PassMedicine Flashcards
what are the three types of colorectal cancer
1 sporadic
2 hereditary non-polyposis colorectal carcinoma
3 familial adenomatous polyposis
what is the most common type of colorectal carcinoma
sporadic (95%)
what is the rarest type of colorectal carcinoma
FAP
what are the causes of sporadic colorectal cancer
a series of genetic mutations
loss of APC gene
activation of K-ras oncogene
deletion of P53 tumour suppressor
what sort of genetic condition is hereditary non-polyposis colorectal carcinoma
autosomal dominant
what is the most common form of inherited colon cancer
HNPCC
where does HNPCC commonly affect and what are the common features
proximal colon
poorly differentiated + highly aggressive
what are the two most common genes associated with HNPCC
MSH2 (most common)
MLH1
what other cancer are patients with HNPCC at risk of
endometrial cancer
what sort of genetic condition is familial adenomatous polyposis
autosomal dominant
what causes APC
mutation in tumour supressor gene APC (adenomatous polyposis coli gene)
on which chromosome is the tumour suppressor gene, APC, found
chromosome 5
what are patients with FAP also at risk of
duodenal tumours
what is streptococcus bovis associated with
colorectal cancer
what are the different types of tumour markers
1 monoclonal antibodies against tumour antigens
2 tumour antigens
3 enzymes
4 hormones
what is the monoclonal antibody CA 125 associated with
ovarian cancer
what is the monoclonal antibody CA 19-9 associated with
pancreatic cancer
what is the monoclonal antibody CA 15-3 associated with
breast cancer
what is the tumour antigen carcinoembryonic antigen associated with
colorectal cancer
what is the tumour antigen bombesin associated with
small cell lung carcinoma
gastric cancer
neuroblastoma
what does loss of tumour suppressor function/production cause
increase cancer risk
what is APC associated with
colorectal carcinoma
what is BRCA1 + BRCA2 associated with
breast + ovarian cancer
where does colorectal cancer most commonly occur
rectal (40%)
sigmoid (30%)
where does colorectal cancer more commonly occur between descending and ascending colon
ascending colon + caecum (15%) descending colon (5%)
what is the 1st line management in spinal cord compression
dexamethasone (corticosteroid)
what is the management of neutropenic sepsis
1st: take blood cultures
2nd: empircal broad spectrum antiboitics
3 with results from cultures give specific antibiotics
how is hypercalcaemia of malignancy treated
IV hydration and pamidronate (biphosphonate)
how is hypercalcaemia treated
IV hydration
what is radical therapy
curative
what is palliative therapy
supportive no curative
what is adjuvant therapy
treatment following surgery
what is neoadjuvant therapy
treatment before surgery
what is the tumour marker for seminomas and teratomas
b-HCG
AFP for teratomas only
what is the treatment for seminomas
inguinal orchidectomy and radiotherapy (radiosensitive)
what is the treatment for teratomas
inguinal orchidectomy and chemotherapy (chemosensitive)
what testicular cancer is chemosensitive
teratomas
what testicular cancer is radiosensitive
seminomas
where do adenocarcinomas of the oesophagus occur
lower third
where do squamous cell carcinomas of oesophagus occur
upper two thirds
what malignancies cause SIADH
SCLC
prostate cancer
pancreatic cancer
what is tumour lysis syndrome
rapid cell death after chemo (esp in haematological malignancies)
what are signs in bloods of tumour lysis syndrome
raised K+ (higher in cells) low Ca (lower in cells)
where do carcinoid tumours arise from
enterochromaffin cells
what is carcinoid tumour
GI tract (asymptomatic)
what is carcinoid syndrome
GI + liver (symptomatic)
what are symptoms of carcinoid syndrome
facial flushing
water diarrhoea
