| Terms |
Definitions |
|
CA 27-29
|
tumor marker for breast cancer
|
|
Abnormalities of what electrolyte and what mineral interfere with cardiac function?
|
Potassium and Calcium
|
|
CA 19-9
|
tumor marker for pancreatic cancer
|
|
Cardiac tamponade definition
|
excessive fluid in pericardial space decreases hearts ability to fill and pump
|
|
Stage 2 Lymphedema
|
3-5 cm difference
skin stretched and shiny
nonpitting
|
|
How to prevent malodorous urine?
|
Decrease alkaline beverages (soda)
drink fluids high in vitamin C
Avoid stinky food (fish, asparagus)
Clean pouch using soap, water, vinegar
|
|
tumor suppressor gene
|
gene that stops, inhibits, or suppresses cell division
|
|
Signs of SVCS
|
JVD
edema of face, neck, upper thorax
dyspnea
tachycardia
|
|
Late effects of RT on Abdomen
|
Adhesions
Fibrosis
|
|
DIC
|
Accelerated activation of the coagulation cascade. Clots form in random places leaving the body open to bleeding without protection
|
|
Difference between benign and malignant tumors
|
Malignant can metastasize
|
|
5FU cardiac effects
|
coronary artery spasm
|
|
Capillary leak syndrome
|
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
|
|
Define gene
|
individual unit of hereditary info
|
|
Modified radical mastectomy
|
removal of the entire breast and the lymphatic-bearing tissue in the armpit
|
|
Signs/Symptoms of DIC
|
bleeding from 3 unrelated sites
hypoxia
SOB
fever
mottled extremities
|
|
Which drug binds to CD33 antigen?
|
Gemtuzumab (Mylotarg)
|
|
Most common cancer associated with DIC?
|
Leukemia, specifically APL
|
|
Most common diagnostic test for RCC?
|
KUB radiography
|
|
Superior Vena Cava Syndrome
|
compromised venous drainage of the head, neck, upper extremities due to compression or obstruction of the vessel
|
|
Define Cytokines
|
protein released by cells that has specific effect on the interactions, communications, & behavior of cells.
|
|
Risk factors for breast cancer
|
No children
First pregnancy after 30
Early periods
Late menopause
Hormone replacement therapy
|
|
Most common symptom of patients in patients with testicular cancer
|
Heavy feeling or mass in scrotum
|
|
CA 125
|
tumor marker elevated in 80% of ovarian cancer patients
|
|
S/S of hypermagnesia
|
lethargy
flushing
diaphoresis
|
|
Tumors associated with malignant pericardial effusions
|
Lung
|
|
Most common loca for malignant invasion of spinal cord that cause SCC
|
Outside of the spinal cord (extradural)
|
|
What cancer commonly produces TLS?
|
High grade lymphoma
|
|
RNA Negative
|
mutation with an abscence of RNA transcribed from gene
|
|
Lymphedema treatment
|
compression garment
manual lymphatic drainage
elevation
aerobic exercise with strength training
low sodium diet
|
|
Ethnic group most at risk for nonmelanoma skin cancers
|
Caucasian
|
|
Most aggressive breast cancer
|
inflammatory breast cancer
|
|
Platelet count, Fibrinogen level, D Dimer, FDP Titer
|
Tests to diagnose DIC
|
|
Mutations in APC
|
increases risk of colon cancer
|
|
Which chemo has a high risk for pulmonary toxicity?
|
bleomycin (Blenoxane)
|
|
Mutations in PTEN
|
increases risk of breast, thyroid, and endometrial cancer
|
|
Define Edema
|
fluid in the interstitial space
|
|
Risk factors for cervical cancer
|
HPV (+)
sex during teen years
multiple sex partners
history of CIN
|
|
CA 19-9
|
tumor marker for pancreatic cancer
|
|
Most common chemo to treat bladder cancer
|
Mitomycin
|
|
Gold standard for staging breast cancer
|
axillary lymph node dissection
|
|
Most common presenting symptoms in liver cancer
|
RUQ pain
|
|
Clinical Trial
Phase 2
|
More than 100 people
Determine if treatment has benefit
Groups of patients with same tumors will be used
Assess response rate
|
|
When should prostate screening start?
|
Age 50 for average risk
Age 40 for African Americans and familial history
|
|
Signs/Symptoms of DIC
|
bleeding from 3 unrelated sites
hypoxia
SOB
fever
mottled extremities
|
|
Anthracycline (Daunorubicin, doxorubicin, and epirubicin) cardiac effects
|
cardiomyopathy
|
|
Pain during SCC usually occurs during what position?
|
Lying down supine
|
|
Tumor marker AFP
|
For testicular and primary liver
|
|
CAUTION
|
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
|
|
S/S of severe hyponatremia
|
seizures
AMS
|
|
Which is most curable gynecologic cancer?
|
Endometrial
|
|
In-Situ Cancer
|
Noninvasive breast cancer
|
|
What are screening tests for prostate cancer?
|
DRE
PSA
|
|
How does Heparin help DIC?
|
Interferes with thrombin production. Maintain PTT at 1-2 times the normal level (18-28 seconds)
|
|
Diagnostic tests for bladder cancer
|
IVP
Cystoscopy
|
|
Define Consolidation therapy
|
given after cancer has disappeared following the initial therapy, used to kill any cancer cells that may be left in the body
|
|
veno-occlusive disease/sinusoidal obstruction syndrome
|
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
|
|
Reed Sternberg cells
|
shows in biopsy of patient with Hodgkins
|
|
Define ileal conduit
|
urine reservoir created after bladder is removed
|
|
Describe B cells
|
Develop in bone marrow
Differentiate into plasma cells, which produce immunoglobulins (IgG, IgA, IgM, IgE, IgD)
|
|
Social Security Disability Insurance Program
|
If patient has paid in previously, they are eligible 6 months after being impaired
|
|
Late effects of RT on Skin
|
fibrosis
necrosis
basal cell
hyperpigmentation
|
|
Paralytic ileus
|
Obstruction of the intestine due to paralysis of the intestinal muscles
|
|
S/S of septic shock
|
Fever
Tachycardia
Hypotension
|
|
Late effects of RT on Skeletal
|
Late fx
osteonecrosis
|
|
Cancer
|
malignant disease with 3 characteristics
1. abnormal cell proliferation
2. unchecked local growth and invasion of surrounding tissue
3. ability to metastasize
|
|
Late effects of RT of Head/Neck
|
hypo or hyperthyroid
mandibular osteonecrosis
alopecia
cavities
decreased hearing
|
|
Neoadjuvant therapy
|
administration of therapeutic agents prior to the main treatment
|
|
How to treat DIC
|
Treat underlying cause
|
|
Most common site of mets from colorectal cancer
|
Liver
|
|
Which cancer is leading cause of death for men and women?
|
Lung
|
|
selective/prescriptive screening
|
looks for specific problems within a high risk group
|
|
Chromosome 3p
|
Abnormal in 80% of renal cell carcinoma
|
|
Nursing teaching for patients with dumping syndrome.
|
small, frequent meals
low carbs
high protein
low fiber
|
|
Most common cause of SVC
|
Cancer, especially non-Hodgkins and lung cancer
|
|
Diagnostic test for pericardial effusion
|
Echo
|
|
Pericardial effusion
|
excess fluid around the heart
|
|
How many chromosomes in human body?
|
46
23 pairs
|
|
Most common cancer associated with DIC?
|
Leukemia, specifically APL
|
|
Most common sites for metastases in renal cell cancer
|
Lymph
Bone
|
|
Late effects of RT on testicles
|
oligospermia
azoospermia
decreased testosterone
|
|
Define phagocytes
|
cells that engulf and consume pathogens
|
|
Most common side effect of interferon therapy
|
Fatigue
|
|
S/S of hypokalemia
|
decreased reflexes
irregular pulse
fatigue
N/V
flat t wave
V fib if severe
|
|
Most frequent site of breast cancer mets
|
Bone
|
|
What type of chemo is standard of care in NSCLC?
|
Platinum based with Cisplatin or Carboplatin
|
|
CA 27-29
|
tumor marker
|
|
High dose cyclophosphamide cardiac effects
|
damaged cardiac endothelium
|
|
Cauda Equina
|
structure within the lower end of the spinal column, that consists of nerve roots and rootlets
|
|
Define Lymphedema
|
obstruction of lymphatic system that caused overload of lymph in the interstitial space
|
|
S/S of osteosarcoma
|
pain
swelling
|
|
Tumor marker B-HCG
|
for gestational trophoblastic disease (tumors in uterus)
|
|
Calcium normal range
|
8.5-10.5 meq/L
|
|
When should prostate screening start?
|
Age 50 for average risk
Age 40 for African Americans and familial history
|
|
Federal Rehab Act of 1973
|
federally funded employers can't discriminate against handicapped
|
|
Types of cytokines
|
interleukins
lymphokines
cell signal molecules (tumor necrosis factor
interferons (trigger inflammation and respond to infections
|
|
Most common sites of mets from breast cancer?
|
IN ORDER
Bone
Lung
Liver Brain
|
|
Most frequently diagnosed HIV related cancer
|
B cell
|
|
Dose limiting toxicity of cisplatin
|
nephrotoxicity
|
|
Most common cause of pain in MM
|
Bone mets/lesions
|
|
Which antineoplastic categories of drugs are nonspecific?
|
Alkylating
Nitrosureas
Antitumor antibiotics
Hormonal therapies
|
|
Define ileal conduit
|
urine reservoir created after bladder is removed
|
|
When used with surgery, what chemo doubles survival rates in bladder cancer?
|
MVAC
MTX
Vinblastine
Adriamycin
Cisplatin
|
|
Signs and Symptoms of pleural effusion
|
tachypnea (fast breathing)
decreased breath sounds
dullness to percussion
|
|
Clinical Trial
Phase 3
|
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
|
|
Mets from osteosarcoma usually affect what area of the body?
|
Lung
|
|
When used with surgery, what chemo doubles survival rates in bladder cancer?
|
MVAC
MTX
Vinblastine
Adriamycin
Cisplatin
|
|
Define Tumor Lysis Syndrome (TLS)
|
metabolic imbalance that occurs with rapid tumor kill
|
|
Hematoma
|
abnormal collection of blood in tissues
|
|
Tumor Marker a-FP
|
Liver cancer
|
|
Chemos used to treat malignant melanoma
|
Dacarbazine
Nitrosureas (Carmustine, Lomustine)
temolozamide (Temodar) (PO)
|
|
Caution nephrectomy patient to avoid nephrotoxic drugs such as what?
|
NSAIDS
|
|
S/S of septic shock
|
Fever
Tachycardia
Hypotension
|
|
First treatment for hyponatremia
|
Fluid restrict 500-1000 ml per day
|
|
Which type of leukemia affects CNS?
|
ALL
|
|
Define immune surveillance
|
The body's ability to scan for and destroy malignant or altered cells
|
|
How to prevent malodorous urine?
|
Decrease alkaline beverages (soda)
drink fluids high in vitamin C
Avoid stinky food (fish, asparagus)
Clean pouch using soap, water, vinegar
|
|
i
|
|
|
Most common infection of oropharynx
|
Candidasis
|
|
Major toxicity of cisplatin
|
Nephrotoxicity
**Also ototoxicity**
|
|
Tests done to measure response to MM treatment
|
Blood tests
Urine tests
24 hour urine- measure protein and creatinine
Myeloma survey - detect skeletal lesions
|
|
Head and Neck cancer with highest survival rate
|
Thyroid
|
|
Paralytic ileus
|
Obstruction of the intestine due to paralysis of the intestinal muscles
|
|
most common worldwide cancers
|
lung
stomach
liver
|
|
Clinical Trial
Phase 4
|
Can it do anything else?
Expand off label use
Assess toxicity and long term effects
Usually after FDA approval
|
|
Most common presenting symptom of endometrial cancer.
|
Abnormal vaginal bleeding
|
|
Triad of symptoms in recurrent cervical cancer
|
sciatic pain
unilateral leg pain
ureteral obstruction
|
|
CEA
|
tumor marker used to monitor the treatment of cancer patients, especially those with colon cancer
|
|
Why are most lung cancer patients good candidates for clinical trials?
|
Low cure rates with current treatments.
|
|
Chemos that affect fertility
|
Lomustine
Doxorubicin
Melphalan
Cyclophosphamide
5FU
Cytarabine
|
|
Common side effects of breast RT
|
skin reactions
fatigue
|
|
Mets to the spine occur most frequently in what cancers?
|
Breast
Lung
Prostate
|
|
Stage 1 Lymphedema
|
less than 3 cm difference
pitting edema
|
|
What is AUC?
|
Amount of drug exposure or total drug concentration over time.
|
|
What are nonmelanoma skin cancers?
|
Basal and Squamos
|
|
Most important feature when determining prognosis in malignant melanoma.
|
Size and depth of lesion at time of diagnosis
|
|
Late signs of cervical cancer
|
pain referred to flank or leg
urinary symptoms
|
|
Define NK Cells
|
kill cells by releasing small proteins that cause the target cell to die by apoptosis.
|
|
When do Carbo reactions happen
|
After 6th cycles, mid cycle.
|
|
Most frequent treatment for advance prostate cancer?
|
Medical castration
|
|
Screening procedure most used to check for cervical cancer
|
Pap smear
|
|
What drug is used in chronic phase CML to control leukocytosis?
|
Hydroxyurea
|
|
Tx of SVCS
|
RT, chemo, steroids, surgery
|
|
Classic triad of symptoms for advanced RCC
|
Flank pain
Hematuria
Flank mass
|
|
Principal toxicity of vincristine
|
peripheral neuropathy
|
|
Late effects of RT on Ovaries
|
failure
premature menopause
|
|
Polymorphisms
|
changes in DNA sequence
often not disease related
|
|
Can women with breast cancer have estrogen replacemtn therapy?
|
No, women who have had HRT have 3 x the recurrence risk
|
|
Most common presenting symptoms in clients with a brain tumor
|
Seizure
HA
Unilateral Hemiparesis
|
|
Causes of DIC
|
Delivery (of baby)
Infection
Cancer
|
|
Most common chemo to treat bladder cancer
|
Mitomycin
|
|
Most common childhood leukemia
|
ALL
|
|
CA 27-29
|
tumor marker for breast cancer
|
|
Neoadjuvant Therapy definition
|
given before primary tx to control potential mets
|
|
Describe Invasive breast ca
|
no longer contained by breast
capable of metastases
|
|
Which is most effective single agent chemo for bladder cancer?
|
Cisplatin
|
|
Define hematopoesis
|
body's ability to regulate, produce, and develop cells
|
|
Platelet count, Fibrinogen level, D Dimer, FDP Titer
|
Tests to diagnose DIC
|
|
Diagnostic tests for esophageal cancer
|
esophagoscopy and biopsy
esophagogram
CT
|
|
PLISSIT
|
Permission to discuss
Limitied Information
Specific Suggestion
Intensive Therapy
|
|
Most common presenting symptom of gastric cancer?
|
Weight loss
|
|
Innate immunity
|
Immunity that does not respond to specific antigens
|
|
What does Arimidex do?
|
used to treat breast cancer in women who have gone through menopause. Stops estrogen production
|
|
Early signs of cervical cancer
|
asymptomatic
|
|
Cushings Triad
|
HTN
bradycardia
abnormal respirations
|
|
Late effects of RT on CNS
|
Stroke
Blindness
|
|
pneumothorax
|
air in the pleural space
|
|
What are sex chromosomes?
|
Chromosomes that decide sex
Women are X X
Men are XY
|
|
Antiangiogenesis factors
|
suppress tumors ability to grow new blood vessels
|
|
S/S of hypocalcemia
|
diarrhea
neuromuscular irritability (Chvostek's sign)
tingling of fingers and toes
seizures
|
|
Screening tests for bladder cancer
|
None. Also none for kidneys.
|
|
Most common diagnostic test for RCC?
|
KUB radiography
|
|
Diagnostic tests for bladder cancer
|
IVP
Cystoscopy
|
|
Most common symptom of esophageal cancer.
|
Dysphagia
|
|
Screening tests for bladder cancer
|
None. Also none for kidneys.
|
|
What dose of radiation will affect serility in:
Males?
Females?
|
Males:
4 cGy temp
5 cGy permanent
Females
> 40 yrs, 20 cGy over 5-6 weeks
< 40 yrs, 6 cGy
|
|
Most common cause of sepsis
|
Gram (-) bacteria
|
|
Causes of DIC
|
Delivery (of baby)
Infection
Cancer
|
|
Target organs of chronic GVHD
|
vagina
eyes
mouth
|
|
Genes responsible for family cancer syndrome are what gene?
|
tumor suppressor gene
|
|
Most common early symptom of SCC
|
neck or back pain
|
|
After pneumonectomy, how should patient be positioned?
|
On back or on operated side. DO NOT let patient lay on unoperated side.
|
|
Can innate immunity target specific pathogens?
|
No
|
|
Target organs of acute GVHD
|
skin
liver
gut
|
|
Most frequent treatment for advance prostate cancer?
|
Medical castration
|
|
Tumor marker CEA
|
Tumor marker elevated in colon cancer, can be used to monitor treatment or recurrence
|
|
Possible alterations in mobility after head and neck surgery
|
shoulder droop
atrophy of trapezius
forward curve of spine
limited ROM
|
|
Late effects of RT on chest
|
Breast Ca
soft tissue sarcoma
dysphagia
pulmoanry fibrosis
|
|
Lab tests done to monitor TLS
|
K
Phos
Uric Acid
Calcium
LDH
Renal function (BUN, Creatinine)
|
|
Pupil changes in ICP
|
unequal, dilated, pinpoint, nonreactive
|
|
S/S of moderate hyponatremia
|
nausea
weakness
anorexia
fatigue
muscle cramps
|
|
Define Humoral Immunity
|
B cell immunity that is meditaed by
|
|
CA 125
|
tumor marker in ovarian cancer, evaluates treatment
|
|
Late complications of stem cell transplant
|
Chronic GVHD
Herpes
|
|
Squamos cell cancers are 90% of what type of cancer?
|
Head and Neck
|
|
Tumor marker AFP
|
For testicular and primary liver
|
|
Most common cause of sepsis
|
Gram (-) bacteria
|
|
Potassium normal range
|
3.5-5.0 meq/L
|
|
CEA
|
tumor marker for colon cancer
|
|
Most aggressive type of lung cancer
|
small cell lung cancer (SCLC)
|
|
Sentinel lymph node dissection
|
removal of the first lymph node that contains cancer cells
|
|
Which IV chemo is used to treat brain tumors?
|
Carmustine
|
|
Translocation
|
chromosomal abnormality where one chromosomal segament breaks off and attaches at another site
|
|
Diagnostic tests to stage lung cancer
|
CXR
CT or MRI
Bronch
|
|
What med can be used to protect heart against effects of doxorubicin
|
Dexrazoxane
|
|
Seminoma is most responsive to what therapy?
|
Radiation
|
|
Tertiary prevention
|
helping people manage complicated, long-term health problems and maximize QOL
Rehab
Support Groups
|
|
Most common types of malignant tumors com from which brain tissue
|
Astrocytes - connective cell tissues
|
|
Stage 3 Lymphedema
|
greater than 5 cm difference
skin discolored, stretched, firm
nonpitting
|
|
Lab results indicating DIC
|
Increased D Dimer
Increased FDP
Decreased fibrinogen
Decreased platelets
|
|
How to treat itching from Hodgkins
|
Chemo or steroids
|
|
Blast crisis
|
LAst phase of CML when 30% of cells in blood or marrow are blasts.
|
|
Dose limiting toxicity for nitrogen mustard
|
Myelosuppression
|
|
S/S of hyperkalemia
|
muscle weakness
muscle cramps
bradycardia
tall T waves
|
|
Chemos used in SCLC
|
Etoposide
Cisplatin
Carboplatin
Cytoxan
Doxorubicin
Vincristine
Ifex
Combo are used most of the time
|
|
Aneuploidy
|
abnormal number of chromosomes
|
|
Late effects of RT on Heart
|
pericarditis
CAD
cardiomyopathy
pericardial effusion
MI
|
|
Adjuvant therapy
|
treatment given in addition to primary therapy
|
|
Primary lymphoid organs
|
Bone marrow - B Cells
Thymus - T Cells
|
|
Paclitaxel cardiac effects
|
asymptomatic bradycardia
|
|
5 year survival rate for lung cancer.
|
15%
|
|
What type of chemo are most effective for metastatic breast cancer?
|
Taxanes
|
|
Tx of SVCS
|
RT, chemo, steroids, surgery
|
|
a-FP tumor marker
|
sensitive for germ cell or primary liver tumor
|
|
What age should mammograms start?
|
40
|
|
Diagnostic tests for gastric cancer
|
Barium study
Biopsy
|
|
Chromosome 3p
|
Abnormal in 80% of renal cell carcinoma
|
|
Long term side effects of HSCT
|
Fatigue
Weight loss
Sexual Dysfunction
Chronic GVHD
Herpes Zoster
|
|
After pneumonectomy, how should patient be positioned?
|
On back or on operated side. DO NOT let patient lay on unoperated side.
|
|
Define Lymphoid cell line
|
Develop T cells and B cells
Key for all immune responses
|
|
Which oral alkylating agent is used to treat brain tumors?
|
Temodar
|
|
Where do more than half of breast cancers occur?
|
Upper outer quadrant
|
|
What is gold standard for treatment of pancreatic cancer?
|
Surgery
|
|
Most common sites for metastases in renal cell cancer
|
Lymph
Bone
|
|
CA 19-9
|
pancreatic tumor marker
|
|
How is esophageal cancer staged?
|
TNM
|
|
Most common site of mets from colorectal cancer
|
Liver
|
|
What chemos are worst for use 1st trimester of pregnancy?
|
Folic acid antagonists- MTX
Antimetabolites - MTX, 5FU, Cytarabine, Gemcitabine
Alkylating - Cyclophosphamide, Ifex, Melphalan, Thiotepa, Carmustine, Carboplatin, Cisplatin
|
|
Symptoms of VOD/SOS
|
weight gain
mental confusion
RUQ pain
|
|
Difference between ileal conduit and continent ileal reservoir.
|
conduit needs bag, reservoir does not
|
|
Late effects of RT on urinary
|
fibrosis
strictures
|
|
Define Cell Mediated Immunity
|
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
|
|
After lobectomy, what position should the patient not be in?
|
The patient should not lay on operative side. Decreases expansion.
|
|
What are screening tests for prostate cancer?
|
DRE
PSA
|
|
S/S of hypercalcemia
|
fatigue
lethargy
muscle weakness
impaired concentration
confusion
constipation
polyuria/polydipsia
|
|
Hematopoesis begins with which cell?
|
Pluripotent stem cells
|
|
What drug is used to treat CML in all phases?
|
Gleevec
|
|
Mesna
|
chemoprotective against hemorrhagic cystitis
|
|
Progression of SCC symptoms
|
pain
motor weakness
sensory loss
motor loss
|
|
When would you advise a patient with a trach to change to a laryngectomy tube?
|
When the stoma begins to get narrow
|
|
Early complications of stem cell transplant
|
N/V
Infection
|
|
Frameshift
|
muttation where 1+ bases are added or deleted
|
|
Most common type of breast cancer
|
invasive ductal carcinoma
70-80%
|
|
Which is most effective single agent chemo for bladder cancer?
|
Cisplatin
|
|
Late effects of RT on testicles
|
oligospermia
azoospermia
decreased testosterone
|
|
Preferred initial therapy for anal cancer
|
Chemoradiation
|
|
Which treatment option offers the best chance for cure of lung cancer?
|
Surgery
|
|
Risk factors associated with pancreatic cancer
|
smoking
processed meats
H pylori
diabetes
|
|
COBRA
|
Provides insurance for employees for 18 months and dependants for 36 months
|
|
Diagnostic studies for brain tumors
|
CT
MRI
|
|
Secondary Prevention
|
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
|
|
DIC
|
Accelerated activation of the coagulation cascade. Clots form in random places leaving the body open to bleeding without protection
|
|
S/S of mild hyponatremia
|
anorexia
HA
N/V
|
|
Sodium normal ranges
|
135-145 meq/L
|
|
Most common sites of metastases from malignant melanoma
|
Lymph
Lung
Brain
|
|
How does Allopurinol work?
|
decreases uric acid production and decreases uric acid deposits in kidney
|
|
Breast Cancer Staging Classification
|
Stage 0 - In Situ
Stage 1 - Under 2 cm with (-) nodes
Stage 2 - <5 with (+) nodes or >5 with (-) nodes
Stage 3 - > 5 with (+) or any size with breast wall extension
Stage 4 - any distant mets
|
|
Late effects of RT on Liver
|
Fibrosis
cirrhosis
|
|
Hallmark sign of hereditary cancer?
|
Multiple cancers in one person
|
|
What is the response rate of hormonal therapy in women with ER/PR (+) tumors?
|
50-70%
|
|
Magnesium normal range
|
1.8-2.4 mg/dl
|
|
Which chemos have greatest potential for producing a secondary malignancy?
|
Alkylating agents
|
|
Early symptoms of colorectal cancer
|
change in bowel habits
blood in stool
|
|
D-DImer test
|
used to diagnose or rule out conditions that cause hypercoagulability (inappropriate clotting)
|
|
Late effects of RT on Bladder
|
Fibrosis
Hyperplasia (increase in cells)
|
|
S/S of hypernatremia
|
polydipsia
low grade fever
dry skin
dry/sticky mucous membrane
|
|
What percent of patients receiving below diaphragm RT have sterility?
|
25%
|
|
Most common cause of SVC
|
Cancer, especially non-Hodgkins and lung cancer
|
|
How to treat DIC
|
Treat underlying cause
|
|
Classic triad of symptoms for advanced RCC
|
Flank pain
Hematuria
Flank mass
|
|
How does Heparin help DIC?
|
Interferes with thrombin production. Maintain PTT at 1-2 times the normal level (18-28 seconds)
|
|
Diagnostic procedures for cervical cancer
|
Colposcopy
HPV testing
cervical biopsy
cone biopsy
leep
|
|
Missense
|
single base pair change mutations
|
|
SVCS diagnostic tests
|
CT and MRI
|
|
Amifostine
|
chemoprotectant against nephrotoxicity from cisplatin
|
|
When maintaining a chest tube, what 2 things would you report to MD?
|
Bubbling in water seal chamber
Air leak noises
|
|
Mutations in p53
|
increases risk of breast, leukemia, sarcoma and adrenal cancer
|
|
Define spinal cord compression
|
Compression of the thecal sac by a tumor in the epidural space
|
|
What does ATRA treat?
|
APL
|
|
Highest risk factor for sepsis
|
Prolonged granulocytopenia (less than 500/mm3)
|
|
Monoclonal Antibodies
Fab vs Fc
|
Fab is the antigen binding site.
Fc signals cells to destroy the cell it is bound to
|
|
Why are ADH and ACTH levels sometimes higher in lung cancer patients, especially small cell?
|
The tumor can release mimics of these hormones.
|
|
What risk factor accounts for 90% of lung cancers?
|
Smoking
|
|
Late effects of RT on urinary
|
fibrosis
strictures
|
|
Important nursing intervention for patients with nephrectomy?
|
Teach deep breathing and incentive spirometry use
|
|
Dysplasia
|
loss of uniformity in the appearance of cells
|
|
Diagnostic tests for SCC
|
Plain Xray
bone scan
MRI
CT scan
|
|
Proto-oncogenes definition
|
gene that regulates normal cell growth and repair
|
|
Primary Prevention
|
protect healthy people from developing a disease
educate
screen
immunize
|
|
Clinical Trial
Phase 1
|
20-25 people
Evaluate tozicity
Establish max dose without side effects
Determine route (PO or IV)
Variety of tumor types
|
|
Common chemos used in breast cancer
|
Cytoxan
Adriamycin
Paclitaxel
Docetaxel
Epirubicin
MTX
5FU
|
|
What are primary treatment modalities for managing head and neck tumors?
|
Surgery and Radiation.
|
|
What do biphosphonates do?
|
prevent the loss of bone mass, used to treat osteoporosis, hypercalcemia, bone pain, and prevention of fractures
|
|
What does FFP do?
|
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.
|
|
Chemotherapy with best results in treating malignant melanoma
|
Dacarbazine (DTIC Dome)
|
|
Pericardial effusion diagnostic test
|
2-D echo
|
|
Late effects of RT on vagina
|
fibrosis
decreased vaginal secretions
|
|
Define interferons
|
a type of cytokine
limit spread of viral infections
first resistance
|
|
Standard treatment for early breast cancer
|
Breast conservation therapy with RT
|
|
When maintaining a chest tube, what 2 things would you report to MD?
|
Bubbling in water seal chamber
Air leak noises
|
|
Which cancers have highest incidence rates?
|
Men - Prostate
Women - Breast
|
|
Pleural Effusion
|
fluid in pleural space
|
|
What percentage of colorectal cancer patients will have surgery?
|
75%
|
|
Sarcomas originate is what tissue?
|
Connective
|
|
Define Apoptosis
|
programmed cell death
|
|
Early symptoms of colorectal cancer
|
change in bowel habits
blood in stool
|
|
S/S of hypomagnesia
|
similar to hypocalcemia
neuromuscular and CNS changes
seizures
|
|
Signs of SVCS
|
JVD
edema of face, neck, upper thorax
dyspnea
tachycardia
|
|
Features of malignant melanoma
|
Asymmetry
Uneven borders
Color variegation
> 6 mm in diameter
|
|
How does Rasburicase work?
|
catalyses the conversion of uric acid to allantoin
|
|
After lobectomy, what position should the patient not be in?
|
The patient should not lay on operative side. Decreases expansion.
|
|
Most common cancer among women
|
Breast
|
|
Triple test for diagnosing breast cancer
|
Physical Exam
Mammography
FNA
|
|
Spiral CT
|
Diagnostic test for pulmonary emboli
|
|
Lab results indicitave of TLS
|
Hyperkalemia (>5.0)
Hyperphosphatemia (>4.5)
Hyperuricemia (>8.0)
Hypocalcemia (>10.5)
Increased BUN (>20)
Increased creatinine (>1.2)
Increased LDH (>333)
|
|
Cancer most commonly associated with lymphedema
|
Breast
|
|
What does FFP do?
|
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.
|
|
Important nursing intervention for patients with nephrectomy?
|
Teach deep breathing and incentive spirometry use
|
|
What are autosomes when talking about genetics?
|
Chromosomal pairs 1-22
Do not determine gender
|
|
Myeloid cell line
|
In hematopoiesis, myeloid describes any leukocyte that is not a lymphocyte.
|
|
What tumor markers are used to measure treatment response in testicular cancer?
|
B-HCG and a-FP
|
|
Why are ADH and ACTH levels sometimes higher in lung cancer patients, especially small cell?
|
The tumor can release mimics of these hormones.
|
|
Hypocapnia
|
reduced carbon dioxide in the blood
|
|
Clinical Trial
Phase 0
|
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
|
|
Regimens that contain which type of chemo are seen as more successful in breast cancer?
|
Anthracyclines
|
|
SVCS diagnostic tests
|
CT and MRI
|
|
SIADH
|
syndrome characterized by excessive release of antidiuretic hormone (ADH or vasopressin)
|
|
Least common sign of breast cancer?
|
Pain
|
|
Tumor marker CEA
|
Tumor marker elevated in colon cancer, can be used to monitor treatment or recurrence
|
|
Most common presenting symptom of bladder cancer?
|
Hematuria
|
|
How to treat severe hyperkalemia
|
hypertonic glucose and insulin. Shifts extracellular K back into intracellular stores
|
|
Difference between ileal conduit and continent ileal reservoir.
|
conduit needs bag, reservoir does not
|
|
Cardiac Tamponade s/s
|
muffled heart sounds
weak apical pulse
mild tachycardia
mild peripheral edema
|
|
Granulocytopenia
|
failure of the bone marrow to make enough
white blood cells (neutrophils)
|
|
Most common presenting symptom of bladder cancer?
|
Hematuria
|
|
For which pulmonary toxicity does bleomycin have a high risk?
|
Pneumonitis
|
|
CA 15-3 and CA 27-29
|
tumor marker used to monitor response to treatment of invasive breast cancer
|
|
Define Innate immunity
|
immunity that occurs before the onset of infection
|
