Oncology

Question 1

What are the signs and symptoms of hypercalcaemia?
What is the management?
What are other causes of hypercalcaemia? (4)

Answer 1

Polyuria, polydipsia, confusion, abdominal pain, nausea, vomiting, constipation, lethargy

IV fluids, monitor U&Es, bisphosphonates if refractory e.g. IV zoledronic acid or PO aldendronic acid

Hyperparathyroidism, sarcoidosis, thyrotoxicosis, prolonged immobilisation

Question 2

What is the criteria for neutropenic sepsis?

What is a differential for fever in cancer patients? (4)

Answer 2

Temp >38 or >37.5 on 2 occasions, <36; neutrophils <0.5

Side effects of anticancer treatment, inflammatory disorders, thyrotoxicosis, secondary malignancy

Question 3

What is the management of MSCC? (5)

Answer 3

MRI within 24 hours
Contact MSCC coordinator
Dexamethasone 8mg BD + PPI + monitor BMs
Analgesia 
Flat bed rest

Question 4

What are the symptoms of SVCO?

What is the managment of SVCO? (2)

Answer 4

Dyspnoea, orthopnoea, cough, headache, blurred vision, red and swollen face, distended neck veins

Dexamethasone 8mg BD + PPI + monitor BMs
Elevate head and give oxygen

Question 5

What are the signs and symptoms of tumour lysis syndrome?
What electrolyte abnormalities would you expect to see?
What is the management? (2)

Answer 5

Nausea, vomiting, lethargy, confusion, haematuria, flank pain, oedema

Raised phosphate, potassium and uric acid; low calcium

Manage hyperkalaemia
IV fluids
Rasburicase
Bloods twice a day

Question 6

What are the phases of a clinical trial?

Answer 6

0 - check if a treatment if harmful
1 - finding out side effects and effect on body
2 - more about side effects and how treatment works
3 - comparing new treatment to other treatment (RCT)
4 - long term benefits and side effects

Question 7

What is required in order to have informed consent to participate in a clinical trial? (5)

Answer 7

Can withdraw at any time
Standard therapy will always be available to them
Details of treament and follow-up
Entry is voluntary and refusal will not affect treatmet
Any other information they require

Question 8

What are the 5 grades for documenting adverse effects in cancer treatments?

Answer 8

1 - mild
2 - moderate
3 - severe
4 - life-threatening
5 - death

Question 9

What paraneoplastic syndromes are associated with lung cancer? (5)

Answer 9

SIADH, Cushing’s, hypercalcaemia

Lambert-Eaton syndrome, hypertrophic osteoarthropathy