Psychiatry - Psychopathology (IV)

Question 1

List 6 hallmarks of cancer

Answer 1

1. Sustain proliferative signalling
2. Evade growth suppressors
3. Activating invasion and metastasis
4. Enabling replicative immortality
5. Inducing angiogenesis
6. Resisting cell death

Question 2

List 6 differences between tumors

Answer 2

1. Site/ organs
2. Histology
3. Biological characteristics: differentiation, gene/ receptor expression
4. Natural behavior
5. Metastasis pattern: Local infiltration, lymphatics spread or haematogenous spread

Question 3

List some NCDs

Answer 3

Non-communicable diseases

Cancer, DM, CV diseases, chronic lung diseases

Question 4

5 leading dietary/ behavioral risks for cancer deaths

Answer 4

High BMI 
Low fruit and vegetable intake 
Low physical activity 
Tobacco use *** (most important rf)
Alcohol use

Question 5

List 5 most common cancers (both sex) in HK

Answer 5

Lung, Colorectal, Breast, Prostate, Liver

Question 6

List top 5 deadly cancers (both sex) in HK

Answer 6

Lung, Colorectal, Liver, Breast, Pancreas

Question 7

Incidence rate of cancer in <30, 45-59, and >65

Answer 7

<30 = <50/ 100,000
45-59 = 350/100,000
>65 = >1000/100,000

Question 8

Top 3 cancer in children and adolescents

Answer 8

1. Leukaemia
2. Lymphoma
3. CNS

Question 9

Define age-specific rate and age-standardized rate?

Answer 9

Age specific rate: The number of health events occurring in a specific age group divided by the total population of that age group

Age standardized rate: weighted average of age specific rate per 100,000 people, standardized to the same age population in other countries

Question 10

8 lifestyle recommendations to lower cancer risk

Answer 10

No smoking
No drinking (2 units/day for man, 1 unit/day for woman max)
Cut red-meat (500g/day max), processed meat and increase fruit and vegetables (3 portions each)
Take vaccinations
Avoid over exposure to UV
Breast feed
Regular exercise
Maintain healthy body weight (150min moderate activity per week)

Question 11

List 5 screening programs for cancers

Answer 11

Colorectal cancer screening with FIT or FOBT
Cervical cancer screening and HPV vaccine
Low-dose CT scan for CA lung
Plasma EBV DNA for NPC
Germline mutation test for familial cancers

Question 12

List 4 syndromes of lung cancer

Answer 12

1. Superior vena cava syndrome
   - Dyspnea, facial swelling, dilated neck, chest wall veins
2. Horner syndrome
   - Partial ptosis, miosis, anhidrosis, enophthalmos
3. Pancoast tumor
   - Pain at shoulder and arm, paresthesias, paresis, atrophy of thenar muscles of hand
4. Paraneoplastic syndromes

Question 13

List 5 paraneoplastic syndromes of lung cancer

Answer 13

1. SIADH
2. Cushing syndrome
3. Lambert-Eaton myasthenic syndrome (autoAb against NMJ)
4. Hypercalcaemia
5. Hypertrophic osteoarthropathy

Question 14

Ddx of benign breast cancers

Answer 14

Fibroadenoma 
Adenoma 
Cysts 
Ductal ectasia 
Sclerosing adenosis 
Atypical ductal hyperplasia 
Atypical lobular hyperplasia 
Benign Phyllodes tumor

Question 15

Systemic constitutional symptoms of malignancies

Answer 15

unintentional weight loss
anorexia
malaise

\+ symptoms of metastasis, e.g. 
Lung: cough, SOB 
Bone: bone pain, cord compression 
Liver: abdominal distention, jaundice 
Brain: headache, convulsion...etc

Question 16

5 Factors that dictate treatment choice

Answer 16

Treatment efficacy 
Function preservation 
Toxicity 
Cost 
Patient's choice