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Oncology > Rando points > Flashcards

Rando points Flashcards

1
Q

Paraneoplastic antibodies: Anti CV2/CRMP5

A

Associated cancers - SCLC, Thymoma, other
Syndrome - Encephalomyelitis, cerebellar degeneration, chorea, peripheral neuropathy

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2
Q

Paraneoplastic antibodies - Anti Ma proteins

A

Associated Cancer - Testicular germ cell tumors, lung cancer, other solid tumors
Syndrome - Limbic, hypothalamic, brainstem encephalomyelitis (infrequently cerebellar degeneration)

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3
Q

Paraneoplastic antibodis: Anti-VGCC

A

Associated Cancer - SCLC
Other - Lambert Eaton myasthenic syndrome (50% will have malignancy)
Syndrome - Cerebellar degeneration

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4
Q

Paraneoplastic antibodies: Anti-amphiphysin

A

Associated Cancer - Breast, Lung
Syndrome - Stiff person syndrome, encephalomyelitis

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5
Q

Paraneoplastic antibodies: Anti-PCA2 (MAP1B)

A

Associated Cancer - SCLC
Syndrome - peripheral neuropathy, cerebellar ataxia, encephalopathy

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6
Q

Paraneoplastc antibodies: Anti-bipolar cells of the retina

A

Associated Cancer - Melanoma
Syndrome - Melanoma associated retinopathy

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7
Q

Which feature conveys the best prognosis in oropharyngeal cancer

A

HPV positive

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8
Q

Management of spinal cord compression in malignancy - draw

A
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9
Q

drug class and common toxicity

A
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10
Q

Biological effects and Normal Tissue Toxicity after radiotherapy

A
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11
Q

Tumour Suppressor involved in familial melanoma, glioblastoma and pancreatic Ca

A

CDKN2a

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12
Q

Drug profile: Cyclophosphamide

A
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13
Q

Taxane Chemotherapy

  • mechanism of action
  • 7 common side effects
A
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14
Q

Paraneoplastic antibodies: Anti-recoverin

A

Associated Cancer - SCLC
Syndrome - Cancer associated retinopathy

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15
Q

ECOG status
-Describe a patient at each level

A
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16
Q

Summary of Treatment of Advanced Testicular Cancer

A
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17
Q

Mechanism of CTLA-4

A
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18
Q

Up to how many brain mets and what size could you use stereotactic radiotherapy

A

4 mets all less than <4cm

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19
Q

Oncovirus - Malignancy
HCV (2)
HBV (1)
HPV (6)
EBV (4)
CMV (1)
HTLV (1)
HHV8 (2)

A
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20
Q

Li Fraumeni Syndrome

A
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21
Q

Rasburicase Drug Profile

A
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22
Q

Risk Factors of Tumour Lysis Syndrome

A
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23
Q

Malignancies with highest association with TLS

A
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24
Q

Brain Tumours
-Epidemiology and RFs

A
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25
Q

Recurrent Disease in Ovarian Ca

  • ?benefit of Ca125 monitoring
  • Platinum sensitivity definition and secondary agents
A
26
Q

Oesophageal Ca: Risk Factors and Epidemiology

A
27
Q

Oesophageal Ca - treatment of metastatic disease

A
28
Q

Pancreatic Cancer: Risk Factors

A
29
Q

Gallbladder Cancer: Summary

A
30
Q

Gastrointestinal Stromal tumours - subtypes

  • Which is most common
  • Which gene mutation is most common
A
31
Q

Management of HER2+ Gastric Ca (met)

A
32
Q

Testicular Ca

A
33
Q

Pathophysiology of Tumour Lysis Syndrome

A
34
Q

Human Papilloma Virus Types and Association with Malignancy

A
35
Q

HPV Vaccination

A
36
Q

Diagnosis of Brain Tumour (Radiological)
-best modality and features of each

A
37
Q

Treatment of High Grade Glioma

A
38
Q

Oesophageal Ca: Treatment of Localised Disease

A
39
Q

Gastric/GOJ Cancer: Risk Factors

A
40
Q

Gastric/GOJ Cancer: Treatment

A
41
Q

Pancreatic Disease: Determinants of whether it is resectable

A
42
Q

Choliangiocarcinoma - Summary

A
43
Q

Anal Cancer -Treatment and post treatment surveillance

A
44
Q

GIST - Treatment

A
45
Q

Immunotoxicity with , general principles and management

  • what’s the most common reaction
  • which reaction won’t respond to steroids
A

Higher incidence of immunotoxicity with CTLA4 inhibitor (ipilimumab)

46
Q

Paraneoplastic antibody: Anti-Hu

A

Associated cancer - SCLC, others
Syndrome - Encephalomyelitis including cortical, limbic, and brainstem encephalitis; cerebellar degeneration; myelitis; sensory neuronopathy; and/or autonomic dysfunction

47
Q

Paraneoplastic antibodies - Anti-Ri

A
48
Q

CEA

  • what’s it’s role (2)
  • what common activity will give a false positive?
A
49
Q

Pancreatic Ca: Treamtent

A

FOLFIRINOX is preferred but more toxic

50
Q

Which chemo agent is the most gonadotoxic?

A

Alkalyting agents
Other - MTx

51
Q

Paraneoplastic anti-bodies: Anti-Tr (DNER)

A

Associated Cancer - Hodgkin lymphoma
Syndrome - Cerebellar degeneration

52
Q

Genetic Mutations associated with Lynch Syndrome

A

patients have autosomal dominant germline mutation in 1 of the following DNA mismatch repeair genes:

  • MLH1
  • MSH2
  • MSH5
  • PMS2 - lower penetrance than other genes
  • EPCAM gene

Lynch syndrome patients have a germline mutation in one allele of a MMR gene 2nd allele is inactivated somatically by mutation, loss of heterozygosity or epigenetic silencing by promoter hypermethylation

  • Muir-Torre syndrome: variant characterised by sebaceous tumors and cutaneous keratoacanthomas + normal ca associated with Lynch syndrome. MSH2 mutations seem to be particularly predisposed
53
Q

Role of MESNA and cyclophosphamide

A
  • used therapeutically to reduce the incidence of haemorrhagic cystitis and haematuria
  • Ifosfamide or cyclophosphamide can be/may be converted to urotoxic metabolites such as acrolein
  • MESNA assists to neutralise these metabolites by binding through its sulfhydryl-moieties and also increases urinary excretion of cysteine
54
Q

Treatment of Bladder Cancer

A
55
Q

Paraneoplastic antibody: Anti-Yo (Anti-purkinje cell)

A

Associated Cancer - Gynae, breast
Syndrome - cerebellar degeneration

56
Q

Strongest RF for chemotherapy induced ovarian failure

A
57
Q

Mechanism of PD-1 in Cancer and Immune Tolerance

A
58
Q

What are the most common causes of infection in neutropoenic patients? Which subset are at risk of fungal pathogens?

A
  • Most commonly by bacterial infection
    • GPCs are the most common pathogens
  • Common
    • Staph epidermitis, by far the most common
    • Staph aureus
    • Streptococci
  • Less common
    • Corynebacterium, bacillus, leuconostoc, lactobacillus, propionibacterium acnes, rhodococcus
    • GNBs used to be more common, but now account for only 10-20% of neutropoenic infections
    • Generally associated with the most severe infections
    • Increasing trend in multiresistant GNB infections
    • Empiric broad cover is targeted at the small but significant risk of infection
  • Fungal
    • Candida and aspergillus spp account for most invasive fungal infections during neutropoenia
  • Disseminated candidiasis with hepatosplenic involvement may not have symptoms until neutropoenia resolves
  • Non albicans spp more common when fluconazole prophylaxis used
59
Q

When is G-CSF use indicated? Is it of use in neutropoenic fever?

A

Primary prophylaxis

  • Initiation of G-CSF during first cycle of myelosuppressive chemotherapy with the goal of preventing neutropoenic complications through all chemotherapy cycles
  • May be used to allow for dose dense/intense strategies when reduction in density/intensity is known to be associated with poorer prognosis
  • Indicated when anticipated incidence of neutropoenic fever is >=20%

Secondary prophylaxis

  • Use of G-CSF in subsequent cycles when neutropoenic fever has occurred in a previous cycle
  • Reduces incidence of subsequent neutropoenic fever by 50%

NOT recommended for routine use in those with established fever and neutropoenia

  • Data show no change in overall mortality or infection related mortality

Filgrastim

  • Start 24-72hrs post end of chemo and continuing until count reaches 5000-10000

Pegfilgrastim

  • Start 24hrs post chemo and leave at least 14 days before next cycle
60
Q

What is myeloid reconstitution syndrome? (In haem onc)

A

Onset or progression of an inflammatory focus that manifests at time of neutrophil recovery

    • Defined clinically or radiologically

Need to consider superinfection

61
Q
A

Oncology (9 decks)

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