Oncology + Palliative Care Flashcards
What cancer is common in Ashkenazi Jews?
Breast cancer via BRCA 1 and BRCA2
What condition causes GI cancer increases the risk of endometrial cancer?
HNPCC
What condition causes hamartomatous polyps and can cause GI cancer?
Peutz-Jeghers syndrome
What is breast screening for women in the UK?
> 50 years every 3 years
Explain the mechanism of the following chemotherapy agents:
Alkylating agents
Methotrexate/ 5-FU
Bleomycin
Alkylating agents- anti-proliferative drugs that bnd to alkylating groups on DNA = apoptosis : cyclophosphamide
Methotrexate/ 5-FU: Anti-metabolite - cell cycle effects, which effect DNA and protein synthesis
Bleomycin- anti-tumour antibiotics= interrupt DNA function
Explain the mechanism of the following chemotherapy agents:
Topoisomerase inhibitors
Vinca-alkaloids and taxanes
Topoisomerase inhibitors- interrupt DNA winding
Vinca-alkaloids and taxanes: affect the spindles involved in cell division. EG: vincristine
What defines neutropenic sepsis?
Temp >38C and <0.5 x 10 ^9 /L
What abnormalities are found in the blood of Tumour lysis syndrome?
Management?
Increase:
- Urate
- Potassium
- Phosphate
Reduction:
-Calcium
Mx:
IV hydration + Phosphate binder (Aluminium hydroxide)
What is most likely to cause migratory thrombophlebitis?
GI malignancies - Trousseau’s sign
What tumor marker is used for breast cancer?
Ca 15-3
What must be prescribed alongside strong opioids?
Laxatives and anti-emetics
What 2 conditions must you be aware of when prescribing morphine?
Renal failure (clearance) Intracranial bleed
Which anti-emetic do you give in palliative care to a patient with intracranial disorders?
Cyclizine
Which anti-emetic do you give in palliative care to a patient for the central trigger zone?
Metoclopramide
Which anti-emetic do you give in palliative care to a patient with metabolic or drug-induced nausea?
Haloperidol
Which anti-emetic do you give in palliative care to a patient with chemo/radiotherapy?
Ondansetron
What drug can help reduce secretions in palliative care if repositioning does not work?
Hyoscine butylbromide
What are the palliative care pain relief medications used in renal impairment patients?
Buprenorphine and Fentanyl (not renal excreted)
Oxycodone in mild-moderate impairment
What is the conversion of morphine to oxycodone?
and oral -> sc morphine
2
What cytotoxic agent causes cardiomyopathy?
Anthracyclines eg Doxorubicin
What cytotoxic drug causes peripheral neuropathy?
Vincristine
How do you calculate breakthrough analgesia?
1/6 of the daily morphine
