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Flashcards in Oncology Deck (47)
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1

List the main oncological emergencies

Spinal cord compression
Superior vena cava obstruction
Raised ICP
Hypercalcaemia

2

What are some causes of spinal cord compression?

Extra-cordal compression (tumour)
Vertebral body extension (osteophyte)
Osteoporotic crush fracture

3

List symptoms and signs of spinal cord compression

Back pain
Radicular (band-like) pain
Pain worse on cough/straining
Bowel/urinary change
Weakness
Altered sensation

4

What investigations would you order for spinal cord compression?

Urgent MRI
Lumbar puncture if suspected meningeal involvement

5

How is spinal cord compression treated?

Acute: IV dexamethasone
Surgery
Radio/chemo therapy

6

List some causes of superior vena cava obstruction

Intrinsic: clot, foreign body, tumour
Extrinsic: mass/tumour, aneurysm, fibrosis
Thrombosis, ovarian hyper-stimulation

7

List symptoms and signs of superior vena cava obstruction

Dyspnoea
Swollen face/neck/arms
Distended veins
Headache
Organomegaly
Non-collapsing veins

8

What is Pemberton's test for superior vena cava obstruction?

Lift arms over head
If causes facial plethora/cyanosis and raised JVP, obstruction is likely

9

How is superior vena cava obstruction?

Clot - streptokinase, anticoagulation
Oral dexamethasone
Chemo/radio therapy
Stenting

10

List causes of hypercalcaemia in oncological patients

Lytic bone mets
Myeloma
PTH-producing tumour

11

List symptoms and signs of hypercalcaemia

Lethargy
Anorexia
Nausea
Polydipsia
Polyuria
Constipation
Confusion
Weakness
Moans, groans, aches and stones

12

How is hypercalcaemia treated?

Manage underlying malignancy
Bisphosphonates
Calcitonin

13

List symptoms and signs of raised ICP

Headache, worse in morning or straining
Nausea
Vomiting
Papilloedema
Fits
Focal neurological deficit

14

What investigations would you order for raised ICP?

Urgent CT/MRI head

15

How is raised ICP treated?

Dexamethasone PO
Radiotherapy
Surgery
Mannitol may give symptomatic relief

16

What is meant by neoadjuvant chemotherapy?

Shrink tumour prior to surgery
Early control of metastasis

17

What is meant by primary chemotherapy?

Sole treatment for malignancy

18

What is meant by adjuvant chemotherapy?

Given post- surgery/radiotherapy to decrease risk of remission

19

What is meant by palliative chemotherapy?

Given for symptomatic relief and prolong survival, i.e. non-curative intent

20

What do antimetabolic chemotherapy agents do? Name some?

Inhibit processes that promote growth/synthesis
Methotrexate, 5-fluoroucil, azathioprine

21

What do anti-tumour antibody chemotherapy agents do? Name some?

Inhibit DNA transcription and replication via topiromase inhibitors
Doxorubicin, etoposide, actinomycin

22

What do antimicrotubule chemotherapy agents do? Name some?

Prevent separation of chromatids during replication
Vincristine, vinblastine, paclitaxel

23

What do alkylating chemotherapy agents do? Name some?

Alkylate functional groups to form covalent bonds
Cyclophosphamide, chlorambucil, cisplatin, busulfan

24

What do monoclonal antibody chemotherapy agents do? Name some?

Target tumour-specific antigens
Rituximab (CD20), cefuximab (EGFR1), bevacizumab (VEGF), imatinib (TK1)

25

List some side effects of chemotherapy

Vomiting
Alopecia
Neutropenia
Infertility
Rash

26

How does radiotherapy work?

Uses ionising radiation to produce free radicals that damage DNA

27

Why is radiotherapy delivered in fractions?

Gives normal cells time to recover

28

What is the difference between radical and palliative radiotherapy in terms of the doseage given?

Radical - 40-70Gy in 15-35 fractions
Palliative - 8-30Gy in 1-10 fractions

29

List some early side effects of radiotherapy

Tiredness
Skin reactions
Mucositis, oral thrush
Nausea, vomiting
Diarrhoea
Dysphagia

30

List some late side effects radiotherapy

CNS: somnolence, weakness, reduced IQ, plexopathy
Lung: pneumonitis, cough, dyspnoea
GI: dry mouth, strictures, inflammation
GU: frequency, infertility, dyspareunia, vaginal stenosis
Erectile dysunction, endocrine disturbance