Oncology

Question 1

Give 2 examples of 5-HT3 antagonists.

Answer 1

• Ondansetron
• Palonosetron

Question 2

Name 2 adverse effects of 5-HT3 antagonists e.g. ondansetron.

Answer 2

• Prolonged QT interval
• Constipation

Question 3

What class of antiemetic is mainly used in the management of chemotherapy-related nausea?

Answer 3

5-HT3 antagonists, e.g. ondansetron

Question 4

Where do 5-HT3 antagonists, e.g. ondansetron, act?

Answer 4

Chemoreceptor trigger zone area of the medulla oblongata

Question 5

What is the mechanism of action of anastrozole?

Answer 5

Aromatase inhibitor (reduces peripheral oestrogen synthesis).

Question 6

What are the microscopy findings in Burkitt’s lymphoma?

Answer 6

‘Starry sky’ appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells.

Question 7

In patients starting chemotherapy for Burkitt’s lymphoma, what medication can be given to reduce the risk of tumour lysis syndrome?

Answer 7

Rasburicase - recombinant version of urate oxidase, which catalyses conversion of urate to allantoin. Allantoin is 5-10x more soluble than urate, so renal excretion is more effective.

Question 8

Give 5 complications of tumour lysis syndrome.

Answer 8

• Hyperkalaemia
• Hyperphosphataemia
• Hypocalcaemia
• Hyperuricaemia
• Acute renal failure

Question 9

Which malignancy is most strongly associated with the translocation t(9;22)(q34;q11)?

Answer 9

Chronic myeloid leukaemia - >95% of CML patients have the Philadelphia chromosome t(9;22) translocation.

Question 10

Which malignancy is most associated with the t(15;17) translocation?

Answer 10

Acute promyelocytic leukaemia (M3)

Question 11

Which malignancy is most associated with the t(8;14) translocation?

Answer 11

Burkitt’s lymphoma

Question 12

Which malignancy is most associated with the t(11;14) translocation?

Answer 12

Mantle cell lymphoma

Question 13

Which malignancy is most associated with the t(14;18) translocation?

Answer 13

Follicular lymphoma