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CHHD > Oncology I > Flashcards

Oncology I Flashcards

1
Q

Define Oncology

A

Study of tumours

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2
Q

What is a tumour

A

An abnormal mass of tissue, the growth of which is virtually autonomous and exceeds that of normal tissues

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3
Q

What are the 2 components of all tumours

A
  • Neoplastic cells

- Supporting storm i.e. CT , blod vessels

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4
Q

Give a few examples of benign tumours

A 
Lipoma
Fibroma
Adenoma
Leiomyoma 
Papillomas
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5
Q

What types of malignant tumours are there

A

Carcinomas - epithelial tissue

Sarcomas - mesenchymal tissues

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6
Q

Name some carcinomas and sarcomas

A

Carcinomas - oral squamous cell carcinoma, adenocarcinoma

Sarcomas - Osteosarcoma, Liposarcoma

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7
Q

How are malignant tumours differentiated from benign tumours

A
  • Appearance (morphology)
    Behaviour:
  • poor cellular differentiation and loss of morphology and orientation
  • Rate of growth
  • Local invasion e.g. OSCC invasion through basement membrane into underlying connective tissue
  • Metastases (most important)
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8
Q

Which malignant tumours metastasise

A

All of them except for tumours of the brain and basal cell carcinomas (generally)

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9
Q

how can spread of tumours occur

A
  • Body cavities
  • Lymphatics
  • Blood vessels
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10
Q

What kinds of tumour primarily spread through the blood system

A

Bone and soft tissue tumours (sarcomas)

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11
Q

What kinds of tumour usually spread through the lymphatic system

A

Melanoma, breast, lung and gastrointestinal

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12
Q

What are the most common forms of cancer

A

Lung cancer, breast cancer, colorectal cancer

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13
Q

Besides lung and colorectal cancers what is a very common cancer among men

A

Prostate

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14
Q

What are some environmental factors that contribute to carcinogenesis

A
  • Chemicals
  • Radiation
  • Viruses
    As a result of mutations in the genome of somatic cells
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15
Q

What can carcinogenic mutations in somatic cells cause to happen that can lead to malignant neoplasms

A
  • Activation of growth-promoting oncogenes
  • Alterations of genes that regulate apoptosis and DNA repair
  • Inactivation of cancer suppressor genes
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16
Q

What cancer are aromatic hydrocarbons carcinogens of

A

Lung cancers

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17
Q

What cancer is asbestos a carcinogen of

A

Mesothelioma

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18
Q

What cancer is Aflatoxin B1 a carcinogen of

A

hepatocellular

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19
Q

What cancer are nitrosamines and amides carcinogens of

A

Gastric

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20
Q

How can ionising radiation lead to cancer

A

May damage cellular genes, resulting in mutations

21
Q

What sources of ionising radiation do people come into contact with

A
  1. Natural radiation from earth and space
  2. Radiation from the nuclear power and weapons industries
  3. Radiation from medical tests
22
Q

What are some predisposing factors to Basal cell carcinomas (BCC) and Squamous cells carcinoma (SCC)

A
  • UV radtiaion
  • Skin type 1 or 2 (freckles)
  • Arsenic
  • Ionising radiation
  • Burn/vaccination scars
  • Immunosuppression
23
Q

What kind of mutation causes the formation of the Philadelphia chromosome

A

Balanced Translocations

24
Q

Name a gene in which a point mutation can lead to cancer

A

H-RAS

25
Q

What are the most common symptoms of Retinoblastoma

A
  • Leucocoria
  • Strabismus/squint
  • Ocular inflammation
26
Q

What DNA viruses can lead to cancers

A
  • HPV - Human Papilloma Virus
  • Epstein Barr Virus (EBV)
  • Hepatitis B
27
Q

What RNA viruses can lead to certain cancers

A
  • Human T cell leukaemia virus type 1
  • Hepatitis C virus
  • (Hepatitis D)
28
Q

What are the symptoms of Lung cancer

A
  • Cough
  • Haemoptysis
  • Dyspnoea
  • Chest pain
  • Pneumonias - recurrent or slowly resolving
  • Loss of appetite and weight loss
29
Q

What are the signs of lung cancer

A
  • Cachexia
  • Clubbing
  • Anaemia
  • HPOA
  • Lymphadenopathy
  • Mestases
  • Complications
30
Q

What causes Horner’s syndrome

A

Preganglionic - white ramus of T1 - sympathetic trunk - superior cervical ganglion - postganglionic fibres - ophthalmic - nano ciliary - long ciliary branches
- Damage to vascular lesions of the cortex/brainstem, cervical rib, Ca lung, thyroid, oesophagus ?

31
Q

What are the features of Horner’s syndrome

A
  • Enophthalmos
  • Meiosis - unopposed parasympathetic activity causing pupillary constriction
  • Ipsilateral facial anhydrosis - damage to superior cervical ganglion
  • Partial ptosis - paralysis of LPS
32
Q

What are the features of left side colon cancer

A
  • Bleeding/mucus pr
  • Altered bowel habit
  • Obstruction
  • Tenesmus
  • Mass on pr
33
Q

What are the features of right side colon cancer

A
  • Reduced weight
  • Anaemia
  • Abdominal pain
  • Obstruction
34
Q

What are the features of colon cancer on both sides

A
  • Abdominal mass
  • Perforation
  • Haemorrhage
  • Fistula
35
Q

What are the symptoms of hodgkin’s lymphoma

A
  • Enlarged painless, non-tender, rubbery superficial lymphadenopathy
  • 65% cervical lymphadenopathy
  • 25% constitutional upset: fever, weight loss, night sweats, pruritus
  • Pel-ebstein fever
  • alcohol induced lymph node pain
36
Q

What are the diagnostic features of malignant melanoma

A

The following changes in a naevus or pigmented lesion may suggest diagnosis:

  • Size - recent increase
  • Shape - irregular outline
  • Colour - variation
  • Erythema - at edge
  • Crusting, oozing or bleeding
  • Itch: common
37
Q

Who is most likely to present with oral squamous cell carcinomas

A

Older males

38
Q

What are some of the risk factors for oral squamous cell carcinomas

A
  • Old age
  • Male
  • Tobacco
  • Alcohol
  • Betel use
  • Sun exposure
  • Lichen planus
  • Ionising radiation
  • Immunosuppression and graft-versus-host disease
  • Low socioeconomic status
  • infection with HPV, Candida or syphilis
39
Q

What are the oral effects of BQ chewing

A
  • Occlusal tooth surface wear
  • Betel chewer’s mucosa (BCM)
  • Lichenoid reaction: resolves in complete cessation of habit
  • Oral precancerous lesions and malignancy: Erythroluekoplakia, Oral sub mucous fibrosis (OSMF), OSCC
40
Q

Describe Betel chewer’s mucosa

A
  • Brownish red discolouration of mucosa
  • Tenacious quid particles
  • Tendency to desquamation and peeling
  • Histology - epithelial hyperplasia and amorphous deposits calcium granules and HPV 11, 16, 18
41
Q

What epithelial malignant oral neoplasms can be found

A
  • Melanoma
  • Maxillary antra carcinoma
  • Glandular carcinoma
  • Intra-bony carcinoma
42
Q

What sarcomas can be found in the oral cavity

A
  • Osteosarcoma
  • Rhabdomyosarcoma
  • Kaposi sarcoma
43
Q

What are the clinical features of OSCC

A
  • Granular ulcer with fissuring or raised exophytic margins
  • Red lesion (erythroplakia)
  • White lesion (leukoplakia)
  • Mixed white and red lesion - speckled
  • Indurated ulcer - lesion fixed to underlying tissue or to overlying skin or mucosa
  • Lump
  • Non-healing extraction socket
  • Lymph node enlargement
  • Pain or numbness
  • Loose tooth
  • Dysphagia
  • Weight loss
44
Q

What are the common OSCC sites

A
  • Lips, lateral border of tongue and floor of the mouth
45
Q

What investigations are there to diagnose OSCC

A
  • Lesions that are non-healing persisting > 3 weeks
  • Potentially malignant
  • Lesions biopsy
  • Fine needle aspiration or regional lymph nodes
    Imaging:
  • Jaw/Chest radiographs
  • Magentic resonance/computed tomography of head and neck
  • Bronchoscopy - to exclude chest lesions
  • Endoscopy
46
Q

What dental management is done for patients who are currently receiving radiotherapy to the head and neck

A
  • Normal saline mouth washes
  • Benzydamine
  • Nystatin
  • Salivary substitute
  • Jaw-opening exercises
47
Q

What oral complications can arise from radiotherapy

A
  • Nausea
  • Vomiting
  • Mucositis
  • Taste changes
  • Dry mouth
  • Infections
  • Caries
  • pulp pain and necrosis
  • Tooth hypersensitivity
  • Trismus
  • Osteoradionecrosis
  • Craniofacial defects
48
Q

Name some cancer screening methods

A
  • Chest radiographs
  • Position emission tomography
  • Genetic analysis
  • Cytology
  • Biopsy
  • Tumour markers (risk of false negs/pos.)

CHHD (27 decks)

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