Oncology causes

Question 1

Nulliparity is a risk factor for

Answer 1

• Endometrial cancer
• Breast cancer
• Ovarian cancer

Question 2

Late menopause is a risk factor for

Answer 2

• Ovarian cancer
• Endometrial cancer
• Breast cancer

Question 3

Risk factors for endometrial cancer

Answer 3

• Obesity
• Nulliparity
• Early menarche
• Late menopause
• Unopposed oestrogen. The addition of a progestogen to oestrogen reduces this risk (e.g. In HRT). The BNF states that the additional risk is eliminated if a progestogen is given continuously
• Diabetes mellitus
• Tamoxifen
• Polycystic ovarian syndrome
• Hereditary non-polyposis colorectal carcinoma

Question 4

Risk factors for cervical cancer

Answer 4

• Human papillomavirus (HPV), particularly serotypes 16,18 & 33 is by far the most important factor in the development of cervical cancer.

Other risk factors include:

• smoking,
• human immunodeficiency virus,
• early first intercourse,
• many sexual partners,
• high parity,
• lower socioeconomic status,
• combined oral contraceptive pill

Question 5

Most common tumours causing bone metastases

Answer 5

• Prostate
• Breast
• Lung

Question 6

Most common site for bone metastases

Answer 6

• Spine
• Pelvis
• Ribs
• Skull
• Long bones

Question 7

Causes of superior vena cava obstruction

Answer 7

• Common malignancies: non-small cell lung cancer, lymphoma
• Other malignancies: metastatic seminoma, Kaposi’s sarcoma, breast cancer
• Aortic aneurysm
• Mediastinal fibrosis
• Goitre
• SVC thrombosis

Link

Question 8

Malignancies associated with pericardial metastases

Answer 8

• Lung cancer
• Breast cancer
• NHL

Question 9

Most common primary tumors that metastasize to the brain

Answer 9

• Lung cancer
• Melanoma
• Renal-cell carcinoma
• Breast cancer

Question 10

Causes of elevated PSA

Answer 10

Transient PSA elevation:

• Urine retention,
• Mild acute prostate infection/inflammation,
• Urologic procedure (eg, cystoscopy),
• Digital rectal examination,
• Recent ejaculation

Persistent PSA elevation:

• Benign prostatic hyperplasia,
• Prostate cancer,
• Severe or chronic prostatitis

Question 11

Commonest tumors causing spinal cord compression from bone metastases

Answer 11

• Lung
• Breast
• Prostate
• Renal
• thyroid
• Lymphoma

Question 12

Cancers commonly associated with high Ca2+

Answer 12

• Squamous cell (lung, head and neck, etc.)
• Breast
• Lung
• Renal
• Multiple Myeloma

Question 13

Causes of different radiographic presentations of metastatic tumors to bone

Answer 13

Predominantly osteoblastic:

• Prostate,
• Carcinoid,
• Small cell lung cancer,
• Hodgkin lymphoma,
• Medulloblastoma,
• POEMS syndrome

Predominantly osteolytic:

• Renal cell cancer,
• Melanoma,
• Multiple myeloma,
• Non-small cell lung cancer,
• Thyroid cancer,
• Non-Hodgkin lymphoma,
• Langerhans cell histiocytosis

Mixed osteoblastic and osteolytic:

• Breast cancer,
• Gastrointestinal cancers,
• Squamous cancers at most primary sites

Question 14

Most common primary tumors of malignant effusions

Answer 14

• Lung
• Breast
• Lymphoma
• Unknown primary
• GU tract
• GI tract