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O&S Flashcards

1
Q

Most common breast cancer

A

IDC

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2
Q

Age of breast cancer screening

A

50-71

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3
Q

Most common method of obtaining biopsy in breast cancer

A

Core biopsy

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4
Q

Prognosis in fibroadenoma

A

Good. Around half regress spontaneously

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5
Q

Indications for surgery in fibroadenoma

A

Large or fast growing. Persistently painful. Difficult to differentiate from a tumour

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6
Q

Age associated with breast cysts

A

Peri-menopausal

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7
Q

Investigation of breast cyst

A

The cyst will be aspirated and if there is blood in the aspirate, this will be sent for cytology studies to exclude cancer. If there’s a residual mass after aspiration a biopsy is taken to check for cancer

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8
Q

Management of breast cyst

A

Reassurance and aspiration

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9
Q

Age of colorectal cancer screening

A

60-75

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10
Q

Risk factors for anal cancer

A

IV drug use, HPV, multiple sexual partners, young first sexual intercourse, receptive anal sex, immunosuppression, and anal intra-epithelial neoplasia (a premalignant condition)

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11
Q

What is anal intra-epithelial neoplasia?

A

A pre-malignant condition of cellular changes on cells of the anus

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12
Q

First line treatment in anal cancer

A

Chemo or radio therapy

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13
Q

Management of lynch syndrome

A

Prophylactic aspirin, H pylori eradication, 2-yearly colonoscopy screening, some patients may have prophylactic salpingo-oopherectomy

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14
Q

Asymptomatic reducible inguinal hernia management

A

Education on signs of complications

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15
Q

Gold standard for diagnosis of achalasia

A

Manometry

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16
Q

Treatments for achalasia

A

Heller’s cardiomyotomy
Balloon dilation
Botulinum injection

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17
Q

What is hereditary diffuse gastric cancer?

A

autosomal dominant condition with a high risk of gastric cancer at a young age. Patients with this condition usually have a prophylactic gastrectomy in early adulthood

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18
Q

Who is offered screening for liver cancer?

A

Patients with cirrhosis

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19
Q

What does screening for liver cancer consist of?

A

USS twice per year and CT/MRI to follow up on abnormalities

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20
Q

When is biopsy needed to diagnose liver cancer?

A

No cirrhosis or diagnostic uncertainty

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21
Q

Treatment options in liver cancer

A 
Resection
Percutaneous radiofrequency ablation
Arterial embolisation to reduce blood supply
Chemo administered via local arteries
Transplant
Chemo / radiotherapy / immunotherapy
Palliative
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22
Q

Treatment options in cholangiocarcinoma

A

Surgery (+/- liver resection). May have adjuvant chemo or radiotherapy
Percutaneous radiofrequency ablation
Arterial embolisation to reduce blood supply
Chemo administered via local arteries
Stenting (symptom control)
Chemo / radiotherapy / immunotherapy
Palliative

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23
Q

Who is screened for pancreatic cancer?

A

High risk patients (e.g. certain mutations, strong family history)

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24
Q

Types on non-small cell lung cancer

A

Adenocarcinoma, squamous cell lung cancer, large cell lung cancer

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25
Q

Where in the lungs is adenocarcinoma more common?

A

Peripheries

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26
Q

Where in the lungs is squamous cell carcinoma more common?

A

Centrally

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27
Q

Prognosis in large cell lung cancer

A

Poor

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28
Q

What is a pancoast tumour?

A

Apical tumour

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29
Q

Complications of pancoast tumour

A

SVC obstruction
Horners syndrome
Brachial plexus involvement (upper limb weakness)

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30
Q

Cancer caused by asbestos exposure

A

Mesothelioma

31
Q

Site of mesothelioma

A

Pleura

32
Q

Main risk factor for empyema

A

Recent pneumonia that hasn’t responded to antibiotics

33
Q

Management of empyema

A

Broad spectrum abx
Chest drain
If unsuccessful, surgery

34
Q

Risk factors for renal cell cancer

A

The main risk factors are older age, smoking, hypertension, obesity and family history. Lots of hereditary syndromes increase risk including Von-Hippel Lindau syndrome, tuberous sclerosis, Birt-Hogg-Dube syndrome and hereditary papillary renal cell carcinoma

35
Q

Age of testicular torsion

A

First year of life or adolescence

36
Q

What is Prehn’s sign and what does it indicate?

A

Pain on lifting testicle. Testicular torsion

37
Q

What is extra-vaginal torsion?

A

Extra-vaginal torsion is when the tunica vaginalis can tort with the spermatic cord as it isn’t yet attached, which affects boys in utero and the first year of life.

38
Q

What is intra-vaginal torsion?

A

Intra-vaginal torsion is if the spermatic cord torts within the tunica vaginalis, which is seen primarily in adolescence

39
Q

Management of CLL

A

May use “watch and wait” approach. Medications that may be used include chemotherapies, tyrosine kinase inhibitors, monoclonal antibodies and steroids (used in frail patients). In patients with few comorbidities, allogenic stem cell transplant can be used

40
Q

What may be seen on blood film in CLL?

A

Smudge cells

41
Q

Natural progression of CML

A

Typically, there is a chronic phase of 3-5 years with few symptoms and the patient is stable. This is followed by an accelerated phase of around a year where symptoms become more severe and finally a blast crisis, which is severe and resembles acute leukaemia with poor prognosis

42
Q

Age associated with AML

A

Older adults

43
Q

Which malignancy is associated with auer rods on blood smear?

A

AML

44
Q

Management of AML

A

Supportive (treat anaemia, treat thrombocytopaenia, treat infections, consider allopurinol / raspuricase, hydroxycarbamide to for cytoreduction if needed)
Induction chemo
Maintenance chemo
Stem cell transplant

45
Q

Most common type of non-Hodgkin lymphoma

A

Diffuse large B cell lymphoma

46
Q

Presentation of diffuse large B cell lymphoma

A

more common in younger people and usually presents as a rapidly enlarging mass

47
Q

First line test for lymphoma diagnosis

A

Excisional biopsy (core biopsy if patient not fit)

48
Q

Most common type of Hodgkin lymphoma

A

Nodular sclerosis

49
Q

Prognosis in Hodgkin lymphoma

A

Good

50
Q

Treatment of lymphoma

A

Varies depending on type and patient but chemo is key

51
Q

How is a biopsy for thyroid cancer obtained?

A

Fine needle aspiration

52
Q

Monitoring for recurrence of thyroid cancer

A

Thyroglobulin levels

53
Q

What does superficial BCC look like?

A

red, scaly, irregular plaque with micro-erosions and a thin, clear, border

54
Q

What does morphoeic BCC look like?

A

irregular boarders and a scar like plaque

55
Q

What does basosquamous BCC look like?

A

Lesions may have central crusting and are often large and fast growing

56
Q

What does Gorlin syndrome predispose to?

A

BCC

57
Q

What does an SCC lesion look like?

A

ulcerating with raised, crusted edges

58
Q

What does Bowen disease predispose to?

A

SCC

59
Q

Most common type of melanoma

A

Superficial spreading

60
Q

Characteristics of lentigo melanoma

A

slow growth in sun exposed areas

61
Q

Characteristics of acral lentiginous melanoma

A

Occurs under nails or on palms or soles

62
Q

Most common brain tumour in adults

A

Glioblastoma multiforme

63
Q

Complications of ovarian cancer

A

Complications include ascites, pleural effusions and adhesions leading to bowel obstruction.

64
Q

Most common type of cervical cancer

A

Squamous cell carcinoma

65
Q

When does neutropaenic sepsis usually present?

A

1-2 weeks after last cycle of chemo

66
Q

Mechanism of SVCO

A

direct tumour growth, thrombosis within the vena cava or lymphadenopathy

67
Q

Symptoms of SVCO

A

The main symptoms are dyspnoea, facial swelling, head fullness and cough. Other symptoms include dysphagia, distended chest and neck veins, upper limb oedema, facial plethora, cyanosis and confusion. These are worse when bending forwards, lying down or raising the arms above the head for 1-2 minutes

68
Q

What is Pemberton’s sign?

A

Symptoms of SVCO are worse when the arms are raised above the head for a couple of mins

69
Q

Diagnostic imaging in SVCO

A

CT

70
Q

Management of acute SVCO with stridor

A

ABCDE
Sit patient upright
Stenting / shunting / thrombolysis

71
Q

Options for management of SVCO

A 
ABCDE with O2 and patient sitting upright
Treat underlying cancer
Dexamethasone
Stenting or shunting
Thrombolysis
72
Q

Common presentations of immunotherapy toxicity

A

Common presentations include thyroid disease, vitiligo, rash, pneumonitis, colitis, hepatitis, nephritis, uveitis and neuropathy

73
Q

Management of immunotherapy toxicity

A

High dose steroids

74
Q

Phosphate levels in hypercalcaemia of malignancy

A

Low

Progress Tests (17 decks)

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