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69 Cards in this Set

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HIV/AIDS primarily affects what lymphocyte?
CD4; Helper T-cell
Which of the following is NOT a result of HIV/AIDS infection?

A) Increased production of incomplete and nonfunctional antibodies
B) Lymphocytopenia with selective CD8 cell depletion
C) Abnormally functioning macrophages
D) Abnormal T cell function
B) Lymphocytopenia with selective CD8 cell depletion.

Remember: HIV/AIDS affects the CD4. or T-helper cells.
What is ELISA?
It is an enzyme test to determine if a person has a particular protein-- used typically in HIV/AIDS patients.
This is a measurement of the level of circulating HIV RNA, reported in copies per ml, and is a direct reflection of ongoing viral replication.
Viral load testing
True/False. Viral load testing is the best means of predicting the rate of progression to the development of AIDS and for monitoring the effects of antiretroviral therapy.
True!
True/False. Because the different viral load tests are in the same category, it is okay to alternate between them.
False. It is important to use the same test every time.
What is a common side effect of nucleoside reverse transcriptase inhibitors?
Lipodystrophy (redistribution of fat)
Peripheral neuropathy
Life threatening lactic acidosis with hepatic steatosis
What is miliary TB, and what does it have to do with HIV/AIDS?
If an HIV/AIDS patient has a CD4 count of less than 200, people with tuberculosis will often present with miliary TB-- meaning the pathogen has infected areas of the body other than the lungs (lymphatics, CNS, soft tissue, bone marrow, liver).
This HIV/AIDS opportunistic infection presents with stroke-like symptoms.
Progressive multifocal leukoencephalopathy.
"Less differentiated."
Anaplastic
The Epstein-Barr virus is associated with what cancer?
Non-Hodgkins/Hodgkins Lymphoma
These endogenous cells help cells grow and divide. Ex: In CML
Oncogenes
These genes slow down division, repair DNA mistakes, or program cells for apoptosis.
Tumor suppressor genes
Involves detection, screening to achieve early diagnosis, intervention.
Secondary intervention
Concerned with reducing cancer risk in healthy people.
Primary intervention
The only time you have metastasis is in Stage ___ of cancer.
IV
Which type of surgery is being done when lesions that are removed are likely to develop into cancer?

A) Diagnostic
B) Palliative
C) Prophylactic
D) Reconstructive
C) Prophylactic
This is the ONLY way to definitively diagnosis cancer.
Biopsy
There are three kinds of ionizing therapy. What are they?
External beam; Brachytherapy; Radiopharmaceutical therapy
This type of radiation source is outside of body, administered by machines.
External beam
In this form of radiation therapy, the source is placed into a body cavity or tumor bed.
Brachytherapy
True/False. When a patient is charged with external beam radiation, they are radioactive.
False. However, when a patient is treated with brachytherapy (internal radiation therapy), they ARE considered radioactive.
True/False. External XRT can be harmful ONLY during the time patient actually being treated.
True.
Radioprotective drug that protects certain normal tissue in the treatment area.
Amofostine
What is chemotherapy dosage based on?
Body surface area
These chemo drugs are NOT phase specific (Ex. Cisplatin).
Alkylating agents, Corticosteroids
These chemo drugs interfere with DNA growth (S phase).
Antimetabolites
These chemo drugs affect all phases of cell division.
Antitumor antibiotics
These chemo drugs interfere with enzymes that help separate strands of DNA.
Topoisomerase inhibitors
What is the chemo protocol for breast cancer?
"FAC"

5FU
Adriamycin
Cytoxan
A drug that is irritating to tissues.
Vesicant
What are the different phases of clinical trials?
Phase I: Initial evaluation in humans
Phase II: Target humans with disease
Phase III: Extended clinical evaluation with thousands of people with disease
Phase IV: Marketing; collects data from professionals
True/False. The most common cause of bleeding in cancer patients is thrombocytopenia.
True.
What are the guidelines for leukopenia?
<2000 WBCs
What are the guidelines for neutropenia?
<500-1000
How do you calculate ANC? (Absolute Neutrophil Count)
[(% neutrophils + % bands) x WBC]/100
What are the ANC guidelines? Not significant/minimal/moderate/severe?
Not significant: ANC 1500-2000
Minimal: ANC 1000-1500
Moderate: ANC 500-1000
Severe: ANC <500
What is the only indication of infection?
Fever
What is the meaning of "allogenic," "autologous," or "syngeneic"?
Allogenic: Matched donor
Autologous: Your own cells
Syngeneic: Identical twin

All of these deal with bone marrow transplants.
Which hematopoietic stem cell transplant is used most often?
Peripheral blood stem cell transplant
These are used as a homing device to take substance to the cancer cells.
Monoclonal antibodies
NHL Zevalin or Bentuximab are examples of what?
Monoclonal antibodies
These non-specific immunotherapies are approved to treat cancer alone for kidney and melanoma.
Cytokines (interleukins)
Enzyme inhibitors, apoptosis-inducing therapies, and angiogenesis inhibitors are all what kind of therapy?
Targeted therapies
True/False. Brain tumor classification is based upon location and histological characteristics.
True.
Inflammatory response of the oral tissues that commonly occurs after chemo.
Stomatitis
What are the four levels of hospice care?
1. Routine home care
2. Inpatient respite care
3. Continuous care
4. General inpatient care
What does "FICA" stand for?
Faith (belief, meaning)
Importance and Influence
Community
Address/Action in Care
This drug is used as a cytoprotective agent against radiation damage.
Amifostine (Ethyol)
Vinca and plant alkaloids are specific to the ___ phase in the cell cycle.
M (They halt mitotic spindle formation).
Agents that, if deposited into the subcutaneous tissue, cause tissue necrosis and damage to underlying tendons, nerves, and blood vessels.
Vesicants
If chemotherapeutic agents inadvertently leak from a vein, that is called:
Extravasation
The use of monoclonal antibodies is an example of what kind of cancer therapy?
Targeted therapy. More specifically, a biologic response modifier.
Neutropenia is defined as an ANC that drops below ___ cells/mm3.
1500 cells/mm3
The lowest ANC after myelosuppressive chemotherapy or radiation therapy that suppresses bone marrow function.
Nadir
Which of these factors does NOT contribute to increased risk of infection?

A) Invasive diagnostic procedures
B) Impaired nutrition
C) Bleeding and hemorrhage
D) Septic shock
E) All of these contribute to infection
E) All of these factors contribute to infection.
This is the most important sign of infection in immunocompromised patients.
Fever
Viral infections in immunocompromised patients are caused most commonly by which viruses?
Herpes and respiratory viruses
Thrombocytopenia is defined as a platelet count of less than ____.
100,000/mm3
In this stage of HIV exposure, infection becomes PERMANENT.
Integration. In this stage, new viral DNA enters the nucleus of the CD4 cell and through the action of integrase is blended with the DNA of the CD4 cell, resulting in permanent, lifelong infection.
A T cell that harbors integrated HIV DNA.
Provirus
The remaining amount of (HIV) virus in the body after the initial immune response.
Viral set point
The ____ test identifies antibodies directed specifically against HIV.
ELISA (Enzyme-linked immunosorbent assay)
True/False. Viral load is a better predictor of the risk of HIV disease progression than the CD4 count.
True. The lower the viral load, the longer the time to AIDS diagnosis and the longer the survival time.
This is the best means of predicting the rate of progression to development of AIDS and for monitoring the effects of antiretroviral therapy.
Viral load testing
This is the most common opportunistic infection in people with AIDS.
Pneumocystis pneumonia
This is the most common HIV-related malignancy.
Kaposi sarcoma
True/False. It is possible to have shingles on more than one dermatome.
True. Usually occurs in patients who are immunocompromised-- i.e., AIDS.
In immunosuppressed patients who test positive for a CMV infection, what is your primary concern?
The EYES! Cytalomegalovirus can make a patient go blind if they are not treated soon enough.