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AKT > Oncology+immuno > Flashcards

Oncology+immuno Flashcards

1
Q

What is the commonest cancer to metastatise to bone

A

Prostate

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2
Q

Commonest site for bone mets to occur

A

Spine

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3
Q

Three most common types of cancer in women in UK (and overall)

A
  1. breast
  2. lung
  3. bowel
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4
Q

Three most common causes of death from cancer in UK

A
  1. Lung
  2. Colorectal
  3. Breast
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5
Q

ovarian cancer blood tumour marker

A

CA125

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6
Q

CA 19-9
tumour marker for?

A

prostate cancer

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7
Q

CA 15-3
tumour marker for?

A

breast cancer

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8
Q

Alpha-feto protein (AFP)
tumour marker associated with…

A

hepatocellular carcinoma
teratoma

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9
Q

Carcinoembryonic antigen (CEA)
tumour marker associated with…

A

Colorectal cancer

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10
Q

S-100
tumour marker associated with…

A

melanoma
schwannomas

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11
Q

bombesin
tumour marker associated with…

A

small cell lung carcinoma
gastric cancer
neuroblastoma

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12
Q

what is the earliest and most common symptom of neoplastic spinal cord compression

A

back pain
worse on lying down and coughing

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13
Q

neurological signs of spinal cord compression depend on the level of the lesion. what kind of signs are seen in lesions:
(a) above L1
(b) below L1

A

(a) above L1 - UMN in legs, sensory level
(b) below L1 - LMN in legs, perianal numbness

Reflexes increase below level of lesion, and absent at level of lesion

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14
Q

Management of neoplastic spinal cord compression

A
  1. high dose oral dexamethasone
  2. urgent oncology review for radiotherapy or surgery
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15
Q

investigation of neoplastic spinal cord compression

A

whole MRI spine within 24 hours of presentation

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16
Q

which cytotoxic agent usually causes haemorrhagic cystitis

A

cyclophosphamide

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17
Q

which cytotoxic agents cause lung fibrosis

A

bleomycin
methotrexate

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18
Q

Chemotherapy side effects - what antiemetics to use

A
  1. If low-risk of symptoms, then metoclopramide
  2. If high-risk, then 5HT3 receptor antagonists e.g. ondansetron, especially if combined with dexamethasone
19
Q

Which cytoxic medications can cause peripheral neuropathy

A

Vincristine (reversible)
Cisplatin

20
Q

Three most common types of cancer in men in UK

A
  1. prostate
  2. lung
  3. bowel
21
Q

Which cytoxic medications can cause peripheral neuropathy

A

Anthracyclines
e.g. doxorubicin

22
Q

superior vena cava obstruction is caused by compression of the SVC, this is most commonly associated with what disease

A

lung cancer

23
Q

superior vena cava obstruction features

A

SOB
swelling of face, neck, arms
headache
visual disturbance
pulseless jugular venous distension

24
Q

Management of superior vena cava obstruction

A
  1. Endovascular stenting
  2. Malignancies may have radical chemo/radiotherapy
  3. Sometimes steroids are given
25
Q

what type of hypersensitivity reaction occurs with anaphylactic reactions

A

Type I

Antigen reacts with IgE bound to mast cells

26
Q

Antigen reacts with IgE bound to mast cells

what type of hypersensitivity is this

A

Type I
Anaphylactic

27
Q

What combines in type II - cell bound hypersensitivity

A

IgG or IgM binds to antigen on cell surface

e.g. AIHA, ITP, Goodpasture’s

28
Q

what binds in type III - immune complex hypersensitivity?

A

Free antigen and antibody (IgG, IgA) combine

SLE
post-strep glomerulonephritis

29
Q

What is the mechanism of type IV - delayed hypersensitivity

A

T-cell mediated

e.g. GBS, graft versus host disease

30
Q

What are the four types of hypersensivity and differences?

A
  1. Type I - anaphylactic (Ag with IgE)
  2. Type II - cell bound (IgG or IgM binds to Ag on cell surface)
  3. Type III - immune complex, free antigen and antibody (IgG, IgA combine)
  4. Type IV - delayed, T-cell mediated
31
Q

what are the 3 main types of bladder cancers

A
  1. urothelial (transitional cell) carcinoma (>90%)
  2. squamous cell carcinoma
  3. adenocarcinoma
32
Q

what type of staging does bladder cancer use

A

TNM staging

  • patients undergo cystoscopy, biopsies or TURBT. regional spread is determined with MRI/CT scanning
33
Q

Most patients (85%) with bladder cancer will present with

A

Painless macroscopic haematuria

34
Q

Superficial lesions of bladder cancer may be managed using what in isolation

A

TURBT

If more spread, then surgery or radiotherapy is offered

35
Q

Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for breast cancer if they are:

A
  • Aged 30 and over with unexplained breast lump
  • Aged 50 and over with symptoms in one nipple only e.g. discharge, retraction etc

CONSIDER it >30 if they have skin changes or unexplained lump in axilla, or non-urgent referral if <30 with lump

36
Q

hormonal therapy for prostate cancer aims to do what to hormones, and what are the options

A

aims to reduce androgen levels

  1. anti-androgen therapy
    - with synthetic GnRH agonist or antagonist
  2. bicalutamide - non-steroidal anti-androgen
  3. cryproterone acetate
  4. abiraterone
  5. bilateral orchidectomy
37
Q

useful test for contact dermatitis

A

skin patch test

38
Q

IM adrenaline doses for anaphylaxis
0-6 years
6-12 years
>12 years

A

0-6 years = 150mcg (0.15ml, 1:1000)
6-12 years = 300mcg (0.3ml, 1:1000)
>12 years = 500mcg (0.5ml, 1:1000)

can be repeated every 5 mins if necessary

39
Q

where is IM adrenaline given for anaphylaxis

A

anterolateral aspect of middle third of thigh

40
Q

refractory anaphylaxis is defined as what

A

resp and/or cardiovascular problems persist despite 2 doses of IM adrenaline

Give IV fluids for shock

41
Q

serum tryptase can be raised in allergy up to how many hours after

A

up to 12 hours after

42
Q

Discharge anaphylaxis patients with what criteria for each below:
(a) after 2 hours
(b) after 6 hours
(c) after 12 hours

A

(a) after 2 hours - good response to one dose of adrenaline, has epi-pen and supervision at home
(b) after 6 hours - 2 doses of adrenaline needed, previous biphasic reaction
(c) after 12 hours - severe reaction needing >2 doses of IM adrenaline, severe asthma, late at night or ongoing reaction

43
Q

Skin prick testing can be read after what timeframe

A

after 15-20 mins

skin patch testing is 48 hours after patch removal

44
Q

Radioallergosorbent test (RAST) determines the amount of what

A

IgE that reacts with allergens

AKT (25 decks)

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