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The One Deck To Rule Them All > Oncology > Flashcards

Oncology Flashcards

1
Q

Used to identify families with Lynch Syndrome (HNPCC)

A

Amsterdam Criteria

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2
Q

Criteria needed for a diagnosis in Amsterdam criteria

A

3+ members of family with colorectal cancer (1 = 1st degree)
2 successive affected generations
1+ member with colon cancer < 50 years old
Familial adenomatous polyposis has been excluded

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3
Q

Familial adenomatous colorectal polyposis (FAP)
Multiple chronic polyps
Retroperitoneal desmond tumours (15%)

Associated with:

  • skull osteoma
  • thyroid cancer
  • epidermoid cysts
A

Gardener’s Syndrome

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4
Q

Management of Gardener’s syndrome

A

Prophylactic colectomy to reduce risk

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5
Q

Gardener’s syndrome genetics

A

Autosomal dominant

  • mutation of APC gene
  • chromosome 5
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6
Q

Pheochromocytoma
RCC
Haemangioblastoma

A

Von-Hippel Lindau Disease

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7
Q

Sarcomas
Leukaemia
Breast cancer
Adrenal gland tumours

A

Li-Fraumeni Syndrome

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8
Q

Criteria to diagnose Li-Fraumeni syndrome

A

Sarcoma < 45 years old
1st degree relative has cancer < 45 year old
Another family member develops cancer < 45 year old

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9
Q

Genetics of Li-Fraumeni syndrome

A

Autosomal dominant

- germline mutations to p53 (tumour suppressor gene)

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10
Q

Genetics of BRCA 1

A

Chromosome 17

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11
Q

Genetics of BRCA 2

A

Chromosome 13

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12
Q

What cancers are associated with BRCA genes

A 
Breast cancer ( both 60% risk) 
Ovarian cancer
 - BRCA 1 (55%)
 - BRCA 2 (25%)
Prostate cancer (BRCA 2)
Pancreatic 
Melanoma
Young-onset colorectal cancer (BRCA 1)
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13
Q

Uses flurodeoxyglucose as a tracer

Shows 3d metabolic activity

A

Positive emission tomography (PET Scan)

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14
Q

Neutropenic sepsis is common in

- presents with fever

A

Adjuvant therapy (curative regimes)

  • Breast cancer
  • Germ cell cancers
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15
Q

Management of neutropenic sepsis

A
  1. Tazocin
    - Teicoplanin/ Aztreonam (if Penicillin allergic)
  2. Vancomycin
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16
Q

What are tumour markers

A

Monoclonal antibodies
Tumour antigens
Enzymes
Hormones

  • Low specificity
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17
Q

Ovarian + testicular cancers drain to the

A

Para-aortic lymph nodes (via gonadal vessels)

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18
Q

Breast cancer drains to the

A

Axillary lymph nodes

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19
Q

Vulval, penile + anal cancers drain to the

A

Inguinal lymph nodes

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20
Q

Colon cancers drain to the

A

Mesenteric lymph nodes

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21
Q

Thoracic, breast + gastric cancers drain to the

A

Supraclavicular nodes

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22
Q 
Oliguria (decreased urine output)
Cardiac arrhythmia 
Seizure
Confusion 
Hx of lymphoma/ germ cell cancer
A

Tumour lysis syndrome

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23
Q

Cancers associated with tumour lysis syndrome

A

Lymphoma

Germ cell cancer

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24
Q

Biochemistry in tumour lysis syndrome

A

Increased Potassium

Increased Phosphate

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25
Q

Management for tumour lysis syndrome

A 
Calcium gluconate (cardio protection from potassium)
Fluids
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26
Q

Most common causes of brain mets

A 
Lung
Breast
Bowel 
Skin (Melanoma)
Kidney
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27
Q

Most common causes of bone mets

A

BLT + Kosher pickle

Breast
Lung
Thyroid
Kidney
Prostate
28
Q

Most common site of bone mets

A 
Spine 
Pelvis
Ribs
Skull
Long bones
29
Q

Biochemistry in bone mets

A

Hypercalcaemia

Increased ALP

30
Q

Investigations for bone mets

A

1st line: MRI

DEXA Scan: picks up lytic mets better then XR

31
Q

Management for bone mets

A

Radiotherapy can be used as pain relief

32
Q 
Bone pain 
 - worse with straining/ coughing
 - nocturnal 
 - tender
Pathological fractures 
 - vertebral wedge compression
A

Bone metastasis

33
Q 
Back pain 
 - worse when lying down + coughing
Lower limb weakness
Sensory changes (numbness)
Disturbed bowel function 
Disturbed bladder function
A

Neoplastic spinal cord compression

  • Oncological emergency
  • 5 % of cancer patients
34
Q

In neoplastic spinal cord compression lesions above L1 exhibit

A

UMN signs in the legs

35
Q

In neoplastic spinal cord compression lesions below L1 exhibit

A

LMN signs in the legs + perianal numbness

36
Q

In neoplastic spinal cord compression tendon reflexes are

A

increased below the level of the lesion

absent at the level of the lesion

37
Q

Investigations for neoplastic spinal cord compression

A

Urgent MRI (whole spine) < 24 hours

38
Q

Management for neoplastic spinal cord compression

A

Oral dexamethasone (high dose)
- reduce oedema
Consider radiotherapy/surgery

39
Q

Causes of superior vena cava obstruction

A 
Small cell lung cancer (right lobe)
Lymphoma
Metastatic seminoma
Kaposi sarcoma 
Breast cancer 
Vein occlusion
40
Q 
Dyspnoea 
Swelling of face, neck + arms
Eyes (conjunctival + peri-orbital oedema)
Headache (worse in mornings)
Visual disturbance 
Pulseless JVP distension
A

Superior vena cava obstruction

41
Q

Tests for superior vena cava obstruction

A

Pemberton’s sign: positive

- Raise arms above head to exacerbate SVCO symptoms

42
Q

Management for superior vena cava obstruction

A

Dexamethasone
Balloon venoplasty/ stenting
Radiotherapy/ surgery

43
Q

Tumour marker for colorectal cancer

A

Carcinoembryonic antigen (CEA)

44
Q

Tumour marker fo prostate cancer

A

Prostate specific antigen (PSA)

45
Q

Tumour marker for ovarian cancer

A

CA 125 (monoclonal antibody)

46
Q

Tumour marker for pancreatic cancer

A

CA 19-9

47
Q

Tumour marker for HCC

A

Alpha-feto protein (AFP)

48
Q

Tumour marker for testicular teratoma

A

Alpha-feto protein (AFP)

Beta hCG

49
Q

Tumour marker for melanoma

A

S-100 (tumour antigen)

50
Q

Tumour marker for gastric cancer

A

Bombesin (tumour antigen)

51
Q

Tumour marker for schwannomas

A

S-100 (tumour antigen)

52
Q

Tumour marker for neuroblastoma

A

S-100 (tumour antigen)

53
Q

Familial causes of colorectal cancer

A

5% - Hereditary Non-polyposis colorectal carcinoma (HNPCC)

1 % - Familial adenomatous polyposis (FAP)

54
Q

Familial causes of endometrial cancer

A

5% - Hereditary Non-polyposis colorectal carcinoma (HNPCC)

55
Q

Cause of Kaposi’s sarcoma

A

Causes by Herpes Virus 8

- common in HIV

56
Q

Purple papules on skin
Plaques on shin/ mucosa
Hx of HIV

A

Kaposi’s sarcoma

57
Q

Management of kaposi’s sarcoma

A

Radiotherapy

Surgical resection

58
Q

Chemo for bladder cancer

A

CMV

Cisplatin
Methotrexate
Vinblastine

59
Q

Chemo for high-grade non-hodgkins lymphoma

A

R-CHOP

Cyclophosphamide
Hydroxydaunorubicin (doxorubicin)
Vincristine (Oncovin)
Prednisolone

60
Q

Chemo for colorectal cancer

A

FOLFOX

5-FU
Leucovorin (colonic acid)
Oxaliplatin

61
Q

Chemo for breast cancer

A

FEC

5-FU
Epirubicin
Cyclophosphamide

62
Q

Chemo for hodgkins lymphoma

A

ABVD

Adriamycin (doxorubicin)
Bleomycin
Vinblastine
Dacarbazine

63
Q

No red reflex

Age 18 months

A

Retinoblastoma

64
Q

Retinoblastoma genetics

A

Autosomal dominant

10% hereditary

caused by loss of function of tumour suppressor gene on chromosome 13

65
Q

Management of Retinoblastoma

A

External beam radiation
Chemo
Photocoagulation
Enucleation

90% survive

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