Radiotherpay

Question 1

Stem; Case of proximal femur fractur known Case of hypothyroidism and history of breast cancer and mastectomy 5 yrs ago.

: check lab results and check the abnormalities ( increase urea, creatinine & hypercalcemia)

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Q2: 2 possible causes of hypercalcemia?

Answer 1

Bone mets / Renal impairment

Question 2

Q3: what to look for in bone scan?

Answer 2

Bone density / Osteopenia / Hot spots (Hypermetabolic area)

Question 3

Q4. Why you will do THR or Hemiarthroplasty not fixation by nail or plate?

Answer 3

Very high risk of failure in fixation (malunion)

Question 4

Q5. why will you send head of femur to pathology?

Answer 4

To role out any mets or know type of tumor / type of pathology in bone / grade of tumor

Question 5

Q6: what is the mechanism of action of radiotherapy?

Answer 5

Direct; direct damage of DNA the tumor cells
Indirect; produce free radicals that kill tumor cells

Question 6

Q7. Why to use radiotherapy other than killing cancer cells?

Answer 6

To relief pain / Shrink cancer before cancer / after resection to kill any cells might escape / x-ray by low dose

Question 7

Q8: Give 3 causes of PE and DVT in this patient after THR?

Answer 7

Hypercoagulability state / Surgery / reduced mobility of pt / Venous stasis

Question 8

Q9. 2 medications for breast cancer.

Answer 8

Aromataze inhibitor (Anastrazole)
Tamoxifen (hormanal therapy)

Question 9

Q10.Herceptine mechanism of action or how it work?

Answer 9

Ab mediated destruction of cells to over producing HER 2 receptor and this will prevent proliferation of tumor / Regimine 3 weekly for 1 yr

Question 10

Q11: Why Aromatase inhibitors not given in for premenopausal women?
Pre-meno there is still production of estrogen from ovaries and Arom Inhi cannot antagonize that (as it prevent peripheral conversion)

Answer 10

Pre-meno there is still production of estrogen from ovaries and Arom Inhi cannot antagonize that (as it prevent peripheral conversion)