is the most common cancer worldwide?

Answer 13

Lung cancer

Question 14

What are the top 3 cancers for men?

Answer 14

• Lung
• Prostate
• Colorectal

Question 15

What are the top 3 cancers for women?

Answer 15

• Breast
• Colorectal
• Lung

Question 16

What are some environmental factors that can cause some mutations in the genome in somatic cells? (3)

Answer 16

• Chemical
• Radiation
• Viruses

Question 17

What can mutations in the genome in somatic cells cause? (3)

Answer 17

• Activation of growth- promoting oncogenes
• Alterations of genes that regulate apoptosis and DNA repair
• Inactivation of cancer suppressor genes

Question 18

Give the chemical carcinogens for the following tumours;

Lung cancer & Mesothelioma (2)

Answer 18

• Aromatic hydrocarbons

- Asbestos

Question 19

Give the chemical carcinogens for the following tumours;

Hepatocellular cancer
Gastric cancer
Bladder cancer
Aplastic anaemia

Answer 19

• Hepatocellular cancer
• Nitrosamines and amides
• Azo dyes
• Alkylating agents

Question 20

How can ionising radiation promote cancer?

Answer 20

By damaging cellular genes resulting in gene mutations

Question 21

What are some sources of radiation? (3)

Answer 21

• Natural radiation
• Nuclear power
• Medical tests

Question 22

What are some predisposing factors of basal cell carcinomas and squamous cell carcinoma? (6)

Answer 22

• UV radiation (sun exposure in childhood)
• Skin type I or II (freckles)
• Arsenic
• Ionising radiation
• Burn/vaccination scars
• Immunosuppression

Question 23

Give some examples of chromosomal abnormalities leading to tumours (4)

Answer 23

• Balanced translocations
• Point mutations
• Deletion of tumour suppressor genes
• Gene amplification

Question 24

A 58-year old smoker has been losing weight and has a poor appetite. She has been increasingly short of breath over the past few weeks and sees her GP for advice. She is found to have clubbing and appears pale. Her chest is clear and her abdominal examination unremarkable. Which one of the following diagnoses is MOST likely to account for these clinical features?

Answer 24

Carcinoma of the bronchus

Question 25

Give some symptoms of lung cancer (6)

Answer 25

• Cough
• Haemoptysis (coughing blood)
• Dyspnoea
• Chest pain
• Pneumonias
• Loss of appetite and weight loss

Question 26

Give some signs of lung cancer (5)

Answer 26

• Cachexia
• Clubbing
• Anaemia
• Lymphadenopathy
• Metastases

Question 27

Give some clinical features of Horner’s syndrome (4)

Answer 27

• Enophthalmos
• Meiosis
• Ipsilateral facial anhydrosis
• Partial ptosis

Question 28

What are some causes of Horner’s syndrome? (5)

Answer 28

• Vascular lesions of cortex/brainstem
• Cervical rib
• Lung cancer
• Thyroid
• Oesophagus

Question 29

What changes in pigmented lesions of the kin would suggest malignancy? (6)

Answer 29

• Size
• Shape (irregular)
• Colour (variation)
• Erythema (at edge)
• Crusting, oozing, bleeding
• Itch

Question 30

What are some cancer screening methods? (5)

Answer 30

• Chest radiograph
• Positron Emission Tomography
• Genetic analysis
• Cytology
• Biopsy

Question 31

Give some risk factors of oral cancers

Answer 31

• Old age
• Male gender
• Tobacco
• Alcohol
• Sun exposure of lip
• Lichen planus
• Ionising radiation
• Immunosuppression
• Low socioeconomic status
• Infection (HPV, candida, syphilis)

Question 32

What are some clinical features of oral squamous cell carcinomas? (6)

Answer 32

• Granular ulcer
• Indurated ulcer
• Red lesions
• White lesions
• Speckled lesions
• Lump