• Archive for May, 2013

    Laryngeal Cancer

    by  • 28/05/2013 • Oncology

    Paraneoplastic syndromes and hormone producing cancers:  When cancers release biologically active substances which cause ‘additional’ diseases these are termed paraneoplastic syndromes.  Most common are: o Tumour-induced hypercalcaemia o SIADH o Cushing’s syndrome from ectopic ACTH release o Hypoglycaemia associated to the production of insulin-like growth factor (IGF-1)  Pathogenesis: o Not really...

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    Granulomatous lung diseases

    by  • 28/05/2013 • Respiratory

    Granulomatous lung diseases Definition  A granuloma is a mass or nodule composed of chronically inflamed tissue formed by the response of the mono-nuclear phagocyte system to a slowly soluble antigen or irritant.  The macrophage walls off the pathogen by chronic inflammation = granuloma  Characterised by epithelioid multinucleate giant cells.  

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    Endometrial Cancer

    by  • 28/05/2013 • Gynecologic Cancer

       95% of uterine cancers  Median age = 60  RFs: exposure to unopposed oestrogens, plus HPNCC mutations (MLH1, MSH2) give 40-60% chance of endometrial cancer  Prevention: chemoprevention = oral contraceptives decrease risk  P/c: abnormal bleeding, intermenstrual or menorrhagia, post-menopausal bleeding.  Pathology: o 80% adenocarcinoma and most treatable. o...

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    Uterine Cancer

    by  • 28/05/2013 • Gynecologic Cancer

       95% are endometrial cancers  Mainly caused by unopposed oestrogen.    Endometrial hyperplasia caused by prolonged unopposed oestrogenic stimulation  Classification: o Hyperplasia with cytological atypia = increased nuclear / cytoplasmic ratio, hyperchromasia and loss of cell polarity. o 20% will progress to adenocarcinoma o Hyperplasia without cytological atypia = benign...

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    Cervical Intraepithelial Neoplasia (CIN)

    by  • 28/05/2013 • Gynecologic Cancer

       RF: HPV 16 and 18, lower socioeconomic status, multiple sexual partners.  P/c: post-coital bleeding in younger female (median age 52), later = menorrhagia, flank/leg pain.  Prevention and diagnosis: regular pap smears (reduces womans risk of death by CIN by 90%)  Pathology: 10 75-80% = squamous cell carcinoma 11 20-25%...

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    Ovarian Cancer

    by  • 28/05/2013 • Gynecologic Cancer

      o 90% epithelial o Other common = Papillary serous cystadenocarcinoma and adenocarcinoma. o OC linked to BRCA1 and 2 genes, HRT and high oestrogen status (ie early menarche & late menopause) are at increased risk. o Few early clinical signs – p/c abdominal distension, ascites, bladder/bowel disturbances, bloating, backpain, fatigue, incontinence, retention. o...

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    Prostate Cancer

    by  • 27/05/2013 • Oncology

       Most common malignancy in men – and may soon be the most frequent cause of cancer death in men.  Many have metastatic disease at time of diagnosis  Prostate cancer is highly sensitive to androgen ablation  The incidence rises exponentially with age.  PSA screening is controversial as it can...

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    Breast Cancer

    by  • 27/05/2013 • Oncology

       2nd most common cancer (1st?!) in women  24,000 women diagnosed/yr/UK. 15,000 dying/yr/UK  By 80yo – lifetime risk of BC is 1:9  Aetiology: o Oestrogen exposure: particularly unopposed oes (no progesterone), so early menarche, late menopause, and nulliparity o Family and personal history: 10% of BC is genetically determined by...

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    Pancreatic Cancer

    by  • 27/05/2013 • Oncology

       Major source of mortality in developed world.  Incidence is 9/100,000 and rising  More common in men of African Caribbean descent.  RFs: smoking, high meat/fat diet, old age  Histopathology: most primary malignant tumours of pancreas are adenocarcinoma.  60% located in head of pancreas (p/c = obstructive jaundice), 25%...

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    Gastric Cancer

    by  • 27/05/2013 • Oncology

       Incidence is decreasing, higher in males than females  Pathophysiology: o RFs include atrophic gastritis, previous surgery for PU disease. Role of H. pylori is controversial. There is a proven association between H.pylori and gastric lymphoma (MALToma), but the relationship with adenocarcinoma is less clear. o Dietary RFs: smoked food, salt, pickled...

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