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Year 3 ICSM COPY > Cancer > Flashcards

Cancer Flashcards

1
Q

What type of cancer is most common in the bladder?

A

Transitional cell carcinomas

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2
Q

Recall 3 risk factors for bladder cancer

A

Recurrent UTIs
Schistomiasis
Naphthylamine dye exposure

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3
Q

Recall a key epidemiological factor for bladder cancer

A

2-3 x more common in males

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4
Q

Recall the symptoms of bladder cancer

A

Normal urinary symptoms you would expect: polyuria, urgency, nocturia
Painless, macrocytic haematuria
Recurrent UTIs

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5
Q

Recall the initial investigation used for bladder cancer

A

Cytoscopy

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6
Q

What sort of scan is used to stage bladder cancer?

A

CT or MRI

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7
Q

What is the most common type of cancer in the breast?

A

Invasive ductal carcinoma

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8
Q

Recall 3 things that prolong oestrogen exposure

A

Nulliparity
Late menopause
Obesity

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9
Q

Recall the symptoms of breast cancer

A

Breast lump: irregular size/shape, may have bloody discharge
Axillary lump
Cardinal symptoms

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10
Q

Recall the signs of breast cancer including the characteristic appearance of the lump

A

Lump is firm and irregular, and tethered to surrounding tissues
Peau d’orange and skin tethering
Nipple inversion
Paget’s disease of the nipple (eczema like surrounding skin)

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11
Q

Recall the triple assessment investigative procedure used in breast cancer

A
  1. Examination
  2. Ultrasound/ mammogram
  3. FNA/ core biopsy
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12
Q

What investigations may be done in breast cancer in order to stage the tumour?

A

CT, CXR, Liver US (looking for mets)

Bloods (including Ca2+ and bone profile)

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13
Q

What is a cholangiocarcinoma?

A

Primary adenocarcinoma of the biliary tree

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14
Q

Recall the 3 risk factors for cholangiocarcinoma

A

Choledochal cyst
Primary sclerosing cholangitis
Ulcerative colitis

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15
Q

Recall the symptoms of jaundice

A 
Mnemonic: You Shall Poo Stools Deemed Unhealthily Pale
Yellow
Skin
Pale
Stool
Dark 
Urine
Prutitis
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16
Q

Recall the symptoms of cholangiocarcinoma

A

Jaundice
Abdominal pain
Cardinal symptoms

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17
Q

Recall the LFT results expected in cholangiocarcinoma

A

Raised ALP and GGT

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18
Q

What tumour marker may be present in cholangiocarcinoma?

A

CEA

Carcinoembryonic antigen

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19
Q

What is the key investigation to do to diagnose cholangiocarcinoma?

A

ERCP - also use to do biopsy

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20
Q

How are CNS tumours classified?

A

High or low grade

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21
Q

What is the difference between high and low grade CNS tumours?

A

Rate of growth - only low grade ones may be treated

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22
Q

Recall examples of high grade CNS tumours

A

Mnemonic = GLUM
Glioma (+ glioblastoma multiforme)
Lymphoma (primary cerebral)
Medulloblastoma

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23
Q

Recall examples of low grade CNS tumours

A

Meningioma
Acoustic neuroma
Chraniopharyngoma

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24
Q

Who is particularly at risk of low grade CNS tumours?

A

HIV/AIDS patients

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25
Q

What is an important differential to rule out when you suspect a CNS tumour?

A

Temporal arteritis

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26
Q

Why are CNS tumours not staged?

A

Metastases from primary pretty much non-existent

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27
Q

What type of cancer is colon cancer?

A

Adenocarcinoma

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28
Q

Recall the relative proportion of distribution of colon cancers

A

10% in ascending and transverse colon
30% in descending colon
60% in sigmoid colon/ recum

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29
Q

What are the key mutations implicated in colon cancer?

A

KRas and APC

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30
Q

Recall the 3 key risk factors for colon cancer?

A

IBD
Polyps
Western diet

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31
Q

Differentiate the symptoms seen in cancers of the ascending/ transverse colon and symptoms that present in descending/sigmoid/rectal tumours

A

Ascending/transverse: later presentation: anaemia, malaiase, weight loss
Descending/sigmoid/rectal = earlier presentation: change in bowel habit, rectal bleeding, tenesmus

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32
Q

Why do colon cancers often present as an emergency?

A

Obstruction/ haemorrhage is common

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33
Q

Where is colon cancer most likely to metastasise to?

A

Liver

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34
Q

What is an important blood test to do in primary investigations for colon cancer?

A

FBC as will show anaemia

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35
Q

Which tumour markers may be present in colorectal cancer?

A

Ca19-9

CEA

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36
Q

What screening test may be used for colorectal cancer?

A

Faecal occult blood

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37
Q

How should a biopsy be obtained for colorectal cancer?

A

Endoscopy

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38
Q

How is colorectal cancer staged?

A

CONTRAST CT

39
Q

Recall 3 risk factors for gastric cancer

A

Smoked/processed foods
H. pylori
Gastric polyps

40
Q

What are the gastric symptoms of gastric cancers?

A

Early satiety
Gastric mass
Tenderness
Dysphagia

41
Q

Recall 2 weird signs of gastric cancer

A

Virchow’s node

Sister Mary Joseph’s Nodule

42
Q

Define hepatocellular carcinoma

A

Primary malignancy of liver parenchyma

43
Q

Recall 3 pathologies associated with hepatocellular carcinoma

A

Chronic liver disease
Metabolic disease (eg haemochromatosis)
Aflatoxin infection

44
Q

Recall 2 symptoms of hepatocellular carcinoma

A

Jaundice

Abdominal distention

45
Q

Recall the signs of hepatocellular carcinoma

A 
Mnemonic: Hepatocellular Carcinoma Always Leaves Bad Jaundice
Hepatomegaly
Cachexia
Ascites
Lymphadenopathy
Bruits over liver
Jaundice
46
Q

What is the tumour marker implicated in hepatocellular carcinoma?

A

AFP

47
Q

How might cytology samples be obtained for hepatocellular carcinoma?

A

Ascitic tap

48
Q

Recall the relative prevalence of small cell and non-small cell lung cancer

A

Small cell = 20%, non-small cell = 80%

49
Q

Which type of cancer is asbestos associated with?

A

Lung cancer

50
Q

What is the relative prevalence of lung cancer in women to men?

A

1:3

51
Q

Recall symptoms of lung cancer due to the primary tumour

A

Haemoptysis
Chest pain
Recurrent pneumonia

52
Q

Recall symptoms of lung cancer that are related to local inflammation

A

Of nerves:
SNS compression: Horner’s
Brachial plexus compression: shoulder/arm pain
LRL compression: hoarseness and bovine cough
Of tissue: dysphagia and arrhythmias

53
Q

What sort of wheeze results from lung tumours

A

Obstruction –> fixed monophonic wheeze

54
Q

What electrolyte imbalance is common in lung cancer?

A

Hypercalcaemia

55
Q

What blood result is indicative of bony mets?

A

Raised LFTs

56
Q

Where does mesothelioma most commonly occur?

A

Pleura (90%)

57
Q

What is the key risk factor to remember for mesothelioma?

A

Asbestos

58
Q

Recall the signs and symptoms of mesothelioma

A 
Mnemonic: Mesothelioma Presents With Particularly Fierce Nail Clubbing Signs
M: mass
P: pyrexia
W: weight loss
P: pain in chest
F: fatigue
N: night sweats
C: clubbing
S: SOB
59
Q

What is the main investigation that needs to be done in mesothelioma?

A

Pleural fluid cytology

60
Q

Recall the diagnostic criteria for neutropenic sepsis

A

Temp >38

Neutrophils < 0.5 x 10^9/L

61
Q

Why may a neutropenically septic patient not have fever even though they have a high temp?

A

They are likely to be on anti-pyretics

62
Q

Recall some acquired causes of neutropenic sepsis, thinking systematically

A
  1. Decreased production of neutrophils: B12/folate deficiency, chemotherapy, aplastic anaemia
  2. Accelerated turnover of neutrophils: hypersplenism
  3. Dengue fever!
63
Q

What is the most common cause of neutropenic sepsis?

A

Cytotoxic chemotherapy

64
Q

Recall the investigations required to identify neutropenia and sepsis

A

FBC

Blood cultures

65
Q

What are the 2 major histological types of oesophageal cancer?

A

Squamous cell carcinoma

Adenocarcinoma

66
Q

Recall 4 risk factors for squamous cell carcinoma of the oesophagus

A

Achalasia
Coeliac
Alcohol
Scleroderma

67
Q

Recall 2 risk factors for adenocarcinoma of the oesophagus

A

GORD

Barrett’s oesophagus

68
Q

Is oesophageal cancer more common in men or women?

A

Men

69
Q

Recall the symptoms of oesophageal cancer

A 
Dysphagia
Regurgitation
Choking
Hoarseness
Odynophagia
Cough
70
Q

Recall 2 investigations for oesophageal cancer

A

Barium swallow

Endoscopy

71
Q

Is pancreatic cancer more common in men or women?

A

Men

72
Q

Recall the symptoms of pancreatic cancer

A 
Mnemonic: Pancreatic Malignancy Affects Disaster With No Justice
Pain
Malaise
Anorexia
Diabetes
Weight loss
Nausea
Jaundice
73
Q

What is trousseau’s sign of malignancy?

A

superficial thrombophlebitis

74
Q

In which cancer is trousseau’s sign of malignancy present?

A

Pancreatic

75
Q

Which tumour markers may be present in pancreatic cancer

A

Ca19-9

CEA

76
Q

Recall the characteristic findings on PR in prostate cancer

A

Loss of midline sulcus

Asymmetrical hard nodular prostate

77
Q

How would a biopsy be done in prostate cancer?

A

TRUS

78
Q

What is the most common medical therapy for prostate cancer?

A

Androgen deprivation therapy

79
Q

Recall the types of renal cell carcinoma and their relative prevalences

A 
Renal CLEAR cell = 80%
Papillary cell carcinoma = 10%
Transitional cell (at renal pelvis) = 10%
80
Q

Recall 3 inherited conditions associated with renal cell carcinoma

A

Von Hippel-Lindau
Tuberous sclerosis
Polycystic kidney disease

81
Q

What is Strauffer’s syndrome?

A

Abnormal LFTs in absence of liver mets due to renal cell carcinoma

82
Q

What percentage of renal cell carcinomas are asymptomatic, and what are the possible symptoms?

A

90%

Haematuria, flank pain, abdominal mass

83
Q

Why does renal cell carcinoma cause hypertension?

A

Suppresses RAAS

84
Q

Why can renal cell carcinoma cause a left-sided varicocele?

A

Obstructs left-sided testicular vein where it joins renal vein

85
Q

Which staging system is used for renal cell carcinoma?

A

Robson staging

86
Q

What are the 3 types of testicular cancer?

A

Seminomas
Non-seminamatous germ cell tumours
Teratoma

87
Q

Which metastases are most common in testicular cancer?

A

Lung

88
Q

Recall 3 signs of testicular cancer

A
  1. Hard mass
  2. Lymphadenopathy
  3. Gynaecomastia (tumour produces hCG)
89
Q

Recall 2 tumour markers for testicular cancer

A

AFP

beta-hCG

90
Q

Which staging system is used for testicular cancer?

A

Royal Marsden Hospital Staging System

91
Q

What is tumour lysis syndrome?

A

Metabolic abnormalities that occur as a complication of cancer treatment

92
Q

In which cancer does the treatment most commonly produce tumour lysis syndrome?

A

Lymphoma/ leukaemia

93
Q

Recall 3 electrolytes that are high in TLS and the consequences of each of these being raised

A

Phosphate: calcium phosphate deposited in kidney leading to acute renal failure
K+: causes arrhythmias
Uric acid: gout

Year 3 ICSM COPY (17 decks)

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