PassMedicine

Question 1

what are the three types of colorectal cancer

Answer 1

1 sporadic
2 hereditary non-polyposis colorectal carcinoma
3 familial adenomatous polyposis

Question 2

what is the most common type of colorectal carcinoma

Answer 2

sporadic (95%)

Question 3

what is the rarest type of colorectal carcinoma

Answer 3

FAP

Question 4

what are the causes of sporadic colorectal cancer

Answer 4

a series of genetic mutations

loss of APC gene
activation of K-ras oncogene
deletion of P53 tumour suppressor

Question 5

what sort of genetic condition is hereditary non-polyposis colorectal carcinoma

Answer 5

autosomal dominant

Question 6

what is the most common form of inherited colon cancer

Answer 6

HNPCC

Question 7

where does HNPCC commonly affect and what are the common features

Answer 7

proximal colon

poorly differentiated + highly aggressive

Question 8

what are the two most common genes associated with HNPCC

Answer 8

MSH2 (most common)

MLH1

Question 9

what other cancer are patients with HNPCC at risk of

Answer 9

endometrial cancer

Question 10

what sort of genetic condition is familial adenomatous polyposis

Answer 10

autosomal dominant

Question 11

what causes APC

Answer 11

mutation in tumour supressor gene APC (adenomatous polyposis coli gene)

Question 12

on which chromosome is the tumour suppressor gene, APC, found

Answer 12

chromosome 5

Question 13

what are patients with FAP also at risk of

Answer 13

duodenal tumours

Question 14

what is streptococcus bovis associated with

Answer 14

colorectal cancer

Question 15

what are the different types of tumour markers

Answer 15

1 monoclonal antibodies against tumour antigens
2 tumour antigens
3 enzymes
4 hormones

Question 16

what is the monoclonal antibody CA 125 associated with

Answer 16

ovarian cancer

Question 17

what is the monoclonal antibody CA 19-9 associated with

Answer 17

pancreatic cancer

Question 18

what is the monoclonal antibody CA 15-3 associated with

Answer 18

breast cancer

Question 19

what is the tumour antigen carcinoembryonic antigen associated with

Answer 19

colorectal cancer

Question 20

what is the tumour antigen bombesin associated with

Answer 20

small cell lung carcinoma
gastric cancer
neuroblastoma

Question 21

what does loss of tumour suppressor function/production cause

Answer 21

increase cancer risk

Question 22

what is APC associated with

Answer 22

colorectal carcinoma

Question 23

what is BRCA1 + BRCA2 associated with

Answer 23

breast + ovarian cancer

Question 24

where does colorectal cancer most commonly occur

Answer 24

rectal (40%)

sigmoid (30%)

Question 25

where does colorectal cancer more commonly occur between descending and ascending colon

Answer 25

``` ascending colon + caecum (15%) descending colon (5%) ```

Question 26

what is the 1st line management in spinal cord compression

Answer 26

dexamethasone (corticosteroid)

Question 27

what is the management of neutropenic sepsis

Answer 27

1st: take blood cultures 2nd: empircal broad spectrum antiboitics 3 with results from cultures give specific antibiotics

Question 28

how is hypercalcaemia of malignancy treated

Answer 28

IV hydration and pamidronate (biphosphonate)

Question 29

how is hypercalcaemia treated

Answer 29

IV hydration

Question 30

what is radical therapy

Answer 30

curative

Question 31

what is palliative therapy

Answer 31

supportive no curative

Question 32

what is adjuvant therapy

Answer 32

treatment following surgery

Question 33

what is neoadjuvant therapy

Answer 33

treatment before surgery

Question 34

what is the tumour marker for seminomas and teratomas

Answer 34

b-HCG | AFP for teratomas only

Question 35

what is the treatment for seminomas

Answer 35

inguinal orchidectomy and radiotherapy (radiosensitive)

Question 36

what is the treatment for teratomas

Answer 36

inguinal orchidectomy and chemotherapy (chemosensitive)

Question 37

what testicular cancer is chemosensitive

Answer 37

teratomas

Question 38

what testicular cancer is radiosensitive

Answer 38

seminomas

Question 39

where do adenocarcinomas of the oesophagus occur

Answer 39

lower third

Question 40

where do squamous cell carcinomas of oesophagus occur

Answer 40

upper two thirds

Question 41

what malignancies cause SIADH

Answer 41

SCLC prostate cancer pancreatic cancer

Question 42

what is tumour lysis syndrome

Answer 42

rapid cell death after chemo (esp in haematological malignancies)

Question 43

what are signs in bloods of tumour lysis syndrome

Answer 43

``` raised K+ (higher in cells) low Ca (lower in cells) ```

Question 44

where do carcinoid tumours arise from

Answer 44

enterochromaffin cells

Question 45

what is carcinoid tumour

Answer 45

GI tract (asymptomatic)

Question 46

what is carcinoid syndrome

Answer 46

GI + liver (symptomatic)

Question 47

what are symptoms of carcinoid syndrome

Answer 47

facial flushing | water diarrhoea