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General Oncology Flashcards

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0
Q

What cancer is associated with exposure to benzene?

A

Leukaemia

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1
Q

What cancer is the Epstein Barr virus associated with?

A

Hodgkins and non Hodgkin’s lymphoma

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2
Q

What cancer is associated with exposure to wood dust?

A

Nasal adenocarcinoma

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3
Q

What cancer is associated with exposure to vinyl chloride?

A

Angiosarcoma

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4
Q

What is the RECIST classification of imaging response to treatment?

A

Complete response - no disease detectable

Partial response - shrunk by >30%
Stable -shrunk by 20%
Progressive disease - new lesions or lesions that have increased by >20%

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5
Q

Who is eligible for mammography screening for breast cancer and how often?

A

Women from the ages of 50 to 65, every three years

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6
Q

How many CT scans does it take to cause one cancer?

A

1000 - 2000 ct scans

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7
Q

For what cancer is carcinoembryonic antigen raised, and in which other conditions may it also be raised?

A

Colorectal carcinoma

Smokers, IBD, hepatitis, pancreatitis, gastritis

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8
Q

For what cancer is CA125 raised, and in which other conditions?

A

Ovarian cancer- raised in 82%
Also raised in 6% of pregnancy, endometriosis, PID
Also raised in pancreatic, lung, colorectal and breast cancer

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9
Q

In what conditions is Alpha fetoprotein raised?

A

First year of life
Hepatitis
Hepatic ellipse carcinoma
Yolk sac cancers

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10
Q

In what conditions is human human chorionic gonadotropin raised?

A

Hydatiform mole
Choriocarcinoma
Non Seminomatous testicular cancer

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11
Q

When is PSA raised?

A 
Prostate cancer
BPH
UTI
After a DRE
prostatitis
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12
Q

In which inherited condition is a prophylactic colectomy sometimes considered?

A

Familial Adenomatous Polyposis

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13
Q

Which chemo drugs can be taken orally?

A

Cyclophosphamide
Capacitabine
Etoposide
Tamoxifen

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14
Q

Which cancer an be treated with chemotherapy administered intraperitoneally?

A

Ovarian cancer

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15
Q

How is chemotherapy dose usually calculated?

A

Body surface area using the Dubois and Dubois calculations

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16
Q

For which cancers is high dose chemo with bone marrow support an option?

A 
Non Hodgkin's lymphoma
Hodgkin's
Acute and chronic leukaemia
Multiple myeloma
Germ cell tumours
Ewing's sarcoma
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17
Q

Which drugs are administered with chemo to prevent nausea and vomiting?

A

Pre med
Ondansetron 8mg IV
Dexamethasone 8mg IV

Post dose
Metoclopramide TDS 14 days
Dexamethasone 6mg PO

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18
Q

Which drugs are most at risk of causing peripheral neuropathies?

A

Platinums eg cisplatin, carboplatin
Vinca alkaloids eg vincristine
Taxanes eg paclitaxel, docetaxel

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19
Q

Which chemo drug may cause cerebellar toxicity?

A

5FU

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20
Q

Which chemo drug may cause cochlear damage resulting in permanent high tone loss?

A

Cisplatin

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21
Q

Which chemo drugs are nephrotoxic

A

Cisplatin

Isosfamide

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22
Q

Which chemo drugs pose a risk of haemorrhagic cystitis, and what is the antidote?

A

Cyclophosphamide
Isosfamide

Antidote is mesna

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23
Q

Which chemo drugs may cause cardiac arrythmia

A

Doxorubicin

Paclitaxel

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24
Which chemo drug may cause coronary artery spasm?
5FU
25
Which chemo drugs may cause palmar plantar erythema?
5FU Capacitabine Sunitinib Erlotinib
26
Which chemo drug may cause photo sensitivity?
5FU
27
Which chemo drug causes pigmentation changes
Bleomycin- also check for pulmonary fibrosis!
28
Which drug may cause myalgia/arthralgia
Paclitaxel
29
Which drugs may cause infertility?
Alkylating agents- cyclophosphamide, Isosfamide, melphalan, busulphan
30
What is the nadir point for myelosuppression?
10-12 days after treatment
31
Which cancers are most likely to cause bone narrow replacement by malignant infiltration, resulting in myelosuppression by pancytopenia?
Haematological Breast Lung Prostate
32
How and when is anaemia treated cancer?
Hb <10 gldl Blood transfusion Recombinant epo if symptomatic
33
How does thrombocytopenia present in cancer, how is it treated?
Petechiae Nosebleeds Corneal haemorrhage 20x10*9- does not require platelets
34
When does neutropenia typically occur after chemo?
7-14 days
35
When is febrile neutropenia diagnosed?
WBC <1x10(9) Fever greater than 38 degrees for an hour Or fever greater than 38.5 degrees in a single reading
36
How is febrile neutropenia treated?
IV tazocin within 60 mins Consider switch to oral within 24 hours 5% overall mortality Mostly no identifiable aetiology
37
When does pneumonitis appear after radiotherapy, and what symptoms does it cause?
6-8 weeks after | Progressive SOB, dyspnoea
38
When do acute side effects develop during radiotherapy
During treatment | Peak during first few weeks post treatment and resolve
39
When do late side-effects develop during treatment
Develop greater than three months after radiotherapy. May be years later Often irreversible Worsen over time Include lung fibrosis, skin atrophy, infertility
40
What is the difference between intercavitary and interstitial brachytherapy
Intercavitary- placed in body such as uterus or cervix Interstitial- placed into target such as prostate Patient is radioactive so counsel about risk!
41
What is an example of radioisotope use in cancer treatment
Iodine 131 use in thyroid cancer Preferentially taken up in normal or malignant thyroid tissue Requires 4 days in lead lined room
42
Who is eligible for cervical cancer screening?
25-49 every three years 49-64 every five years Only women because only women have cervices
43
What screening programme is used for colorectal cancer?
Faecal occult blood Every two years 60-69 Currently being extended to 74
44
In which part of the spine does metastatic spinal cord compression most commonly occur?
2/3 thoracic | 1/3 lumbar/cervical
45
What is the treatment for metastatic spinal cord compression
16mg dexamethasone With PPI for gastric protection 8gy single fraction radiotherapy Or refer to spine surgeons
46
What is the prognosis for metastatic spinal cord compression for patients ambulance and paraplegic prior to treatment?
Ambulant- 70% retain function Paraplegic- 5% retain function Overall one fifth of patients will survive greater than one year
47
What are the symptoms of superior vena cava obstruction?
Facial oedema Prominent blood vessels Cyanosis
48
What is the treatment for superior vena cava obstruction?
Dexamethasone 16mg | Vascular stenting followed by radiotherapy, chemo
49
What are the cardiac symptoms of hypercalcaemia?
Bradycardia Short QT intervals Prolonged PR interval Wide T wave
50
How is rehydration managed in hypercalcaemia?
Rehydration with saline 1l 4 hourly for 24 hours IV pamidronate 60-90mg over 2-4 hour Calcitonin and corticosteroids?
51
What are the signs that someone is nearing the end of their life?
``` Profound weakness Confined to bed Disorientated Confused Drowsiness for extended periods Reduced attention Loss of attention in food and drink Too weak to swallow ```
52
When is a blood transfusion indicated in cancer?
Prognosis >2 weeks And Symptoms of anaemia And Hb <8g/dl
53
In what order are muscles affected in corticosteroid induced myopathy?
Legs then arms then chest muscles Proximal muscles are affected before distal muscles
54
What are the symptoms of metastatic spinal cord compression?
Low back pain - band like, increased in movement, coughing, or lying flat Motor weakness Subjective sensory disturbance Bladder/bowel dysfunction Increased reflexes Clonus
55
What is the investigations for MSCC?
MRI within 24 hours FBC, calcium, LFTs (raised all phosphate)
56
What causes superior vena cava obstruction?
Extrinsic compression, thrombosis or invasion if the wall of the vessel Usually in lung cancer, lymphoma
57
What are the symptoms of SVCO?
Facial oedema Prominent blood vessels Cyanosis
58
How is SVCO managed?
Dexamethasone 16 mg Vascular stenting - may be followed by radiotherapy, chemo
59
What cancers commonly cause hypercalcaemia?
``` Breast cancer Lung cancer - NSCLC SCC Myeloma/lymphoma Head and neck ```

Oncology (8 decks)

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