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Oncology Flashcards

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1
Q

Most common site of spread of ER+ve Breast Ca

A

Bone

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2
Q

What is the commonest targetable in non-squamous NSCLC

A

EGFR > ALK > ROS1

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3
Q

General mgmt of pancoast tumour

A

Neoadjuvant Chemo/RTx followed by resection to get the tumour away from the nerve bundle

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4
Q

Standard rx for mgmt of Stage III unresectable NSCLC

A

chemoradiotherapy + adjuvant Durvalumab

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5
Q

Clinical Trial Phase 1:

A

dose ranging on healthy volunteers for safety; find PK/PD

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6
Q

Clinical Trial Phase 2

A

Assess efficacy and side effects

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7
Q

Trial Phase 3

A

intervention to current gold standard

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8
Q

Cell cycle: G0 is

A

cell is chilling

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9
Q

Cell cycle, G1 is:

A

replicating contents but not chromosomes

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10
Q

Cycle cycle, S is:

A

chromosomes duplicating

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11
Q

Helicase function

A

splits dsDNA

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12
Q

Topoisomerase function

A

unwinds DNA

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13
Q

DNA polymerase function

A

matches base pairs -> purine and pyramidine analogues

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14
Q

Ligase function

A

joins fragments

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15
Q

Cell cycle, G2 is

A

double checking chromosomes

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16
Q

Cell cycle, mitosis is

A

Mitotic spindles pulling apart

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17
Q

Alkylating agents MOA

A

alkylate guanine -> disorts structure directly and cross links so helicase can no longer unwind

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18
Q

examples of alkylating agents

A

cyclophosphamide, melphalan, dacarbazine, cyclosporin, temozolomide, chlorambucil; and platinums

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19
Q

anti-metabolites MOA

A

anti-folates: prevent all NS/NT formation

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20
Q

anti-metabolits examples

A

MTX, permetrexed; purine analogues- fludarabine, 6-MP,; pyrimidine analogues- 5FU, Capecitabine, gemcitabine

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21
Q

Deficiency of what can make 5-FU fatal?

A

dihydro pyramidine dehydrogenase (breaks down 5-FU)

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22
Q

Alkaloids MOA

A

microtubule poisons- bind tubulin and stop microtubule formation

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23
Q

Alkaloids examples

A

Vinca alkaloids (vincristine, vinblastine, vinorelbine); taxanes; topoisomerase poisons- etoposide, irinotecan

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24
Q

Anthracyclines act on which part of cell cycle?

A

not cell cycle specific

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25
Platinums side effects
neuropathy and nausea esp. cisplatin
26
High emetogenicity chemo
Cisplatin > anthracyclines + cyc, cyc alone
27
Medium emetogenicity chemo
other platinums, irinotecan
28
Cancers with highest somatic mutation burden
melanoma >SqCC lung > adeno lung >bladder> small cell lung
29
Lynch mutations
MSH2 >MLH1 > PMS2, MSH6
30
Lynch mechanism of inheritance
AD
31
Which Lynch MSI mutations go together?
MLH1 and PMS2; and MSH2 with MSH6
32
Lynch Amsterdam criteria:
3 cases, 2 generations, 1 <50
33
Which BRCA gives you a higher risk of ovarian cancer?
1 = 44% vs. 17% for 2
34
histology of BRCA breast cancers
majority are ductal carcinomas of no specific type; atypical medullary carcinomas more common in BRCA 1
35
What histology ovarian cancer is NOT assoc. w. BRCA?
mucinous histology
36
what else can cause loss of expression of MLH1 coupled with PMS2
not just germline mutation; but MLH1 methylation or somatic mutation- V600E BRAF
37
Is BRCA 1 or 2 worse for females/males?
1 worse for females w. higher cancer rates and more aggressive; 2 worse for males
38
receptor status of BRCA 1/2 breast cancers
1 = triple -ve; 2 = ER/PR +ve
39
BRCA test if:
any BRCA cancer and <40yrs, triple -ve breast, male breast, Jewish, 2 primary breast Cas, 2 BRCA assoc. cancers
40
BRCA mgmt
bilateral proph mastect or RRSO; or annual MRI +/- USS from 30 y.o; bilateral SPO by 35 but no ovarian screening
41
Most important prognostic factor for early breast ca
axillary LN involvement
42
When to perform axillary dissection? I’m breast ca
>2 sentinel nodes
43
Who receives adjuvant rx in early breast ca?
high risk = nodes, HR -ve, size
44
Adjuvant chemo regime for breast cancer
anthracycline + taxane
45
Tamoxifen side effects
VTE, endometrial cancer, hot flushes
46
Who gets CDK4/6 inhibitors?
ER +ve, 1st line metastatic
47
Are SERMs agonists or antagonists?
depends on the organ, diff tissues have diff co-stimulators with which it combines -> Breast = ER antagonist, endometrial/bone = ER partial agonist
48
Fulvestrant MOA
selective oestrogen receptor down regulator
49
Fulvestrant place
superior to AI in pts. w. met HR+ve BC WITHOUT visceral mets i.e. bony disease
50
Example CKD 4/6 inhibitor
Palbociclib, Ribociclib
51
Lapatinib MOA
Dual EGFR/HER2 TKI
52
In bowel ca screening, FIT binds to
Human Globin
53
Does FIT detect digested blood?
No
54
HNPCC screening guidelines
1-2 yearly scopes from age 25 OR 5 yrs before youngest relative
55
GIST appearance
spindle shaped cells
56
molecular finding of GIST
c-kit / CD117 positive
57
Rx of GIST
TKIs, escalate dose if progressing
58
HCC Milan criteria
single lesion <5cm, 3x <3xm each
59
which testicular cancer does better/ responds better to rx?
seminomatous better than non sem
60
Which testicular cancer type produces what tumour marker?
seminomatous- HCG; Non- AFP and HCG
61
seminomatous/Nonseminom rx
carboplatin/BEP. almost always resect.
62
long-term cisplatin risks in men
metabolic syndrome, hearing loss, hypogonadism
63
EGFR TKIs inhibitors
Ertlotinib, Gefitinib, afatanib
64
EGFR TKI against T790M
Osimertinib
65
ALK TKI
Alectinib, Crizotinib
66
ROS1 TKI
Crizotinib
67
TKI side effects
acne, diarrhoea, nausea, ILD
68
Which TKIs cross the BBB?
Osimertinib, alectinib
69
IHC of small cell/ SqCC/ Adeno
chromogranin + synaptophysin/ p40/ TTF1
70
DNA repair of single strand breaks via
base excision repair
71
DNA repair of double strand breaks via
homologous recombination or non-homologous end joining
72
Cetuximab doesn't work if
KRAS mutant
73
MEN2 is due to which gene
RET gain of function
74
What is the usual mechanism of de novo AD conditions?
gonadal mosaicism
75
What risk do siblings have in de novo AD conditions?
1%
76
Uveal melanoma most commonly metastasises to...
liver

BPT Written (21 decks)

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