Oncology ICM revision Flashcards
Raised Ca125 suggestive of?
Ovarian Cancer
Raised CA19-9 suggestive of?
Pancreatic Cancer
Raised Ca15-3 suggestive of?
Breast Cancer
Raised PSA suggestive of?
Prostate Cancer
Raised AFP suggestive of?
Teratoma (Gonadal cancers)
Hepatocellular Carcinoma
Raised CEA suggestive of?
Colorectal Cancer
Raised S100 suggestive of?
Melanoma
Schwannomas
Raised Bombesin suggestive of?
Small Cell Lung Cancer
Gastric Cancer
Neuroblastoma
What is the current Biomarkers of choice?
Troponin
- alongside ECG/Imaging evidence - indicative of an MI
What does increased troponin mean?
increased trop us suggestive of heart muscle strain
trops may also be raised in myocarditis, HF, arrhythmias, PE
What does BNP tell us?
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.
If a patient has an increased level of trop but no supportive ECG/Imaging, What is done?
Usually will have serial Trops
also serial ECGs
What is an ECHO and what are its uses?
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
What is an angiogram and what are its uses?
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
What is Ambulatory Blood Pressure?
Blood pressure cuff is fitted around arm and will automatically take BP readings at regular intervals throughout the day.
What is Ambulatory ECG?
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
What is Tilt Testing?
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
What is an Exercise Tolerance test ? When is it used?
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.
What is a Transeosophageal ECHO and when is it used?
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.
What is Electrophysiology?
Electrophysiological or EP study looks at the heart’s electrical activity in more detail and often used to diagnose a wide variety of arrhythmias
What is a catheterisation laboratory?
an examination room in hospital or clinic with diagnostic equipment often used to visualise changer of the heart and treta stenosis or other abnormalities
Types of procedures done in a Cath Lab?
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 -
What is coronary angioplasties used for?
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
What is Pacing?
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.
What are the different types of pacemakers?
- single chamber pacemakers = have onelead
- dual chamber pacemakers = have two leads
- biventricular =have three leads.
What is cardiac resynchronisation therapy (CRT) - helps to coordinate the pumping action of the heart muscle
helps to coordinate pumping action of heart muscle and usually people need this in HF when heart muscle isn’t pumping well enough
What is an Implantable Cardioverter Defibrillator?
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
