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Flashcards in General Oncology Deck (60):
0

What cancer is the Epstein Barr virus associated with?

Hodgkins and non Hodgkin's lymphoma

1

What cancer is associated with exposure to benzene?

Leukaemia

2

What cancer is associated with exposure to wood dust?

Nasal adenocarcinoma

3

What cancer is associated with exposure to vinyl chloride?

Angiosarcoma

4

What is the RECIST classification of imaging response to treatment?

Complete response - no disease detectable

Partial response - shrunk by >30%
Stable -shrunk by 20%
Progressive disease - new lesions or lesions that have increased by >20%

5

Who is eligible for mammography screening for breast cancer and how often?

Women from the ages of 50 to 65, every three years

6

How many CT scans does it take to cause one cancer?

1000 - 2000 ct scans

7

For what cancer is carcinoembryonic antigen raised, and in which other conditions may it also be raised?

Colorectal carcinoma
Smokers, IBD, hepatitis, pancreatitis, gastritis

8

For what cancer is CA125 raised, and in which other conditions?

Ovarian cancer- raised in 82%
Also raised in 6% of pregnancy, endometriosis, PID
Also raised in pancreatic, lung, colorectal and breast cancer

9

In what conditions is Alpha fetoprotein raised?

First year of life
Hepatitis
Hepatic ellipse carcinoma
Yolk sac cancers

10

In what conditions is human human chorionic gonadotropin raised?

Hydatiform mole
Choriocarcinoma
Non Seminomatous testicular cancer

11

When is PSA raised?

Prostate cancer
BPH
UTI
After a DRE
prostatitis

12

In which inherited condition is a prophylactic colectomy sometimes considered?

Familial Adenomatous Polyposis

13

Which chemo drugs can be taken orally?

Cyclophosphamide
Capacitabine
Etoposide
Tamoxifen

14

Which cancer an be treated with chemotherapy administered intraperitoneally?

Ovarian cancer

15

How is chemotherapy dose usually calculated?

Body surface area using the Dubois and Dubois calculations

16

For which cancers is high dose chemo with bone marrow support an option?

Non Hodgkin's lymphoma
Hodgkin's
Acute and chronic leukaemia
Multiple myeloma
Germ cell tumours
Ewing's sarcoma

17

Which drugs are administered with chemo to prevent nausea and vomiting?

Pre med
Ondansetron 8mg IV
Dexamethasone 8mg IV

Post dose
Metoclopramide TDS 14 days
Dexamethasone 6mg PO

18

Which drugs are most at risk of causing peripheral neuropathies?

Platinums eg cisplatin, carboplatin
Vinca alkaloids eg vincristine
Taxanes eg paclitaxel, docetaxel

19

Which chemo drug may cause cerebellar toxicity?

5FU

20

Which chemo drug may cause cochlear damage resulting in permanent high tone loss?

Cisplatin

21

Which chemo drugs are nephrotoxic

Cisplatin
Isosfamide

22

Which chemo drugs pose a risk of haemorrhagic cystitis, and what is the antidote?

Cyclophosphamide
Isosfamide

Antidote is mesna

23

Which chemo drugs may cause cardiac arrythmia

Doxorubicin
Paclitaxel

24

Which chemo drug may cause coronary artery spasm?

5FU

25

Which chemo drugs may cause palmar plantar erythema?

5FU
Capacitabine
Sunitinib
Erlotinib

26

Which chemo drug may cause photo sensitivity?

5FU

27

Which chemo drug causes pigmentation changes

Bleomycin- also check for pulmonary fibrosis!

28

Which drug may cause myalgia/arthralgia

Paclitaxel

29

Which drugs may cause infertility?

Alkylating agents- cyclophosphamide, Isosfamide, melphalan, busulphan

30

What is the nadir point for myelosuppression?

10-12 days after treatment

31

Which cancers are most likely to cause bone narrow replacement by malignant infiltration, resulting in myelosuppression by pancytopenia?

Haematological
Breast
Lung
Prostate

32

How and when is anaemia treated cancer?

Hb <10 gldl
Blood transfusion
Recombinant epo if symptomatic

33

How does thrombocytopenia present in cancer, how is it treated?

Petechiae
Nosebleeds
Corneal haemorrhage

20x10*9- does not require platelets

34

When does neutropenia typically occur after chemo?

7-14 days

35

When is febrile neutropenia diagnosed?

WBC <1x10(9)
Fever greater than 38 degrees for an hour
Or fever greater than 38.5 degrees in a single reading

36

How is febrile neutropenia treated?

IV tazocin within 60 mins
Consider switch to oral within 24 hours

5% overall mortality

Mostly no identifiable aetiology

37

When does pneumonitis appear after radiotherapy, and what symptoms does it cause?

6-8 weeks after
Progressive SOB, dyspnoea

38

When do acute side effects develop during radiotherapy

During treatment
Peak during first few weeks post treatment and resolve

39

When do late side-effects develop during treatment

Develop greater than three months after radiotherapy.
May be years later
Often irreversible
Worsen over time
Include lung fibrosis, skin atrophy, infertility

40

What is the difference between intercavitary and interstitial brachytherapy

Intercavitary- placed in body such as uterus or cervix

Interstitial- placed into target such as prostate

Patient is radioactive so counsel about risk!

41

What is an example of radioisotope use in cancer treatment

Iodine 131 use in thyroid cancer
Preferentially taken up in normal or malignant thyroid tissue
Requires 4 days in lead lined room

42

Who is eligible for cervical cancer screening?

25-49 every three years
49-64 every five years
Only women because only women have cervices

43

What screening programme is used for colorectal cancer?

Faecal occult blood
Every two years
60-69

Currently being extended to 74

44

In which part of the spine does metastatic spinal cord compression most commonly occur?

2/3 thoracic
1/3 lumbar/cervical

45

What is the treatment for metastatic spinal cord compression

16mg dexamethasone
With PPI for gastric protection

8gy single fraction radiotherapy

Or refer to spine surgeons

46

What is the prognosis for metastatic spinal cord compression for patients ambulance and paraplegic prior to treatment?

Ambulant- 70% retain function
Paraplegic- 5% retain function

Overall one fifth of patients will survive greater than one year

47

What are the symptoms of superior vena cava obstruction?

Facial oedema
Prominent blood vessels
Cyanosis

48

What is the treatment for superior vena cava obstruction?

Dexamethasone 16mg
Vascular stenting followed by radiotherapy, chemo

49

What are the cardiac symptoms of hypercalcaemia?

Bradycardia
Short QT intervals
Prolonged PR interval
Wide T wave

50

How is rehydration managed in hypercalcaemia?

Rehydration with saline 1l 4 hourly for 24 hours
IV pamidronate 60-90mg over 2-4 hour

Calcitonin and corticosteroids?

51

What are the signs that someone is nearing the end of their life?

Profound weakness
Confined to bed
Disorientated
Confused
Drowsiness for extended periods
Reduced attention
Loss of attention in food and drink
Too weak to swallow

52

When is a blood transfusion indicated in cancer?

Prognosis >2 weeks

And

Symptoms of anaemia

And

Hb <8g/dl

53

In what order are muscles affected in corticosteroid induced myopathy?

Legs then arms then chest muscles

Proximal muscles are affected before distal muscles

54

What are the symptoms of metastatic spinal cord compression?

Low back pain - band like, increased in movement, coughing, or lying flat

Motor weakness

Subjective sensory disturbance

Bladder/bowel dysfunction

Increased reflexes

Clonus

55

What is the investigations for MSCC?

MRI within 24 hours

FBC, calcium, LFTs (raised all phosphate)

56

What causes superior vena cava obstruction?

Extrinsic compression, thrombosis or invasion if the wall of the vessel

Usually in lung cancer, lymphoma

57

What are the symptoms of SVCO?

Facial oedema
Prominent blood vessels
Cyanosis

58

How is SVCO managed?

Dexamethasone 16 mg

Vascular stenting - may be followed by radiotherapy, chemo

59

What cancers commonly cause hypercalcaemia?

Breast cancer
Lung cancer - NSCLC
SCC
Myeloma/lymphoma
Head and neck