question

Pleural Effusion

answer

fluid in pleural space

question

pneumothorax

answer

air in the pleural space

question

Which chemo has a high risk for pulmonary toxicity?

answer

bleomycin (Blenoxane)

question

For which pulmonary toxicity does bleomycin have a high risk?

answer

Pneumonitis

question

Hypocapnia

answer

reduced carbon dioxide in the blood

question

Signs and Symptoms of pleural effusion

answer

tachypnea (fast breathing) decreased breath sounds dullness to percussion

question

Define Lymphedema

answer

obstruction of lymphatic system that caused overload of lymph in the interstitial space

question

Define Edema

answer

fluid in the interstitial space

question

Cancer most commonly associated with lymphedema

answer

Breast

question

Stage 1 Lymphedema

answer

less than 3 cm difference pitting edema

question

Stage 2 Lymphedema

answer

3-5 cm difference skin stretched and shiny nonpitting

question

Stage 3 Lymphedema

answer

greater than 5 cm difference skin discolored, stretched, firm nonpitting

question

Lymphedema treatment

answer

compression garment manual lymphatic drainage elevation aerobic exercise with strength training low sodium diet

question

Sentinel lymph node dissection

answer

removal of the first lymph node that contains cancer cells

question

Hematoma

answer

abnormal collection of blood in tissues

question

Pericardial effusion

answer

excess fluid around the heart

question

Tumors associated with malignant pericardial effusions

answer

Lung

question

High dose cyclophosphamide cardiac effects

answer

damaged cardiac endothelium

question

Paclitaxel cardiac effects

answer

asymptomatic bradycardia

question

5FU cardiac effects

answer

coronary artery spasm

question

Anthracycline (Daunorubicin, doxorubicin, and epirubicin) cardiac effects

answer

cardiomyopathy

question

Diagnostic test for pericardial effusion

answer

Echo

question

Abnormalities of what electrolyte and what mineral interfere with cardiac function?

answer

Potassium and Calcium

question

What med can be used to protect heart against effects of doxorubicin

answer

Dexrazoxane

question

Spiral CT

answer

Diagnostic test for pulmonary emboli

question

D-DImer test

answer

used to diagnose or rule out conditions that cause hypercoagulability (inappropriate clotting)

question

DIC

answer

Accelerated activation of the coagulation cascade. Clots form in random places leaving the body open to bleeding without protection

question

Platelet count, Fibrinogen level, D Dimer, FDP Titer

answer

Tests to diagnose DIC

question

How to treat DIC

answer

Treat underlying cause

question

What does FFP do?

answer

Contains all of the clotting factors except platelets. Used to supplement red blood cells when whole blood is not available or to correct a bleeding problem of unknown cause. It is also used to correct DIC.

question

Most common cancer associated with DIC?

answer

Leukemia, specifically APL

question

Signs/Symptoms of DIC

answer

bleeding from 3 unrelated sites hypoxia SOB fever mottled extremities

question

Causes of DIC

answer

Delivery (of baby) Infection Cancer

question

How does Heparin help DIC?

answer

Interferes with thrombin production. Maintain PTT at 1-2 times the normal level (18-28 seconds)

question

S/S of septic shock

answer

Fever Tachycardia Hypotension

question

Most common cause of sepsis

answer

Gram (-) bacteria

question

DIC

answer

Accelerated activation of the coagulation cascade. Clots form in random places leaving the body open to bleeding without protection

question

Platelet count, Fibrinogen level, D Dimer, FDP Titer

answer

Tests to diagnose DIC

question

How to treat DIC

answer

Treat underlying cause

question

What does FFP do?

answer

Contains all of the clotting factors except platelets. Used to supplement red blood cells when whole blood is not available or to correct a bleeding problem of unknown cause. It is also used to correct DIC.

question

Most common cancer associated with DIC?

answer

Leukemia, specifically APL

question

Signs/Symptoms of DIC

answer

bleeding from 3 unrelated sites hypoxia SOB fever mottled extremities

question

Causes of DIC

answer

Delivery (of baby) Infection Cancer

question

How does Heparin help DIC?

answer

Interferes with thrombin production. Maintain PTT at 1-2 times the normal level (18-28 seconds)

question

S/S of septic shock

answer

Fever Tachycardia Hypotension

question

Most common cause of sepsis

answer

Gram (-) bacteria

question

Granulocytopenia

answer

failure of the bone marrow to make enough white blood cells (neutrophils)

question

Highest risk factor for sepsis

answer

Prolonged granulocytopenia (less than 500/mm3)

question

What cancer commonly produces TLS?

answer

High grade lymphoma

question

Define Tumor Lysis Syndrome (TLS)

answer

metabolic imbalance that occurs with rapid tumor kill

question

Lab results indicating DIC

answer

Increased D Dimer Increased FDP Decreased fibrinogen Decreased platelets

question

Lab results indicitave of TLS

answer

Hyperkalemia (>5.0) Hyperphosphatemia (>4.5) Hyperuricemia (>8.0) Hypocalcemia (>10.5) Increased BUN (>20) Increased creatinine (>1.2) Increased LDH (>333)

question

Lab tests done to monitor TLS

answer

K Phos Uric Acid Calcium LDH Renal function (BUN, Creatinine)

question

How to treat severe hyperkalemia

answer

hypertonic glucose and insulin. Shifts extracellular K back into intracellular stores

question

How does Allopurinol work?

answer

decreases uric acid production and decreases uric acid deposits in kidney

question

How does Rasburicase work?

answer

catalyses the conversion of uric acid to allantoin

question

S/S of hyperkalemia

answer

muscle weakness muscle cramps bradycardia tall T waves

question

S/S of hypokalemia

answer

decreased reflexes irregular pulse fatigue N/V flat t wave V fib if severe

question

Calcium normal range

answer

8.5-10.5 meq/L

question

S/S of hypercalcemia

answer

fatigue lethargy muscle weakness impaired concentration confusion constipation polyuria/polydipsia

question

S/S of hypocalcemia

answer

diarrhea neuromuscular irritability (Chvostek's sign) tingling of fingers and toes seizures

question

Potassium normal range

answer

3.5-5.0 meq/L

question

Sodium normal ranges

answer

135-145 meq/L

question

S/S of hypernatremia

answer

polydipsia low grade fever dry skin dry/sticky mucous membrane

question

S/S of mild hyponatremia

answer

anorexia HA N/V

question

S/S of moderate hyponatremia

answer

nausea weakness anorexia fatigue muscle cramps

question

S/S of severe hyponatremia

answer

seizures AMS

question

First treatment for hyponatremia

answer

Fluid restrict 500-1000 ml per day

question

Magnesium normal range

answer

1.8-2.4 mg/dl

question

S/S of hypermagnesia

answer

lethargy flushing diaphoresis

question

S/S of hypomagnesia

answer

similar to hypocalcemia neuromuscular and CNS changes seizures

question

SIADH

answer

syndrome characterized by excessive release of antidiuretic hormone (ADH or vasopressin)

question

Most common cause of SVC

answer

Cancer, especially non-Hodgkins and lung cancer

question

Signs of SVCS

answer

JVD edema of face, neck, upper thorax dyspnea tachycardia

question

SVCS diagnostic tests

answer

CT and MRI

question

Tx of SVCS

answer

RT, chemo, steroids, surgery

question

Superior Vena Cava Syndrome

answer

compromised venous drainage of the head, neck, upper extremities due to compression or obstruction of the vessel

question

Most common cause of SVC

answer

Cancer, especially non-Hodgkins and lung cancer

question

Signs of SVCS

answer

JVD edema of face, neck, upper thorax dyspnea tachycardia

question

SVCS diagnostic tests

answer

CT and MRI

question

Tx of SVCS

answer

RT, chemo, steroids, surgery

question

Cushings Triad

answer

HTN bradycardia abnormal respirations

question

Pupil changes in ICP

answer

unequal, dilated, pinpoint, nonreactive

question

Cardiac tamponade definition

answer

excessive fluid in pericardial space decreases hearts ability to fill and pump

question

Cardiac Tamponade s/s

answer

muffled heart sounds weak apical pulse mild tachycardia mild peripheral edema

question

Pericardial effusion diagnostic test

answer

2-D echo

question

Define spinal cord compression

answer

Compression of the thecal sac by a tumor in the epidural space

question

Cauda Equina

answer

structure within the lower end of the spinal column, that consists of nerve roots and rootlets

question

Most common loca for malignant invasion of spinal cord that cause SCC

answer

Outside of the spinal cord (extradural)

question

Most common early symptom of SCC

answer

neck or back pain

question

Progression of SCC symptoms

answer

pain motor weakness sensory loss motor loss

question

Pain during SCC usually occurs during what position?

answer

Lying down supine

question

Diagnostic tests for SCC

answer

Plain Xray bone scan MRI CT scan

question

Antiangiogenesis factors

answer

suppress tumors ability to grow new blood vessels

question

Cancer

answer

malignant disease with 3 characteristics 1. abnormal cell proliferation 2. unchecked local growth and invasion of surrounding tissue 3. ability to metastasize

question

Sarcomas originate is what tissue?

answer

Connective

question

Proto-oncogenes definition

answer

gene that regulates normal cell growth and repair

question

tumor suppressor gene

answer

gene that stops, inhibits, or suppresses cell division

question

Neoadjuvant Therapy definition

answer

given before primary tx to control potential mets

question

CA 125

answer

tumor marker in ovarian cancer, evaluates treatment

question

Difference between benign and malignant tumors

answer

Malignant can metastasize

question

Dysplasia

answer

loss of uniformity in the appearance of cells

question

Define hematopoesis

answer

body's ability to regulate, produce, and develop cells

question

Define immune surveillance

answer

The body's ability to scan for and destroy malignant or altered cells

question

Hematopoesis begins with which cell?

answer

Pluripotent stem cells

question

Monoclonal Antibodies Fab vs Fc

answer

Fab is the antigen binding site. Fc signals cells to destroy the cell it is bound to

question

Which antineoplastic categories of drugs are nonspecific?

answer

Alkylating Nitrosureas Antitumor antibiotics Hormonal therapies

question

What is AUC?

answer

Amount of drug exposure or total drug concentration over time.

question

What percent of patients receiving below diaphragm RT have sterility?

answer

25%

question

What dose of radiation will affect serility in: Males? Females?

answer

Males: 4 cGy temp 5 cGy permanent Females > 40 yrs, 20 cGy over 5-6 weeks < 40 yrs, 6 cGy

question

Chemos that affect fertility

answer

Lomustine Doxorubicin Melphalan Cyclophosphamide 5FU Cytarabine

question

What chemos are worst for use 1st trimester of pregnancy?

answer

Folic acid antagonists- MTX Antimetabolites - MTX, 5FU, Cytarabine, Gemcitabine Alkylating - Cyclophosphamide, Ifex, Melphalan, Thiotepa, Carmustine, Carboplatin, Cisplatin

question

PLISSIT

answer

Permission to discuss Limitied Information Specific Suggestion Intensive Therapy

question

Federal Rehab Act of 1973

answer

federally funded employers can't discriminate against handicapped

question

COBRA

answer

Provides insurance for employees for 18 months and dependants for 36 months

question

Social Security Disability Insurance Program

answer

If patient has paid in previously, they are eligible 6 months after being impaired

question

Late effects of RT on Abdomen

answer

Adhesions Fibrosis

question

Late effects of RT on Bladder

answer

Fibrosis Hyperplasia (increase in cells)

question

Late effects of RT on CNS

answer

Stroke Blindness

question

Late effects of RT on chest

answer

Breast Ca soft tissue sarcoma dysphagia pulmoanry fibrosis

question

Late effects of RT of Head/Neck

answer

hypo or hyperthyroid mandibular osteonecrosis alopecia cavities decreased hearing

question

Late effects of RT on Heart

answer

pericarditis CAD cardiomyopathy pericardial effusion MI

question

Late effects of RT on Liver

answer

Fibrosis cirrhosis

question

Late effects of RT on Ovaries

answer

failure premature menopause

question

Late effects of RT on Skeletal

answer

Late fx osteonecrosis

question

Late effects of RT on Skin

answer

fibrosis necrosis basal cell hyperpigmentation

question

Late effects of RT on testicles

answer

oligospermia azoospermia decreased testosterone

question

Late effects of RT on urinary

answer

fibrosis strictures

question

Late effects of RT on testicles

answer

oligospermia azoospermia decreased testosterone

question

Late effects of RT on urinary

answer

fibrosis strictures

question

Late effects of RT on vagina

answer

fibrosis decreased vaginal secretions

question

Myeloid cell line

answer

In hematopoiesis, myeloid describes any leukocyte that is not a lymphocyte.

question

Primary lymphoid organs

answer

Bone marrow - B Cells Thymus - T Cells

question

Define Lymphoid cell line

answer

Develop T cells and B cells Key for all immune responses

question

Define Humoral Immunity

answer

B cell immunity that is meditaed by

question

Define Cell Mediated Immunity

answer

T cell driven immune response that does not involve antibodies or complement but involves activating macrophages, NK cells, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen

question

Define NK Cells

answer

kill cells by releasing small proteins that cause the target cell to die by apoptosis.

question

Define Apoptosis

answer

programmed cell death

question

Define Cytokines

answer

protein released by cells that has specific effect on the interactions, communications,

question

Types of cytokines

answer

interleukins lymphokines cell signal molecules (tumor necrosis factor interferons (trigger inflammation and respond to infections

question

Define Innate immunity

answer

immunity that occurs before the onset of infection

question

Describe B cells

answer

Develop in bone marrow Differentiate into plasma cells, which produce immunoglobulins (IgG, IgA, IgM, IgE, IgD)

question

Define phagocytes

answer

cells that engulf and consume pathogens

question

Define interferons

answer

a type of cytokine limit spread of viral infections first resistance

question

Can innate immunity target specific pathogens?

answer

No

question

Define gene

answer

individual unit of hereditary info

question

Genes responsible for family cancer syndrome are what gene?

answer

tumor suppressor gene

question

How many chromosomes in human body?

answer

46 23 pairs

question

What are autosomes when talking about genetics?

answer

Chromosomal pairs 1-22 Do not determine gender

question

What are sex chromosomes?

answer

Chromosomes that decide sex Women are X X Men are XY

question

Mutations in APC

answer

increases risk of colon cancer

question

Mutations in PTEN

answer

increases risk of breast, thyroid, and endometrial cancer

question

Mutations in p53

answer

increases risk of breast, leukemia, sarcoma and adrenal cancer

question

Hallmark sign of hereditary cancer?

answer

Multiple cancers in one person

question

Frameshift

answer

muttation where 1 bases are added or deleted

question

Missense

answer

single base pair change mutations

question

RNA Negative

answer

mutation with an abscence of RNA transcribed from gene

question

Polymorphisms

answer

changes in DNA sequence often not disease related

question

Translocation

answer

chromosomal abnormality where one chromosomal segament breaks off and attaches at another site

question

Aneuploidy

answer

abnormal number of chromosomes

question

In-Situ Cancer

answer

Noninvasive breast cancer

question

Most common type of breast cancer

answer

invasive ductal carcinoma 70-80%

question

Most aggressive breast cancer

answer

inflammatory breast cancer

question

Least common sign of breast cancer?

answer

Pain

question

Modified radical mastectomy

answer

removal of the entire breast and the lymphatic-bearing tissue in the armpit

question

Can women with breast cancer have estrogen replacemtn therapy?

answer

No, women who have had HRT have 3 x the recurrence risk

question

Most common sites of mets from breast cancer?

answer

IN ORDER Bone Lung Liver Brain

question

What do biphosphonates do?

answer

prevent the loss of bone mass, used to treat osteoporosis, hypercalcemia, bone pain, and prevention of fractures

question

What does Arimidex do?

answer

used to treat breast cancer in women who have gone through menopause. Stops estrogen production

question

Clinical Trial Phase 0

answer

10-12 people Identify drugs that do not produce desired effect Limited doses Low doses Less risk Useful for molecularly target drugs Useful for drugs that require biomarker development

question

Clinical Trial Phase 1

answer

20-25 people Evaluate tozicity Establish max dose without side effects Determine route (PO or IV) Variety of tumor types

question

Clinical Trial Phase 2

answer

More than 100 people Determine if treatment has benefit Groups of patients with same tumors will be used Assess response rate

question

Clinical Trial Phase 3

answer

100-1000's of people Compare new drug to current standard Establish efficacy by assessing survival and time to progression LAst step before FDA consideration Usually double blind trials

question

Clinical Trial Phase 4

answer

Can it do anything else? Expand off label use Assess toxicity and long term effects Usually after FDA approval

question

Most common cancer among women

answer

Breast

question

Describe Invasive breast ca

answer

no longer contained by breast capable of metastases

question

Most frequent site of breast cancer mets

answer

Bone

question

What age should mammograms start?

answer

40

question

Triple test for diagnosing breast cancer

answer

Physical Exam Mammography FNA

question

Breast Cancer Staging Classification

answer

Stage 0 - In Situ Stage 1 - Under 2 cm with (-) nodes Stage 2 - 5 with (-) nodes Stage 3 - > 5 with ( ) or any size with breast wall extension Stage 4 - any distant mets

question

Standard treatment for early breast cancer

answer

Breast conservation therapy with RT

question

Gold standard for staging breast cancer

answer

axillary lymph node dissection

question

Adjuvant therapy

answer

treatment given in addition to primary therapy

question

Neoadjuvant therapy

answer

administration of therapeutic agents prior to the main treatment

question

Common side effects of breast RT

answer

skin reactions fatigue

question

What is the response rate of hormonal therapy in women with ER/PR ( ) tumors?

answer

50-70%

question

Common chemos used in breast cancer

answer

Cytoxan Adriamycin Paclitaxel Docetaxel Epirubicin MTX 5FU

question

Regimens that contain which type of chemo are seen as more successful in breast cancer?

answer

Anthracyclines

question

What type of chemo are most effective for metastatic breast cancer?

answer

Taxanes

question

Risk factors for breast cancer

answer

No children First pregnancy after 30 Early periods Late menopause Hormone replacement therapy

question

Where do more than half of breast cancers occur?

answer

Upper outer quadrant

question

CA 15-3 and CA 27-29

answer

tumor marker used to monitor response to treatment of invasive breast cancer

question

CA 27-29

answer

tumor marker

question

CEA

answer

tumor marker used to monitor the treatment of cancer patients, especially those with colon cancer

question

Most aggressive type of lung cancer

answer

small cell lung cancer (SCLC)

question

Which cancer is leading cause of death for men and women?

answer

Lung

question

What risk factor accounts for 90% of lung cancers?

answer

Smoking

question

Which cancers have highest incidence rates?

answer

Men - Prostate Women - Breast

question

5 year survival rate for lung cancer.

answer

15%

question

Which treatment option offers the best chance for cure of lung cancer?

answer

Surgery

question

Diagnostic tests to stage lung cancer

answer

CXR CT or MRI Bronch

question

Chemos used in SCLC

answer

Etoposide Cisplatin Carboplatin Cytoxan Doxorubicin Vincristine Ifex Combo are used most of the time

question

What type of chemo is standard of care in NSCLC?

answer

Platinum based with Cisplatin or Carboplatin

question

Why are most lung cancer patients good candidates for clinical trials?

answer

Low cure rates with current treatments.

question

Why are ADH and ACTH levels sometimes higher in lung cancer patients, especially small cell?

answer

The tumor can release mimics of these hormones.

question

When maintaining a chest tube, what 2 things would you report to MD?

answer

Bubbling in water seal chamber Air leak noises

question

After lobectomy, what position should the patient not be in?

answer

The patient should not lay on operative side. Decreases expansion.

question

After pneumonectomy, how should patient be positioned?

answer

On back or on operated side. DO NOT let patient lay on unoperated side.

question

Tumor marker CEA

answer

Tumor marker elevated in colon cancer, can be used to monitor treatment or recurrence

question

CA 19-9

answer

tumor marker for pancreatic cancer

question

CA 27-29

answer

tumor marker for breast cancer

question

Tumor marker AFP

answer

For testicular and primary liver

question

Early symptoms of colorectal cancer

answer

change in bowel habits blood in stool

question

Most common site of mets from colorectal cancer

answer

Liver

question

Why are ADH and ACTH levels sometimes higher in lung cancer patients, especially small cell?

answer

The tumor can release mimics of these hormones.

question

When maintaining a chest tube, what 2 things would you report to MD?

answer

Bubbling in water seal chamber Air leak noises

question

After lobectomy, what position should the patient not be in?

answer

The patient should not lay on operative side. Decreases expansion.

question

After pneumonectomy, how should patient be positioned?

answer

On back or on operated side. DO NOT let patient lay on unoperated side.

question

Tumor marker CEA

answer

Tumor marker elevated in colon cancer, can be used to monitor treatment or recurrence

question

CA 19-9

answer

tumor marker for pancreatic cancer

question

CA 27-29

answer

tumor marker for breast cancer

question

Tumor marker AFP

answer

For testicular and primary liver

question

Early symptoms of colorectal cancer

answer

change in bowel habits blood in stool

question

Most common site of mets from colorectal cancer

answer

Liver

question

What percentage of colorectal cancer patients will have surgery?

answer

75%

question

Most common symptom of esophageal cancer.

answer

Dysphagia

question

What is gold standard for treatment of pancreatic cancer?

answer

Surgery

question

Most common presenting symptom of gastric cancer?

answer

Weight loss

question

Nursing teaching for patients with dumping syndrome.

answer

small, frequent meals low carbs high protein low fiber

question

Most common presenting symptoms in liver cancer

answer

RUQ pain

question

Tumor Marker a-FP

answer

Liver cancer

question

Preferred initial therapy for anal cancer

answer

Chemoradiation

question

Diagnostic tests for esophageal cancer

answer

esophagoscopy and biopsy esophagogram CT

question

How is esophageal cancer staged?

answer

TNM

question

Diagnostic tests for gastric cancer

answer

Barium study Biopsy

question

Most common presenting symptom of endometrial cancer.

answer

Abnormal vaginal bleeding

question

Tumor marker B-HCG

answer

for gestational trophoblastic disease (tumors in uterus)

question

Most common symptom of patients in patients with testicular cancer

answer

Heavy feeling or mass in scrotum

question

CA 125

answer

tumor marker elevated in 80% of ovarian cancer patients

question

Seminoma is most responsive to what therapy?

answer

Radiation

question

What tumor markers are used to measure treatment response in testicular cancer?

answer

B-HCG and a-FP

question

Screening procedure most used to check for cervical cancer

answer

Pap smear

question

Diagnostic procedures for cervical cancer

answer

Colposcopy HPV testing cervical biopsy cone biopsy leep

question

Triad of symptoms in recurrent cervical cancer

answer

sciatic pain unilateral leg pain ureteral obstruction

question

Risk factors for cervical cancer

answer

HPV ( ) sex during teen years multiple sex partners history of CIN

question

Early signs of cervical cancer

answer

asymptomatic

question

Late signs of cervical cancer

answer

pain referred to flank or leg urinary symptoms

question

Which is most curable gynecologic cancer?

answer

Endometrial

question

Most common sites for metastases in renal cell cancer

answer

Lymph Bone

question

Chromosome 3p

answer

Abnormal in 80% of renal cell carcinoma

question

Most common diagnostic test for RCC?

answer

KUB radiography

question

Classic triad of symptoms for advanced RCC

answer

Flank pain Hematuria Flank mass

question

When should prostate screening start?

answer

Age 50 for average risk Age 40 for African Americans and familial history

question

What are screening tests for prostate cancer?

answer

DRE PSA

question

Most frequent treatment for advance prostate cancer?

answer

Medical castration

question

Most common presenting symptom of bladder cancer?

answer

Hematuria

question

Diagnostic tests for bladder cancer

answer

IVP Cystoscopy

question

Important nursing intervention for patients with nephrectomy?

answer

Teach deep breathing and incentive spirometry use

question

Paralytic ileus

answer

Obstruction of the intestine due to paralysis of the intestinal muscles

question

Screening tests for bladder cancer

answer

None. Also none for kidneys.

question

Most common chemo to treat bladder cancer

answer

Mitomycin

question

When used with surgery, what chemo doubles survival rates in bladder cancer?

answer

MVAC MTX Vinblastine Adriamycin Cisplatin

question

Define ileal conduit

answer

urine reservoir created after bladder is removed

question

Difference between ileal conduit and continent ileal reservoir.

answer

conduit needs bag, reservoir does not

question

Which is most effective single agent chemo for bladder cancer?

answer

Cisplatin

question

How to prevent malodorous urine?

answer

Decrease alkaline beverages (soda) drink fluids high in vitamin C Avoid stinky food (fish, asparagus) Clean pouch using soap, water, vinegar

question

Most common sites for metastases in renal cell cancer

answer

Lymph Bone

question

Chromosome 3p

answer

Abnormal in 80% of renal cell carcinoma

question

Most common diagnostic test for RCC?

answer

KUB radiography

question

Classic triad of symptoms for advanced RCC

answer

Flank pain Hematuria Flank mass

question

When should prostate screening start?

answer

Age 50 for average risk Age 40 for African Americans and familial history

question

What are screening tests for prostate cancer?

answer

DRE PSA

question

Most frequent treatment for advance prostate cancer?

answer

Medical castration

question

Most common presenting symptom of bladder cancer?

answer

Hematuria

question

Diagnostic tests for bladder cancer

answer

IVP Cystoscopy

question

Important nursing intervention for patients with nephrectomy?

answer

Teach deep breathing and incentive spirometry use

question

Paralytic ileus

answer

Obstruction of the intestine due to paralysis of the intestinal muscles

question

Caution nephrectomy patient to avoid nephrotoxic drugs such as what?

answer

NSAIDS

question

Screening tests for bladder cancer

answer

None. Also none for kidneys.

question

Most common chemo to treat bladder cancer

answer

Mitomycin

question

When used with surgery, what chemo doubles survival rates in bladder cancer?

answer

MVAC MTX Vinblastine Adriamycin Cisplatin

question

Define ileal conduit

answer

urine reservoir created after bladder is removed

question

Difference between ileal conduit and continent ileal reservoir.

answer

conduit needs bag, reservoir does not

question

Which is most effective single agent chemo for bladder cancer?

answer

Cisplatin

question

How to prevent malodorous urine?

answer

Decrease alkaline beverages (soda) drink fluids high in vitamin C Avoid stinky food (fish, asparagus) Clean pouch using soap, water, vinegar

question

Ethnic group most at risk for nonmelanoma skin cancers

answer

Caucasian

question

Chemotherapy with best results in treating malignant melanoma

answer

Dacarbazine (DTIC Dome)

question

Most important feature when determining prognosis in malignant melanoma.

answer

Size and depth of lesion at time of diagnosis

question

Most common sites of metastases from malignant melanoma

answer

Lymph Lung Brain

question

What are nonmelanoma skin cancers?

answer

Basal and Squamos

question

Features of malignant melanoma

answer

Asymmetry Uneven borders Color variegation > 6 mm in diameter

question

Chemos used to treat malignant melanoma

answer

Dacarbazine Nitrosureas (Carmustine, Lomustine) temolozamide (Temodar) (PO)

question

Squamos cell cancers are 90% of what type of cancer?

answer

Head and Neck

question

Head and Neck cancer with highest survival rate

answer

Thyroid

question

What are primary treatment modalities for managing head and neck tumors?

answer

Surgery and Radiation.

question

When would you advise a patient with a trach to change to a laryngectomy tube?

answer

When the stoma begins to get narrow

question

Most common infection of oropharynx

answer

Candidasis

question

Major toxicity of cisplatin

answer

Nephrotoxicity **Also ototoxicity**

question

Possible alterations in mobility after head and neck surgery

answer

shoulder droop atrophy of trapezius forward curve of spine limited ROM

question

Most common presenting symptoms in clients with a brain tumor

answer

Seizure HA Unilateral Hemiparesis

question

Most common types of malignant tumors com from which brain tissue

answer

Astrocytes - connective cell tissues

question

Which oral alkylating agent is used to treat brain tumors?

answer

Temodar

question

Which IV chemo is used to treat brain tumors?

answer

Carmustine

question

Mets to the spine occur most frequently in what cancers?

answer

Breast Lung Prostate

question

Diagnostic studies for brain tumors

answer

CT MRI

question

What does ATRA treat?

answer

APL

question

Which drug binds to CD33 antigen?

answer

Gemtuzumab (Mylotarg)

question

Blast crisis

answer

LAst phase of CML when 30% of cells in blood or marrow are blasts.

question

Which type of leukemia affects CNS?

answer

ALL

question

Most common childhood leukemia

answer

ALL

question

Define Consolidation therapy

answer

given after cancer has disappeared following the initial therapy, used to kill any cancer cells that may be left in the body

question

What drug is used in chronic phase CML to control leukocytosis?

answer

Hydroxyurea

question

What drug is used to treat CML in all phases?

answer

Gleevec

question

Reed Sternberg cells

answer

shows in biopsy of patient with Hodgkins

question

Most common cause of pain in MM

answer

Bone mets/lesions

question

Tests done to measure response to MM treatment

answer

Blood tests Urine tests 24 hour urine- measure protein and creatinine Myeloma survey - detect skeletal lesions

question

How to treat itching from Hodgkins

answer

Chemo or steroids

question

Mets from osteosarcoma usually affect what area of the body?

answer

Lung

question

S/S of osteosarcoma

answer

pain swelling

question

Most frequently diagnosed HIV related cancer

answer

B cell

question

Capillary leak syndrome

answer

condition in which fluid and proteins leak out of tiny blood vessels and flow into surrounding tissues, resulting in dangerously low blood pressure. Capillary leak syndrome may lead to multiple organ failure and shock

question

Most common side effect of interferon therapy

answer

Fatigue

question

Innate immunity

answer

Immunity that does not respond to specific antigens

question

Principal toxicity of vincristine

answer

peripheral neuropathy

question

Dose limiting toxicity of cisplatin

answer

nephrotoxicity

question

Dose limiting toxicity for nitrogen mustard

answer

Myelosuppression

question

Mesna

answer

chemoprotective against hemorrhagic cystitis

question

Amifostine

answer

chemoprotectant against nephrotoxicity from cisplatin

question

When do Carbo reactions happen

answer

After 6th cycles, mid cycle.

question

Early complications of stem cell transplant

answer

N/V Infection

question

Late complications of stem cell transplant

answer

Chronic GVHD Herpes

question

Target organs of acute GVHD

answer

skin liver gut

question

Target organs of chronic GVHD

answer

vagina eyes mouth

question

veno-occlusive disease/sinusoidal obstruction syndrome

answer

some of the small veins in the liver are blocked as a complication of high-dose chemotherapy given before a bone marrow transplant (BMT) and is marked by weight gain due to fluid retention, increased liver size, and raised levels of bilirubin in the blood. 7-21 days after HSCT

question

Long term side effects of HSCT

answer

Fatigue Weight loss Sexual Dysfunction Chronic GVHD Herpes Zoster

question

Symptoms of VOD/SOS

answer

weight gain mental confusion RUQ pain

question

Which chemos have greatest potential for producing a secondary malignancy?

answer

Alkylating agents

question

Risk factors associated with pancreatic cancer

answer

smoking processed meats H pylori diabetes

question

Primary Prevention

answer

protect healthy people from developing a disease educate screen immunize

question

Tertiary prevention

answer

helping people manage complicated, long-term health problems and maximize QOL Rehab Support Groups

question

Secondary Prevention

answer

happen after an illness or serious risk factors have already been dx. Goal is to halt or slow the progress of disease (if possible) in its earliest stages limiting long-term disability, prevent re-injury

question

most common worldwide cancers

answer

lung stomach liver

question

selective/prescriptive screening

answer

looks for specific problems within a high risk group

question

a-FP tumor marker

answer

sensitive for germ cell or primary liver tumor

question

CAUTION

answer

Change in bowel or bladder A sore that doesn't heal Unusual bleeding Thickening or lumps Indigestion Obvious changes in wart or mole Nagging cough

question

CEA

answer

tumor marker for colon cancer

question

CA 19-9

answer

pancreatic tumor marker

OCN Study Guide – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards