EMQs in Clinical Medicine.pdf - Peshawar Medical College

Adverse effects of chemotherapy – answers 67
D
A 34-year-old man is referred to radiotherapy with seminoma.
-hCG is also raised in choriocarcinoma. Unlike teratoma, AFP is not
raised in seminoma.
26 Risk factors for malignancy
Answers: K A H C J
K
A
H
C
J
Previous exposure to aniline dyes.
Contact with aniline dyes is associated with bladder cancer.
Epstein–Barr virus infection in a native African.
Epstein–Barr virus infection is a risk factor for Burkitt’s lymphoma, posttransplant
lymphoma and HIV-associated lymphoma.
Coeliac disease.
There is an increased incidence of T-cell lymphoma and adenocarcinoma
of the small bowel.
Pernicious anaemia.
Pernicious anaemia is associated with later gastric carcinoma.
Unprotected sexual intercourse with several sexual partners.
Transmission of human papilloma virus is believed to be relevant in the
association of cervical cancer with unprotected sexual intercourse with
many partners.
27 Adverse effects of chemotherapy
Answers: M A J E G
M
A
A 66-year-old woman treated with an alkylating agent for myeloma
presents with severe haematuria.
Haemorrhagic cystitis is caused by toxic metabolites of cyclophosphamide,
e.g. acrolein. Mesna is a uroprotective agent that can be given
orally or by intravenous injection to react specifically with this metabolite
in the urinary tract and prevent toxicity.
A 34-year-old woman treated with a microtubular inhibitor for
carcinoma of the breast develops a peripheral neuropathy.
Microtubular inhibitors include the vinca alkaloids, e.g. vinblastine,
vincristine, and the taxanes, e.g. paclitaxel, docetaxel. Tubulin is a
protein that is essential for formation of the spindle that separates the
chromosomes during mitosis.
Neurotoxicity occurs as a result of involvement of microtubules concerned
with neuronal growth and axonal transport.