Which one of the following is not a risk factor for the development of bladder cancer?
Correct Answer C: Schistosomiasis rather than Strongyloides infection is associated with an increased risk of bladder cancer.
Bladder cancer: risk factors:
The following factors are associated with the development of bladder cancer:
A 17-year-old man is investigated after he bled excessively following a tooth extraction. The following results are obtained:
Which clotting factor is he most likely to be deficient in?
Correct Answer C: This man is most likely to have haemophilia A, which accounts for 90% of cases of haemophilia.
Haemophilia:
Haemophilia is a X-linked recessive disorder of coagulation. Up to 30% of patients have no family history of the condition. Haemophilia A is due to a deficiency of factor VIII whilst in haemophilia B (Christmas disease) there is a lack of factor IX.
Features:
Blood tests:
Up to 10-15% of patients with haemophilia A develop antibodies to factor VIII treatment.
A 48-year-old female who has just completed a course of chemotherapy complains of difficulty using her hands associated with 'pins and needles'. She has also experienced urinary hesitancy.
Which cytotoxic drug is most likely to be responsible?
Correct Answer D: Vincristine - peripheral neuropathy.
Vincristine is associated with peripheral neuropathy. Urinary hesitancy may develop secondary to bladder atony.
Cytotoxic agents:
The table below summarizes the mechanism of action and major adverse effects of commonly used cytotoxic agents:
A 67-year-old woman is diagnosed with multiple myeloma.
Which one of the following complications is she most likely to develop as a result of her primary diagnosis?
Correct Answer E: This is a difficult question as all of the above may be seen with myeloma. However, up to 60% of patients will develop a pathological fracture.
Myeloma: features: Multiple myeloma is a neoplasm of the bone marrow plasma cells. The peak incidence is patients aged 60-70 years.
Clinical features:
Diagnosis is based on:
Hypercalcaemia in myeloma:
Which electrolyte disturbance is cisplatin most associated with?
Correct Answer C: Cisplatin is associated with hypomagnesaemia.
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