Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Exam > Oncology > Flashcards

Oncology Flashcards

(76 cards)

Start Studying
1
Q

Cell cycle phases

A 
Gap 0 = no division
Interphase:
- G1 (Cells increase in size, G1 checkpoint)
- Synthesis (DNA replication)
- G2
Mitosis
- Prophase
- Metaphase
- Anaphase
- Telophase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chemo agents that affect mitosis

A

Antimicrotubule agents eg. vinca alkaloids
Topoisomerase II inhibitors eg/ anthracyclines
Etoposide

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

Chemo agents that are not specific to any cell cycle phase

A

Alkylating agents

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

Chemo agents that affect the S phase

A

Antimetabolites eg. methotrexate
Topoisomerase II inhibitors eg. anthracyclines
Prednisolone

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

Alkylating agents MOA and examples

A

Contain chemical groups that form covalent bons with particular nucleophilic substances in the cell -> interferes with transcription and replication

Cyclophosphamide
Ifosfamife
Cisplatin
Carboplatin

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

Alkylating agents general side effects

A

Bone marrow depression
GI disturbance
Gametogenesis –> sterility esp in men with prolonged used
Increased risk of non-lymphocytic leukaemic and other malignancies with prolonged use

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

Cyclophosphamide side effects

A

N/V
Bone marrow depression- pronounced effect on lymphocytes
Haemorrhagic cystitis (due to toxic metabolite acrolein, minimised by NAD/mesna which interact with acrolein)
Bladder cancer
Pulmonary fibrosis
SIADH
Anaphylaxis

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

Ifosfamide side effects

A

N/V
Bone marrow depression- pronounced effect on lymphocytes
Haemorrhagic cystitis (due to toxic metabolite acrolein, minimised by NAD/mesna which interact with acrolein)
Bladder cancer
Pulmonary fibrosis
SIADH
Anaphylaxis

*More cardiac toxicity than cyclophosphamide

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

Cisplatin side effects

A 
Nephrotoxic 
* Low myelotoxicity 
Severe N/V, can be delayed
Tinnitus and hearing loss in the high frequency range 
Peripheral neuropathy
Hyperuricaemia
Anaphylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Carboplatin side effects

A

Similar to cisplatin- more myelotoxicity, less of the other side effects

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

Antimetabolites examples

A

Folate antagonists eg. methotrexate
Pyrimidine analoges eg. fluorouracil, cytarabine
Purine analogues eg. metcaptopurine,

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

Methotrexate
MOA
Side effects

A

Folate is requires for synthesis of purine nucelotide and thymidylate
MTX inhibits dihydrofolate reductase

Bone marrow supression
Mucositis, stomatitis
Dermatitis
Hepatitis
Nephrotoxicity (high dose- caused by precipitation in the tubules)
CNS toxicity (high dose)
Don’t give if there are fluid compartments eg. pleural effusions, ascites

IT: arachnoiditis, leukoencephalopathy, leukomyelopathy

Long term- osteopenia + #s

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

Fluorouracil
MOA
SEs

A

Inhibits thymidalate synthesis

Usual
Cerebellar disturbances

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

Cytarabine
MOA
SEs

A

Inhibits DNA polymerase

Usual
Conjunctivitis
IT: CNS dysfunction

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

Mercaptupurine

A

Converted to a fraudulent purine nucleotide

Hepatic necrosis
Mucositis
Allopurinol increases toxicity by inhibiting metabolism

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

Cytotoxic antibiotics
MOA
Examples

A

Produce their effects through direct action on DNA
Do not give with radiotherapy
Eg. anthracyclines (doxorubicin, idarubicin, daunorubicin)
Dactinomycin, bleomycin, hydroxyurea

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

Doxorubicin

A

Inhibits DNA and RNA synthesis by interfering with topoisomerase II

Necrosis with extravasation
Usual
Dose related cardiac damage
Marked alopecia 
Red urine
COnjunctivitis
Radiation dermatitis
Arrythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Dactinomycin

A

Topoisomerase II

Necrosis with extravasation
Usual
*No cardiac damage unlike doxorubicin
Marked alopecia 
Red urine
Conjunctivitis
Radiation dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Bleomycin

A

Fragmentation of DNA chains
Often used for germline cancers

*Little myelosupression 
Pulmonary fibrosis 10%, fatal 1%
50% muycocutaneous reactions esp palsm 
Hyperpyrexia
Raynaud phenomenon
Dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hydroxyurea

A

Urea analogue that inhibits ribonucleatase reductase

Usual, but sigifiant bone marrow supression

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

Vinca alkaloids MOA

A

Bind to tubulin and inhibitos polymerisation to microtubules –> arrests that cell cycle at metaphase

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

Vincristine

A 
*Only mild myelosupression
Parasthesias and peripheral neuropathy
Constipation, ileus
Abdo pain
Muscle weakness
Local cellulitis, extravasation reactions
Jaw pain
SIADH
Seizures 
Ptosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Vinblastine

A

Less neurotoxic than vincristine
Leucopenia
Still has same issues with cellulitis and extravasation

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

Etoposide

A

o Inhibits topoisomerase II and inhibits mitochondrial function
o Nausea, vomiting, myelosuppression, alopecia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Campothecins eg. irinotecan, topotecan
Inhibit topoisomerase I Dairrhoea, bone marrow supression Generally fewer side effects than other chemotherapy agents
26
Asparaginase
Selective action on leukaemia cell, which are unable to synthesis their own aspariginase ``` Minimal bone marrow suppression, GI effects or alopecia Marked anaphylaxis N/V CNS depression Liver damage Pancreatitis Platelet dysfunction and coagulopathy Hyperglycaemia Encephalopathy ```
27
Rituximab
Used for lymphoma Lyses B lymphocytes by binding to CD20 and activating complement Hypotension, fever, hypersensitivity
28
Imatinib
``` Inhibits signalling pathway kinases including tyrosine kinase and Bcr/Abl kinase Abdo pain, diarrhoea, nausea Fatigue Headache Rash ```
29
5 year survival rate for all childhood cancers
83.5%
30
Risk factors for ALL
Ionising radiation White race T21- 10-20x higher NF1, Bloom syndrome, ataxia-telangiectasia, Langerhan's cell histiocytosis
31
Risk factors AML
Alkylating agents (cyclosphophamide) + etoposide T21 NF1 Familial monsomy 7
32
Li-Fraumeni
p53 mutation AD 3 criteria: - Proband Dx with sarcoma <45 years - 1st degree relative with any cancer Dx <45 years - Another 1st or 2nd degree relative with any cancer <45 years or sarcoma any age
33
WAGR
Wilm's tumour, aniridia, genitourinary anomalies, mental retardation WT1 gene- chromosome 11p deletion
34
Risk factors hepatoblastoma
Beckwith-Wiedeman, hemihypertrophy, Gardner syndrme, adenomatous polyposis
35
Chromosome 13q deletion syndrome
Retinoblastoma and sarcoma
36
Monosomy 5 and monosomy 7
Myelodysplastic syndrome
37
Tyrosinaemia
Hepatocellular carcinoma
38
Galactosaemia
Hepatocellular carcinoma
39
Acute adverse effects of radiation therapy
``` Dermatitis (MC) Nausea, diarrhoea (abdo radiation) Mucositis Somnolence (cranial radiation) Alopecia (scalp radiation) ```
40
Late effects of radiation therapy
Impaired growth (cranial or vertebral) Endocrine dysfunction (Cranial) Pulmonary or cardiac insufficiency (chest) Strictures and adhesions (abdo) Infertility (pelvic) Secondary malignancy in the radiation field
41
Tumour lysis syndrome
High urate, phosphate, potassium Renal dysfunction Hypocalcaemia Usually seen within 12-48 hours of chemo Allopurinol (xanthine oxidase inhibitor) prevents further accumulation of urates Rasburicase - enzyme that degrades uric acid
42
High risk for neurocognitive deficits after cancer
``` Age <3 at time of Rx Female Supratentorial tumours Premorbid/FHx of learning or attention problems Radiation doses >24Gy Whole brain irradiation ```
43
High risk for SNHL after cancer
Higher dose cisplatin Higher radiation dose >30Gy Concurrent radiation and cisplatin
44
High risk for gondal dysfunction after cancer- delayed puberty, premarity menopause, infertility
High dose alkylating agents eg. alkylating agent conditioning for HSCT Radiation dose >15Gy in prepubertal girls, >10Gy in pubertal girls Pelvic/gonadal irradiation in boys
45
High risk for caridac issues post cancer
``` Females Age <5 at time of Rx High doses chemo >300mg/m2 - daunorubicin, doxorubicin, idarubicin High dose cardiac radiation Combined cardiac chemo and cardiac radio ```
46
Cancers most commonly associated with secondary malignancy
1. RB (50% at 50 years) 2. Hodgkin lymphoma 3. Soft tissue sarcoma
47
B- ALL favourable chromosome
``` T4 T10 T17 T(12;21) ETV6-RUNX1 Hyperdiploidy ```
48
B-ALL unfavourable chromosomes
t(4;11) MLL-AF4 t(9;22) BCR-ABL Hypodiploidy
49
T4 in ALL
Favourable
50
T10 in ALL
Favourable
51
T17 in ALL
Favourable
52
ETV6-RUNX1
Favourable | t(12;22)
53
t(1;19) E2A-PBX
No prognostic implication
54
MLL-AF4
Unfavourable | t(4;11)
55
t(8;14) | Burkitt leukaemia
No prognostic implication
56
t(10;14) | T-ALL
Favourable
57
MLL rearrangments
Occur in infant leukaemia (60% infant leukaemia, 5% all leukaemia) 11q23 Unfavourable Results in t(4;11), t(11;19), t(9;11)
58
Higher leukocyte count in T or B ALL
T-ALL
59
Occult testicular involvement in what % of boys with leukaemia at diagnosis
25%
60
Diagnosis of ALL
Bone marrow with >25% of marrow cells as a homogenous population of lymphoblasts
61
Standard risk ALL
Age 1-10 | Leukocyte count <50
62
High risk ALL
Age <1 or >10 | Leukocyte count >50
63
Very high risk ALL
``` Philadephia MLL T-ALL Slow response to initial therapy Hypodiploidy IKZF1 MRD >0.01 on day 29 of induction ```
64
TPMT gene
Thiopurine S-methytransferase Wild type = normal Heterozygous = slightly decreased enzyme activity Homozygous = low or absent enzyme activity Decreased TPMT activity needs a lower 6-MP dose to prevent severe myelosupression
65
Percentage of patients with ALL who relapse
15-20% <5% CNS relapse <2% boys testicular relapse - TALL more likely during Rx, BALL more likely after treatment
66
Chloromas
Subcutaneous AML deposits Esp t(8;21) Can occur in the absence of bone marrow involvement
67
Favourable chromosomes AML
t(8;21) AML1-ETO inv(16) CBFB-MYII t(15;17) PML-RARA
68
Unfavourable chromosomes AML
11q23 MLL PLT3 Del(7q), -7
69
AML survival | AML survival post transplant
60-70% 2/3 disease free survival
70
APL
Gene rearrangment involving the retinoic acid receptor t(15;17) PML-RARA Very responsive to ATRA combine with anthracyclines and cytarabine
71
Leukaemia and Down syndrome
Acute leukaemia 15-20x more common than gen pop AML 400x more common in first 3 years, after this same as general population Prognosis with ALL slightly worse than gen pop, AML slightly better (80% survival) Very sensitive TO MTX- needs lower doses
72
Transient leukaemia/myloproliferative disorder in Down syndrome
10% of neonates Elevated WCC, blasts in peripheral blood, anaemia, thrombocytopenia, hepatosplenomegaly Resolves without Rx in first 3 months Can require transfusions Chemo only if life threatening complications 20-30% develop leukaemia by age 3- usually megakaryoblastic AML Assoc with GATA1 mutation
73
CML
99% of cases t(9;22) Chronic phase for 3-4 years, then blast crisis Imatinib Hydroxyurea to control WCC in chronic phase BMT curative in 80%
74
JMML
Typically <2 years Assoc with Noonans (PTPN11) and NF1 (RAS oncogenes) Anaemia with erythroblasts Bone marrow shows a myelodysplastic pattern with <20% blasts
75
Hodgkin lymphoma
MC malignancy 15-19 yrs Assoc with HHV6, CMV, EBV (EBV infection = 4x greater risk HL) Reed-Sternberg cells CD30 and CD40 positive
76
RET
Multiple endocrine neoplasias

Exam (16 decks)

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