Just give me the c-answer

Question 1

What gene’s are involved in breast cancer?
Are they oncogenes or tumour suppressor genes?
How do they work?

Answer 1

P53, BRCA-1
Tumour suppressor genes
Recognising cells undergoing neoplastic changes and causing them to enter apoptosis

Question 2

What does Bence-Jones proteins in urine indicate?
What is the definition of this disease?
What does CRABS stand for?
What sort of bone lesions will be present?

Answer 2

Multiple myeloma
Proliferation of Ig-producing plasma cells
Calcium increase, Renal issues, Anaemia, Bone pain, Sensation (nerve damage)
Lytic bone lesions

Question 3

What is the pathogenesis of immune thrombocytopenia (ITP)?
What virus’ do all patients presenting with ITP need tested?
Treatment?

Answer 3

Combination of increased platelet destruction and impaired platelet production caused by anti-platelet auto-antibodies
Virus’ = HIV and Hep C
Treatment = Prednisone, IV Ig and splenectomy

Question 4

What are 4 signs of bleeding in ITP?

Describe each

Answer 4

Petechiae - flat, red lesion that DO NOT blanch under pressure
Purpura - lesions caused by a collection of petechiae
Epistaxis - minor to severe bleed
Severe haemorrhage - 10% of patients

Question 5

What virus is Burkitt’s lymphoma associated with?

What cells does it attack specifically?

Answer 5

EBV

B-cells

Question 6

What does Reed-Sternberg cells on pathological examination indicate?
What cells are effected?
Early stage vs Advanced stage treatment?

Answer 6

Hodgkin’s lymphoma
B-cells
Early = chemo plus radiotherapy
Advanced = combination chemo

Question 7

Definition of leukaemia (based on peripheral blood smear)

Chronic vs Acute

Answer 7

20% of WBC need to be blasts
Chronic = <5%
Acute = >20%

Question 8

What does a “leucoerythromblastic film” indicate?

Next investigation?

Answer 8

Bone marrow infiltrate, nucleated RBC and pre-myelocyte

Bone marrow biopsy

Question 9

What cancer is linked to each marker;
AFP?
CEA?
CA-125

Answer 9

AFP = liver and testicular 
CEA = colonic
CA-125 = ovarian

Question 10

What is the most common childhood cancer?
Does Downs increase or decrease the incidence?
What is the cure rate?

Answer 10

Acute lymphoblastic leukaemia
Downs increases the incidence
Cure rate = 80%

Question 11

Which lymph nodes does testicular cancer usually metastasise to first?
What is the most common type of testicular cancer?
What congenital abnormality increases the risk of testicular cancer?

Answer 11

Lymph nodes
Germ cell - 95%
Cryptorchidism

Question 12

What cancer does the Philadelphia chromosome indicate?

Answer 12

Chronic myeloid leukaemia

Question 13

When does uric acid nephropathy occur in cancer patient?

Why?

Answer 13

During chemotherapy

Why? Because of high levels of circulating blasts and cell breakdown

Question 14

What are 3 complications of radiotherapy?

Answer 14

Lymphoedema 
Delayed wound healing 
Proctitis
Telangestasia 
Anaemia

Question 15

Where do the following cancers most commonly metastasise to;
Prostate?
Pancreas?
Stomach?
Melanomas?

Answer 15

Prostate = bone/lumbar spine
Pancreas = liver
Stomach = liver and ovaries
Melanomas = liver, lung and brain

Question 16

What are 4 tumour genes and what does each indicate?

Answer 16

PSA = prostate
CEA = colon
CA125 = gonadal and ovarian
CA 19.9 = pancreas
AFP = testicular

Question 17

What are 4 signs of malignant change in a skin lesion?

Answer 17

Bleeding/ulceration
Change in size or shape
Itching
Lymph node involvement 
Pain

Question 18

What medical conditions can cause raised CA125?

Answer 18

Pancreatitis
endometriosis
Pelvic inflammatory disease
Uterine fibroids

Question 19

Which vaccinations are contraindicated in chemo?

Which are withheld until after chemo?

Answer 19

Contraindicated = Measles, mumps and rubella and Polio 
Withheld = Varicella and influenza are withheld