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ONCO Flashcards

1
Q

name the 5 most common site for head and neck cancers

A

nasophrynx
oral cavithy
oropharynx
hypopharynx
larynx

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2
Q

what is the most commonhistological type of head & neck cancer

A

squamous ce3ll carcinoma

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3
Q

what is the main risk factor for Head and neck cancers

give 2 others

A

HPV (16)

2 others: alcohol, smoking, EBV

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4
Q

give 5 Sx suggesting head & neck cancer

A
  • Dysphagia
  • odynophagia
  • dysphonia ,
  • ALARM symptoms ( tiredness, unexplained weight loss, loss of appetite)
  • Lymphadenopathy
    o Many cancers may just present as a neck lump due to metastasis to lymph node
  • airway compromise (stridor)
  • halitosis
  • focal neurology (VII cranial nerve palsy)
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5
Q

what is the genetic inheritance of Li-Fraumeni syndrome

A

Autosomal dominant

an inherited condition that is characterized by an increased risk for certain types of cancer (sarcomas/ leukaemiaS)

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6
Q

mutations to what gene causes Li-Fraumeni syndrome

A

p53 tumour suppressor gene

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7
Q

what cancers are associated with Li Fraumnei syndrome

A

an inherited condition that is characterized by an increased risk for certain types of cancer.

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8
Q

when are Ix for Li-Fraumeni syndrom conducted

A

Hx sarcoma in <45 yo

1st degree relative with cancer <45 + other family member with malignancy (<45yo) or sarcoma ( any age)

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9
Q

on what chromosome is BRCA 1 carried

A

17

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10
Q

what chromosome is the BRCA 2 gene found

A

13

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11
Q

the BRCA genes are associated with a 60% risk of developing breast cancer. what other cancer are females with these genes at risk of devloping

A

ovarian
( 55% risk with BRCA 1 , 25% risk with BRCA 2)

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12
Q

the BRCA genes are associated with a 60% risk of developing breast cancer. Which of these genes increases the risk of what other cancer in males ?

A

prostate
BRCA 2

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13
Q

what is hereditary non-polyposis colorectal cancer (HNPCC) also known as

A

lynch syndrome

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14
Q

what is the hereditary pattern of lynch syndrom

A

AD

( as with Li-Fraumeni)

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15
Q

what cancers are people with Lynch syndrome at risk of devloping at a young age?

A

colonic
endometrial

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16
Q

what criteria is used to determine the risk of having lynch syndrome

A

amsterdam criteria

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17
Q

what are the features of amsterdam criteria

A

> /=3 family members with confirmed colorectal cancer ( 1 is 1st degree relative of the other 2)
2 successive affected generations
/= 1 colon cancer in diagnosed <50yrs
Familial adenomatous polyposis has been excluded

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18
Q

what gene is mutated in Gardners syndrome

A

APC gene (chromosome 5)

19
Q

what is the genetic inheritance of gardners syndrome

A

AD
( like Li-Fraumeni (breast cancer) and Lynch (colon cancer) )

20
Q

what are the non-GI signs of gardners syndrome

A

skull osteoma, thyroid cancer and epidermoid cysts, dental issues (e.g caries/ supernumary teeth)

21
Q

what Mx is often used in pts with Gardners syndrome

A

colectomy to reduce colorectal cancer risk

22
Q

what anti-emetic is used in nausea and vomiting caused by intracranial tumours

A

dexamethasone

(reduces ICP)

23
Q

Sx of metastasis to bones (x2)

A

pain
pathological fractures
hypercalcaemia
raised ALP ( raised ALP on its own is bone)

24
Q

sx metastasis to brain (x3)

A

headaches
seizures
neuro deficits

25
Sx metastasis of lung cancer
cough SOB chest pain
26
what are the most common causes of bone mets (x3)
descrending order prostate breast lung Po – Prostate R – Renal Ta – Thyroid B – Breast Le – Lung
27
what cancers typically metastesis to the lung
breast (also common in bone) colorectal renal (also common in bone) bladder prostate (also common in bone)
28
how do lung mets appear on X-ray
cannonball metastases multiple, round, well-defined lung cancers most common with renal cell cancer but also choriocarcinoma/prostate
29
what is the monoclonal antibody tumour marker for breast cancer?
CA 15-3
30
what is the monoclonal antibody tumour marker for pancreatic cancer?
CA 19-9
31
what is the monoclonal antibody tumour marker for ovarian cancer?
CA 125 ( think of them in order form top to bottom - breast (15-3), pancreas (19-9), ovarian (125))
32
what is the tumour antigen tumour marker for prostatic carcinoma?
Prostate specific antigen (PSA)
33
what is the tumour antigen tumour marker for hepatocellular carinomas & teratomas ?
alpha-feto protein (AFP)
34
what is the tumour antigen tumour marker for colorectal cancer?
carcinoembryonic agent (CEA)
35
what is the tumour antigen tumour marker for melanoma & schwannomas ?
S-100
36
what cancer(s) does the tumour antigen bombesin indicate?
small cell lung carcinoma gastic cancer neuroblastoma
37
how do pathological fractures appear
compression fractures and focal sclerotic bony lesions.
38
how do the fractures in bone mets differ to those in Pagets disease of the bone/multiple myeloma on X-ray
multiple myeloma/ pagest disease osteolytic lesions ( loss of bones) bone mets - sclerotic regions - thick areas of bones
39
apart from metastatic cancer and multiple myeloma, give 2 causes of pathological fractures
cancerous: sarcoma non-cancerous: metabolic: - osteoporosis, - hyperparathyroidism Bone disease pagets disease
40
what is the most common cause of pathological fractures
tumours
41
features suggesting a pathological fracture
Pain: localised, severely disproportionate to injury fracture followign minor trauma deformity at fracture site impaired function of affected limb
42
what genetic condition are desmoid tumours associated with
Gardners syndrome, mutation of PAPC gene on chromosome 5 desmoid tumours (fibrous growths which occur anywhere in the body) are found in 15% of cases
43
44
what is the difference in location between squamous cell lung canrcinomas and lung adenocarcinomas
squamous cell - close to large airways "lung nodule in close proximity to his left main bronchus." adenocarcinomas: peripheral lung

Its the final countdown (23 decks)

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