Onc

Question 1

What is the grade of a cancer?

Answer 1

How much is resembles cells of origin

Poorly differentiated= dont resemble original cell and rpaid growth

Question 2

What is stage of cancer?

Answer 2

Size and spread

Question 3

Explain TNM staging?

Answer 3

Tumour 0-4 depending on cancer
Nodes (0 -2)
Mets (0-1)

Question 4

What is neo adjuvant chemo?

Answer 4

Before surgery to shrink tumour

Question 5

What is adjuvant chemo?

Answer 5

Post chemo

Question 6

How does radiotherapy work?

Answer 6

Creates O2 free radicals whichdamage DNA

Question 7

Which causes more side effects? More small sessions or fewer long ones?

Answer 7

Fewer long ones- used for palliative chemo

Question 8

What are short term side effects of chemo?

Answer 8

Nausea
Vomit
Anorexia
Oesophagitis
Diarrhoea

Question 9

What is initial response to immunotherapy?

Answer 9

Causes tumour to swell

Question 10

What ECG sign is present in hypercalcaemia?

Answer 10

Short QT

Question 11

How is hypercalcaemia managed?

Answer 11

Rehydrate

Bisphosphonates- Pamindronate

Question 12

What are side effects of bisphosphonates?

Answer 12

Bone pain
Myalgia
Headache
Low phosphate
Osteonecrosis of jaw

Question 13

What is given for persistant hypercalcaemia?

Answer 13

Denosumab monoclonal ab which inhibits RANK and this osteoclast maturation

Question 14

What malignancies cause hypercalcaemia?

Answer 14

Breast
Myeloma
Lung
Prostate

Question 15

How do you investigate SVCO?

Answer 15

CT and Doppler

Question 16

How to you manage SVCO?

Answer 16

Elevate head
O2
Dexamethasone
Stenting or radiotherapy

Question 17

Why are cancer patients prone to catastrophic bleed?

Answer 17

Low platelets or liver pathology

Question 18

How is catastrophic bleeding managed?

Answer 18

Transexamic acid
Arenaline soaked gauze
Oral transxeamic acid

Question 19

What are risk factors for tumour lysis syndrome?

Answer 19

Volume depletion
Renal impairment
High pre treatment urate/lactate/LDH

Question 20

What is presentation of tumour lysis syndrome?

Answer 20

Weakness
Constipation
Vomit
Palpitations
Chest pain
Arrythmias and collapse
Decrased urine output
AKI

Question 21

What is pathophysiology of tumour lysis syndrome?

Answer 21

AKI caused by high urate and calcium deposits in tubules

Question 22

What is seen in metabolic picture in tumour lysis syndrome?

Answer 22

Hyperuricaemia
Hyperphosphateaemia
Hyperkalaemia
Hypocalcaemia

Question 23

What is prophylaxis used in tumour lysis syndrome?

Answer 23

Fluids
Allopurinol (lowers uric acid production)
Rasburicase (lower uric acid in blood)

Question 24

How is tumour lysis syndrome treated?

Answer 24

FLUID
Calcium gluconate
IV insulin
Salbutamol neb
Rasburicase
Acetazolomide
Dialysis if severe

Question 25

What is given as prophylaxis for neutropaenic sepsis?

Answer 25

Fluoroquinolone

Question 26

Where does the spinal cord end of cauda equina?

Answer 26

L1

Question 27

What is given to manage Spinal cord compression?

Answer 27

``` Dex and PPI Bisphosphonate for bone pain VTE prophylaxis REHAB MRI whole spine ```

Question 28

What is given to treat neutropaenic sepsis?

Answer 28

Piperacillin | Tazobactam

Question 29

What are most breast cancers?

Answer 29

Ductal

Question 30

What is used to treat oestrogen sensistive breast cancers in premenopausal women?

Answer 30

Tamoxifen

Question 31

What is used to treat oestrogen sensitive breast cancers if post menopausal?

Answer 31

Aromatase inhibitors

Question 32

What is used to treat HER 2 sensitive breast cancers?

Answer 32

Herceptin

Question 33

What is used to treat triple negative breast cancers?

Answer 33

AGGRESSIVE Adjuvant chemo only

Question 34

What kind of lung cancer do non smokers get?

Answer 34

Adenocarcinoma (NSCLC)

Question 35

What prognostic score is use in breast cancer?

Answer 35

Nottingham

Question 36

What score is used for survuval in Colorectal cancer?

Answer 36

Duke's

Question 37

How is prostate cancer diagnosed?

Answer 37

TRUS biopsies | Low is less than 6

Question 38

What aged people are screened for breast cancer and how often and how?

Answer 38

50-70 every 3 years | Mammography

Question 39

What age of person is screened for bowel cancer?

Answer 39

FIT test | 50-74 years

Question 40

What ages of women are scervical screened?

Answer 40

25-49 3 yearlys | 50-65 5 yearly

Question 41

What results are seen in cytology from a smear?

Answer 41

Inadequate, normal or abnormal

Question 42

Of the abnormal cytology how is broken down further?

Answer 42

Borderline Low grade dyskaryosis- colp High grade (2 week wait) Borderline then tested for HPV- if pos = colposcopy

Question 43

WHat is done if colposcopy is positive?

Answer 43

Cone biopsy

Question 44

What % of background dose is used for breakthrough pain?

Answer 44

1/10 to 1/6

Question 45

How do you calculate a 24 plan for pain releif on opiates?

Answer 45

Convert all doses of opiates in 24 hours to oral morphine and sum up, then convert to subcut/IV

Question 46

How much stronger is IV/subcut opiate to oral

Answer 46

DOUBLE as strong subcut

Question 47

What is given for nausea in palliative care if mechanical cause?

Answer 47

Metoclopramide | Pro kinetc

Question 48

What is given for nausea in palliative care if chemical induced?

Answer 48

Haloperidol (D2)

Question 49

What anti sickness drugs arent given in palliative care?

Answer 49

Cyclizine Ondansetron (constipation) Antimuscarinics

Question 50

Why is cyclizine not given palliatively?

Answer 50

Causes halluncations when mixed with opiates

Question 51

What is used in palliative care anxiolytic?

Answer 51

Midazolam

Question 52

What is used for breathlessness in palliative care?

Answer 52

Morphine

Question 53

What is used for secretions in palliative care?

Answer 53

Hyoscine Butylbromide (anticholinergic)

Question 54

What is the gene mutation for breast cancer that is checked as well as BRCA?

Answer 54

P53 gene mutations