Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

P yr > Oncology > Flashcards

Oncology Flashcards

(88 cards)

Start Studying
1
Q

Most common area for colorectal cancer?

A

Rectal colon 40%
Sigmoid colon 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Colorectal cancer screening

A

Men + women - 50-74 every 2 yrs
FIT - faecal immunochemical test
Specifically recognises human haemoglobin
1 faecal sample
If abnormal result - offer colonoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When else is FIT testing used?

A

When pt do not meet 2ww referral but have new symptoms:
>50 + unexplained abdo pain or wgt loss
<60 - changes in bowel habit or Fe def anaemia
>60 - anaemia in absence of Fe def

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When to refer for 2ww?

A

> 40 - unexplained wgt loss + abdo pain
50 - unexplained rectal bleeding
60 - Fe deficiency anaemia/change in bowel habits
occult blood shown in faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When to consider 2ww for colonic cancer?

A

Abdominal/rectal mass
Unexplained anal mass/ulceration
pt <50 + rectal bleed +
- abdo pain
- change in bowel habits
- Fe def anaemia
- wgt loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When would you do APER for resection of a rectal tumour? = abdomino-perineal resection of the rectum

A

Very low tumours/involvement of sphincter complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why can you offer neoadjuvant therapy for rectal tumours but not for colonic tumours?

A

As the rectum is a extraperitoneal organ, therefore can irradiate it
Neoadjuvant therapy is offered prior to resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What should be done before treating an obstructing bowel cancer?

A

Staging + defunctioning loop colostomy
As more technically difficult procedure, anastomotic leak rate higher, chance of +ve resection margin is higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tx rectal tumours

A

T1/2 + N0 –> proceed to surgery
T3 + N0 –> short radiotherapy
T4 –> long course chemo-radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When would a right hemicolectomy be done and what would be the associated anastomosis?

A

Caecal, ascending colon, proximal transverse colon
Ileocolic anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When would a left hemicolectomy be done + associated anastomosis?

A

Distal transverse colon, descending colon
Colo-colon anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When would a high anterior resection be done?

A

For tumours of sigmoid colon
Colo-rectal anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which resection procedures would be done for the upper + lower rectum?

A

Upper rectum - anterior resection
Lower rectum - anterior resection (low TME)
colo-rectal anastomosis +/- defunctioning stoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When would a APER be used?

A

For tumours on the anal verge
no anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which procedure should be done if bowel perforation has occurred/great risk?

A

End colostomy - can reverse later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hartmann’s procedure?

A

Sigmoid colectomy + formation end stoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Do ileo-colic anastomosis need defunctioning?

A

Safe procedure - do not need to be defunctioned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common form of inherited colon cancer?

A

HNPCC - AD
Get cancers of proximal colon - highly differentiated + aggressive
MSH2
MLH1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What other cancer are those w/ HNPCC at high risk of?

A

Endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is FAP?

A

AD condition
Leads to formation of hundreds of polyps by 30-40 years
Mutn APC gene on chr 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the tx for FAP?

A

Total colectomy w/ ileoanal pouch in 20s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Gardner’s syndrome?

A

Form of FAP where pt have extra-colonic features:
osteoma skull
retinal pigmentation
thyroid carcinoma
epidermoid cysts on skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Gastric cancer - bg

A

disease of elderly
male predominance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Risk fx gastric cancer

A

H. pylori - triggers inflammation of mucosa –> atrophy + intestinal metaplasia
Atrophic gastritis + diet
Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Features of gastric cancer
vague abdominal pain - dyspepsia wgt loss + anorexia N+V Dysphagia lymph nodes - Virchow's node - left supraclavicular lymph node Sister Mary Joseph's node - perumbilical nodule
26
Ix gastric cancer
OGD + biopsy CT for staging
27
Mx gastric cancer
partial gastrectomy total gastrectomy Endoscopic mucosal resection + chemo
28
Most common cause of HCC in the world + in Europe?
World - Hep B Europe - Hep C
29
What is the main risk factor for HCC development? What are the causes of this risk factor?
Liver cirrhosis caused by: - alcohol - haemochromatosis - hep B+C - primary biliary cirrhosis extra risk fx - A1 anti-trypsin def
30
What are the presenting features of HCC?
Often present late See features of liver disease/failure = - jaundice - pruritus - ascites - RUQ pain - hepatosplenomegaly Raised AFP Common case = decompensation of chronic liver disease
31
HCC screening?
U/S + AFP in high risk groups: Liver cirrhosis pt - due to hep B/C, haemochromatosis, alcohol
32
Mx options HCC
Surgical resection Liver transplant Radiofrequency ablation Transarterial chemoembolisation Serafinib - multikinase inhibitor
33
Features of pancreatic cancer
Painless jaundice Pale stool, dark urine Masses - hepatomegaly, palpable gall bladder, epigastric mass Non-specific symptoms - anorexia, weight loss, epigastric pain Steatorrhoea - loss of exocrine fn Diabetes mellitus - loss of endocrine fn Trosseu sign - migratory thrombophlebitis
34
Ix for pancreatic cancer
CT scanning - may show double duct sign U/S also 90% sensitive
35
Mx pancreatic cancer
Presents v late - usually unable to resect <20% suitable for surgery at presentation Whipple's procedure - pancreaticoduodenectomy but get dumping syndrome, peptic ulcer disease adjuvant chemotherapy ERCP - stenting for palliation
36
Type of pancreatic cancer, associations
Adenocarcinoma in head of pancreas Associated w/ HNPCC
37
Most common type of oesophageal cancer?
Adenocarcinoma - more likely to develop in pt w/ hx GORD/Barrett's oesophagus Developing - Squamous cell carcinoma
38
Where are: (i)SCCs (ii) Adenocarcinoma found in the oesophagus?
(i) Upper 2/3 oesophagus (ii) Gastro-oesophageal junction
39
Features of oesophageal carcinoma?
Dysphagia Anorexia + wgt loss Vomiting Odynophagia, hoarseness, cough, melaena
40
Ix oesophageal carcinoma
Diagnosis = Upper GI endoscopy + biopsy Staging = CT chest, abdomen, pelvis Locoregional staging - U/S
41
Tx oesophageal carcinoma
Surgical resection - Ivor-Lewis type Oesophagectomy Adjuvant chemotherapy Risk - anastomotic leak --> mediastinitis
42
Risk fx SCC oesophagus
Smoking/Alcohol Plummer Vinsen syndrome Achalasia Nitrosamine rich diet
43
Risk fx adenocarcinoma oesophagus
Smoking Barrett's oesophagus GORD Obesity
44
What is the most common type of bladder cancer?
Transitional cell carcinoma/urothelial SCC - most common with schisctosomiasis
45
Risk fx for each type of bladder cancer?
Transitional cell carcinoma - Smoking - Exposure to analine dyes - benzadine - cyclophosphamide - Rubber manufacture SCC: - Schistosomiasis - smoking - long term catheter 10+ yrs
46
What is the most common growth pattern of urothelial carcinomas?
Papillary growth pattern
47
Features of bladder cancer
Macroscopic, painless haematuria
48
Ix bladder cancer
Diagnosis = Cystoscopy/TURBT Locoregional spread - pelvic MRI Distant disease - CT scan
49
Mx bladder cancer
Superficial lesions - manage using TURBT Recurrent/higher grade - offer intravesical chemotherapy T2 - offer surgery, radical cystectomy, ileal conduit/radical radiotherapy
50
Where does renal cell carcinoma commonly arise?
Proximal renal tubular epithelium Most common histological subtype = clear cell
51
Features of renal cell carcinoma
Haematuria, loin pain, abdominal mass Pyrexia unknown origin Endocrine effects - EPO = polycythaemia PTHrP - hypercalcaemia Varicocoele - left sided because tumour compresses veins Stauffer syndrome - liver dysfunction due to renal cell carcinoma - cholestasis/hepatosplenomegaly
52
Mx renal cell carcinoma
confined - partial/total nephrectomy T1 = partial reduce tumour size + tx mets - A-interferon/IL-2 Sorefinib/sunitinib - better than interferon
53
Features of prostate cancer
Localised = often asymptomatic because in periphery .˙. doesn't cause outflow obstruction Bladder outlet obstruction - urinary hesitancy, retention Haematuria, haematospermia Back pain, perineal pain, testicular pain DRE - asymmetrical, hard, nodular enlargement + loss median sulcus
54
Ix prostate cancer
Multiparametric US - results reported using 5 point Likert scale >3 - do biopsy
55
What are the criteria for referral for prostate cancer?
50-69 - PSA >3.0 or abnormal DRE
56
Mx localised prostate cancer T1/T2
Conservative - watchful waiting surgery - radical prostatectomy radiotherapy - external beam + brachytherapy
57
Mx localised advanced prostate cancer T3/T4
Hormonal therapy Radical prostatectomy Radiotherapy - external beam + brachytherapy
58
Complications of radical prostatectomy + radiotherapy
Erectile dysfunction radiotherapy - proctitis + increased risk of bladder, colon, rectal cancer
59
Hormonal therapies for prostate cancer?
Anti-androgens - GnRH agonists/antagonists eg. gosrelin - causes initial increase testosterone levels can give anti-androgen to avoid tumour flare - may give bone pain/bladder obstruction symptoms Bicalutamide - blocks androgen receptor non-steroidal anti-androgen Bilateral orchidectomy - reduces levels of testosterone Chemo w/ docetaxel
60
Most common type of testicular cancer
Germ cell tumour: Seminoma Non-seminoma - teratoma. yolk-sac, choriocarcinoma
61
What cancers are in included in non-germ cell tumours?
Leydig cell cancers, sarcomas
62
Risk fx testicular cancer
Infertility Cryptorchidism Mumps Orchitis Kleinfelter's Family hx
63
Features of testicular cancer
Painless lump Hydrocele Gynaecomastia - increased oestrogen:androgen ratio Germ-cell tumours → hCG → Leydig cell dysfunction → increases in both oestradiol and testosterone production, but rise in oestradiol is relatively greater than testosterone Leydig cell tumours → directly secrete more oestradiol and convert additional androgen precursors to oestrogens
64
What is beta hCG associated with?
Seminomas
65
Which tumour markers are elevated in non-seminoma tumours?
AFP B-hCG
66
What is elevated in germ cell tumours?
LDH elevated 40% germ cell tumours
67
Ix testicular cancer
U/S
68
Mx testicular cancer
Orchidectomy Chemoradiotherapy
69
Which system is used for grading of prostate cancer?
Gleason system - gives 2 scores as prostate cancer often multifocal Score given between 1-5 to most dominant grades
70
Referral criteria to ENT for suspected laryngeal cancer
>45 + - persistent sore throat - unexplained neck lump
71
Referral criteria for oral cancer
Mouth ulcer >3wks Persistent + unexplained lump in neck Refer to dentist if: Lump on lip/oral cavity Red/red+white patch - erythroplakia/erythroleukoplakia
72
Thyroid cancer referral
Unexplained thyroid lump
73
What is the most common type of nasopharyngeal cancer and what is associated with it?
Adenocarcinoma Associated w/ EBV
74
Features of nasopharyngeal cancer
Systemic features - cervical lymphadenopathy Local - otalgia, unilateral middle ear effusion/serous otitis media Nasal obstruction, discharge, expistaxis Cranial nerve palsies - CN III-VI
75
Imaging for nasopharyngeal cancer
Combined CT + MRI
76
Tx nasopharyngeal cancer
Radiotherapy
77
What is the most common site of ovarian cancer?
Distal end of the fallopian tube
78
Risk fx ovarian cancer
BRCA 1/2 Early menarche, late menopause, nulliparity
79
Clinical features ovarian cancer
Abdominal distension Bloating Abdo + pelvic pain Urinary symptoms - urgency Early satiety Diarrhoea Post menopausal bleeding
80
Ix ovarian cancer
CA125 If raised >35 --> US abdomen + pelvis US May need diagnostic laparotomy
81
Mx ovarian cancer
Surgery + platinum based chemotherapy
82
Risk fx endometrial cancer
Nulliparity, early menarche, late menopause, unopposed oestrogen Metabolic syndrome - PCOS, DM, obesity Tamoxifen HNPCC
83
Features endometrial cancer
Post-menopausal bleeding Menorrhagia, inter-menstrual bleeding
84
Referral criteria for endometrial cancer
>55 + post-menopausal bleeding
85
Ix endometrial cancer
Transvaginal U/S - if >4mm unlikely Hysteroscopy w/ endometrial biopsy
86
Mx endometrial cancer
Surgery Localised - total abdominal hysterectomy, bilateral salpingoophorectomy High risk disease - post-operative radiotherapy Unsuitable for surgery - progestogen
87
Most common type of thyroid cancer
Papillary - 70% Follicular - 20% Medullary - 5%
88
Mx papillary + follicular cancer
Total thyroidectomy Radioiodine - kill residual cells

P yr (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions