Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
348 Cards in this Set
- Front
- Back
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
|