lab topics

• What is the mortality rate in neutropenia?

  10%
• What are the late effects of brain irradiation?

  • Cerebral somnolence
  • Decreased cognitive function
  • Radiation necrosis
  • Hearing loss
• Which tumors are treated with brachytherapy?

  • Prostate
  • Breast
  • Cervix
  • ENT
  • Skin cancer
• What is the most fearful effect of chemotherapy?

  Leukopenia
• When does leukopenia typically appear after chemotherapy?

  7 - 14 days
• What type of microbes can cause neutropenia?

  Gram +/-, fungi, rare anaerobic microbes
• What are the contraindications for chemotherapy?

  • Infection
  • Neutropenia
  • Thrombocytopenia
  • Severe clinical damage
  • Pregnancy
  • Terminal illness
  • Major surgery in last 2 weeks
  • Difficult patient
  • Psychological problems
• What history and clinical data are important for neutropenia?

  • History of chemotherapy
  • Clinical manifestation: fever
  • Signs of infection location: lungs, pharynx, urinary tract, cutaneous, intestinal, CNS
• What characterizes high-risk patients in neutropenia?

  • Hemodynamically unstable
  • Altered general condition
  • Associated with other diseases
  • Organ failure
  • Persistent fever
  • Septicemia
  • ATB treatment
  • Supportive treatment ICU
  • Difficult recovery mortality
• What characterizes low-risk patients in neutropenia?

  • Clinically stable
  • Absence of organ failure
  • No associated disease
  • Absence of pneumonia & severe catheter-associated infection
  • Can be treated with oral ATB
  • Fever disappears within 48h
  • Can be treated as outpatient
• When is the right time to start palliative care for a cancer patient?

  At any stage of cancer treatment
• Who benefits from palliative care?

  Cancer patients with complex needs
• What factors necessitate dose adjustments in cytostatic treatment?

  Obesity, malignant effusion, elderly status
• When should dose adjustments be made after treatment cycles?

  After febrile neutropenia, CBC, and biochemistry
• Why are well-oxygenated tumors more sensitive to radiation?

  Oxygen enhances radiation therapy effectiveness
• What are the steps in the therapeutic strategy in oncology?

  1. Suspicion of cancer (clinical/paraclinical)
  2. Confirmation of cancer (pathology)
  3. Pretherapeutic evaluation (staging, grading, performance status)
  4. Therapeutic decision
  5. Actual treatment
  6. Follow up
• What is the tumor marker CA 125 associated with?

  Ovarian cancer, 80% sensitivity
• In which conditions can CA 125 levels be elevated?

  Menstruation, pregnancy, endometriosis
• What is the primary use of CA 125 in clinical practice?

  Monitoring and recurrence detection
• What does CA 15-3 indicate?

  Breast cancer marker
• What does CA 19-9 indicate?

  Pancreatic, colorectal, and gastric cancers
• What is the use of CEA in clinical practice?

  Differentiation between benign and malignant tumors
• What conditions can cause elevated CEA levels?

  Cirrhosis, IBD, chronic lung disease
• What is the primary use of PSA as a tumor marker?

  Screening, diagnosis, and monitoring of prostate cancer
• What can cause elevated PSA levels besides cancer?

  Prostatitis and benign prostate hypertrophy
• What does Beta-HCG indicate?

  Testicular cancer marker
• What does AFP indicate?

  Testicular and liver cancer marker
• What is the primary use of LDH as a tumor marker?

  Monitoring testicular cancer and lymphoma
• What does B2-microglobulin indicate?

  Multiple myeloma and lymphoma
• What are calcitonin and thyroglobulin used for?

  Thyroid cancer markers
• What are the specific cell surface antigens identified by immunohistochemistry?

  • ER, PR, Her2 = breast cancer
  • CD 117 = GIST
  • CD3, CD20, CD45 = lymphoma
  • S100 = malignant melanoma
  • EGFR = colorectal cancer
• What does FISH detect in cancer diagnostics?

  Chromosomal abnormalities and Her2 overexpression
• What does the ECOG performance scale measure?

  • 0 = asymptomatic
  • 1 = symptomatic but fully ambulant
  • 2 = symptomatic, ambulant >50%
  • 3 = symptomatic, confined to bed >50%
  • 4 = symptomatic, bedfast
  • 5 = dead
• What are the general symptoms of paraneoplastic syndrome?

  • Fever from pyrogenic cytokines
  • Weight loss/cachexia
  • Asthenia
  • Hypercalcemia of malignancy
• What is the most important paraneoplastic hematologic syndrome?

  Anemia due to decreased erythropoietin
• What is the treatment for anemia in paraneoplastic syndrome?

  Erythropoietin replacement therapy
• What is adjuvant treatment?

  Treatment after primary tumor removal
• What is neoadjuvant treatment?

  Treatment before surgery to downsize tumors
• What are the goals of radiotherapy?

  • Curative
  • Prophylactic
  • Control
  • Palliative
• What is the unit of measurement for radiation dose?

  Gray (Gy)