Pass med onc Flashcards

Question

bleomycin s/e

Answer 1

lung fibrosis

Answer 2

Stabilizes DNA-topoisomerase II complex inhibits DNA & RNA synthesis

Answer 3

cardiomyopathy

Answer 4

Inhibits dihydrofolate reductase and thymidylate synthesis

Answer 5

Myelosuppression, mucositis, liver fibrosis, lung fibrosis

Answer 6

Pyrimidine analogue inducing cell cycle arrest and apoptosis by blocking thymidylate synthase (works during S phase)

Answer 7

Myelosuppression, mucositis, dermatitis

Answer 8

Purine analogue that is activated by HGPRTase, decreasing purine synthesis

Answer 9

myelosuppression

Answer 10

Pyrimidine antagonist. Interferes with DNA synthesis specifically at the S-phase of the cell cycle and inhibits DNA polymerase

Answer 11

myelosuppression, ataxia

Answer 12

inhibits formation of microtubules

Answer 13

Vincristine: Peripheral neuropathy (reversible) , paralytic ileus Vinblastine: myelosuppression

Answer 14

Prevents microtubule depolymerisation & disassembly, decreasing free tubulin

Answer 15

neutropenia

Answer 16

inhibits topoisomerase I which prevents relaxation of supercoiled DNA

Answer 17

myelosuppression

Answer 18

crosslinking of dna

Answer 19

Ototoxicity, peripheral neuropathy, hypomagnesaemia

Answer 20

Inhibits ribonucleotide reductase, decreasing DNA synthesis

Answer 21

myelosuppresion

Answer 22

aut dom germline mutations to p53 tumour supressor gene

Answer 23

sarcomas and leukaemias

Answer 24

brca 1 - chromosome 17 brca 2 - 13

Answer 25

breast cancer ovarian cancer just brca 2 - prostate cancer

Answer 26

colon cancer and endometrial cancer at young age

Answer 27

high risk individuals identified using amsterdam criteria

Answer 28

Three or more family members with a confirmed diagnosis of colorectal cancer, one of whom is a first degree (parent, child, sibling) relative of the other two. Two successive affected generations. One or more colon cancers diagnosed under age 50 years. Familial adenomatous polyposis (FAP) has been excluded

Answer 29

aut dom familial colorectal polyposis Mutation of APC gene located on chromosome 5 considered a variant of familial adenomatous polyposis coli

Answer 30

Multiple colonic polyps Extra colonic diseases include: skull osteoma, thyroid cancer and epidermoid cysts Desmoid tumours are seen in 15%

Answer 31

most undergo colectomy as risk of colorectal cancer

Answer 32

FBC, U&E, LFT, calcium, urinalysis, LDH Chest X-ray CT of chest, abdomen and pelvis AFP and hCG

Answer 33

myeloma screen

Answer 34

PSA testicular US in men with germ cell tumour

Answer 35

mammography

Answer 36

squamous cell adenocarcinoma large cell

Answer 37

typically central hypercalcaemia (PTHrP secretion) finger clubbing cavitating lesions hypertrophic pulmonary osteoarthropathy

Answer 38

typically peripheral most common type of lung cancer in non-smokers, although the majority of patients who develop lung adenocarcinoma are smokers

Answer 39

typically peripheral anaplastic, poorly differentiated tumours with a poor prognosis may secrete β-hCG

Answer 40

oncological emergency

Answer 41

extradural compression from vertebral body mets

Answer 42

lung breast prostate

Answer 43

back pain the earliest and most common symptom may be worse on lying down and coughing lower limb weakness sensory changes: sensory loss and numbness neurological signs depend on the level of the lesion. Lesions above L1 usually result in upper motor neuron signs in the legs and a sensory level. Lesions below L1 usually cause lower motor neuron signs in the legs and perianal numbness. Tendon reflexes tend to be increased below the level of the lesion and absent at the level of the lesion

Answer 44

urgent whole MRI scan within 24 hours

Answer 45

high dose oral dexamethasone urgent oncological assesment for consideration f radiotherapy or sugrery

Answer 46

a form of nuclear imaging which uses fluorodeoxyglucose (FDG) as the radiotracer. This allows a 3D image of metabolic activity to be generated using glucose uptake as a proxy marker. The images obtained are then combined with a conventional imaging technique such as CT to decide whether lesions are metabolically active.

Answer 47

evaluating primary and possible metastatic disease cardiac PET: not used mainstream currently

Answer 48

Unrelenting lumbar back pain Any thoracic or cervical back pain Worse with sneezing, coughing or straining Nocturnal Associated with tenderness

Answer 49

oncological emergency

Answer 50

lung cancerc

Answer 51

dyspnoea is the most common symptom swelling of the face, neck and arms - conjunctival and periorbital oedema may be seen headache: often worse in the mornings visual disturbance pulseless jugular venous distension

Answer 52

common malignancies: small cell lung cancer, lymphoma other malignancies: metastatic seminoma, Kaposi's sarcoma, breast cancer aortic aneurysm mediastinal fibrosis goitre SVC thrombosis

Answer 53

endovascular stenting is often the treatment of choice to provide symptom relief certain malignancies such as lymphoma, small cell lung cancer may benefit from radical chemotherapy or chemo-radiotherapy rather than stenting the evidence base supporting the use of glucocorticoids is weak but they are often given

Answer 54

low generally

Answer 55

ovarian cancer

Answer 56

pancreatic cancer

Answer 57

breast cancer

Answer 58

prostatic carcinoma

Answer 59

hepatocellular carcinoma, teratoma

Answer 60

colorectal cancer

Answer 61

melanoma, schwannomas

Answer 62

small cell lung carcinoma, gastric cancer, neuroblastoma

Answer 63

fibrocystic, lipoma, fibroadenoma

Answer 64

size grade BRCA 1/2 positive and er negaticvebr

Answer 65

<50 yrs and close relative, two or more close relatives with breast cancer

Answer 66

sporadic (95%) hereditary non-polyposis colorectal carcinoma (HNPCC, 5%) familial adenomatous polyposis

Answer 67

The Amsterdam criteria are sometimes used to aid diagnosis: at least 3 family members with colon cancer the cases span at least two generations at least one case diagnosed before the age of 50 years

Answer 68

the NHS now has a national screening programme offering screening every 2 years to all men and women aged 60 to 74 years in England, 50 to 74 years in Scotland. Patients aged over 74 years may request screening

Answer 69

increasing age smoking diabetes chronic pancreatitis (alcohol does not appear an independent risk factor though) hereditary non-polyposis colorectal carcinoma multiple endocrine neoplasia BRCA2 gene KRAS gene mutation

Answer 70

high-resolution CT scanning is the investigation of choice if the diagnosis is suspected imaging may demonstrate the 'double duct' sign - the presence of simultaneous dilatation of the common bile and pancreatic ducts

Answer 71

a Whipple's resection - rare (pancreaticoduodenectomy) is performed for resectable lesions in the head of pancreas. Side-effects of a Whipple's include dumping syndrome and peptic ulcer disease adjuvant chemotherapy is usually given following surgery ERCP with stenting is often used for palliation

Answer 72

more common in middle-aged men smoking von Hippel-Lindau syndrome tuberous sclerosis incidence of renal cell cancer is only slightly increased in patients with autosomal dominant polycystic kidney disease

Answer 73

for confined disease a partial or total nephrectomy depending on the tumour size patients with a T1 tumour (i.e. < 7cm in size) are typically offered a partial nephrectomy alpha-interferon and interleukin-2 have been used to reduce tumour size and also treat patients with metatases receptor tyrosine kinase inhibitors (e.g. sorafenib, sunitinib)

Answer 74

radical prostatectomy (erectile dysfunction) radiotherapy: external beam and brachytherapy (patients may develop proctitis and are also at increased risk of bladder, colon, and rectal cancer following radiotherapy for prostate cancer) GnRH agonists: e.g. Goserelin (Zoladex) b/l orchidectomy bicalutamide non-steroidal anti-androgen blocks the androgen receptor cyproterone acetate steroidal anti-androgen

Answer 75

infertility (increases risk by a factor of 3) cryptorchidism family history Klinefelter's syndrome mumps orchitis

Answer 76

a painless lump is the most common presenting symptom pain may also be present in a minority of men hydrocele gynaecomastia this occurs due to an increased oestrogen:androgen ratio germ-cell tumours → hCG → Leydig cell dysfunction → increases in both oestradiol and testosterone production, but rise in oestradiol is relatively greater than testosterone leydig cell tumours → directly secrete more oestradiol and convert additional androgen precursors to oestrogens

Answer 77

orchidectomy radio or chemo

Answer 78

hepatitis B & C, alcohol, haemochromatosis and primary biliary cirrhosis. Other risk factors include: alpha-1 antitrypsin deficiency hereditary tyrosinosis glycogen storage disease aflatoxin drugs: oral contraceptive pill, anabolic steroids porphyria cutanea tarda male sex diabetes mellitus, metabolic syndrome

Answer 79

ultrasound (+/- alpha-fetoprotein)

Answer 80

early disease: surgical resection liver transplantation radiofrequency ablation transarterial chemoembolisation sorafenib: a multikinase inhibitor

Pass med onc Flashcards

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