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296 Cards in this Set
- Front
- Back
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Pleural Effusion
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fluid in pleural space
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pneumothorax
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air in the pleural space
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Which chemo has a high risk for pulmonary toxicity?
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bleomycin (Blenoxane)
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For which pulmonary toxicity does bleomycin have a high risk?
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Pneumonitis
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Hypocapnia
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reduced carbon dioxide in the blood
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Signs and Symptoms of pleural effusion
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tachypnea (fast breathing)
decreased breath sounds dullness to percussion |
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Define Lymphedema
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obstruction of lymphatic system that caused overload of lymph in the interstitial space
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Define Edema
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fluid in the interstitial space
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Cancer most commonly associated with lymphedema
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Breast
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Stage 1 Lymphedema
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less than 3 cm difference
pitting edema |
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Stage 2 Lymphedema
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3-5 cm difference
skin stretched and shiny nonpitting |
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Stage 3 Lymphedema
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greater than 5 cm difference
skin discolored, stretched, firm nonpitting |
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Lymphedema treatment
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compression garment
manual lymphatic drainage elevation aerobic exercise with strength training low sodium diet |
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Sentinel lymph node dissection
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removal of the first lymph node that contains cancer cells
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Hematoma
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abnormal collection of blood in tissues
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Pericardial effusion
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excess fluid around the heart
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Tumors associated with malignant pericardial effusions
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Lung
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High dose cyclophosphamide cardiac effects
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damaged cardiac endothelium
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Paclitaxel cardiac effects
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asymptomatic bradycardia
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5FU cardiac effects
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coronary artery spasm
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Anthracycline (Daunorubicin, doxorubicin, and epirubicin) cardiac effects
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cardiomyopathy
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Diagnostic test for pericardial effusion
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Echo
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Abnormalities of what electrolyte and what mineral interfere with cardiac function?
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Potassium and Calcium
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What med can be used to protect heart against effects of doxorubicin
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Dexrazoxane
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Spiral CT
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Diagnostic test for pulmonary emboli
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D-DImer test
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used to diagnose or rule out conditions that cause hypercoagulability (inappropriate clotting)
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DIC
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Disseminated Intravasular Coagulation
Accelerated activation of the coagulation cascade. Clots form in random places leaving the body open to bleeding without protection |
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Platelet count, Fibrinogen level, D Dimer, FDP Titer
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Tests to diagnose DIC
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How to treat DIC
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Treat underlying cause
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What does FFP do?
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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.
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Most common cancer associated with DIC?
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Leukemia, specifically APL
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Signs/Symptoms of DIC
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bleeding from 3 unrelated sites
hypoxia SOB fever mottled extremities |
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Causes of DIC
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Delivery (of baby)
Infection Cancer |
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How does Heparin help DIC?
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Interferes with thrombin production interrupting the coagulation cascade. Maintain PTT at 1-2 times the normal level (18-28 seconds)
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Lab results indicating DIC
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Increased D Dimer
Increased Fibrin Degradation Products (FDP) Decreased fibrinogen Decreased platelets |
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S/S of septic shock
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Fever
Tachycardia Hypotension |
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Most common cause of sepsis
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Gram (-) bacteria
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Granulocytopenia or Neutropenia
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failure of the bone marrow to make enough
white blood cells (neutrophils) |
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Highest risk factor for sepsis
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Prolonged granulocytopenia or neutropenia (less than 500/mm3= 5000/cmm)
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Define Tumor Lysis Syndrome (TLS)
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metabolic imbalance that occurs with rapid tumor kill
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What cancer commonly produces TLS?
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High grade lymphoma
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Lab results indicitave of TLS
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Hyperkalemia (>5.0)
Hyperphosphatemia (>4.5) Hyperuricemia (>8.0) Hypocalcemia (>10.5) Increased BUN (>20) Increased creatinine (>1.2) Increased LDH (>333) |
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Lab tests done to monitor TLS
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Complete Metabolic Profile (CMP)
specifically K+, Phos, Uric Acid, Calcium, LDH, BUN, Creatinine |
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How to treat severe hyperkalemia
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hypertonic glucose and insulin. Shifts extracellular K back into intracellular stores
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How does Allopurinol work?
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decreases uric acid production and decreases uric acid deposits in kidney
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How does Rasburicase work?
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catalyses the conversion of uric acid to allantoin
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S/S of hyperkalemia
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muscle weakness
muscle cramps bradycardia tall T waves |
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S/S of hypokalemia
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decreased reflexes
irregular pulse fatigue N/V flat t wave V fib if severe |
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Calcium normal range
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8.5-10.5 meq/L
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S/S of hypercalcemia
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fatigue
lethargy muscle weakness impaired concentration confusion constipation polyuria/polydipsia |
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S/S of hypocalcemia
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diarrhea
neuromuscular irritability (Chvostek's sign) tingling of fingers and toes seizures |
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Potassium normal range
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3.5-5.0 meq/L
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Sodium normal ranges
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135-145 meq/L
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S/S of hypernatremia
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polydipsia
low grade fever dry skin dry/sticky mucous membrane |
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S/S of mild hyponatremia
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anorexia
HA N/V |
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S/S of moderate hyponatremia
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nausea
weakness anorexia fatigue muscle cramps |
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S/S of severe hyponatremia
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seizures
AMS |
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First treatment for hyponatremia
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Fluid restrict 500-1000 ml per day
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Magnesium normal range
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1.8-2.4 mg/dl
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S/S of hypermagnesia
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lethargy
flushing diaphoresis |
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S/S of hypomagnesia
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similar to hypocalcemia
neuromuscular and CNS changes seizures |
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SIADH
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Syndrome of Inappropriate Diuretic Hormone
syndrome characterized by excessive release of antidiuretic hormone (ADH or vasopressin) causes retention of water and NA+ concentration dilution |
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Superior Vena Cava Syndrome
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compromised venous drainage of the head, neck, upper extremities due to compression or obstruction of the vessel
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Most common cause of SVC
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Cancer, especially non-Hodgkins and lung cancer
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Signs of SVCS
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JVD
edema of face, neck, upper thorax dyspnea tachycardia |
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SVCS diagnostic tests
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CT and MRI
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Tx of SVCS
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RT, chemo, steroids, surgery
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Cushings Triad symptoms
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HTN
bradycardia abnormal respirations |
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Pupil changes in ICP
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unequal, dilated, pinpoint, nonreactive
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Cardiac tamponade definition
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excessive fluid in pericardial space decreases hearts ability to fill and pump
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Cardiac Tamponade s/s
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muffled heart sounds
weak apical pulse mild tachycardia mild peripheral edema |
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Pericardial effusion diagnostic test
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2-D echo
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Define spinal cord compression (SCC)
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Compression of the thecal sac by a tumor in the epidural space
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Cauda Equina
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structure within the lower end of the spinal column, that consists of nerve roots and rootlets
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Most common loca for malignant invasion of spinal cord that cause SCC
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Outside of the spinal cord (extradural)
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Most common early symptom of SCC
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neck or back pain
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Progression of SCC symptoms
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pain
motor weakness sensory loss motor loss |
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Pain during SCC usually occurs during what position?
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Lying down supine
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Diagnostic tests for SCC
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Plain Xray
bone scan MRI CT scan |
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Tumor Antiangiogenesis factors
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factors that suppress tumors ability to grow new blood vessels
angiogeneis is the growth process by which develops new blood supplies and allows for metastisis |
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Cancer
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malignant disease with 3 characteristics
1. abnormal cell proliferation 2. unchecked local growth and invasion of surrounding tissue 3. ability to metastasize |
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Sarcomas originate is what tissue?
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Connective
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Proto-oncogenes definition
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gene that regulates normal cell growth and repair
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tumor suppressor gene
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gene that stops, inhibits, or suppresses cell division
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Neoadjuvant Therapy definition
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given before primary tx to control potential mets
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CA 125
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tumor marker in ovarian cancer, evaluates treatment, elevated in over 80% of ovarian ca pts
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Difference between benign and malignant tumors
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Malignant can metastasize
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Dysplasia
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abnormality of cellular development, alteration in size, shape, and organization of adult cells
Ex. Carcinoma in situ |
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Define hematopoesis
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Hematopoiesis is the process of production, multiplication, and specialization of blood cells in the bone marrow
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Define immune surveillance
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The body's ability to scan for and destroy malignant or altered cells
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Hematopoesis begins with which cell?
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Pluripotent stem cells
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Fab vs Fc
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Parts of a antibody
Fragment Antigen Binding (Fab) is the antigen binding site. Fragment Crystalization (Fc) signals cells to destroy the cell it is bound to |
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Which antineoplastic categories of drugs are nonspecific?
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Alkylating - Cytoxan, Platinums (Carbo, Cis, Oxal)
Nitrosureas - Lomustine Antitumor antibiotics - Bleo, Doxorubicin Hormonal therapies - Tamoxifen, Armotase Inhibitor |
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What is AUC?
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Area Under the Curve
Amount of drug exposure or total drug concentration over time. Used for Carboplatin dosing AUC = (Drug Bioavailability * Dose) / Drug Clearence |
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What percent of patients receiving below diaphragm RT have sterility?
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25%
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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 |
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Chemos that affect fertility
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Lomustine
Doxorubicin Melphalan Cyclophosphamide 5FU Cytarabine |
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What chemos are worst for use 1st trimester of pregnancy?
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Folic acid antagonists- MTX
Antimetabolites - MTX, 5FU, Cytarabine, Gemcitabine Alkylating - Cyclophosphamide, Ifex, Melphalan, Thiotepa, Carmustine, Carboplatin, Cisplatin |
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What is the PLISSIT model of nursing?
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Permission to discuss
Limitied Information Specific Suggestion Intensive Therapy |
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Federal Rehab Act of 1973
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federally funded employers can't discriminate against handicapped
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What is COBRA
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Consolidated Omnibus Budget Reconciliation Act
Allows employees to pay premiums to keep group insurance despite loss of employment for 18 months and dependents for 36 months |
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Social Security Disability Insurance Program
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Federal insurance program, If patient has paid in previously, they are eligible 6 months after being impaired
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Late effects of RT on Abdomen
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Adhesions
Fibrosis |
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Late effects of RT on Bladder
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Fibrosis
Hyperplasia (increase in cells) |
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Late effects of RT on CNS
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Stroke
Blindness |
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Late effects of RT on chest
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Breast Ca
soft tissue sarcoma dysphagia pulmoanry fibrosis |
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Late effects of RT of Head/Neck
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hypo or hyperthyroid
mandibular osteonecrosis alopecia cavities decreased hearing |
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Late effects of RT on Heart
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pericarditis
CAD cardiomyopathy pericardial effusion MI |
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Late effects of RT on Liver
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Fibrosis
cirrhosis |
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Late effects of RT on Ovaries
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failure
premature menopause |
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Late effects of RT on Skeletal
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Late fx
osteonecrosis |
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Late effects of RT on Skin
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fibrosis
necrosis basal cell hyperpigmentation |
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Late effects of RT on testicles
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oligospermia - Low sperm count
azoospermia - NO sperm count decreased testosterone |
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Late effects of RT on urinary
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fibrosis
strictures |
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Late effects of RT on vagina
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fibrosis
decreased vaginal secretions |
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Define Myeloid cell line
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precursor stem cells that when mature produce leukocytes ( Neutrophil, esinophil, basophil, monocytes, erythrocytes macrophages and megakaryocytes )
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Primary lymphoid organs
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Bone marrow - producing B Cells
Thymus - producing T Cells |
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Define Lymphoid cell line
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precursor stem cells that produce specialized lymphocytes (T cells, B cells & NK-natural killer cells)
Key for all immune responses |
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Define Humoral Immunity
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acquired immunity in which the role of circulating antibodies is predominant mediated by B cells
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Define Cell Mediated Immunity
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T cell driven immune response that does not involve antibodies but involves activating macrophages, NK cells, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen
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Define NK Cells
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Natural Killer Cells
kill cells by releasing small proteins that cause the target cell to die by apoptosis. |
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Define Apoptosis
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programmed cell death
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Define Cytokines
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protein released by cells that has specific effect on the interactions, communications, & behavior of cells.
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Types of cytokines
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interleukins
lymphokines cell signal molecules (tumor necrosis factor interferons (trigger inflammation and respond to infections |
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Describe Innate immunity
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Innate immunity refers to immunity you are born with, present at all times and is nonspecific defense mechanisms occurs immediately after antigen's appearance, mechanisms include physical barriers (Skin), chemicals in the blood (stomach pH), and immune system cells that attack foreign cells (NK cells & WBC)
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Describe B cells
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Developed in bone marrow
Differentiate into plasma cells, which produce immunoglobulins (IgG, IgA, IgM, IgE, IgD) attach to antigens & pathogens and reproduce to provide active and future immunity |
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Define phagocytes
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cells that engulf and consume pathogens
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Define interferons
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a type of cytokine
limit spread of viral infections first resistance |
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Can innate immunity target specific pathogens?
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No - Innate immunity is non-specific, responds to all pathogens the same
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Define gene
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individual unit of hereditary info
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Genes responsible for family cancer syndrome are what gene?
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tumor suppressor gene
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How many chromosomes in human body?
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46 individual or 23 pairs
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What are autosomes when talking about genetics?
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Chromosomal pairs 1-22
Do not determine gender |
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What are sex chromosomes?
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Chromosomes that decide sex
Women are X X Men are XY |
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Mutations in APC gene (Adenomatous Polyposis Coli)
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increases risk of colon cancer
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Mutations in PTEN gene (Phosphatase and Tensin Homolog)
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increases risk of breast, thyroid, and endometrial cancer
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Mutations in Tp53
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increases risk of breast, leukemia, sarcoma and adrenal cancer
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Hallmark sign of hereditary cancer?
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Multiple cancers in one person
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Frameshift mutation
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A mutation in a DNA chain that occurs when the number of nucleotides inserted or deleted is not a multiple of three, so that every codon beyond the point of insertion or deletion is read incorrectly during translation
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Missense mutation
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is a point mutation in which a single nucleotide change results in a codon that codes for a different amino acid
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RNA Negative Mutation
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mutation with an abscence of RNA transcribed from gene
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Polymorphisms
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the presence of genetic variation within a population
changes in DNA sequence often not disease related |
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Translocation Mutation
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chromosomal abnormality where one chromosomal segament breaks off and attaches at another site
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Aneuploidy
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The occurrence of one or more extra or missing chromosomes leading to an unbalanced chromosome complement, or, any chromosome number that is not an exact multiple of the haploid number
**abnormal number of chromosomes |
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In-Situ Cancer
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Noninvasive, early stage cancer in which the cancerous growth or tumor is still confined to the site from which it started, and has not spread
Ex: Breast Cancer DCIS |
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Most common type of breast cancer
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invasive ductal carcinoma
70-80% |
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Most aggressive breast cancer
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inflammatory breast cancer
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Least common sign of breast cancer?
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Pain
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Modified radical mastectomy
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removal of the entire breast and the lymphatic-bearing tissue in the armpit
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Can women with breast cancer have estrogen replacemtn therapy?
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No, women who have had HRT have 3 x the recurrence risk
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Most common sites of mets from breast cancer?
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IN ORDER
Bone Lung Liver Brain |
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What do biphosphonates do?
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prevent the loss of bone mass, used to treat osteoporosis, hypercalcemia, bone pain, and prevention of fractures Ex: Zometa & Reclast
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What do Aromatase Inhibitors do?
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used to treat breast cancer in women who have gone through menopause. Stops estrogen production by blocking key enzyme from changing other hormones into estrogen. Ex: Exemestrane (Aromasin), Letrozole (Femera), Anastrozole (Aremidex)
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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 |
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Clinical Trial
Phase 1 |
20-25 people
Evaluate tozicity Establish max dose without side effects Determine route (PO or IV) Variety of tumor types |
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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 |
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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 |
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Clinical Trial
Phase 4 |
Can it do anything else?
Expand off label use Assess toxicity and long term effects Usually after FDA approval |
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Most common cancer among women
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Breast
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Describe Invasive breast ca
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no longer contained by breast
capable of metastases |
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What age should mammograms start?
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40
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Three tests for diagnosing breast cancer
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Physical Exam
Mammography Biopsy - Fine Needle Aspiration (FNA) |
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Breast Cancer Staging Classification
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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 |
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Standard treatment for early breast cancer
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Breast conservation therapy with Radiation Therapy
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Gold standard for staging breast cancer
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axillary lymph node dissection
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Adjuvant therapy
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Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back
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Neoadjuvant therapy
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Treatment given as a first step to shrink a tumor before the main treatment, which is usually surgery, is given. It is a type of induction therapy.
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Common side effects of breast RT
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skin reactions
fatigue |
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What is the response rate of hormonal therapy in women with ER/PR (+) tumors?
|
50-70%
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Common chemos used in breast cancer
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Cytoxan, Adriamycin, Paclitaxel, Docetaxel, Epirubicin
Methotraxate (MTX), 5FU |
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What type of chemo are most effective for metastatic breast cancer?
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Taxanes
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Risk factors for breast cancer
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No children
First pregnancy after 30 Early periods Late menopause Hormone replacement therapy |
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Where do more than half of breast cancers occur?
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Upper outer quadrant
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CA 15-3 and CA 27-29
|
tumor marker used to monitor response to treatment of invasive breast cancer
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CEA
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Tumor marker elevated in colon cancer, can be used to monitor treatment or recurrence
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Most aggressive type of lung cancer
|
small cell lung cancer (SCLC)
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Which cancer is leading cause of death for men and women?
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Lung
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What risk factor accounts for 90% of lung cancers?
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Smoking
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Which cancers have highest incidence rates?
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Men - Prostate
Women - Breast |
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5 year survival rate for lung cancer.
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15%
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Which treatment option offers the best chance for cure of lung cancer?
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Surgery
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Diagnostic tests to stage lung cancer
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CXR
CT or MRI Bronchoscopy |
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Chemos used in SCLC
|
Etoposide
Cisplatin Carboplatin Cytoxan Doxorubicin Vincristine Ifex Combo are used most of the time |
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What type of chemo is standard of care in NSCLC?
|
Platinum based with Cisplatin or Carboplatin
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Why are most lung cancer patients good candidates for clinical trials?
|
Low cure rates with current treatments.
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Why are ADH and ACTH levels sometimes higher in lung cancer patients, especially small cell?
|
The tumor can release mimics of these hormones. Contributes to occurrence of SIADH symptoms
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When maintaining a chest tube, what 2 things would you report to MD?
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Bubbling in water seal chamber
Air leak noises |
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After lobectomy, what position should the patient not be in?
|
The patient should not lay on operative side. Decreases expansion.
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After pneumonectomy, how should patient be positioned?
|
On back or on operated side. DO NOT let patient lay on unoperated side.
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CA 19-9
|
tumor marker for pancreatic cancer
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Tumor marker AFP
|
For testicular and primary liver
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Early symptoms of colorectal cancer
|
change in bowel habits
blood in stool |
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Most common site of mets from colorectal cancer
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Liver
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What percentage of colorectal cancer patients will have surgery?
|
75%
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Most common symptom of esophageal cancer.
|
Dysphagia
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What is gold standard for treatment of pancreatic cancer?
|
Surgery
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Most common presenting symptom of gastric cancer?
|
Weight loss
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Patient education for dumping syndrome should include:
|
small, frequent meals
low carbs high protein low fiber |
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Most common presenting symptoms in liver cancer
|
RUQ pain
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Preferred initial therapy for anal cancer
|
Combined treatment Chemo and Radiation (Chemoradiation)
|
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Diagnostic tests for esophageal cancer
|
esophagoscopy and biopsy
esophagogram CT |
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Diagnostic tests for gastric cancer
|
Barium study
Biopsy |
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Most common presenting symptom of endometrial cancer.
|
Abnormal vaginal bleeding
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Tumor marker B-HCG
|
for gestational trophoblastic disease (tumors in uterus)
|
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Most common symptom of patients in patients with testicular cancer
|
Heavy feeling or mass in scrotum
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Seminoma is most responsive to what therapy?
|
Radiation
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What tumor markers are used to measure treatment response in testicular cancer?
|
B-HCG and a-FP
|
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Screening procedure most used to check for cervical cancer
|
Pap smear
|
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Diagnostic procedures for cervical cancer
|
Colposcopy
HPV testing cervical biopsy cone biopsy LEEP (Loop Electrosurgical Excision Procedure) |
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|
Triad of symptoms in recurrent cervical cancer
|
sciatic pain
unilateral leg pain ureteral obstruction |
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Risk factors for cervical cancer
|
HPV (+)
sex during teen years multiple sex partners history of CIN (Cervical Intraepithelial Neoplasm) |
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Early signs of cervical cancer
|
asymptomatic
|
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Late signs of cervical cancer
|
pain referred to flank or leg
urinary symptoms |
|
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Which is most curable gynecologic cancer?
|
Endometrial
|
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Most common sites for metastases in renal cell cancer
|
Lymph
Bone |
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Chromosome 3p mutation
|
Translocation of chromosome 3 - Abnormal in 80% of renal cell carcinoma
|
|
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Most common diagnostic test for Renal Cell Carcinoma (RCC)?
|
KUB (Kidneys / Ureters / Bladder) radiography
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Classic triad of symptoms for advanced Renal Cell Carcinoma
|
Flank pain
Hematuria Flank mass |
|
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When should prostate screening start?
|
Age 50 for average risk
Age 40 for African Americans and familial history |
|
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What are screening tests for prostate cancer?
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Digital Rectal Exam
PSA (Prostate Specific Antigen) |
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Most frequent treatment for advanced prostate cancer?
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Medical castration
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Most common presenting symptom of bladder cancer?
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Hematuria
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Diagnostic tests for bladder cancer
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IVP (Intravenous Pylogram)
Cystoscopy |
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Paralytic ileus
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Obstruction of the intestine due to paralysis of the intestinal muscles
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Screening tests for bladder and Kidney cancer
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None
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Most common chemo to treat bladder cancer
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Intravesically administered Mitomycin
**BCG - Is common but is not a chemotherapy agent |
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When used with surgery, what chemo doubles survival rates in bladder cancer?
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MVAC
(Methotrexate-MTX, Vinblastine, Adriamycin, Cisplatin) |
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Define ileal conduit
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urine reservoir created after bladder is removed
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Difference between ileal conduit and continent ileal reservoir.
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conduit needs bag, reservoir does not
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Which is most effective single agent chemo for bladder cancer?
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Cisplatin
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How to prevent malodorous urine?
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Decrease alkaline beverages (soda)
drink fluids high in vitamin C Avoid stinky food (fish, asparagus) Clean pouch using soap, water, vinegar |
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Caution nephrectomy patient to avoid nephrotoxic drugs such as what?
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NSAIDS
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Difference between ileal conduit and continent ileal reservoir.
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conduit needs bag, reservoir does not
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Ethnic group most at risk for nonmelanoma skin cancers
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Caucasian
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Chemotherapy with best results in treating malignant melanoma
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Dacarbazine (DTIC Dome)
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Most important feature when determining prognosis in malignant melanoma.
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Size and depth of lesion at time of diagnosis
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Most common sites of metastases from malignant melanoma
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Lymph
Lung Brain |
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What are nonmelanoma skin cancers?
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Basal and Squamos
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Features of malignant melanoma
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Asymmetry
Uneven borders Color variegation > 6 mm in diameter |
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Chemos used to treat malignant melanoma
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Dacarbazine
Nitrosureas (Carmustine, Lomustine) temolozamide (oral Temodar) |
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Squamos cell cancers are 90% of what type of cancer?
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Head and Neck
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Head and Neck cancer with highest survival rate
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Thyroid
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What are primary treatment modalities for managing head and neck tumors?
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Surgery and Radiation.
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When would you advise a patient with a trach to change to a laryngectomy tube?
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When the stoma begins to get narrow
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Most common infection of oropharynx
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Candidasis
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Major toxicity of cisplatin
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Nephrotoxicity
**Also ototoxicity** |
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Possible alterations in mobility after head and neck surgery
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shoulder droop
atrophy of trapezius forward curve of spine limited ROM |
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Most common presenting symptoms in clients with a brain tumor
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Seizure
HA Unilateral Hemiparesis |
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Most common types of malignant tumors com from which brain tissue
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Astrocytes - connective cell tissues
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Which oral alkylating agent is used to treat brain tumors?
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Temodar
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Which IV chemo is used to treat brain tumors?
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Carmustine
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Mets to the spine occur most frequently in what cancers?
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Breast
Lung Prostate |
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Diagnostic studies for brain tumors
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CT
MRI |
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What does ATRA treat?
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APL - Acute Promyeloctic Leukemia
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Blast crisis
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Last phase of CML (Chronic Myeloid Leukemia) when 30% of cells in blood or marrow are blasts
Terminal Phase |
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Which type of leukemia affects CNS?
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ALL - Acute Lymphocytic Leukemia
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Most common childhood leukemia
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ALL - Acute Lymphocytic Leukemia
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Define Consolidation therapy
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Cancer treatment given after induction therapy to consolidate the gains obtained, further reduces the number of cancer cells and enhance the likelihood of a durable complete remission. Often just called consolidation.
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What drug is used in chronic phase CML to control leukocytosis?
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Hydroxyurea
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What drug is used to treat CML in all phases?
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Gleevec (Imatinib)
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What are Reed Sternberg cells
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indicative of Hodkin's lymphoma disease
(large cells with large, pale nuclei containing large purple nucleoli at the arrowheads.) |
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Most common cause of pain in Multiple Myeloma (MM)
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Bone mets/lesions
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Tests done to measure response to Multiple Myeloma treatment
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Blood tests
Urine tests 24 hour urine- measure protein and creatinine Myeloma survey - detect skeletal lesions |
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How to treat itching from Hodgkins Lymphoma
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Chemo or steroids
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Mets from osteosarcoma usually affect what area of the body?
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Lung
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S/S of osteosarcoma
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pain
swelling |
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Most frequently diagnosed HIV related cancer
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B cell
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Capillary leak syndrome
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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
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Most common side effect of interferon therapy
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Fatigue
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Principal toxicity of vincristine
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peripheral neuropathy
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Dose limiting toxicity of cisplatin
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nephrotoxicity
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Dose limiting toxicity for nitrogen mustard
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Myelosuppression
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Mesna
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chemoprotective against hemorrhagic cystitis used with Ifosfamide
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Amifostine
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chemoprotectant against nephrotoxicity from cisplatin
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When do most Carboplatin reactions happen
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After 6th cycles, mid cycle.
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Early complications of stem cell transplant
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N/V
Infection |
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Late complications of stem cell transplant
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Chronic GVHD (Graft vs Host disease)
Herpes |
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Target organs of Acute GVHD (Graft vs Host disease)
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skin
liver gut |
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Target organs of Chronic GVHD
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vagina
eyes mouth |
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What is veno-occlusive disease
(sinusoidal obstruction syndrome) |
Hepatic injury as a complication of high-dose chemo given before bone marrow transplant; small veins in the liver are blocked
Occurs 7-21 days after Stem Cell Transplant |
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Long term side effects of Hematopietic Stem Cell Transplant (HSCT)
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Fatigue
Weight loss Sexual Dysfunction Chronic GVHD Herpes Zoster |
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Symptoms of Veno-Occlusive Disease
(sinusiodal obstruction syndrome) |
weight gain due to fluid retention / ascites
mental confusion hepatomegly elevated bilirubin RUQ pain |
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Which chemos have greatest potential for producing a secondary malignancy?
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Alkylating agents
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Risk factors associated with pancreatic cancer
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smoking
processed meats H pylori diabetes |
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Describe what Primary Prevention is
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protect healthy people from developing a disease
educate screen immunize |
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Describe what Tertiary Prevention is
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helping people manage complicated, long-term health problems and maximize QOL
Rehab Support Groups |
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Describe what Secondary Prevention is
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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 |
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most common worldwide cancers
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lung
stomach liver |
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selective/prescriptive screening
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screening of selected groups of people in high-risk categories, for example, genetic screening of people with a strong family history of breast cancer
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What is the CAUTION acronym for early s/s of cancer stand for
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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 |
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Which cancer is most often associated with SIADH?
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Small Cell Lung Cancer
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What is the main cause of Cushings Triad?
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Increased intercranial pressure
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Describe Adaptive Immunity
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Antigen-specific immune response that is more complex than the innate. Antigen recognized adaptive immune system creates an army of immune cells specifically designed to attack that antigen. Adaptive immunity also includes a "memory" that makes future responses against a specific antigen more efficient.
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What does Tamoxifen do?
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used to treat breast cancer in women who are Pre-menopausal. Estrogen antagonist binds to estrogen receptors blocking the action of estrogen
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Which chemotherapy is associated with potential for Capillary Leak Syndrome (CLS)
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Interleukin-2
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What type of cancer is associated with dumping Syndrome
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Gastric Cancer
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