Oncology

Question 1

Which gene mutations are commonly seen in breast and ovarian cancer?

Answer 1

BRCA1 (chr 17) - breast 80%, ovarian 40%, colorectal

BRCA2 (chr 13) - breast 80%, prostate

Question 2

Which 4(/5) cancers have the commonest incidence?

Answer 2

Skin
Breast / prostate
Lung
Colorectal

Question 3

Which 3(/4) cancers have the commonest mortality?

Answer 3

Lung
Breast/prostate
Colorectal

Question 4

What is familial adenomatous polyposis?

Answer 4

An AD condition in which numerous adenomatous polyps form in the epithelium of the large intestine. They may malignantly transform into colon cancer if left untreated.

Question 5

What is an adenoma?

Answer 5

A benign tumour of glandular tissue

Question 6

What genetic mutation occurs in familial adenomatous polyposis?

Answer 6

APC gene on chr 5

+ p53 or kRAS

Question 7

Which genes are associated with hereditary nonpolyposis colorectal cancer (HNPCC)

Answer 7

Lynch 1 and Lynch 2

Question 8

Which cancers are associated with lynch 2?

Answer 8

Colorectal cancer + 1 of:

• ovarian
• endometrial
• pancreas
• small bowel
• renal pelvis

Question 9

What is Peutz-Jeghers syndrome?

Answer 9

AD genetic disorder characterised by the development of benign hamartomatous polyps in the GI tract + hyperpigmented macules on the lips and oral mucosa

Question 10

What is a koilocyte?

Answer 10

A squamous epithelial cell that has undergone structural changes due to infection by human papillomavirus (HPV)

Question 11

What is CA 125 a tumour marker for?

Answer 11

Ovarian cancer

Question 12

What is CA 19-9 a tumour marker for?

Answer 12

Pancreatic cancer

Question 13

What is CA 15-3 a tumour marker for?

Answer 13

Breast cancer

Question 14

CA 125, CA 19-9 and CA 15-3 are all what type of antibody?

Answer 14

Monoclonal antibodies

Question 15

What is alpha-feto protein a tumour marker (antigen) for ?

Answer 15

Hepatocellular carcinoma, teratoma

Question 16

What is carcinoembryonic antigen a tumour marker for?

Answer 16

Colorectal cancer

Question 17

What is S-100 (antigen) a tumour marker for?

Answer 17

Melanoma, schwannomas

Question 18

What is Bombesin (antigen) a tumour marker for?

Answer 18

Small cell lung carcinoma, gastric cancer, neuroblastoma

Question 19

What do PET scans measure?

Answer 19

Metabolic activity

Question 20

Give an example of a 5HT3 receptor antagonist used for nausea during chemotherapy.

Answer 20

Ondansatron

Question 21

What is LiFraumeni syndrome?

Answer 21

AD condition where there are mutations to the p53 tumour suppression gene
–> sarcomas and leukaemias
Occurs <45 yrs

Question 22

What is the most common early feature of spinal cord compression?

Answer 22

Back pain

Question 23

What are the 3 most common tumours to spread to bone? (Most common first)

Answer 23

Prostate
Breast
Lung

Question 24

What is a side-effect of doxorubicin?

Answer 24

Cardiomyopathy

Question 25

What are the most common sites for bone mets (most common first)?

Answer 25

``` Spine Pelvis Ribs Skull Long bones ```

Question 26

Name 4 features of bone mets.

Answer 26

Bone pain Pathological fractures Hypercalcaemia Raised ALP

Question 27

What is the initial management of spinal cord compression?

Answer 27

Oral dexamethasone

Question 28

What is Pemberton sign and when is it positive?

Answer 28

Patient raises arms until they touch the side of their face. Positive = develops cyanosis, worsening SOB, facial congestion - sign of SVC obstruction

Question 29

What is the initial treatment of SVC obstruction?

Answer 29

Oxygen and dexamethasone

Question 30

Name 4 adverse effects of methotrexate.

Answer 30

Myelosuppresion, mucositis, liver fibrosis, lung fibrosis

Question 31

What is the most common cause of SVC obstruction?

Answer 31

Small cell lung cancer

Question 32

What is the most common type of lung cancer in non-smokers?

Answer 32

Lung adenocarcinoma

Question 33

What type of lung cancer might secrete beta-hCG?

Answer 33

Large cell lung carcinoma

Question 34

Which type of lung cancer is strongly associated with finger clubbing?

Answer 34

Squamous cell cancer

Question 35

Which type of lung cancer is associated with parathyroid hormone-related protein secretion (PTH-rP)?

Answer 35

Squamous cell cancer | --> hypercalcaemia

Question 36

What is the major adverse effect of bleomycin?

Answer 36

Lung fibrosis

Question 37

Which type of lung cancer has the strongest association with smoking?

Answer 37

Squamous cell lung cancer (commonly found near large airways)