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Oncology Flashcards

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1
Q

Mechanism of action of anthracycline (e.g., doxorubicin)

A

Stabilises DNA topoisomerase II complex inhibits DNA and RNA synthesis

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2
Q

Side effects of Methotrexate

A

Myelosupression
Mucositis
Liver Fibrosis
Lung Fibrosis

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3
Q

Mechnism of action of 5-Fluorouracil

A

Pyrimidine analogue inducing cell cycle arrest and apoptosis by blocking thymidylate synthase (S phase)

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4
Q

Adverse effects of 5-fluorouracil

A

Myelosupression
Mucositis
Dermatitis

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5
Q

Function of mercaptopurine

A

Purine analogue activated by HGPRTase decreasing purine synthesis

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6
Q

Side effect of Mercaptopurine

A

Myelosupression

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7
Q

Mechanism of action of Cytarabine

A

Pyrimidine antagonist - inhibits DNA Polymerase

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8
Q

Side effect of Sytarabine

A

Myelosupression

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9
Q

Mechanism of action of Vincristine

A

Inhibits formation of microtubules

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10
Q

Side effect of vincristine

A

Peripheral neuropathy

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11
Q

Mechanism of atcion of docetaxel

A

Prevents microtubule depolymerisation

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12
Q

Side effect of docetaxel

A

Neutropenia

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13
Q

Name a topoisomerase inhibitor

A

Iriniotecan

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14
Q

Side effects of Irinotecan

A

Myelosupression

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15
Q

Mechanism of action of cisplatin

A

Cross linking in DNA

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16
Q

Side effects of Cisplatin

A

Nephrotoxicity
Ototoxicity
Peripheral Neuropathy
Hypomagenesaemia

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17
Q

Mechanism of action of hydroxyurea

A

Inhibits ribonucleotide reductase

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18
Q

What is Prophase

A

Centrosomes duplicate forming microtubules

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19
Q

What is Metaphase

A

Chromosomes align in the middle of the cells.

The microtubules attach to the centromeres on either side

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20
Q

What is anaphase

A

The chromosomes are separates and moved by centromeres to the other side

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21
Q

What is Telophase

A

The membrane separates to form two cells

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22
Q

Name the three check points in cells

A

G1
G2
M-phase

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23
Q

What happens in the S phase

A

DNA replication - during this Helicase separates the two dna strands

This causes super coils as the process continues.

Topoisomerase II fixes supercoils to reduce tension on the DNA (ie., stop damage).

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24
Q

Role of alkylating agents

A

Bind to nucleotides, form cross links with DNA strands which stops normal replication or cell division - causes cell arrest

Causes apoptosis.

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25
Examples of alkylating agents
Cyclophosphamide and Cisplatin
26
How do anthracyclines function
Inhibits Topoisomerase II causing DNA to not relax -> causes it to break!
27
What is the DVT Well's score criteria and associated score meanings
Active Cancer Paralysis Bedridden for 3 days or surgery within 12 weeks Localised tenderness Entire leg swollen Calf 3cm nbigger than the other Pitting Oedema COllateral superficial veins Orevious DVT An alternative diagnosis has been excluded. DVT likely if over 2
28
Management of Wells' score over 2
Proximal leg vein ultrasound within 4 hours. Positive then anticoagulate Negative then do d-dimer. If both negative consider another diagnosis
29
If Ultrasound is negative but d-dimer is positive, what should be done
Stop therapeutic anticoagulation Offer repeat leg vein ultrasound 6-8 days later
30
If a DVT is unlikely in Well's score, what should be done
Perform d-dimer test
31
Management of a VTE
DOAC first line then LMWH followed by a DOAC or LMWH followed by Vit K antagonist (ie., warfarin)
32
What is responsible for the break down of fibrin clots
Plasmin
33
How does tissue factor result in DIC
Upon extensive trauma, TF is exposed on teh surface of many cells, this binds to coagulation factors activating the extrinsic pathway and intrinsic pathway
34
Blood tests for DIC
Low platelets Low fibrinogen Increased PT AND ApTT Schistocytes due to microangiopathic hameolytic anaemia
35
What drugs can induce pancytopaenia
Cytotoxics Antibiotics (trimethoprim and chloramphenicol) Gold and Penicillamine Carbimazole Carbamazapine Tolbutamide
36
What is an ECOG score
Performance status of a patient measure
37
Causes of Eosinophilia
Pulmonary: Asthma Aspergillosis Churg-Strauss syndrome Loffler's Eosinophilic penumonias Hypereosinophilic syndrome Infective: Schistosomiasis Nematoses (TOxocara, Ascaris, Strongyloids) Echinococcus Drugs: Sulfsalazine and nitrofurantoin Psoriasis/Eczema
38
Role of Thrombin (Factor 2)
Increases platelet activation Factors 8, 11, 5, 13
39
Describe the process in which Factor 5 usually gets inactivated
AT the end of the formation of a mesh, thrombin binds to thrombomodulin recpetors on the endothelial cells Protein C then joints the party with Protein S. When protein S binds to Protein C, this leaves a gap in Protein C's back. Factor 5 gets caught off guard by this gap and gets cleaved - stopping further fibrin mesh production
40
What is the result of cleaving Factor 5
Stops Factor 10 and 9 activation
41
What type of mutation causes Factor V leiden deficiency
Singel point mutation where an amino acid is replaced by another
42
How is Factoe V Leiden deficiency inherited
Autosomal Dominant
43
WHat type of Factor V Leiden deficiency carry the highest risk of VTEs
Factor V Leiden (Heterozygeous)
44
Role of Glutathione
Anti-oxidant - neutralises free radicals Usually are reduced. Can donate H+ to free radicals to produce water instead. It then gets oxidised in the process. Glutathione reductase donates a H+ back to Glutathione to reduce it again so it can function. In the process Glutathiona Reductase recieves another H+ from NADPH NADP+ as a bbyproduct.
45
Role of G6PD
Reduces NADP+ to NADPH from glucose-6-phosphate
46
How is G6PD deficiency inherited
X-Linked recessive Only affects men (not dominant)
47
What happens in G6PD Deficiency
Enzymes do not last very long.
48
What does G6PD deficiency provide protetcion against and why
Protects against Falciparum Malaria due to reduced half-life of G6PD. Means that erythrocytes are more likey to die from free radicals that are not being swept up by glutathione.
49
Why do we get bite cells in G6PD deficiency
RBCs haemo get destroyed by free radicals, leaving heinz bodies. Splenn macrophages detect they are abnormal and take a bit of the red cells leaving bite cells
50
What happens to Glutathione and NADPH in G6PD deficiency
Decreased all of them
51
Causes for G6PD Deficiency causes
Food: Fava Beans Soy Red Wine Infections: Viral Hepatitis Pneumonia Medications: Primaquine and Chloroquine NSAIDs + Aspirin Quinidine Trimethoprim + Sulphonamides
52
What drugs can cause G6PD Haemolysis
Primaquine Ciprofloxacin Sulphonamides, Slufonylueras, Sulphsalazine
53
What ethnicity are affected by G6PD Deficiency
African and Mediterranean
54
What is G6PD Deficiency diagnosed
Measure enzyme activity of G6PD
55
How is Li-Fraumeni syndrome inherited
Autosomal Dominant
56
On what chromosome is BRCA1 carried on
17
57
On What chromosome is BRCA 2 carried on
13
58
What gene mutation is associated with prostate cancer in men
BRCA2
59
What is the Amsterdam criteria
Three or more family members with a confirmed diagnosis of colorectal cancer (first degree) Two sucessive affected generations One or more colon cancers diagnosed under 50
60
What drug can be given to increase neurophil count in neutropenic patients and how do these work
Filgrastim - granulocyte-colony stimulating factors
61
What translocation causes mantle cell lymphoma
11:14
62
What does 11:14 translocation do to cause mantle cell lymphoma
Deregulation of cyclin D1 gene
63
What happens in 14:18 translocation to cause follicular lymphoma
Increased BCL-2 transcription
64
What two malignancies are caused by EBV
Hodgkin's and Burkitt's lymphoma
65
What malignancy is caused by HTLV-1 infection
T cell leukaemia/lymphoma
66
What haematological malignancy can be caused by HIV
High grade B Cell lymphoma
67
What infection typically results in Burkitt's lymphoma
Malaria
68
Causes of extravascular haemolysis
Sickle cell, thalasaaemia Hereditary Spherocytosis Haemolytic disease of the newborn Warm autoimmune haemolytic anaemia
69
Symptoms of hairy cell leukaemia
Pancytopaenia Splenomegaly Vasculitis (skin) DRY TAP on bone marrow TRAP positive
70
Management of Hairy cell leukaemia
Chemotherapy - Cladribine and pentostatin
71
How is hereditary angioedema inherited
Autosomal Dominant
72
Blood test reuslts in hereditary angiooedema
C1-INH levels low during attacks Low C2 and C4 between attacks
73
Symptoms of hereditary angiooedema
Painful macular rash Painless swelling of tissues NO URTICARIA
74
Management of Hereditary Angiooedema
IV C1-inhibitor concentrate NB: Does not response to antihistamines or adrenaline
75
Prophylaxis of hereditary angiooedema
Danazol
76
Most common type of Hodgkin's lymphoma
Nodular sclerosing (good prognosis)
77
What type of Hodgkin's lymphoma has the worst prognosis
Lymphocyte depleted the presence of b-symptoms
78
What Hodgkin's lymphoma carries the best prognosis
Lymphocyte predominant
79

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