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Year 2 EMS CS > Screening & cancers > Flashcards

Screening & cancers Flashcards

1
Q

What is screening?

A

Identifying apparently healthy people at increased risk of a disease/condition
-never 100% sensitive or specific

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2
Q

What are the Wilson and Jungner criteria?

A

Principles for screening programmes;

  • disease sufficiently common
  • natural history known
  • early treatment beneficial
  • diagnostic confirmatory test
  • acceptable & affordable
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3
Q

How are neonates screened in the UK?

A

All babies tested between 5-8 days

- 3mm dry blood samples

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4
Q

What is included in the current UK programme for screening babies?

A 
PKU
Congenital hypothyroidism
Sickle cell & Hb disorders
CF
MCADD
New; MSUD, IVA, GA1, homocystinuria
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5
Q

What does phenylketonuria cause if untreated?

A

Severe mental retardation
Seizures
Eczema
-prognosis good if treated early

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6
Q

What does congenital hypothyroidism cause if untreated?

A

Severe developmental delay

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7
Q

What does sickle cell disease cause if untreated?

A

20% die within 2 years

-acute infection, stroke, splenic sequestration, etc.

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8
Q

What is the treatment if babies are diagnosed with sickle cell disease?

A

Prophylactic penicillin initiated

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9
Q

Who is screened for breast cancer and how often?

A

50-70 year olds

-3 yearly mammography

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10
Q

What is the ‘triple assessment’ for breast cancer screening?

A

RADIOGRAPHY - mammography, ultrasound, MRI
CLINICAL ASSESSMENT
PATHOLOGY - biopsy

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11
Q

What do most breast tumours arise from?

A

The epithelium

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12
Q

What is LCIS?

Breast cancer

A

Lobular Carcinoma In-Situ

-often picked up accidently

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13
Q

What is DCIS?

Breast cancer

A

Ductal Carcinoma In-Situ

-often calcifies & picked up on x-ray

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14
Q

What is the most common type of breast cancer?

A

Invasive ductal carcinoma

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15
Q

How does breast cancer typically spread?

A

Lymphatic channels

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16
Q

What is typically the 1st lymph node bed for breast tumours?

A

The axilla (sentinel node)

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17
Q

Where do soft tissue tumours occur?

A

Connective tissue, muscle, fat, blood vessels, etc.

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18
Q

What are the commonest sites of malignant soft tissue tumours? (2)

A

Thigh and retroperitoneum

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19
Q

What are the clinical clues for soft tissue tumours?

A

Painful lumps
Deep to fascia
>5cm & enlarging

20
Q

What does “oma” suggest?

A

Benign tumour

21
Q

What does “sarcoma” suggest?

A

Malignant tumour

22
Q

What is the possible diagnosis for small round blue cell tumour?

A

Sarcoma (eg. Ewing’s)
Carcinoma
Germ cell tumour
Lymphoma

23
Q

What are the features of a malignant tumour?

A

Metastases
Necrosis
Abnormal mitoses
Cytological atypia

24
Q

What is the general prognosis for sarcomas?

A

50% alive at 5 years

25
Q

What is a GI stromal tumour (GIST)?

A

Tumour of smooth muscle of bowel wall

  • involves cell membrane receptor CD117
  • treated with Imatinib
26
Q

What is the most fatal malignancy in men?

A

Lung cancer (8%)

27
Q

How many deaths does lung cancer cause per year?

A

35,000

28
Q

What are the 2 histological types of lung cancer?

A
  • Non-small cell carcinomas (NSCLC)

- Small cell carcinoma (SCLC)

29
Q

What is the normal bronchus lined with?

A

Pseudostratified collumnar epithelium.

with ciliated and mucous cells

30
Q

What metaplastic change occurs in the bronchus lining?

A

Pseudostratified collumnar epithelium&raquo_space; stratified squamous (METAPLASIA)
-may&raquo_space; irreversible change to neoplastic cell that proliferates more successfully (DYSPLASIA)

31
Q

His lung cancer diagnosed?

A
  • Bronchial brushing
  • Bronchoscopy
  • Fine needle aspiration
  • Sputum
  • Biopsy
32
Q

What are the main types of non-small cell carcinomas? (3)

A
  • Squamous carcinoma
  • Adenocarcinoma
  • Undifferentiated large cell carcinoma
33
Q

What are the main stages of lung cancer development?

A

Bronchial epithelium
» squamous metaplasia
» dysplasia

34
Q

How does NSCLC squamous carcinoma produce distant metastases?

A

Neoplastic cells breach basement membrane
»invasive squamous carcinoma
» infiltrates lymphatic and blood vessels
»distant metastases

35
Q

What are the main features of NSCLC squamous carcinoma?

A
  • Resembles squamous epithelium
  • Desmosomes link cells
  • ~90% in smokers
  • More central than peripheral
  • Hypercalcaemia
36
Q

What causes hypercalcaemia in squamous lung carcinoma?

A

Parathyroid hormone related peptide.

37
Q

What are the main feature of NSCLC adenocarcinoma?

A
  • Glandular cells
  • ~80% in smokers
  • Atypical alveolar cell hyperplasia
38
Q

What are the main features of SCLC?

A
  • Most malignant (lung tumours)
  • Neurosecretory granules with peptide hormones (e.g. ACTH)
  • ~99% in smokers
  • May have metastases before presentation
39
Q

What are paraneoplastic syndromes?

A

Rare disorders triggered by an altered immune system response to a neoplasm.

40
Q

What are common presenting features linked to primary lung tumours? (4)

A
  • Cough
  • Haemoptysis
  • SOB
  • Chest pain
41
Q

What are common presenting features linked to secondary lung tumours? (4)

A
  • Lumps
  • Neurological signs
  • SVCO (sup vena cava obstruction)
  • Heart failure
42
Q

What are common presenting features linked to systemic lung tumours? (3)

A
  • Weight loss
  • Hypercalcaemia
  • Paraneoplastic
43
Q

What investigations are carried out for suspected lung cancer? (5)

A
  • CXR
  • Blood tests
  • CT
  • Bronchoscopy
  • Biopsy
44
Q

How is lung cancer treated? (4)

A
  • Surgery
  • Chemotherapy
  • Radiotherapy
  • Supportive care
45
Q

What is the prognosis for lung cancer?

A

Poor prognosis.

-usually inoperable due to late presentation

Year 2 EMS CS (4 decks)

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