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70 Cards in this Set
- Front
- Back
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Macule
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a small, flat, nonpalpable spot up to 1cm in diameter with a circumscribed area of color change. Examples include freckles, care-au-lait spots, and pigment changes associated with vitiligo. - a spot 1 cm or larger is called a patch
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Papule
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an elevated solid lesion measuring up to 1 cm. Common examples include insect bites, scabies, and the viral infection molluscum contagiosum
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Plaque
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an elevated superficial palpable solid mass, 1 cm or larger, frequently formed by coalescent papules. Examples include psoriasis and discoid lupus erythematosus
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Nodule
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an elevated, palpable, firm and sometimes tender lesion larger than 0.5 cm that can involve all layers of the skin. Examples include dermatofibroma and nodules associated with cutaneous dermatitis
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Bulla
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a vesicle 1 cm or larger, such as bullous pemphigoid lesion or severe reactions to an insect bite
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Pustule
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an elevated, superficial lesion filled with purulent fluid or pus, caused by conditions such as impetigo and acne
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Wheals
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Relatively transient, superficial, elevated, palpable, irregular-shaped areas of localized cutaneous edema with red, pale pink, or white color. An example is urticara (hives) caused by insect bites
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Epidemiology
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looking at what environmental conditions, lifestyles or circumstances are associated with disease
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Prevalence
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designated time of disease in one area
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Incidence
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new disease in a certain time period in a certain population
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Hyperplasia
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Increase in # of cells in a tissue or organ
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Metaplasia
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process in which once cell type in an organ is replaced by another cell type
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Dysplasia
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alteration in the shape, size, or organization of adult cells
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Anaplasia
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undifferentiated cells that have lost their structural organization
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Intravasation
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process where malignant cells invade the vascular or lymphatic system
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Cachexia
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condition of malnutrition, muscle wasting and ill health
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Extravasation
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process where medications or cancer cells can escape vascular system and enter tissue
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Alkylating drugs which inhibit production of DNA and are utilized in cancer therapy to stop cancer growth can cause:
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Nausea & vomiting
Reduction of white blood cells Stomatitis Renal Failure |
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A good option for the cancer patient experiencing N&V besides an antiemetic is:
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High calorie, high-protein dietary supplements
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The nurse may identify this as an early warning sign of cancer:
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Changes in bowel or bladder habits
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Vitiligo
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Localized loss of melanocytes from the skin and hair causing white patches
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Exfoliative
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produces a "scalded skin" appearance due to toxins from s. aureus strains
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Vesicle
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A small blister like round elevation on the skin containing serous fluid that can be clear or opaque
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Lice of the head
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pediculosis capitis
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Lice of the body
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pediculosis corporis
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An antibiotic prescribed for acne problems is intended to:
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decrease the bacterial lode on the skin
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Varicella Immunization
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First dose 12 mo, second dose before 4 years or at least 3 mo after first dose
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MMR immunization (measles, mumps, rubella)
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First dose after 12 (to 18) mo, second before 4 years with at least 4 weeks between doses (roughly 36 mo)
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Scarlet Fever
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Infectious disease, most commonly affects 6 - 12 y/o
Sx: sore throat, fever, characteristic red rash Usually spread via inhalation, no vaccine is available but antibiotics are effective. Infection caused by group A strep |
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Roseola
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Viral infection that usually affects children 6mo - 3yr.
Sx: marked by several days of fever and a characteristic rash that appears as the fever breaks, mild upper resp illness Caused by virus closely related to herpes simplex virus |
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Fifth Disease or Erythema infectiosum (parovirus B19)
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Mild rash illness.
Sx: shows 4 to 14 days after infection. Fever, runny nose, headache, followed by rash. Rash on face known as "slapped cheek rash", hallmark of the disease Usually affects kids between 5 & 15. Relatively mild and will spontaneously resolve without tx |
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Rubella - German Measles signs and symptoms)
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Intensely red discrete macular rash, starts on face and spreads rapidly to trunk, arms, and legs.
Other symptoms include: lethargy, slight temp, general lymphadenopathy, anorexia. Mild infection will last 3 to 5 days. Transmission: direct contact through nasopharyngeal secretions (airborne, droplet, blood, stool, urine, and skin) or indirect from objects Incubation: 14 - 21 days Communicable: 7 days before and 5 days after rash |
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Effects of congenital Rubella
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cataracts, cardiac defects, deafness and blind, mental retardation, still born. Pregnant women should be isolated from those infected.
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Rubella: Transmission, incubation, when is it communicable
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Transmission: direct contact, through nasopharyngeal secretions (airborne and droplet), and blood, stool, urine, and skin, or indirectly from objects.
Incubation: 14 - 21 days Communicable: 7 days before and 5 days after rash |
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Rubeola - Measles (signs and symptoms)
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Sx: early sx fever and malaise. Begins upper resp with fever, soar throat, and cough. (up to 104 F). With in 24 hours rash and koplik spots appear. 3 to 4 days confluent maculopapules appear on the trunk and face and discrete on extremities. Koplik spots on buccal mucosa are the characteristic sign of rubeola.
Grain of sand size small red spots with bluish white center on buccal mucosa. After 3 to 4 full days desquemation occurs. Infected with generally present with abdominal pain, malaise, and lymphadenopathy |
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Rubeola: Transmission, incubation, and when it is communicable
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Transmission: usually direct contact with droplets, primarily occurs in winter
Incubation: 10 - 20 days Communicable: 4 days before and 5 days after rash |
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Mumps
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Virus
Transferred: saliva During prodromal phase will show fever, malaise, HA, anorexia 24 hour then earache. Painful enlargement of the parotid unilateral or bilateral causing the pain. Lasts 14 - 21 days and is communicable immediately before and after Tx: analgesics, antipyretics Complications: infections of ear. Males may be left sterile from the high fever. Relieve orchitis with warmth and support. |
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Scarlet Fever -- B Hemolytic Strep Group A
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During first 2 days: tongue becomes white and furry appearing,
Day 3: papillae enlarge and tongue looks like white strawberry Day 4/5: coat goes away and leaves "strawberry tongue" -- hallmark that differentiates scarletfever from other diseases Tx: analgesic for pain, fever, itch. Penicillin or cephalosporin oral for 10 days (may also use bicillin IM) Complications: Otitis media, sinusitis, abcesses, acute rheumatic fever (autoimmune response to bacterial antigens in strep), and acute glomerulonephritis in 2 - 3% |
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Varicella zoster - Herpes Virus
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Highly contagious - transferred through contact, airborne, droplet, objects
10 - 21 days: Infectious from 1-2 days before lesions appear until all lesions crust over (5 - 6 days) Most commonly occurs in late winter, early spring Lifelong immunity once exposed |
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Varicella zoster -- Symptoms and Tx
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Sx: low grade fever, malaise, anorexia, prodromal phase lasts 24 hours
Acute phase: lesions begin to turn red, maculopapular rash, almost immediately turns into vesicles with erythemic bases. Vesicles ooze and crust. Tx: manage sx. Cut nails, cool sponge baths, fluids. Diphenhydramine or antihistamine. Don't remove crusts, will increase the scarring. |
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What is staging?
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Staging describes the severity of a person’s cancer based on the extent of the original (primary) tumor and whether or not cancer has spread in the body. Staging is important for several reasons
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Why is staging important?
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• Staging helps the doctor plan the appropriate treatment.
• The stage can be used to estimate the person’s prognosis. • Knowing the stage is important in identifying clinical trials that may be suitable for a particular patient. • Staging helps health care providers and researchers exchange information about patients; it also gives them a common terminology for evaluating the results of clinical trials and comparing the results of different trials |
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Common elements considered in staging systems?
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• Site of the primary tumor.
• Tumor size and number of tumors. • Lymph node involvement (spread of cancer into lymph nodes). • Cell type and tumor grade* (how closely the cancer cells resemble normal tissue cells). • The presence or absence of metastasis |
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What is tumor grade?
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Tumor grade is a system used to classify cancer cells in terms of how abnormal they look under a microscope and how quickly the tumor is likely to grow and spread. Many factors are considered when determining tumor grade, including the structure and growth pattern of the cells. The specific factors used to determine tumor grade vary with each type of cancer.
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Histologic grade / differentiation
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refers to how much the tumor cells resemble normal cells of the same tissue type
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Oncogenesis
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Process of causing or cancerous cell changes. CA may be activated ny genes called proto-oncogenes. May be caused when certain viruses invade normal cells or once the correct mutation has occured.
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Hypertrophy
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the increase in the size of a cell, tissue, or body organ. May be normal in the case of muscle growth with exercise
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Atrophy
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cells small, decreased in size, wasting away or decline -- may be normal in age
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Hyperplasia
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increase in the number of cells in a tissue or organ. It is normal cellular response when a physiologic demand exists and an abnormal response when growth exceeds demand. Normal instances would be wound healing, inflammatory response, or adolescent growth spurts
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Metaplasia
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Process in which one adult cell type in an organ is replaced by another adult cell type -- may be reversible if the cause is removed, or may progress to dysplasia
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Dysplasia
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Alteration in the shape, size, and organization of adult cells. Loss of DNA control over differentiation occuring in response to adverse conditions. Can be reversible or can proceed to irreversible neoplastic changes
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Anaplasia
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undifferentiated cells (poorly developed); have lost their structural organization -- not reversible
Tabers: loss of cellular differentiation and function, characteristic of most malignancies |
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8 Signs of cancer in children
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1) swollen glands
2) Headache 3) Eye deviation (remember cross eyed for first 6/mo 4) Weight loss 5) Palpable Abdominal Mass 6) Ecchymotic Marks 7) Heat or swelling in large joint 8) Nausea and Vomiting |
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3 most common cancers in children
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Leukemia, Brain, Soft tissue
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Growth Fractions
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Relationship between those cells proliferating and those resting (proliferating vs G0)
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Unguium
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Fungal infection of nails
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Urticaria
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Hives
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Lichenification
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Skin becomes thick and leather
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Primary Cancer Prevention
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Trying to prevent the pt from getting the problem. Includes education, immunization, reduce carcinogens in the environment and diet, and safety programs/sanitation
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Secondary Cancer Prevention
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Signs of the disease may already be present in the pt - trying to slow/stop/remove problem. Includes Screenings, Exams (mammo), yearly physicals, hemoccult, weight reduction, mental health counseling
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Tertiary Cancer Prevention
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Pt already has the problem. Includes asthma/child cancer camps, rehab treatment, obesity/anorexia, special education
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Neoplasm
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New and abnormal tissue formation, as tumor or growth. No purpose in the body and grows at the expense of the healthy body
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Benign Neoplasm
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Well differentiated
Slow growth/orderly Encapsulated Expands rather than invading Well defined borders / regular shape Does not recur Constantly divides |
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Malignant Neoplasm
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Poorly differentiated / anaplastic
Persistent proliferation Not encapsulated (invasive) Formation of metastases Immortality (can recur/end less divisions) Irregular shape |
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Tumor Markers
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Cell surface proteins (Ca 125 - ovarian)
Oncofetal antigens (AFP, CEA) Cell enzymes (PSA - prostate) Hormones (ACTH, ADH, hCG) Tissue injury marker (LDH) Antibodies - specific to cancer antigens or proteins (gamma globulins) microRNA (SCCA-7/08) |
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Tumor grade
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How closely the cancer cells resemble normal tissue cells
Grade GX Grade cannot be assessed (Undetermined grade) G1 Well-differentiated (Low grade) G2 Moderately differentiated (Intermediate grade) G3 Poorly differentiated (High grade) G4 Undifferentiated (High grade) |
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Staging
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(1-4) TNM
Tumor Size & number of tumors Lymph Node involvement Metastasis (presence of) |
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Diagnosing cancer
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WBC may be to high or to low
H & H generally to low -- Normal hemoglobin: 12 - 17 Normal Hematocrit: 37 - 49 Platelet generally to low (normal 150 - 450) Increase in protein and IGg in certain cancers. Difnitice diagnostic is biopsy Cytological Exam Imaging -- xray, CT, MRI Direct visualization (surgery) |
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Seven warning signs of cancer
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Change in bowel and bladder habits
A sore that does not heal Unusual bleeding or discharge Thickening or lump breast or other Indigestion or difficulty swallowing Obvious change in wart or mole Nagging cough or hoarseness |
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Healthy living choices for preventing cancer
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Avoid tobacco - quit if using
Exercise 30 min 3 to 4x per week Limit time in the sun Maintain healthy weight 5 fruit/veg serving QD Limit alcohol consumption Protect from STI Get annual check up, recommended screening tests Know family Hx (suggests which prevention strategies and early screenings may be beneficial) Should begin in early childhood |
