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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
what type of hypersensitivity reaction occurs with anaphylactic reactions
Type I Antigen reacts with IgE bound to mast cells
26
Antigen reacts with IgE bound to mast cells what type of hypersensitivity is this
Type I Anaphylactic
27
What combines in type II - cell bound hypersensitivity
IgG or IgM binds to antigen on cell surface e.g. AIHA, ITP, Goodpasture's
28
what binds in type III - immune complex hypersensitivity?
Free antigen and antibody (IgG, IgA) combine SLE post-strep glomerulonephritis
29
What is the mechanism of type IV - delayed hypersensitivity
T-cell mediated e.g. GBS, graft versus host disease
30
What are the four types of hypersensivity and differences?
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
what are the 3 main types of bladder cancers
1. urothelial (transitional cell) carcinoma (>90%) 2. squamous cell carcinoma 3. adenocarcinoma
32
what type of staging does bladder cancer use
TNM staging - patients undergo cystoscopy, biopsies or TURBT. regional spread is determined with MRI/CT scanning
33
Most patients (85%) with bladder cancer will present with
Painless macroscopic haematuria
34
Superficial lesions of bladder cancer may be managed using what in isolation
TURBT If more spread, then surgery or radiotherapy is offered
35
Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for breast cancer if they are:
- 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
hormonal therapy for prostate cancer aims to do what to hormones, and what are the options
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
useful test for contact dermatitis
skin patch test
38
IM adrenaline doses for anaphylaxis 0-6 years 6-12 years >12 years
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
where is IM adrenaline given for anaphylaxis
anterolateral aspect of middle third of thigh
40
refractory anaphylaxis is defined as what
resp and/or cardiovascular problems persist despite 2 doses of IM adrenaline Give IV fluids for shock
41
serum tryptase can be raised in allergy up to how many hours after
up to 12 hours after
42
Discharge anaphylaxis patients with what criteria for each below: (a) after 2 hours (b) after 6 hours (c) after 12 hours
(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
Skin prick testing can be read after what timeframe
after 15-20 mins skin patch testing is 48 hours after patch removal
44
Radioallergosorbent test (RAST) determines the amount of what
IgE that reacts with allergens

AKT (25 decks)

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