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Year 4 - Cancer Care > 1.07 - H&N Cancer > Flashcards

1.07 - H&N Cancer Flashcards

1
Q

What percentage of brain tumours are benign?

A

50%

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2
Q

What causes the signs and symptoms associated with brain tumours?

A
  • local brain invasion
  • increased intracranial pressure
  • compression of adjacent structures
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3
Q

What is the location and function of oligodendrocytes?

A

Location: CNS

Function: myelination of axons and electrical insulation.

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4
Q

What is the location and function of Schwann cells?

A

Location: PNS

Function: myelination of axons and electrical insulation.

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5
Q

What is the location and function of astrocytes?

A

Location: CNS

Function: Repair processes and establishing the blood brain barrier.

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6
Q

What is the location and function of ependymal cells?

A

Location: CNS

Function: Single-layered columnar and cuboidal cells that line the ventricles and the central canal.

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7
Q

What is the location and function of microglial cells?

A

Location: CNS

Function: Protective and phagocytic immune-based function.

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8
Q

What is the location and function of satellite cells?

A

Location: PNS

Function: Cover the PNS ganglia for support.

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9
Q

Location of brain mass and respective deficit / symptom.

Temporal lobe.

A
  • Wernicke’s aphasia
  • homonymous superior quadranopsia
  • mild contralateral facial weakness
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10
Q

Location of brain mass and respective deficit / symptom.

Frontal lobe.

A
  • drowsiness
  • decreased attention
  • seizures
  • altered judgement
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11
Q

Location of brain mass and respective deficit / symptom.

Parietal lobe.

A
  • impaired position sense
  • focal sensory and motor seizures
  • homonymous hemianopsia
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12
Q

Location of brain mass and respective deficit / symptom.

Cerebellum.

A
  • ataxia
  • nystagmus
  • ipsilateral incoordination of arm and leg movements with intention tremor
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13
Q

Location of brain mass and respective deficit / symptom.

Brainstem.

A
  • facial weakness
  • dysphagia
  • cranial nerve palsy
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14
Q

Most frequently occurring primary brain tumours.

A

Gliomas.

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15
Q

Risk factors for brain tumours.

A
  • 50-55 years old
  • male > female
  • synthetic rubber
  • vinyl chloride
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16
Q

Signs and symptoms of gliomas.

A
  • headaches
  • seizures
  • memory loss
  • motor weakness
  • visual symptoms
  • language deficit
  • cognitive / personality change
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17
Q

Headache features of gliomas.

A
  • headache on exertion
  • headache onset at night or early morning
  • headache with neurological signs
  • valsalva worsening (ie. coughing, sneezing, bending over)
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18
Q

Examination of gliomas.

A
  • mental status
  • cranial nerve exam
  • motor system exam
  • reflexes
  • sensation
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19
Q

Gold standard imaging for gliomas.

A

Gadolinium-enhanced MRI.

20
Q

Management of gliomas.

A
  • maximal surgical resection
  • adjuvent chemotherapy
  • post-operative radiation
21
Q

Prognostic factors for CNS tumours.

A
  • age
  • tumour grade
  • extent of surgical resection
  • molecular alterations
  • KPS score
22
Q

Most common type of oral cancer.

A
  • squamous cell carcinoma
23
Q

Risk factors for oral cavity cancer (OCC).

A
  • tobacco
  • alcohol use
  • sun exposure
  • betel nut chewing
  • previous radiation exposure
  • poor oral hygiene
24
Q

Premalignant conditions of the oral cavity.

A
  • leukoplakia: white, well-defined keratotic pathces)
  • erythroplakia: red mucosal plaques

Both are caused by chronic inflammation.

25
Q

Prevention of oral cavity cancer.

A
  • avoidance of tobacco
  • alcohol avoidance
  • good oral hygiene
  • regular dental appointments
  • HPV vaccination
26
Q

Symptoms of oral cavity cancer.

A
  • painful oral lesion / mass
  • oral cavity bleeding
  • loose teeth
  • dysphagia
  • halitosis
  • numbness of lower teeth
  • referred otalgia (CNVc)
27
Q

Signs of oral cavity cancer.

A
  • asymmetry on tongue extension
  • trismus
  • halitosis
  • numbness of lower teeth
28
Q

Imaging of oral cavity cancer.

A
  • biopsy on initial presentation
  • CT / MRI
29
Q

Treatment of oral cavity cancer.

A
  • surgical resection
  • radiation therapy
  • chemotherapy
  • targeted therapy
  • immunotherapy
30
Q

Prognostic factors for oral cavity cancer.

A
  • depth of tumour invasion
  • close surgical margins
  • positive cervical nodes
  • extracapsular spread
31
Q

Layers of the eye.

A

1) sclera - white outer part visible to the eye.

2) uvea - heavily pigmented and vascular, providing nutrients to the retina and lens.

3) retina - nerve fibres that sense light that are sent through the optic nerve to the brain.

32
Q

Components of the uveal tract.

A
  1. Iris
  2. Ciliary body
  3. Choroid
33
Q

Function of the iris.

A

Sphincter pupillae constrict the pupil in bright light (parasympathetic).

Dilator pupillae dilate the pupil in dark light (sympathetic).

34
Q

Function of the ciliary body.

A

Ciliary smooth muscle fibres result in the accommodation reflex under parasympathetic control.

Contains epithelial cells that produce aqueous humour.

35
Q

Most common primary intraocular malignancy.

A

Uveal melanoma

36
Q

Risk factors for uveal melanoma.

A
  • fair skin
  • BRCA1 mutation
  • family history
  • ## UV light exposure
37
Q

Risk factors that dispose pre-existing iris nevi into developing malignancy.

A

ABCDEF risk factors:

Age at presentation ≤40 years

Blood (spontaneous hyphema)

Clock hour location (inferior quadrant)

Diffuse involvement of the entire iris

Ectropion uvaea

Feathery edges

38
Q

Presentation of uveal melanoma.

A
  • incidental finding on ophthalmic examination
  • vision loss
  • flashes / floaters
39
Q

Imaging for uveal melanoma.

A

Optical coherence tomography (OCT).

40
Q

Treatment of uveal melanoma.

A
  • observation
  • radiation
  • laser therapy
  • surgical resection
  • thermotherapy
41
Q

Risk factors for thyroid cancer.

A
  • radiation exposure
  • female sex
  • FAP
  • chronic TSH elevation
  • goitre
42
Q

Prevention of thyroid cancer.

A

Diet with adequate amounts of iodine.

43
Q

Signs and symptoms of thyroid cancer.

A
  • painless swelling in neck
  • goitre / tight collar
  • persistant cough
  • dysphagia
  • difficulty breathing
  • hoarseness of voice
44
Q

Diagnostic workup of thyroid nodule.

A
  • neck ultrasound
  • fine need aspiration
45
Q

Most common type of thyroid cancer.

A
  • papillary carcinoma (80%)
  • follicular carcinoma
  • anaplastic carcinoma (<1%)

Anaplastic carcinoma is the most aggressive type and is fast growing with early spread.

46
Q

What is the difference in matastatic spread between papillary carcinoma vs follicular carcinoma.

A

Papillary carcinoma: lymphatic metastasis.

Follicular carcinoma: haematogenous metastasis.

Year 4 - Cancer Care (13 decks)

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