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Medical School Finals > Speciality: Oncology > Flashcards

Speciality: Oncology Flashcards

1
Q

Tumour markers
CA-125

CA-19-9

CA-15-3

PSA

AFP

CEA

S-100

Bombesin

Calcitonin

A

Ovarian

Pancreatic

Breast

Prostate

HCC or teratoma

Colorectal

melanoma or schwannoma

SCLC, gastric Ca, neuroblastoma

Medullary thyroid cancer

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2
Q

SVCO Aetiology

A
  • Compression of the SVCO by a thoracic tumour.
  • Common = NSCLC, SCLC, metastatic seminoma, Kaposi, breast ca, lymphoma.
  • Aortic aneurysm
  • Goitre
  • Medistinal fibrosis
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3
Q

SVCO Presentation

A
  • SOB
  • Swelling of the face, neck and arms (peri-orbital oedema)
  • Headache - worse en la manana
  • Visual problems
  • Jugular distention due to lack of flow.
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4
Q

SVCO Ix

A

1) Often clinical

2) Imaging; CXR/CT/Doppler (shows stasis in flow)

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5
Q

SVCO Rx

A

1) Elevation of head (gravity) + Oxygen
2) Steroids and diuretics if an emergency (reduced CO, cerebral or laryngeal oedema)
3) Radio
4) Chemo
5) Stenting

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6
Q

Alkylating agents

A

Cyclophosphamide

SE = Haemorrhagic cystitis, myelosuppression and Transitional cell carcinoma.

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7
Q

Cytotoxic antibiotics

A

Bleomycin

SE = Lung fibrosis

Doxorubicin

SE = Cardiomyopathy

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8
Q

Antimetabolites

A

MTX
SE = Myelosuppression, mucositis, lung and liver fibrosis

5-FU
SE = Myelosupression, mucositis and dermatitis

6-MCP
SE = Myelosuppression

Cytarabine
SE = Myelosuppression and ataxia

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9
Q

Chemo acting on microtubules

A

Vincristine/Vinblastine
SE = Peripheral neuropathy, paralytic ileus

Docetaxel
SE = Neutropenia

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10
Q

Bone mets

  1. Common cancers
  2. Common sites
  3. Common features
A
  1. Prostate
    - Breast
    - Lung
  2. Spine
    - Pelvis
    - Ribs
    - Skull
    - Long bones
  3. Pathological ###
    - Hypercalcaemia
    - Raised ALP
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11
Q

Malignant SCC

  1. Causes
  2. Presentation
  3. Ix
  4. Rx
A
  1. Onc emergency.
    - Extradural compression often due to spine mets.
    - Common in prostate, lung and breast ca.
  2. 1st sign = back pain (worse on coughing or lying down)
    - Lower limb weakness
    - Sensory changes
    - Neurology - Lesion below L1 cause LMN signs and perianal numbness.
  3. Clinical
    - MRI to visualise
  4. 8mg oral dexamethasone BD and urgent onc assessment.
    - Radio or surgery to decrease lesion size may be indicated.
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12
Q

Palliative care - Agitation and confusion management

A
  1. Look for reversible causes; hypercalcaemia, infection, UTI, meds.
  2. Oral haloperidol
  3. Chlorpromazine, levopromazine.
  4. Terminal phase best treated w/ midazolam.
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13
Q

Antiemetics; Ondansetron, Haloperidol, Cyclizine, Metoclopramide, Dexamethasone

  1. MOD
  2. Indication
A

Ondansetron

  1. 5HT-3 receptor antagonist
  2. Gastroenteritis or chemo

Haloperidol

  1. Antipsychotic
  2. Anti-emetic in palliative care

Cyclizine

  1. H1-antagonist
  2. Inner-ear induced nausea

Metoclopramide

  1. D2 antagonist
  2. Promotes gastric emptying

Dexamethsone

  1. Steroid
  2. Useful in brain mets to lower ICP and help N&V
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14
Q

SCC with upper motor neurone signs and normal peri-anal sensation

A

Lesion is above L1.

- consider if SCC Sx w/ brisk reflexes etc.

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15
Q

Non-small cell lung cancer types

A

Squamous;

  • Central
  • Associated with PTH secretion
  • Finger clubbing

Adenocarcinoma

  • Peripheral
  • Most common in non-smokers

Large cell

  • Peripheral
  • Anaplastic, poor differentiated
  • May secrete BHCG
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16
Q

Palliative care Sx management; Hiccups

A
  • Gargling cold water, breath holding, peppermint water.
  • Chlorpromazine
  • Haloperidol, gabapentin
17
Q

Palliative care; syringe drivers

A
  • When a patient is unable to take oral meds.
  • Majority of drugs are mixed w/ water for injection apart from; Granisetron, ketamine, ketorolac, ocreotide and ondansetron which require NACL.
- Common drugs = 
N&V - Cyclizine, levomepromazine, haloperidol, metoclopramide 
Secretions - Hyoscine hydrobromide 
Bowel colic - Hyoscine butylbromide 
Agitation - midazolam, haloperidol
Pain - Diamorphine.
18
Q

Codeine to morphine conversion

A

Divide codeine dose by 10

19
Q

Oral tramadol to morphine

A

Divide by 10

20
Q

Oral morphine to oral oxycodone

A

divide by 1.5-2

21
Q

Oral morphine to SC morphine

A

Divide by 2

22
Q

Oral morphine to SC diamorphine

A

Divide by 3

Medical School Finals (24 decks)

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