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Flashcards in CLASP Deck (116)
1

what is vertebraplasty?

used in palliative care
cement added to spine to hold it together again
E.G after high steroid dose has destroyed bone

2

when is O2 used in breathlessness?

only if they are hypoxic as well

3

what produces SiADH?

small cell lung cancer

4

what produces ACTH?

small cell (neuroendocrine)

5

what is lambert-eaton myasthenic syndrome?

muscles problems, antibody related in pre-synaptic membrane, not hormone-related

6

what indicates melanoma on histology?

brown pigments

7

what can be used to determine if mets are from lung, liver, stomach etc?

immunohistochemistry
If premalignant part of tumour is present

8

what is a carcinoid tumour?

neuroendocrine derived tumour usually in appendix/small bowel
yellow and assoc with serotonin

9

how is a carcinoid tumour diagnosed?

Urine 5-HIAA and plasma

10

what is required for carcinoid syndrome?

liver mets
chromogranin A

11

Lymphoma?

B cell MALT
assoc w/ coeliac disease

12

what cancer is kartageners syndrome associated with?

squamous cell carcinoma
cilia defect so affects lungs and fallopian tubes

13

what does BCL2 do?

evasion of apoptosis

14

what does P53 do?

spell checker

15

what tumour stage do you look for mets?

not T1, only T2-4

16

when is radio/chemotherapy used?

radio = local sit of malignancy
chemo = systemic

17

what are the endpoints for cancer treatments?

overall survival
progression free survival
disease free survival
local control
NOT TOXICITY FREE

18

what is atelectasis?

lung collapse

19

what is seen with asbestos exposure?

pleural effusion
rounded atelectasis
pleural plaques
asbestosis
adenocarcinoma (esp. w/ smoking)
mesothelioma

20

what is the worst indication with mesothelioma?

blue fibres (eg. amphipole)

21

how does HPV cause cancer?

E6 targets P53 production
E7 targets pRB
(does not directly cause mutations however)

22

can HIV cause cancer?

not directly
immunosuppressed making susceptible to cancer causing viruses

23

what is plummer vinson?

increased risk of dysphagia, webs and then oesophageal cancer (squamous cell)

24

what does lynch syndrome cause?

endometrial and colon cancer

25

who gets screened for lynch syndrome?

everyone with MSI (microsatellite instability = spelling mistakes)

26

example of hyperplasia?

lining of uterus
liver regeneration
testes

27

example of hypertrophy?

muscle (skeletal and cardiac)

28

example of atrophy?

leg in plaster cast

29

example of metaplasia?

barrets
change from ciliated pseudostratified columnar epithelium in bronchi to squamous in response to smoking

30

squamous carcinoma in lung can only occur with smoking, true or false?

true
usually isn't any squamous epithelium unless metaplastic change

31

anything shiny that's exposed to air?

non-keratinised

32

anything hard that's exposed to air?

keratinised

33

"heaped, rolled up edges"?

malignancy (means lesion is not well defined etc)

34

what is more common on greater/lesser curvature?

lesser = malignancy
greater = ulcer

35

signet rings?

nucleus pushed to the side
= adenocarcinoma

36

does exrcise increase cancer risk?

yes
bowel, breast and endometrial

37

breastfeeding cancer link?

reduced risk with breastfeeding
- linked to oestrogen

38

vit A carotenoid?

reduced in smokers
increases cancer risk when low

39

beta carotene?

anti-oxidant at low levels
pro-oxidant at high levels

40

dairy guidelines?

2-3 milk portions
700mg calcium per day

41

acrylamide?

forms in starchy foods when burnt
likely human carcinogen

42

transitional epithelium?

in bladder

43

epithelial tumour (carcinomas) almost never occur in children, true or false?

true

44

what cancers do children get?

blood
brain
bone

45

most common type of cancer?

carcinoma

46

older person with brain lesion?

metastatic carcinoma until proven otherwise

47

how does epithelial malignancy spread?

local growth
spreads via haematogenous and lymphatic routes

48

where will lung, breast, GI and prostate tumours spread haematogenously?

lung = bone, brain, adrenal, liver
breast = similar to lung
GI = liver
Prostate = anywhere

49

what is a mesenchymal tumour?

derived of connective tissue
(sarcomas)

50

where do sarcomas occur?

bone
cartilage
fat
fibrous tissue
muscle
blood vessels
nerves

51

defining feature of sarcoma?

local growth but don't often spread so can get very big

52

what do sarcomas lesions look like?

spindle cell lesions (cigar shaped)

53

diagnosis of sarcoma?

FISH
karyotyping (eg. ewings sarcoma = t11;22)

54

myeloid malignancy?

platelets
red cells
granulocytes

55

lymphoma presentation?

big lymph nodes in more than one area that doesn't fit with anatomical drainage of one location/area
large liver and spleen
less white cells

56

how are lymphoma cells different than other cancer cells?

not pleomorphic
all look similar

57

glioma?

brain tumour

58

brain tumours don't spread, true or false?

true

59

most common causes of prostatism?

benign prostatic hyperplasia
prostate cancer

60

what is PSA?

prostate specific antigen
type of tumour marker
can be high in prostate cancer of benign prostatic hyperplasia

61

sensitivity?

% of people with disease that have +ve test result

62

specificity?

where disease is absent, the % of people that will be diagnosed as healthy

63

positive predictive value?

likelihood of +ve test result meaning person has the disease

64

negative predictive value?

likelihood of a -ve test result meaning person is healthy

65

how is recurrence of prostate cancer checked?

PSA monitoring

66

ACG?

checks germ cells tumours and pregnancy

67

when does ALP rise?

cholestatic disease
pregnancy
cancer bone mets (osteoblasts make new bone after osteoclasts break it down, increasing ALP)

68

how are bone mets diagnosed?

isotope bone scan

69

failed ERCP?

possible malignancy

70

what causes more than1 area of pleural effusion (eg. bilateral)?

benign things
HF, nephrotic syndrome

71

hypercalcaemia common in malignancy, true or false?

true (>2.55)
- stones
- bones
- groans
- moans (depression)

72

result of high calcium?

dehydration

73

how is calcium levels controlled?

parathyroid glands via PTH

74

how does PTH control calcium?

causes bone absorption (calcium absorbed from skeleton)
more calcium reabsorbed from renal tubules
indirectly - activates Vit D causing gut absorption of calcium

75

what is PTHrP?

parathyroid hormone related peptide
same action as PTH but not picked up on in PTH assay

76

how is PTHrP detected?

really high calcium and very low PTH = presence of PTHrP

77

symptoms of cushings syndrome?

low K+
hypertension
nocturia
polydipsia
truncal obesity
plethora
ankle oedema
purpura of arms

78

what can cause cushings?

steroids
ectopic ACTH (small cell lung cancer)

79

radical treatment?

curative intent - at expense of side effects

80

palliative treatment?

non-curative - aims to improve QoL but not at expense of side effects

81

adjuvant therapy?

after surgery
aimed at reducing recurrence

82

neo-adjuvant therapy?

before surgery
usually shrinking a tumour before removal

83

local control?

time without recurrence or progression at specific tumour site

84

brachytherapy?

injecting tiny pellets of radioisotopes into tumour killing it from inside

85

systemic anti-cancer therapy (SACT)?

cytotoxic chemo
targeted therapy
immunotherapy

86

haematological effects of chemo?

neutropenia
thrombocytopenia

87

GI chemo side effects?

diarrhoea
nausea
mucositis (mouth ulcers)
altered taste

88

how does external beam radiotherapy work?

breaks double strand causing cell to die

89

targeted cancer treatment?

monoclonal antibody
(tractuzumab/Herceptin)

90

what cancer is radiotherapy good for?

squamous cancers

91

length of time between decision to treat and first chemo/brachytherapy treatement?

31 days

92

how can cancer cause facial swelling?

if tumour obstructs head and neck drainage (e.g SVC)
treated with a stent

93

most common cancer inheritance?

multifactoral

94

most common mutation causing oncogene activation?

missence amino acid change

95

cancer is disease of somatic mosaicism?

yes

96

BRCA gene?

DNA strand breaks

97

hereditary colorectal cancer?

mismatched base

98

what does UV or chemical crosslinking cause?

xeroderma pigmentosa

99

what determines characteristic of cancer?

driver mutation
(not origin site)

100

how does BRAF mutation cause melanoma?

activates KRAS pathway
specific BRAF inhibitor effective

101

what is the Philadelphia chromosome?

genetic abnormality in chromosome 22 that causes leukaemia

102

how can driver mutations and genomic profiles of tumours be found?

NGS

103

what determines cancer behaviour?

somatic mutation

104

in a family with suspected inherited cancer gene, who would you test?

surviving affected relative

105

what is low cancer risk?

population risk

106

what is medium cancer risk?

3% 10 year risk

107

what is high cancer risk?

8% 10 year risk

108

what is MLH1 assoc with?

hereditary, nonpolyposis colorectal cancer

109

what does the MLH1 gene do?

DNA repair gene

110

what type of cancer is mesothelioma?

not a lung cancer
primary pleural malignancy
epithelial malignancy as mesothelial cells rest on basement membrane

111

how are asbestos fibres shown?

pearl stain (shows blue fibres)

112

rounded atelectasis?

asbestos

113

re-planning of stem cells?

metaplasia

114

name some viral carcinogens?

HPV
EBV
polyomavirus
HHV-8

115

how does plummer vinson syndrome present?

dysphagia
anaemia
oesophageal webs

116

risk of plummer vinson?

increased risk of oesophageal SCC