ModC: Oncology & palliative care Flashcards

1
Q

Bladder cancer

A

Px: painless haematuria
RFs: smoking, chronic schistosoma haematobium infection (in Africa and Middle East), rubber industry previously a RF prior to 1949

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2
Q

Bowel cancer

A

Colon
Px: bowel habit changes, unintentional weight loss, vague abdominal discomfort
Ix: colonoscopy (to visualise up to caecum)
45% left-sided, 25% sigmoid colon

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3
Q

Breast cancer

A

Breast
Px: breast lump (check mobility, skin tethering, regularity), bloody discharge
Ductal carcinoma (most common) associated with bloody discharge, age 50-70
Ix: triple assessment (examination, imaging (USS or mammogram), FNA/core biopsy

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4
Q

Cervical cancer

A

Cervix

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5
Q

Endometrial cancer

A

Womb

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6
Q

Gastric cancer

A

Stomach

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7
Q

Lymphoma

A

Haem

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8
Q

Leukaemia

A

Haem

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9
Q

Myeloma

A

Haem

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10
Q

Laryngeal cancer

A

Larynx

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11
Q

Liver cancer

A

Alcohol

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12
Q

Lung cancer

A

Small cell and non-small cell

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13
Q

Malignant bowel obstruction

A

bowel

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14
Q

Neutropenic sepsis

A

Emergency

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15
Q

Bone metastases

A

bone

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16
Q

Liver metastases

A

liver

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17
Q

Brain metastases

A

brain

18
Q

Spinal cord metastases

A

spine

19
Q

Oesophageal cancer

A
oesophagus
RFs: previous achalasia (suggests upper tumour), smoking, alcohol
Px: 
- upper (20%) = hoarseness, cough
- middle =
- lower =
- lower oesophageal sphincter =
20
Q

Ovarian cancer

A

ovary

Complications: intra-abdominal metastases resulting in bowel obstruction

21
Q

Pancreatic cancer

A

Poor prognosis unless diagnosed early

22
Q

Prostate cancer

A

common

Px: asymptomatic with significantly raised PSA

23
Q

Renal cancer

A

poor prognosis

24
Q

Spinal cord compression

A

spine

25
Q

Superior vena cava obstruction

A

Seen with advanced lung cancer especially if pt has received multiple lines of treatment
Px: SOB, neck/upper arm swelling
Ix: CXR (mediastinal widening)
Mx: high dose steroids until further ix available

26
Q

Testicular cancer

A

Testicles

27
Q

Lynch syndrome

A

Improved prognosis if microsatellite instability identified via genetic testing

28
Q

Tumour lysis syndrome

A

Due to rapid breakdown of tumour cells after initiation of tx, high uric acid levels can result in renal tubular necrosis
Typically associated with acute leukaemia and non-Hodgkin’s lymphoma (Burkitt’s)
Px: dysuria, oliguria, abdominal pain, weakness
Ix: U&E, calcium, uric acid, ECG
Complications: renal tubular acidosis, arrhythmia secondary to hyperkalaemia
Prevention: hydration to improve blood flow, allopurinol or urate oxidase to remove uric acid
Tx: correct electrolyte abnormalities, hydration

29
Q

Syringe driver medications

A

Morphine

Anti-emetic

30
Q

Community palliative care

A

TPN via NG tube

Symptomatic relief e.g., pain relief

31
Q

Mx if NG tube removed in palliative care pt

A

Anti-secretory medication to prevent excessive vomiting

Anti-emetics

32
Q

Pleural effusion

A

Usually associated with tumour

Mx: VATs procedure

33
Q

Mesothelioma

A

Cancer of pleura

34
Q

Mx breathlessness in a palliative care pt

A

Lorazepam if anxiety driven

Oramorph if physical cause identified for breathlessness

35
Q

Opioid toxicity

A

May cause drowsiness

36
Q

Prescribing opioids

A

PRN opioid should be 1/6th a regular dose

37
Q

Multiple myeloma

A

Px: dyspepsia, hypercalcaemia, low mood, back pain, immune paresis (increased risk of infection e.g., UTI, resp. infection), renal impairment, anaemia

38
Q

Chronic lymphoid leukaemia

A

Ix: lymphocytosis (incidental finding)

39
Q

Squamous cell carcinoma

A

Px: central cavitating lesion

40
Q

Small cell lung cancer

A

cancer

41
Q

Lung adenocarcinoma

A

cancer

42
Q

Carcinoid tumour

A

cancer