Cancer Exercise Specialist Exam – Flashcards
Unlock all answers in this set
Unlock answersquestion
diseases characterized by abnormal regulation of cell growth and reproduction
answer
cancer
question
What are the two main phases of normal somatic cell division?
answer
duplication, segregation
question
What is the major target pathway of human cancer-causing mutations?
answer
retinoblastoma protein
question
What are 5 hypotheses for cell growth regulation?
answer
RB pathway, presence of growth factors, ratio of cell surface area to cell volume, contact inhibition, cell growth inhibition
question
process by which normal cells become cancerous; it occurs over two phases of initiation and promotion
answer
carcinogenesis
question
idea that a carcinogen from environment or genetic, will initiate an attack on a gene in a cell, causing the cell to mutate. If a second attack (multiple hit) occur from a carcinogen and it knocks out the second gene (mutates), then that cell will become cancerous Once both gene sets are knocked out and the cell is cancerous, promotion occurs as part of uncontrolled cell growth
answer
multiple hit theory
question
gene that has the potential to cause cancer; when mutated they ignore signals that stop cell growth and accelerate tumor development
answer
oncogene
question
gene that protects a cell from one step on the path to cancer; code for proteins which have a dampening ore repressive effect on the regulation of cell cycle and/or promote apoptosis or programmed cell death
answer
tumor-suppressor gene
question
What are 3 common oncogenes?
answer
HER2, Ras, Myc
question
What are 5 examples of tumor-suppressor genes?
answer
RB, p16, p53, BRCA1/2
question
What are 4 characteristics of cancer cells?
answer
lack appropriate responses to signals which control growth, loss of cell differentiation, decreased drug sensitivity, metastasis
question
system used to classify cancer cells in terms of how abnormal they look under a microscope and how quickly the tumor is likely to grow and spread
answer
tumor grade
question
In which tumor grade do tumors resemble normal cells and grow and multiply slowly? Which do they resemble undifferentiated cells and grow rapidly and spread quickly?
answer
G1, G4
question
How does cancer staging differ from tumor grades?
answer
Staging refers to the extent or severity of the cancer using the TNM system
question
What does TNM stand for?
answer
tumor, number of nodes, metastasis
question
List the Stages of cancer according to TNM staging criteria?
answer
Stage 1: mass limited to organ of origin Stage 2: local spread into surrounding tissues Stage 3: extensive lesions with fixation to deeper structures and lymph node invasion Stage 4: distant metastases
question
How are leukemias staged?
answer
age, WBC at presentation, presence or absence of CNS involvement
question
How are lymphomas staged?
answer
international prognostic index based on age, stage of lymphoma, presence in organs outside lymph system, performance status, LDH level
question
solid tumors that originate in epithelial cells such as lungs, breast, kidney, esophagus, stomach, uterus, and intestinal tract (85-90% of all cancers)
answer
carcinoma
question
solid tumors that originate in connective tissue such as bone, muscle, cartilage, and vascular (less than 2% of all cancers)
answer
sarcoma
question
cancers that result from abnormal white blood cell production in the bone marrow (2% of all cancers)
answer
leukemia
question
arise from the lymphatic system (5% of all cancers)
answer
lymphoma
question
cancers that begin in the tissues of the brain and spinal cord
answer
CNS cancers
question
What are the 4 major risk factors for cancer?
answer
Unstable growth control systems, genetics, diminished defense systems, environmental carcinogenic stressors
question
cancer treatment that works in prevention by removing the organ or growth that could be malignant, in diagnosis using biopsy tissue for histological examination, and treatment to remove the cancerous tumor cells and reduce the bulk of the disease
answer
surgery
question
cancer treatment that works as an administered form of photons or charged particles that damage or destroy malignant cancer cells; kills all cells; most beneficial for stage III & IV
answer
radiation
question
administration of antitumor drugs that destroy malignant tumor cells by altering the phases of cell life cycle and preventing cell growth
answer
chemotherapy
question
chemotherapies that directly damage DNA to prevent cancer cells from reproducing; can cause leukemia later in life due to damage done to bone marrow
answer
alkylating agents
question
What are 3 examples of alkylating agents?
answer
cytoxan, temodara, platinum drugs
question
type of chemo that interfere with DNA and RNA growth by substituting themselves in its place
answer
antimetabolites
question
What are 4 examples of antimetabolites?
answer
5-FU, xeolda, floxuridine, gemzar
question
type of chemo that interfere with enzymes involved in DNA replication; major cardiotoxicities seen with these drugs
answer
anthracyclines
question
What are 2 examples of anthracyclines?
answer
doxorubicin, daunorubicin
question
type of chemo that is a plant alkaloids or other compounds that stop mitosis or inhibit enzymes needed for protein synthesis; can cause neuropathy
answer
mitotic inhibitors
question
What are 4 common mitotic inhibitors?
answer
taxol, taxotere, velban, oncovin
question
What are 5 factors to consider when determining type of treatment for cancer patients?
answer
tumor grade, TNM class, cancer stage, personal factors
question
What are 4 immune system toxicities due to cancer treatments?
answer
myelosuppression including leukopenia, lymphocytopenia, anemia, thrombocytopenia
question
What are 6 cardiovascular toxicities due to cancer treatments?
answer
cardiomyopathy, pericarditis, EKG abnormalities, mucosa epithelial cell injury, inflammatory responses, decreased blood perfusion in tissues
question
What are 2 pulmonary toxicities due to cancer treatment?
answer
abnormal development of pulmonary tissue, pulmonary fibrosis
question
What are 4 gastrointestinal system toxicities due to cancer treatment?
answer
vascular and connective tissue injury, intestinal fibrosis, increased intestinal motility leading to diarrhea, reduction in nutrient absorption
question
What are 6 musculoskeltal alterations due to cancer treatment?
answer
disturbs bone marrow, alters muscle integrity, loss of muscle force, limit muscle contraction, myofibril and myofilament alterations, decreased protein synthesis
question
What are two hepatic toxicities due to cancer treatment?
answer
hepatic fibrosis, cytotoxic lesions
question
What are 2 neuroendocrine toxicities due to cancer treatment?
answer
malfunction of thyroid, abnormalities in the release of growth hormone leading to growth problems
question
What are 2 dermatological toxicities due to cancer treatments?
answer
alopecia, skin lesions
question
What are the 4 main long term decrements of cancer treatments?
answer
decreased muscular strength, cardiac, pulmonary, and motor function
question
What are 5 considerations when working with surgical patients?
answer
incisions and sutures, pain with movement, changes in body image, edema, extreme fatigue
question
What are 9 considerations when working with radiation patients?
answer
acute and chronic skin reactions, leukopenia, nausea, vomiting, anemia, diarrhea, dehydration, edema, extreme fatigue
question
What are 10 considerations when working with chemotherapy patients?
answer
leukopenia, thrombocytopenia, susceptible to bruising, nausea, vomiting, diarrhea, dehydration, extreme fatigue, drug effects on physiological parameters, ports
question
What are 7 common symptoms generally associated with cancer treatment?
answer
lymphedema, pain, body image changes, muscle weakness, depression, anxiety, fatigue
question
What are 4 cardiac benefits of exercise?
answer
strengthens myocardium, increases cardiac output and stroke volume, decreases RHR, lowers exercise HR
question
what are 2 pulmonary benefits of exercise?
answer
strengthens intercostal muscles, improves ventilation and transport of air from the environment to the cellular level
question
What are 4 muscular benefits of exercise?
answer
increase integrity of muscle tissue, increases protein synthesis, stimulates the release of hormones that increase muscle cell growth and development, improves metabolism which increases the efficiency of energy utilization
question
What are 4 neural benefits of exercise?
answer
enhances motor unit recruitment, improves neurochemical availability at the cellular and tissue levels, improves coordination, improves peripheral neuropathy and increases motor neurons
question
What are 3 gastrointestinal benefits of exercise?
answer
increases uptake of nutrients, improves weakness and fatigue, improves appetite
question
What are 3 benefits of exercise in regards to reducing myelosuppression?
answer
increases RBC production, blood volume, and hemoglobin concentration
question
Actual state of the body where there is not enough energy to restore body and heal itself
answer
cancer treatment-related fatigue
question
What are 2 theories for fatigue?
answer
Depletion of energy yielding substances such as phosphagens, glycogen, blood glucose; accumulation of metabolites
question
muscle wasting after chemotherapy and radiation
answer
cancer cachexia
question
What are 8 ways in which treatment effects manifest into fatigue symptoms
answer
cachexia, cardiovascular disturbances, inflammatory immune response, psychological stress, social stress, insomnia, decreased strength and endurance, decreased aerobic capacity
question
injury to bone marrow cells leading to inhibition of bone marrow function
answer
myelosuppression
question
What are 6 ways to improve assessment effectiveness?
answer
relevant parameters, valid and reliable parameters, rigidly controlled, regular reassessments, interpretation of data, HIPAA
question
In what phase does true cancer rehabilitation take place?
answer
Phase 2
question
It is based upon an objective evaluation of the individual's response to exercise, including observations of HR, BP, RPE, and a subjective response to exercise. It is used to create an exercise intervention, which is guided by the client overview
answer
exercise prescription
question
What 4 principles of exercise physiology are applied to the exercise prescription and client overview?
answer
progression, overload, individuality, reversibility
question
How do the exercise prescription, client overview, and the exercise program intervention relate?
answer
The client overview is what determines the steps in the exercise intervention. The exercise intervention is based on the exercise prescription and modified as needed due to the individual's treatment status and progression.
question
instantaneous response to the stress of exercise, once exercise stops the physiological changes quickly return to normal resting levels
answer
acute adaptations
question
if exercise is performed consistently over time adaptations to the stress of exercise will persist
answer
chronic adaptations
question
everyone responds differently to exercise based on factors such as: age, initial fitness level and health status; max benefits come from individualized prescriptive exercise interventions
answer
individuality
question
volume of exercise must be progressively increased to stimulate further improvements; but also needs to be gradual to prevent injuries and avoid dropouts
answer
progression
question
physiological systems must be taxed beyond normal to stimulate improvement
answer
overload
question
positive physiological effects and health benefits of regular physical activity and exercise are reversible; planned "graduation" must be part of cancer rehab
answer
reversibility
question
each person has a genetic ceiling that limits the extent of improvement that is possible due to exercise training
answer
diminishing returns
question
physiological and metabolic responses are adaptations to exercise training are specific to the type of exercise and the muscle groups involved
answer
specificity
question
Hans Selye theory that the body's resistance to stress can only last so long before exhaustion sets in
answer
general adaptation syndrome
