Misc

Question 1

Describe what happens in tumour lysis syndrome, the blood test results + when its most likely to occur

Answer 1

High uric acid, hyperkalaemia, hyperphosphatemia, hypocalcaemia
Causes painful joints, kidney stones, AKI, arrhythmias, confusion.
More common in leukaemias, lymphomas etc.
Seen 2-3 days after chemo

Question 2

MRCP vs ERCP - what are they?

Answer 2

MRCP = MRI of liver, gallbladder, pancreas
ERCP = endoscopy, injection of dye into pancreatic ducts, X rays taken

Question 3

What is lymphangitis carcinomatosis?

Answer 3

Inflammation of lymph vessels due to malignancy. Breast, lung, stomach, pancreas + prostate common. Can cause kerley B lines on CXR

Question 4

What can cause mediastinal lymphadenopathy?

Answer 4

TB, sarcoidosis, lung cancer, lymphangitis carcinomatosis, CF

Question 5

What are the causes of leg pain in oncology patients?

Answer 5

Bone mets, neuropathic pain, peripheral neuropathy, fracture, co-existing disease

Question 6

What are the characteristics of bone mets (S+S)?

Answer 6

dull ache over large area or well localized tenderness over bone. Worse on weight bearing + movement

Question 7

What meds to consider stopping in EOL care?

Answer 7

steroids, hpyoglycaemics, anticonvulsants

Question 8

What meds to stop in EOL care?

Answer 8

anti-HTN, anti-depressants, laxatives, anti ulcer drugs, anticoags, iron, vitamins, diuretics, arrhythmics

Question 9

What are the 4 anticipatory meds?

Answer 9

diamorphine injection, midazolam, hyoscine butylbromide + haloperidol

Question 10

What is a DS1500 form?

Answer 10

Used for the terminally ill to get more funding

Question 11

What are the causes of confusion in oncology pts?

Answer 11

Hypercalcaemia, infection, opiate OD, cerebral mets

Question 12

What does a CXR of SVCO reveal?

Answer 12

Mediastinal mass

Question 13

When to use RT vs surgery for spinal cord compression

Answer 13

Radiotherapy for:
Comorbidities 
Non- collapse of vertebrae
Metastasis 
2 or more levels with compression 
Palliative 

Surgery for:
Young
Healthy
One level disease

Question 14

What are the key principles of external beam RT?

Answer 14

Immobilisation 
Imaging 
Target definition (margins) Dose delivery 
Verification 
image guidance

Question 15

How does hypercalcaemia cause problems?

Answer 15

Calcium acts like an osmotic diuretic causing:
Polyuria 
Dehydration 
D+ V 
Leads to AKI

Question 16

What would prompt a referral to the coroner?

Answer 16

Cause of death unknown
Death occurred within 24hrs of admission
Death due to industrial disease/ employment
Occurred during an operation or before recovery from anaesthetic
Suicide
Occurred while pt was on a DoLs of MHA detention