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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

25
What are the most common symptoms of Retinoblastoma
- Leucocoria - Strabismus/squint - Ocular inflammation
26
What DNA viruses can lead to cancers
- HPV - Human Papilloma Virus - Epstein Barr Virus (EBV) - Hepatitis B
27
What RNA viruses can lead to certain cancers
- Human T cell leukaemia virus type 1 - Hepatitis C virus - (Hepatitis D)
28
What are the symptoms of Lung cancer
- Cough - Haemoptysis - Dyspnoea - Chest pain - Pneumonias - recurrent or slowly resolving - Loss of appetite and weight loss
29
What are the signs of lung cancer
- Cachexia - Clubbing - Anaemia - HPOA - Lymphadenopathy - Mestases - Complications
30
What causes Horner's syndrome
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
What are the features of Horner's syndrome
- Enophthalmos - Meiosis - unopposed parasympathetic activity causing pupillary constriction - Ipsilateral facial anhydrosis - damage to superior cervical ganglion - Partial ptosis - paralysis of LPS
32
What are the features of left side colon cancer
- Bleeding/mucus pr - Altered bowel habit - Obstruction - Tenesmus - Mass on pr
33
What are the features of right side colon cancer
- Reduced weight - Anaemia - Abdominal pain - Obstruction
34
What are the features of colon cancer on both sides
- Abdominal mass - Perforation - Haemorrhage - Fistula
35
What are the symptoms of hodgkin's lymphoma
- 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
What are the diagnostic features of malignant melanoma
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
Who is most likely to present with oral squamous cell carcinomas
Older males
38
What are some of the risk factors for oral squamous cell carcinomas
- 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
What are the oral effects of BQ chewing
- 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
Describe Betel chewer's mucosa
- 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
What epithelial malignant oral neoplasms can be found
- Melanoma - Maxillary antra carcinoma - Glandular carcinoma - Intra-bony carcinoma
42
What sarcomas can be found in the oral cavity
- Osteosarcoma - Rhabdomyosarcoma - Kaposi sarcoma
43
What are the clinical features of OSCC
- 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
What are the common OSCC sites
- Lips, lateral border of tongue and floor of the mouth
45
What investigations are there to diagnose OSCC
- 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
What dental management is done for patients who are currently receiving radiotherapy to the head and neck
- Normal saline mouth washes - Benzydamine - Nystatin - Salivary substitute - Jaw-opening exercises
47
What oral complications can arise from radiotherapy
- Nausea - Vomiting - Mucositis - Taste changes - Dry mouth - Infections - Caries - pulp pain and necrosis - Tooth hypersensitivity - Trismus - Osteoradionecrosis - Craniofacial defects
48
Name some cancer screening methods
- Chest radiographs - Position emission tomography - Genetic analysis - Cytology - Biopsy - Tumour markers (risk of false negs/pos.)

CHHD (27 decks)

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