Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Oncology > Oncology whatever > Flashcards

Oncology whatever Flashcards

(53 cards)

Start Studying
1
Q

What proportion of feb neuts are culture positive in the end?

A

10-25%

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

What proportion of feb neut infections are caused by endogenous flora?

A

80%

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

What are the most common gram positives that cause feb neut?

A

staph epidermis
staph aureus
enterococcus
strep

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

What are the gram negatives that usually cause feb neut

A

E coli
Klebsiella
Pseudomonas

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

What proportion of feb neut have in hospital mortality?

A

9%

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

What is the most common mechanism of spinal cord compression?

A

Extension of the tumour from vertebral body or pedicle

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

What is the best predictor of outcome in spinal cord compression?

A

Neurological function at the start of treatment

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

What are the most common tumours that cause SC compression?

A

Lung
Breast
Prostate
(lymphoma, myeloma)

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

In SC compression, you should always image…

A

THE WHOLE SPINE

one third have multilevel deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the treatment of SC compression?

A

10mg dex stat then 4mg QID
surgery best to stabilise spine
radiotherapy in sensitive tumours
chemo rarely indicated but good if very sensitive

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

Name some symptoms of SVC obstruction

A 
face and arm swelling
pressure sensation in head
dyspnoea
cough
hoarse voice
headaches
epistaxis

Often worse on bending forward or lying down

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

Treatment of SVC syndrome

A

remove CVAD if present and thrombus
anticoagulate if thrombus
no evidence for steroids or diuretics
chemo: SC lung ca, NHL, germ cell
Endoluminal stent: rapid and sustained sx improvement
radiotherapy can be given alone or with stent.

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

What are the mechanisms of hypercalcaemia in malignancy?

A

pTHRP released by tumour (80%)- usually SCC
paracrine stimulation of osteosclasts eg breast, MM
Vitamin D analogue secretion by tumour- NHL and HD

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

When do you use bone modifying agents in advanced cancer?

A

when you have mets in breast and prostate cancer
decrease time to first skeletal related event
Effect: improve bone pain but do not improve survival

less data in other cancers, not PBS funded, not used

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

What are the two main classes of bone modifying agents in cancer?

A

Bisphosphonate
RANKL inhibitor

BOTH GIVEN WITH VIT D AND CA

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

What are the toxicities of zoledronic acid?

A 
acute phase reaction
renal insufficiency - caution under 60, CI under 30
hypocalcaemia
ON jaw
occular inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Denosumab MOA

A

Inhibit RANKL–>inhibition of osteoclast activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is denosumab given?

A

Monthly subcut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Denosumab toxicities

A 
hypocalcaemia (more than ZA)
ON jaw (same risk as ZA)

not renally cleared so no need to monitor renal function

might be better than ZA in delaying first SRE in breast and prostate ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If you get chest pain during Flurouracil and capcitabine what is it from

A

probably coronary artery spasm
not predictive if have pre-existing cardiac disease
plan: stop drug and do not re-challenge

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

What pulmonary toxicity is associated with the taxanes

A

diffuse intersitital pneumoinia
pulmonary oedema
pleural effusions

treat with cessation and steroids if severe

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

What pulmonary toxicity do erlotinib and gefitinib cause?

Study These Flashcards
A

interstitial lung disease
higher risk if smoker, pre-existing lung disease
fatal in one third

23
Q

What cardiovascular side effect is known for Bevacizumab?

Study These Flashcards
A

Hypertension- low risk of heart failure

24
Q

What are the cardiac toxicities with Sorafebib/Sunitinib

Study These Flashcards
A

Reduced LVEF, rarely clinical heart failure

Re-challenge is feasible if have to stop agent

25
Cisplatin: describe the neuroloogical side effects
peripheral neuropathy - glove and stocking sensory loss due to damage to DRG - no treatment once established - stop drug if functional impairment - usually reversible Also get ototoxicity with tinitus and high frequency hearing loss
26
Does carboplatin cause neurotoxicity?
Yes but much less often than with cisplatin and only at very high doses.
27
What neurological side effects are seen with oxaliplatin?
Acute neurotoxicity - cold induced paresthesias and dysthesias hands and feet - pharyngolaryngeal dysthesias - may get jaw tightening or cramps - avoid cold stimulus - reversible Chronic neurotoxicity with peripheral neuropathy glove and stocking distribution
28
What are the neurological side effects seen with taxane chemotherapy?
nap-paclitaxel > paclitaxel >docetaxel >cabazitaxel Glove and stocking sensory neuropathy with loss of reflexes motor function preserved should delay or dose reduce if severe reversible in half
29
What are the chemo agents that can cause peripheral neuropathy?
Oxaliplatin Cisplatin taxanes Vinka alkaloids eg vincristine
30
What neurological side effect is associated with Bevacizumab?
Reversible posterior leukoencephalopathy syndrome rare- headaches, confusion, visual change, seizures Symmetrical white matter oedema in posterior cerebral hemispheres Plan: stop drug and control hypertension and most will improve
31
What are the three roles for CEA in colorectal Ca?
1. Elevated pre-op levels confer a poor prognosis 2. Use to monitor for relapse post resection 3. Use to assess response of metastatic disease to treatment
32
What is the role of Ca19.9 in pancreatic cancer?
Levels at diagnosis and post resection have prognostic value. Monitor for disease relapse post resection. Monitor for response to metastatic disease treatment.
33
What are the roles of CA 15-3 and CEA in breast cancer?
Used ONLY to monitor response of metastatic disease in treatment. NO ROLE for looking for disease relapse. May flare as response to treatment starts.
34
What are non breast cancer causes of elevated CA 15-3?
B12 def thalassaemia sickle cell disease liver dysfunction
35
What is the role of CA 125 in ovarian cancer?
In advanced disease, monitor the response to therapy.
36
What are non ovarian causes of CA 125?
``` heart failure hepatic disease, ascites renal diseaser fibroids, endometriosis breast, lung, pancreatic Ca ```
37
What are the tumour markers in pure seminoma and non-seminomatous germ cell tumour and how do they compare.
beta HCG, AFP, and LDH. - In pure seminoma, the AFP is always normal - remainder of markers in both cases can be either normal or increased - beta HCG is increased in less than 20% of pure seminomas - beta HCG or AFP or both are increased in 80% of non-seminomatous GCT
38
How does chromograninA compare with 5HIAA in neuroendocrine tumours
Less specific but more sensitive so better at looking for disease relapse after treatment Can also monitor response to treatment Also elevated in PPI use, renal disease, liver disease, atrophic gastritis IBD
39
How is thyroglobulin used in differentiated thyroid cancer?
prognostication Assess response to treatment Monitor for disease recurrence
40
What is the role of Calcitonin and CEA in medullary thyroid cancer?
pre-op levels have prognostic value assess for residual disease post op monitor response to treatment in advanced disease beta blockers, PPI, steroids, renal failure, hypercalcaemia, goitre and autoimmune thyroiditis can give you benign elevations of calcitonin. Neuroendocrine, papillary and follicular thyroid tumours also.
41
ECOG 0
Fully active, able to carry on all pre-disease performance without restriction
42
ECOG 1
Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work
43
ECOG 2
Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours
44
ECOG 3
Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours
45
ECOG 4
Totally confined to bed or chair, no self care, completely disabled
46
Neutropaenic sepsis - what bugs?
>80% endogenous flora | 70% gram positive - staph epi most common
47
What is empirical treatment for feb neut?
Haemodynamically stable- - Taz - If penicillin non life threat allergy- Cefepime or Ceftazidime - If penicillin life threat - Cipro + vanc Haemodynamically unstable -As above plus gent +/- vanc Suspect cellulitis or have a catheter in -Vanc add Features abdo infection or suspect C diff colitis and not using taz- add metronidazole
48
Most common for cord compression
lung, breast, prostate, lymphoma, myeloma
49
What is the benefit of using denosumab in skeletal mets?
Subcut and easy to give Dont have to adjust for renal function Beware can get profound hypocalcaemia if underlying vitamin D deficiency.
50
Malignancies associated with EBV?
PTLD Burkitt Lymphona (more than 95% of these in endemic areas, 15-20% in low incidence areas) NHL especially in HIV (less than 15% in non HIV) Nasopharyngeal CA (100%) HL 50% cases nasal angiocentric lymphoma in africa (all of these NK origin tumours)
51
Over expression of P53 in head and neck squamous?
Poor prognosis
52
Why give adjuvant chemo
eliminate micro mets
53
``` Overall survival vs median survival time vs mean survival time vs disease free survival vs time to progression vs progression free survival vs time to treatment failure ```
time from randomisation to death from any cause vs point where half alive and half dead vs length time people alive divided by length of study -->gives AUC vs time from randomisation until recurrence tumour or death any cause vs time from randomisation to OBJECTIVE tumour progression (not including death) vs time from randomisation to objeective tumour progression OR death vs time from randomisation to discontinuation of treatment for any reason including disease progression, toxicity, death

Oncology (13 decks)

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