Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 1: Fundamentals of Medicine
07 Oncology MCQs
Davidson's Medicine - Part 1: Fundamentals of Medicine · Davidson's Principles of Medicine · 13 practice questions
- Oncological emergencies
- Tumour markers
- Breast cancer
- Acute oncology
- Immunotherapy
- Treatment toxicities
- Paraneoplastic syndromes
- Imaging
1. A patient with a pelvic mass has CA-125 of 800; another with cirrhosis and chronic hepatitis B has a raised alpha-fetoprotein; a third has a seminoma. Which statements about markers are correct?
- ACA-125 is raised only in ovarian cancer
- BAFP is raised only in pregnancy
- CCA-125 is specific for ovarian cancer, AFP for colon cancer and PLAP for teratoma
- DCA-125 is also raised in ascites, effusion and heart failure, AFP in hepatocellular carcinoma and non-seminomatous germ cell tumours, and PLAP in seminoma
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D. CA-125 is also raised in ascites, effusion and heart failure, AFP in hepatocellular carcinoma and non-seminomatous germ cell tumours, and PLAP in seminoma CA-125 is raised in about 75% of ovarian epithelial cancers but is non-specific; AFP is raised in HCC and non-seminomatous germ cell tumours; PLAP in seminoma.
2. A 58-year-old woman on chemotherapy for ovarian cancer has a temperature of 38.6 C for over an hour, heart rate 118 and a neutrophil count of 0.3 x 10^9/L, but looks well. Another patient after chemotherapy has a count of 0.8 with a temperature of 38.4 C and expected nadir of 0.4 within 48 hours. Which statements are correct?
- ANeither needs urgent antibiotics
- BOnly the first meets the definition
- COnly the second meets the definition
- DBoth meet the definition of neutropenic fever and need immediate empirical broad-spectrum intravenous antibiotics
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D. Both meet the definition of neutropenic fever and need immediate empirical broad-spectrum intravenous antibiotics Neutropenic fever is a single temperature of 38.3 C or 38 C sustained over an hour with neutrophils below 0.5, or below 1.0 if expected to fall below 0.5 in 48 hours; treatment is immediate.
3. A woman has ER-positive, HER2-negative bone-only metastases and performance status 0; another has HER2-amplified breast cancer treated with a humanised antibody. Which treatments and shared risk apply?
- AAn aromatase inhibitor with a CDK4/6 inhibitor, and trastuzumab, with cardiomyopathy a shared risk with anthracyclines
- BRadiotherapy, and bevacizumab, with neutropenia
- CTrastuzumab, and aromatase inhibitor, with osteoporosis
- DChemotherapy, and tamoxifen, with hypertension
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A. An aromatase inhibitor with a CDK4/6 inhibitor, and trastuzumab, with cardiomyopathy a shared risk with anthracyclines Hormonal therapy plus CDK4/6 targeted therapy is first-line in ER-positive HER2-negative bone-only disease; trastuzumab is a humanised monoclonal antibody to HER2; HER2 inhibitors and anthracyclines cause cardiomyopathy.
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