Cancer

Front 1

bone cancer assoc with Gardners syndrome

Back 1

osteoma

Front 2

woven bone surrounded by osteoblasts, MC men < 25 to

Back 2

osteoid osteoma

Front 3

"double bubble" or "soap bubble" on xray, epiphyseal, spindle shaped cells w/multinucleated giant cells

Back 3

giant cell tumor (osteoclastoma)

Front 4

MC benign bone tumor
cartilaginous cap
men < 25
long metaphysis

Back 4

osteochondroma

Front 5

2nd MC primary malignant tumor of bone
peak incidence men 10-20
metaphysis
assoc with familial RB
codman's triable or sunburst pattern

Back 5

osteosarcoma

Front 6

t11;22
diaphysis
anaplastic small blue cell tumor
MC in boys < 15
"onion skin" in bones
homer wright pseudorosette

Back 6

Ewing's sarcoma

Front 7

MC in men 30-60
epansile glistening mass within medullar cavity

Back 7

chondrosarcoma

Front 8

malignant fat tumor

Back 8

liposarcoma

Front 9

assoc with tuberous sclerosis and found in the heart

Back 9

rhabdomyoma (from striated muscle)

Front 10

most common soft tissue tumor of childhood, most often in head/necl

Back 10

rhabdomyosarcoma

Front 11

MC primary brain tumor

Back 11

glioblastoma multiforme

Front 12

the brain tumor that can cross corspus callosum

Back 12

glioblastoma multiforme

Front 13

stain astrocytes for GFAP

Back 13

glioblastoma multiforme

Front 14

"pseudopalisading" pleomorphic tumors cells - border central areas of necrosis and hemorrhage in brain

Back 14

glioblastoma multiforme

Front 15

2nd MC primary brain tumor

Back 15

meningioma

Front 16

occurs in convexities of hemispheres and parasagittal region of brain

Back 16

meningioma

Front 17

arises from arachnoid cells external to brain and are resectable

Back 17

meningioma

Front 18

spindle cells concentrically arranged in whorled patterns with psammoma bodies in brain

Back 18

meningioma

Front 19

3rd MC primary brain tumor

Back 19

schwannoma

Front 20

S-100 positive and assoc with NF2

Back 20

schwannoma

Front 21

"fried egg" cells and chicken-wire capillary pattern most often seen in frontal lobes

Back 21

oligodendroglioma

Front 22

most commonly a prolactinoma

Back 22

pituitary adenoma

Front 23

can cause bitemporal hemianopsia

Back 23

pituitary adenoma

Front 24

most often found in posterior fossa of children and may be supratentorial and are GFAP positive

Back 24

pilocytic astrocytoma

Front 25

rosenthal fibers are present in brain

Back 25

pilocytic astrocytoma

Front 26

a form of primitive neuroectodermal tumor that can compress the 4th ventricle and hydrocephalus

Back 26

medulloblastoma

Front 27

homer-wright rosettes in the brain

Back 27

medulloblastoma

Front 28

rod-shaped blepharoplasts found near nucleus

Back 28

ependyoma

Front 29

associated with von Hippel Lindau syndrome when found with retinal angiomas

Back 29

hemangiomablastoma

Front 30

brain cancer that can produced EPO

Back 30

hemangioblastoma

Front 31

foamy cells and high vascularity are highly characteristic of this brain tumor

Back 31

hemangioblastoma

Front 32

can cause bitemporal hemianopsia in children and derived from remnants of rathke's pouch

Back 32

craniopharyngioma

Front 33

Inflammatory Polyneuropathy in which cancer

Back 33

Lymphoma

Front 34

Treatment of neuropathic pain

Back 34

Amytriptilin

Pregabalin

Carbemazepine

Front 35

Treatment of bone pain with hypercalcaemia

Back 35

Clodronate

Front 36

Treatment of oesophageal spasm and tenesmus secondary to cancer

Back 36

Nifedipine

Front 37

Treatment of CNS tumour and CNS compression pain

Back 37

Dexamethasone

Front 38

non-PO Analgesia with quick onset and titration

Back 38

Subcut Continuous morphine

Front 39

2 week Criteria for breast woman

Back 39

Any hard fixed discrete lump

Bloody nipple discharge

Uni eczematous change

Previous breast cancer

>30 lump for over one perios cycle

<30 lump enlarging, FHx

Front 40

2 week Criteria for breast man

Back 40

>50 unilateral discrete lump fixed

Front 41

Breast Screening

Back 41

50-70

Strong family history screen younger

Front 42

Breast Cancer Risk

Back 42

FHx

Gynaecological: Age menarche, menopause

Parity, Contraceptive, HRT

Past Medical Hx,: Breast disease, Cancers, radiation

Smoking

Front 43

Breast Dx

Back 43

Triple assessment:

Clinical Examination +Hx

Imaging <35 ultrasound, >35 Mammography

Core biopsy for histology, FNA Lymph nodes

Front 44

Staging

Back 44

MRI/CT

Front 45

Receptor Status

Back 45

Her2/PR/ER

Front 46

Mastectomy

Back 46

Multifocal

Central

Large lesion in smal breast

DCIS >4 cm

Radiotherapy - sentinal node postive

Front 47

WLE always with

Back 47

Radiotherapy

Front 48

Chemotherapy only with

Back 48

Node +ve Doxataxel

Front 49

If on Anastrazole and tamoxifene you need to do

Back 49

DEXA and give Bisphosphonates as appropriate

Front 50

Metastatic Cancer

Back 50

MDT

ER +ve - tamoxifene and anastrazole

Ovarian suppression - zoladex

Chemo- Doxarubicin

Front 51

Breast metastatic site

Back 51

Bone

Lung

Lymph node

Less common: liver brain pancreas

Front 52

Persisten bloating

Abdo pain

PV bleeding

Urinary symptoms

Unexplained bowel habit change

Back 52

Ovarian cancer

Front 53

2 week referal for ovarian cancer

Back 53

Clinical examination show ascites, pelvic or abdominal mass

Front 54

ovarian Symptom +ve Rx

Back 54

send CA125, if abnormal, send ultrasound. If abnormal or over 5cm then urgent referral

Front 55

If Ultrasound -ve

Back 55

Watch and wait for symptom change

Front 56

Ultrasound over 5cm + CA 125 normal

Back 56

wait for twelve weeks to rescan if premenopausal, if post menopausal refer straight away

Front 57

RMI threshold

Back 57

250

Front 58

Risk factors for Ovarian Cancer

Back 58

BRCA

Many ovulations

FHx

Breast, Lynch syndrome

COC protective

Front 59

Dx of Ovarian Cancer

Back 59

CT CAP

Extirpation for biopsy

Front 60

Ovarian Cancer stages

Back 60

1. Ovaries only

2. Ovary and pelvis

3. Ovary, pelvis and abdomen

4. Distant metastasis

Front 61

Ovarian Chemotherapy

Back 61

Carboplatin + Paclitaxel

Only for grade 3 or stage 2+above

Front 62

PV bleeding in a Post-menopausal woman

Back 62

Endometrial CA

Front 63

2 week referal for Endometrial

Back 63

PV Bleeding in post menopausal woman

>55 year old new PV discarge or PV discharge with thrombocytosis or haematuria

>55 yr old haematuria low HB, thrombocytosis or haematuria

Front 64

Risk Factors for Endometrial cancer

Back 64

unopposed Oestrogen:

Obesity, DM, PCOS, HRT oestrogen only

More oestrogen:

Early Menarche, Late menopause

FHx: Lynch, Breast, Ovarian

Front 65

Protective For Endometrial Cancer

Back 65

Multiparity, COC

Front 66

Dx for Endometrial Cancer

Back 66

Ultrasound 4mm for Post menopausal women not on HRT, if on 5mm.

Hysteroscopy and papelle biopsy

MRI for metastasis

Front 67

Staging of endometrial Cancer

Back 67

FIGO:

1.Uterus only - a <50% b>50% thickness

2. Uterus and Cervix

3. Uterus cervix, and peritoneum, lymph node

4. Beyond Peritoneum, i.e bladder and bowel

Front 68

Endometrial CA Rx

Back 68

Surgery: TAH and BSO

Lymph nodes for late disease

Front 69

Endometrial Radiotherapy for

Back 69

1b and above disease

Brachy vaginal vault therapy for recurrence/palliation

Front 70

Cauliflower cervix on speculum

Back 70

Cervical cancer - 2 week referal

Front 71

Cervical Screening

Back 71

25-49 / 3yrs

50-64/ 5yrs

Front 72

Refer to colposcolpy criteria

Back 72

Severe dyskaryosis

Moderate dyskaryosis

Mild dyskaryosis HPV 16/18/33 +ve

3 inadequate result

Front 73

Risk factors

Back 73

HPV 16/18

Not had vaccine

COC

Smoking

Early Debut

Lots of Sex

Front 74

Dx of Cervical Cancer

Back 74

PV, PR, Speculum, Cystoscopy

Punch biopsy, small loop biopsy

MRI abdo pelvis

Front 75

Staging Cervical Cancer

Back 75

1. Cervix a microscopic b macroscopic :1. <4cm, 2. > 4cm

2. Not to pelvic wall but other structures

3. Pelvic Wall (muscles and ligaments)

4. Bladder/ Bowel

Front 76

Cervical Cancer RX

Back 76

1a.Cone excision

1b.Hysterectomy and lymph nodes

2 and above. radiotherapy+ platin based Chemo

Front 77

Random high PSA

Back 77

Prostate cancer

Front 78

Zones for Prostate cancer

Back 78

70% in Peripheral zone

5% in Central Zone

Front 79

Referral Criteria for Prastate

Back 79

Raised PSA without obvious cause (ruled out secondary cause)

or

Abnormal DRE

Front 80

Action on Raised PSA

Back 80

Rule out secondary cause and repeat PSA 4-6 weeks

Front 81

When to offer PSA and/or DRE

Back 81

Erectile dysfunction

LUTS

Visible haematuria

Front 82

Risk Factors for Prostate

Back 82

Black

Old

Front 83

Dx for Prostate

Back 83

PSA, Transrectal ultrasound guided biopsy (12 samples), MRI/CT, Bone scan

Front 84

Screening Study

NNS, NNT

Back 84

NNS- 1410

NNT- 48

Front 85

Glaeson Score

Back 85

Most prevalent grade+ second most prevalent grade

1 good, 5 bad

a+b=max of ten

Front 86

Staging

Back 86

T1 DRE + Imaging -ve

T2 Confined to prostate a- half of one lobe b- up to one lobe c- both lobes

T3-T4 local - beyond

Front 87

High risk

Back 87

PSA > 20 or

Gleason 8-10 or

T3-4

Front 88

Intermediate risk

Back 88

PSA 10-20 or

Gleason 7 or

T2b-c

Front 89

Low risk

Back 89

PSA<10 and

Gleason 6 and

T1-2a

Front 90

Localised disease def

Back 90

T1-T2

or clear borders

Front 91

Local Disease Rx

Back 91

Watch and Wait

Active Surveillance

Surgery/External beam/Brachy Therapy

HIFU

Front 92

Watch and Wait for Prostate Cancer

Back 92

Leave and come back when symptoms appear, then repeat PSA

Front 93

Active Surveillance

Back 93

Annual Template biopsy Transperoneal

Annual DRE, PSA