Weekly Quiz

Every week a short quiz with 3- 10 questions on Oncology. Click on the “here” below each one for full illustrated answers, and then on red highlighted text for futher information from linking websites. Looking forward to your input too.

Week 31: Rectal Cancer

1. If you are a colo-rectal surgeon, how are you going to treat a rectal tumour?

2. If you are an Oncologist how are you going to treat the same disease?

3. What are the long term sequelae of such treatment?

Answers now available….

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Week 30: Myeloma

1. How would you describe this x-ray? What is the text book term?

2. How would you investigate a patient you are suspicious may have multiple myeloma?

3. What abnormal blood results would you expect?

Answers here.

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Week 29: Brain lesion – benign or malignant?

1. Describe this MRI image.

2. What could be the differential diagnosis?

3. If this is a tumour arising from the meninges, which hereditary condition is it more common in?

Answers here…

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Week 28: Sarcoma

1. In what age groups are osteosarcomas most prevalent?

2. What are the risk factors for developing a sarcoma?

3. Where do leiomyosarcomas most frequently present?

Answers here…

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Week 28: Cervical cancer

1. From what age and how frequently should women be screened for cervical cancer in the UK?

2. If diagnosed early the disease is still curable – how is it cured?

3. If the disease is advanced, what treatment is possible?

Answers here…

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Week 27: Gastric Cancer

1. Which country in the world has the greatest incidence and hence experience in gastric cancer?

2. What are the risk factors for this tumour?

3. How would you investigate a patient with weight loss and early satiety?

Answers here…

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Week 26: Evidence

Levels of Evidence

Oncology, and indeed medicine as a whole, tries to be evidence based. This diagram illustrates the different types of evidence and the weight or credit that can be given to each, in terms of changing practice.

1. What is a randomised controlled trial?
2. What is a systematic review?
3. What is a p value?

Answers here...

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Week 25: Prostate Cancer:

1. What is the upper limit of normal for PSA?

2. What benign factors can cause a PSA to be elevated?

3. Surgery, radiotherapy, brachytherapy and HIFU are all possible radical treatments for prostate cancer. What do you know about brachytherapy and HIFU?

Answers here!

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Week 24: Renal Cancer

1. What is the commonest pathology of renal cell cancers?

2. Do you have to do a total nephrectomy, if the disease is localised?

3. How does SUNITINIB work – the targeted agent licenced for advanced renal call cancer?

Click here for answers.

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Week 23 : Testicular Cancer

1. What are the 2 commonest pathological types of testicular cancer?

2. Which tumour markers are used to monitor disease progress / response to chemotherapy?

3. If metastatic, is the disease still curable? if so in what proportion of patients?

Click here for answers.

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Week 22: Mesothelioma

1. Is the incidence of this disease increasing or decreasing in the UK? Why?

2. Which fibre, exactly, is causative?

3. What are the treatment options?

Click here for answers!

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Week 21: Brain Tumours : Gliomas

1. What is the commonest glioma?
2. What is Temozolamide?
3. What benefit does it bring to glioma patients?

Answers here .

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Week 20: Hormones and Cancer

1. Is the oral contraceptive Pill associated with Cancer?
2. Is hormone replacement therapy (HRT) associated with cancer?
3. Is testosterone associated with any cancers? If so, which?

Answers here!

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Week 19: Colorectal cancer

The Colon

The Colon

1. In which part of the colon do cancers most commonly occur?
2. What does Duke’s B staging mean?
3. After surgery, is chemotherapy useful? If so, in which patients? Which chemotherapy would you use?

Click here for the answers.

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Week 18: Breast Cancer

Breast cancer ribbon

Breast cancer ribbon

1. Between what ages is mammography recommended in the UK?
2. Which two pathological types make up the majority of breast cancer?
3. Are all women treated with chemotherapy? If not, why not?
4. Are all women treated with radiotherapy? If not, why not?

Answers here!

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Week 17: The financial costs of health care – we should have some idea.

1. How much does one course of chemotherapy for lung cancer cost?
2. How much does one fraction of radiotherapy cost?
3. How much does simvastatin cost?
4. How much does a day and night in hopsital cost?

Click here for answers.

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Week 16: Bladder Cancer:

1. Name 2 causative factors for bladder cancer?
2. How does bladder cancer frequently present?
3. If the cancer invades the bladder muscle wall, how does this change management as opposed to non invasive cancer?
4. What is the median survival for patients with muscle invasive, but non metastatic, bladder cancer?

Click here for the answers.

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Week 15: Radiotherapy treatment toxicities:

1. How are early and late side effects of radiotherapy defined?
2. What early and late side effects would you warn a patient of who is receiving radiotherapy to the head and neck region?
3. What early and late side effects would you warn a patient of who is receiving radiotherapy for a meningioma?

Click here for answers

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Week 14: Targeted cancer therapies

1. Give an example of a tyrosine kinase inhibitor? For what tumour type is it indicated in the UK?
2. Give an example of a vascular endothelial growth factor inhibitor (VEFGF) ? For what tumours are these licensed in the UK?
3. Give an example of a monoclonal antibody that is used to treat cancer? Which type of cancer does it treat?

Click here for the answers

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Week 13: Cancer and Viruses:

1. Which cancers are associated with HPV infection?

The HPV Virus

2. Which cancers are associated with HTLV virus?
3. Which cancer is associated with EBV virus?
4. How do viruses cause cancer?

Click here for the answers

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Week 11:Skin cancers

1. What types of malignant melanoma exist?

2. What is Breslow’s depth?
3. What does Clark’s Level refer to?

Click here for the answers

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Week 10: Bowel obstruction….

1. Which types of cancer may lead to malignant bowel obstruction?

Large bowel obstruction

2. By what mechanisms could the obstruction occur?
3. How would you treat the obstruction?

Click here for the answers

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Week 9: Lung cancer …

1. What types of NSCLC are there?
2. Are paraneoplastic syndromes more frequently associated with NSCLC or small cell lung cancer?
3.What is the benefit of giving prophylactic cranial radiotherapy in small cell lung cancer?

Click here for the answers

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Week 8: Investigating cancer..

1. What is a PET Scan?

Normal PET scan

2. What is a Bone scan? Which isotope is used?
3. What is an MIBG scan? When would you use one?

Click here for the answers

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Week 7: Oncology Emergencies…

1. How do you manage spinal cord compression?

Spinal Cord Compression

2. How do you manage malignant hypercalcaemia?
3. How do you manage malignant pericardial tamponade?

Gross cardiomegaly from pericardial effusion

Click here for the answers

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Week 6: General quiz:

1. Name 5 markers of cancer that can be found on a blood test?
2. Between which ages is screening for breast cancer recommended in the UK?
3. If a previously fit 52 year old patient has a PSA of 14, what would you recommend as the next step in investigations?

Click here for the answers

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Week 5: General Quiz:

1. Name a benign brain tumour.
2. Name a familial syndrome associated with cancer.
3. What are the BRCA genes and with which cancers are they associated?

Click here for the answers

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Week 4: General Quiz:

1.Which malignancies are AIDS defining?
2. How do you treat neutropenic sepsis?
3. Which cancer is asbestos associated with?

Click here for the answers

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Week 3: General Quiz:

1. What is Maggie’s Centre?

Maggie's Centre Dundee

2. Are PET scans used in Oncology? If so, when and why?
3. Which cancers are driven by hormones? Which hormones are involved?
4. If someone is opiate toxic, what should you do?
5. What is the difference between Medical Oncology and Clinical Oncology?

Click here for the answers

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Week 2: General Quiz:

1) What is a carcinogen? Name 5.
2) What is the analgaesic ladder?
3) How are cancers staged?
4) Which chemotherapy agents cause alopecia?
5) what is p53?

Click here for the answers.

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Week 1:General Quiz:

1) What is the commonest cancer in men?
2) Who discovered x-rays and is the father of Radiotherapy? What else do you know about him?
3) Name the commonest chemotherapy drug used today?
4) What is the commonest cancer in women?
5) Can viruses cause cancer?
6) Which treatment cures more cancers – surgery, radiotherapy or chemotherapy?
7) What is “Performance Status”?
8) In what unit is radiotherapy prescribed?
9) Can chemotherapy be given as a tablet?
10) Which ward in Ninewells is the Oncology Unit?

Click here for the answers

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Responses

  1. Next week I need some feedback to keep me going here. Answers on a postcard please!

  2. Ok, the quizz is getting in to its stride now. I think 5 questions are perhaps too many for you – certainly ten are. So this week it is down to three.

    Come on – I want some answers. No excuses now.

  3. Week 4:
    1. Kaposi’s sarcoma
    2. IV antibiotics: tazocin+gentamicin (+Teicoplanin if prev MRSA/catheter infection/low systolic BP) (+ clarithromycin if respiratory origin)
    3. Mesothelioma. Not much! Poor prognosis? Asbestos particles ingested by macrophages but not broken down -> chronic inflammation -> cancer.

    Hmm, I had to Google for most of that (especially 2!)

  4. Excellent. Along the right lines – any other suggestions? Full answers will be posted next week.

  5. A comment:The Power of Conversation
    Battling cancer is like no other experience. It can be difficult to go through it alone. Friends and family are usually there to help, but they just don’t seem to understand what you’re going through, and how could they? You don’t blame them, but you’d like to reach out to others who are going through the same thing, or those who have overcome cancer.

    Communicating with other cancer patients and survivors is crucial when you are going through treatment, or after your cancer has gone into remission. Even if you have survived cancer, the experience can continue to remain in your mind, and talking about it will boost your esteem. If you are a cancer survivor, you can help others who are going through something that you conquered. You can be an uplifting friend to someone who wants to know that there is a light at the end of the tunnel. Positive encouragement is imperative when battling cancer. It seems to have a positive effect on the patient’s outlook, and may play a role in decreasing cancer, as well.

    If you have mesothelioma, you are not alone. According to the American Cancer Society, about 120,000 people will develop mesothelioma each year. There are many resources to turn to if you want to talk about your experiences in dealing with mesothelioma, or any other type of cancer. Communicating with others who have experienced what you’re going through can be the best thing you’ve done to treat cancer. Cancer not only decreases physical health, but it also weighs heavily on your mental and emotional wellbeing. Depression is a side effect of cancer, and talking about your feelings and the difficulty you’re facing will brighten up your spirits. Try to see humor in any situation possible, and this will positively affect your overall health.

    The mesothelioma life expectancy varies depending on age, gender, and other variables, such as smoking. Quitting smoking is very important if you want to lower your risk for developing cancer, or increase your chance for survival. “Smokers are 90% more likely to develop lung cancer after asbestos exposure.”* There are support groups that you can join either online, or in a facility, that can help you quit smoking. If you are interested in joining a group of people to share your thoughts, join a forum, or go to group counseling sessions at a local mental health clinic.
    By: David Haas


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