Oncology ICM revision

Question 1

Raised Ca125 suggestive of?

Answer 1

Ovarian Cancer

Question 2

Raised CA19-9 suggestive of?

Answer 2

Pancreatic Cancer

Question 3

Raised Ca15-3 suggestive of?

Answer 3

Breast Cancer

Question 4

Raised PSA suggestive of?

Answer 4

Prostate Cancer

Question 5

Raised AFP suggestive of?

Answer 5

Teratoma (Gonadal cancers)

Hepatocellular Carcinoma

Question 6

Raised CEA suggestive of?

Answer 6

Colorectal Cancer

Question 7

Raised S100 suggestive of?

Answer 7

Melanoma

Schwannomas

Question 8

Raised Bombesin suggestive of?

Answer 8

Small Cell Lung Cancer
Gastric Cancer
Neuroblastoma

Question 9

What is the current Biomarkers of choice?

Answer 9

Troponin

- alongside ECG/Imaging evidence - indicative of an MI

Question 10

What does increased troponin mean?

Answer 10

increased trop us suggestive of heart muscle strain

trops may also be raised in myocarditis, HF, arrhythmias, PE

Question 11

What does BNP tell us?

Answer 11

Stretching of the heart causes BNP to be released.

Elevated concentrations of BNP - suggestive of person HF
- can also be suggestive of CKD

further tests are required before the diagnosis is made.

Question 12

If a patient has an increased level of trop but no supportive ECG/Imaging, What is done?

Answer 12

Usually will have serial Trops

also serial ECGs

Question 13

What is an ECHO and what are its uses?

Answer 13

Non-invasive test which allows visualisation of the structure of the heart and the pumping function the heart

ECHOs are used to diagnoses and assess valvular conditions and congenital heart conditions

Question 14

What is an angiogram and what are its uses?

Answer 14

An angiogram is a test which allows us to visualise vessels - a dye is given and XR images are taken

Allows detection of any narrowing or obsrtuction of vessels

often used in MI - both diagnostic for obstructions and also therapeutic

Question 15

What is Ambulatory Blood Pressure?

Answer 15

Blood pressure cuff is fitted around arm and will automatically take BP readings at regular intervals throughout the day.

Question 16

What is Ambulatory ECG?

Answer 16

Also referred to as a 24HRtap or Holter

A continuously recording ECG for 24-48hrs

help to diagnose cause of particular symptoms including
such as palpitations

Question 17

What is Tilt Testing?

Answer 17

A test often done in patients who report having dizzy spells or blackouts thought to be related to the heart or BP

ECG and BP cuff is attached to patient as they are tilted/rotated on a flat surface until they report symptoms

Question 18

What is an Exercise Tolerance test ? When is it used?

Answer 18

aka stress test/ECG

used to assess the range of ability the of the heart and ifs function during increased activity

often used in diagnosis of Coronary Heart Disease
most commonly a coronary angiogram is done if any abnormalities are found.

Question 19

What is a Transeosophageal ECHO and when is it used?

Answer 19

TOE takes detailed pictures of the heart from the oesophagus which lies behind the heart

allows better visualisation of the hearts structures giving us better understanding on how to manage patient.

Question 20

What is Electrophysiology?

Answer 20

Electrophysiological or EP study looks at the heart’s electrical activity in more detail and often used to diagnose a wide variety of arrhythmias

Question 21

What is a catheterisation laboratory?

Answer 21

an examination room in hospital or clinic with diagnostic equipment often used to visualise changer of the heart and treta stenosis or other abnormalities

Question 22

Types of procedures done in a Cath Lab?

Answer 22

ablation - surgical removal of any areas in the heart that may be triggering arrhythmias

angiograms - imaging to detct any narrowed areas or blockages in the artery on the x-ray

angioplasties - repair of coronary stenotic arteries - balloon inflation and stenting

Pacemaker/ICD implantation -

Question 23

What is coronary angioplasties used for?

Answer 23

Coronary angioplasty is used:

• To widen narrowed coronary arteries to allow blood to flow through them again.
• To relieve angina symptoms.
• As an emergency treatment for people during a MI

an angiogram is often done prior to angioplasty - often done together one before the other

Question 24

What is Pacing?

Answer 24

A pacemaker is a small electrical device that’s implanted into the chest to treat arrhythmias.

Some pacemakers are also able to help synchronise the beating of the heart.

Question 25

What are the different types of pacemakers?

Answer 25

• single chamber pacemakers = have onelead
• dual chamber pacemakers = have two leads
• biventricular =have three leads.

Question 26

What is cardiac resynchronisation therapy (CRT) - helps to coordinate the pumping action of the heart muscle

Answer 26

helps to coordinate pumping action of heart muscle and usually people need this in HF when heart muscle isn’t pumping well enough

Question 27

What is an Implantable Cardioverter Defibrillator?

Answer 27

An ICD is a small device which can treat dangerously abnormal heart rhythms

It can detect arrhythmias and can deliver the the following :

• Pacing = low-voltage electrical impulses
• cardioversion = small electric shocks to restore normal rhythm
• defibrillation = shock and restore normal heart rhythm