Principles of Oncology

Question 1

Which tumours typically spread to bone?

Answer 1

Breast
Bronchus
Renal
Thyroid
Prostate

Question 2

Which metastases tend to be hyper vascular?

Answer 2

renal

Question 3

What is the most common cause of osteolytic bone metastasis in children?

Answer 3

Neuroblastoma

Question 4

Non operative treatment of osteolytic lesions?

Answer 4

Hypercalcaemia- Treat with re hydration and bisphosphonates.
Pain- Opiate analgesics and radiotherapy.
Some tumours such as breast and prostate will benefit from chemotherapy and or hormonal agents.

Question 5

MOA of antimetabolite drugs?

Answer 5

S Phase specific drug, mimics uracil and is incorporated into RNA e.g. 5FU

Question 6

MOA of anthracyclines?

Answer 6

Inhibits DNA and RNA synthesis by intercalating base pairs e.g. doxorubicin

Question 7

MOA of topoisomerase inhibitors?

Answer 7

Inhibits topoisomerase II, prevents efficient DNA coiling e.g etoposide

Question 8

MOA of platinum?

Answer 8

Crosslinks DNA, this then distorts molecule and induces apoptosis (similar to alkylating agents) e.g. cisplatin

Question 9

MOA of alkylating agents?

Answer 9

Phosphoramide mustard forms DNA crosslinks and then cell death e.g. cyclophosphamide

Question 10

MOA of taxanes?

Answer 10

Disrupts microtubule formation e.g. docetaxal

Question 11

What does metastatic bone pain respond to?

Answer 11

NSAIDs, bisphosphonates or radiotherapy

Question 12

Conversion from oral codeine to oral morphine

Answer 12

/10

Question 13

Conversion from oral tramadol to oral morphine?

Answer 13

/5

Question 14

Conversion from oral morphine to oral oxycodone?

Answer 14

/2

Question 15

Conversion from oral morphine to subcutaneous diamorphine?

Answer 15

/3

Question 16

Conversion from oral oxycodone to subcutaneous diamorphine?

Answer 16

/1.5

Question 17

What is chordoma?

Answer 17

Chordoma is a neoplasm originating from ectopic cellular remnants of the notochord and therefore arises from the midline of the axial skeleton.

Question 18

Where does chordoma commonly occur?

Answer 18

sacrococcygeal (50%) and clival (40%)

Chordomas can arise anywhere from the skull base to the sacrum

Question 19

Contraindications to lung cancer surgery?

Answer 19

Contraindications to lung cancer surgery include SVC obstruction, FEV < 1.5, MALIGNANT pleural effusion, and vocal cord paralysis (implies extracapsular spread to mediastinal nodes )