OCN Study Guide Flashcards

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

MTX
Vinblastine
Adriamycin
Cisplatin
Define ileal conduit
urine reservoir created after bladder is removed
Difference between ileal conduit and continent ileal reservoir.
conduit needs bag, reservoir does not
Which is most effective single agent chemo for bladder cancer?
Cisplatin
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
Most common sites for metastases in renal cell cancer
Lymph
Bone
Chromosome 3p
Abnormal in 80% of renal cell carcinoma
Most common diagnostic test for RCC?
KUB radiography
Classic triad of symptoms for advanced RCC
Flank pain
Hematuria
Flank mass
When should prostate screening start?
Age 50 for average risk
Age 40 for African Americans and familial history
What are screening tests for prostate cancer?
DRE
PSA
Most frequent treatment for advance prostate cancer?
Medical castration
Most common presenting symptom of bladder cancer?
Hematuria
Diagnostic tests for bladder cancer
IVP
Cystoscopy
Important nursing intervention for patients with nephrectomy?
Teach deep breathing and incentive spirometry use
Paralytic ileus
Obstruction of the intestine due to paralysis of the intestinal muscles
Caution nephrectomy patient to avoid nephrotoxic drugs such as what?
NSAIDS
Screening tests for bladder cancer
None. Also none for kidneys.
Most common chemo to treat bladder cancer
Mitomycin
When used with surgery, what chemo doubles survival rates in bladder cancer?
MVAC

MTX
Vinblastine
Adriamycin
Cisplatin
Define ileal conduit
urine reservoir created after bladder is removed
Difference between ileal conduit and continent ileal reservoir.
conduit needs bag, reservoir does not
Which is most effective single agent chemo for bladder cancer?
Cisplatin
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
Ethnic group most at risk for nonmelanoma skin cancers
Caucasian
Chemotherapy with best results in treating malignant melanoma
Dacarbazine (DTIC Dome)
Most important feature when determining prognosis in malignant melanoma.
Size and depth of lesion at time of diagnosis
Most common sites of metastases from malignant melanoma
Lymph
Lung
Brain
What are nonmelanoma skin cancers?
Basal and Squamos
Features of malignant melanoma
Asymmetry
Uneven borders
Color variegation
> 6 mm in diameter
Chemos used to treat malignant melanoma
Dacarbazine
Nitrosureas (Carmustine, Lomustine)
temolozamide (Temodar) (PO)
Squamos cell cancers are 90% of what type of cancer?
Head and Neck
Head and Neck cancer with highest survival rate
Thyroid
What are primary treatment modalities for managing head and neck tumors?
Surgery and Radiation.
When would you advise a patient with a trach to change to a laryngectomy tube?
When the stoma begins to get narrow
Most common infection of oropharynx
Candidasis
Major toxicity of cisplatin
Nephrotoxicity

**Also ototoxicity**
Possible alterations in mobility after head and neck surgery
shoulder droop
atrophy of trapezius
forward curve of spine
limited ROM
Most common presenting symptoms in clients with a brain tumor
Seizure
HA
Unilateral Hemiparesis
Most common types of malignant tumors com from which brain tissue
Astrocytes - connective cell tissues
Which oral alkylating agent is used to treat brain tumors?
Temodar
Which IV chemo is used to treat brain tumors?
Carmustine
Mets to the spine occur most frequently in what cancers?
Breast
Lung
Prostate
Diagnostic studies for brain tumors
CT
MRI
What does ATRA treat?
APL
Which drug binds to CD33 antigen?
Gemtuzumab (Mylotarg)
Blast crisis
LAst phase of CML when 30% of cells in blood or marrow are blasts.
Which type of leukemia affects CNS?
ALL
Most common childhood leukemia
ALL
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
What drug is used in chronic phase CML to control leukocytosis?
Hydroxyurea
What drug is used to treat CML in all phases?
Gleevec
Reed Sternberg cells
shows in biopsy of patient with Hodgkins
Most common cause of pain in MM
Bone mets/lesions
Tests done to measure response to MM treatment
Blood tests
Urine tests
24 hour urine- measure protein and creatinine
Myeloma survey - detect skeletal lesions
How to treat itching from Hodgkins
Chemo or steroids
Mets from osteosarcoma usually affect what area of the body?
Lung
S/S of osteosarcoma
pain
swelling
Most frequently diagnosed HIV related cancer
B cell
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
Most common side effect of interferon therapy
Fatigue
Innate immunity
Immunity that does not respond to specific antigens
Principal toxicity of vincristine
peripheral neuropathy
Dose limiting toxicity of cisplatin
nephrotoxicity
Dose limiting toxicity for nitrogen mustard
Myelosuppression
Mesna
chemoprotective against hemorrhagic cystitis
Amifostine
chemoprotectant against nephrotoxicity from cisplatin
When do Carbo reactions happen
After 6th cycles, mid cycle.
Early complications of stem cell transplant
N/V
Infection
Late complications of stem cell transplant
Chronic GVHD
Herpes
Target organs of acute GVHD
skin
liver
gut
Target organs of chronic GVHD
vagina
eyes
mouth
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
Long term side effects of HSCT
Fatigue
Weight loss
Sexual Dysfunction
Chronic GVHD
Herpes Zoster
Symptoms of VOD/SOS
weight gain
mental confusion
RUQ pain
Which chemos have greatest potential for producing a secondary malignancy?
Alkylating agents
Risk factors associated with pancreatic cancer
smoking
processed meats
H pylori
diabetes
Primary Prevention
protect healthy people from developing a disease

educate
screen
immunize
Tertiary prevention
helping people manage complicated, long-term health problems and maximize QOL

Rehab
Support Groups
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
most common worldwide cancers
lung
stomach
liver
selective/prescriptive screening
looks for specific problems within a high risk group
a-FP tumor marker
sensitive for germ cell or primary liver tumor
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
CEA
tumor marker for colon cancer
CA 19-9
pancreatic tumor marker
/ 348
Term:
Definition:
Definition:

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Comments ({[ getComments().length ]})

{[comment.username]}

{[ comment.comment ]}

View All {[ getComments().length ]} Comments
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