Burkitt's lymphoma is associated with a mutation in which one of the following genes?
Correct Answer E:
Haematological malignancies: genetics: Below is a brief summary of the common translocations associated with haematological malignancies:
A 18-year-old man who is known to have hereditary spherocytosis is admitted to hospital with lethargy. Admission bloods show the following:
What is the most likely explanation for these findings?
Correct Answer C: This man has had an aplastic crisis secondary to parvovirus infection.
Hereditary spherocytosis: Basics:
Presentation:
Diagnosis:
Management:
A 23-year-old woman presents with lethargy. The following blood results are obtained:
What is the most likely diagnosis?
Correct Answer C: Disproportionate microcytic anaemia - think beta-thalassaemia trait.
A microcytic anaemia in a female should raise the possibility of either gastrointestinal blood loss or menorrhagia.
However, there is no history to suggest this and the microcytosis is disproportionately low for the haemoglobin level. This combined with a raised HbA2 points to a diagnosis of beta-thalassaemia trait.
Basophilic stippling is also seen in lead poisoning but would not explain the raised HbA2 levels.
Beta-thalassaemia trait The thalassaemias are a group of genetic disorders characterized by a reduced production rate of either alpha or beta chains. Beta-thalassaemia trait is an autosomal recessive condition characterized by a mild hypochromic, microcytic anaemia. It is usually asymptomatic
Features:
A patient presents as she has a strong family history of cancer.
Which one of the following cancers is least likely to be inherited?
Correct Answer C: Between 5 and 10% of all breast cancers are thought to be hereditary. Mutation in the BRCA1 and BRCA2 genes.
also increase the risk of ovarian cancer. For colorectal cancer around 5% of cases are caused by hereditary nonpolyposis.
colorectal carcinoma (HNPCC) and 1% are due to familial adenomatous polyposis. Women who have HNPCC also have a markedly increased risk for developing endometrial cancer - around 5% of endometrial cancers occur in women with this risk factor.
Cancer in the UK:
The most common causes of cancer in the UK are as follows*
The most common causes of death from cancer in the UK are as follows:
*Excludes non-melanoma skin cancer.
A 72-year-old man is diagnosed with prostate cancer and goserelin (Zoladex) is prescribed.
Which one of the following is it most important to co-prescribe for the first three weeks of treatment?
Correct Answer D: Anti-androgen treatment such as cyproterone acetate should be co-prescribed when starting gonadorelin analogues due to the risk of tumour flare. This phenomenon is secondary to initial stimulation of luteinizing hormone release by the pituitary gland resulting in increased testosterone levels.
The BNF advises starting cyproterone acetate 3 days before the gonadorelin analogue.
Prostate cancer: management:
1- Localized prostate cancer (T1/T2):
Treatment depends on life expectancy and patient choice. Options include:
2- Localized advanced prostate cancer (T3/T4):
Options include:
3- Metastatic prostate cancer disease - hormonal therapy:
Synthetic GnRH agonist:
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