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100 Cards in this Set
- Front
- Back
only disease of parathyroid glands is overactivity
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Hyperparathyroidism
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one of the parathyroid glands has lost its control mechanism and continues to make large amounts of parathyroid hormone without paying attention to how high the blood ________
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CA+
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T/F hyperparathyriodism is a hormone problem secreted by a benign parathyroid tumor. It is not a cancer problem.
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T
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Under the presence of ______, bones will give up their calcium in an attempt to increase the blood level of calcium
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pth
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Too much PTH means too much _____. in the blood and not in the bones. Too little PTH (eg. if all 4 are removed) means too little Ca. in the blood.
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CA+
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Too much Ca in blood=
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tired, poor concentration, osteoporosis, kidney stones.
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Too little Ca in the blood =
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tetany, cramps, spasms, paresthesia.
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UTERINE FIBROIDS are also called?(5)
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leiomyomas, myomas, fibromyomas, fibromas and myofibromas
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S/sx of uterine fibroids?
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hypermenorrhea, (dysmenorrhea or leukorrhea -Vaginal discharge during pregnancy- may occur) pain, reproductive disorders, backache, constipation, urinary frequency or urgency or intestinal obstruction
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Tx for uterine fibroids?(3)
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observation, blood transfusion or hysterectomy
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how are uterine fibroids Dx
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blood tests, palpation of the tumor, laparoscopy or D & C
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GESTATIONAL TROPHOBLASTIC DISEASE =
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hydatidiform mole
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developmental anomaly of the placenta at the beginning of a pregnancy
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hydatidiform mole
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in _________chorionic villi convert into a mass of clear vesicles. (chorionic tumor--"Choriocarcinoma
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hydatidiform mole
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s/s of hydaitform mole?
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rapid growth of the uterus, vaginal bleeding and cramping
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classic s/s of _______ is uterus that is large for gestational age.
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hydatiform mole
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hydatiform mole is dx by?
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HCG levels are extremely high for early pregnancy
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UltraSound fails to reveal a _______
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fetal skeleton
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what is done if a miscarriage does not occur and the diagnosis is confirmed in mole?
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therapeutic abortion is performed by suction curettage (D and C), then weekly monitoring of HCG until they remain normal for 3 consecutive weeks
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Periodic follow-up for 1 to 2 years because of increased risk of ______ in mole
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neoplasm
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_______prophylactically is the drug of choice for choriocarcinoma (Folex (methotrexate) immunosuppressant anti-neoplastic
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methotrexate
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Give _______ 24-48 hours after Rx to prevent reversal of bone marrow and GI toxicity in mole w/ methotrexate
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Ca+
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what must be emphasized w/molar pregnancy?
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.). Emphasize contraception for a patient following removal of a gestational trophoblastic neoplasm until HCG is normal (may take as long as 2 years).
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overgrowths of fibrous tissue in the area of the ducts forming small cysts that develop and disappear quickly
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FIBROCYSTIC DISEASE OF THE BREAST
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what ages for FBD?
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30-50
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when does pain increase in FBD?
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just before period(inc hormones)
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Diet should not include ____ and _____ in FBD?
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caffeine and salt
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T/F Cysts have no malignant potential; however, breasts that have cysts are more prone to develop cancer
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T
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what Tx for FBD? what meds?
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aspiration of fluid, medication (Danocrine), analgesics for pain
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hyperplasia and hypertrophy of the circular muscle at the pylorus narrows the pyloric canal
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PYLORIC STENOSIS
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pyloric stenosis is common in _____ infants between ages 1-6 months
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males
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describe s/s of pyloric stenosis?
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Asymptomatic first 2 weeks of life (or, may have occasional vomiting), then projectile vomiting, visible reverse peristaltic waves, weight loss, constipation and a hypertrophied sphincter, the size of an olive can be felt in the abdomen
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what are the 2 major complications of pyloric stenosis?
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Dehydration is common and metabolic alkalosis (due to vomiting
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what E to monitor for vomit w/pyloric stenosis
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K+
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what test to dx pyloric stenosis?
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ultrasound ; barium upper GI series; flat film of abdomen; tests for metabolic alkalosis; urinalysis(urine alkaline and concentrated); Hgb, Hct
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Sx for pyloric stenosis?
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pyloromyotomy performed by laparoscopy
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Nrs: pre-op in pyloric stenosis?
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Rehydration via IV
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NSG post-op in pyloric stenosis?
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VS, IV fluids, NG tubes
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parent teaching p/o pyloric stenosis Sx?
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diet from NPO to Clear liquids and elevate head/place slightly right side; pacifier for infants who are NPO ; Possible vomiting within 24 hour of surgery;Report all increase voimting to MD
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in ______ calculi may develop because of alkalinization of the residual urine
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BPH
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Secondary test screening may include transrectal ultrasound or _____ scan of the prostate
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TRUS
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which med for BPH inhibits androgens?
how long must be taken? major SE? |
Proscar
continuous basis for therapeutic results erectile dysfunction |
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______are also used to relax muscle in the prostate and the bladder neck(meds)
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Alpha adrenergic blockers
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what are the Alpha adrenergic blockers used to Tx BPH?
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Minipress, Cardura, Hytrin, and Flomax
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what are the major SE of Alpha adrenergic blockers?
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hypoTN and fatigue especially when taken w/other cardiac or HTN meds
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excessive irrigating solution being absorbed during surgery seen in TURP?
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water intoxication( TURP syndrome)
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1st s/s of TURP syndrome?
why? |
confusion and agitation.
cerebral edema |
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If bladder spasms develop p/o TURP the catheter should be checked for _____. If present, the clots should be removed by ______
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clots
irrigation |
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The output should be at least _______the hourly flow of the irrigation after TURP?
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50 ml per hour greater than
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what meds to relieve pain and decrease spasm p/o TURP?
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B&O suppository and oxybutin -Ditropan
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Post-op TURP: teach pt to avoid vigorous exercise, heavy lifting and sexual intercourse for at least _____; avoid driving/long sitting for ____ wks p/o TURP?
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3 weeks
2 |
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drink at least _____ ml of fluids per day to prevent urinary stasis, infection and keep stool soft p/o TURP?
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2500
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most common CA for men(3)
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PROSTATE ,LUNG, COLON/RECTAL
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most common CA for women (3)?
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BREAST, then either COLO-RECTAL or LUNG.
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_____are cancers of epithelial (lining) cells
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Carcinomas
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_____refers to carcinoma derived from cells of glandular origin
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Adenocarcinoma
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_____ are cancers of the connective tissue, cartilage, bone, muscle, and so on
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Sarcomas
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three main types of skin cancer
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BASAL CELL
Squamous Cell Malignant melanoma |
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most common form of skin cancer
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BASAL CELL
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which are at the bottom of the epidermis (outer skin layer), continue dividing and form an enlarging mass; related to excessive sun exposure, genetic skin type, arsenicals, x-ray radiation, scars and some type of nevi.
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BASAL CELL
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s/s of _____ include small, slowly enlarging papule; borders semitranslucent or ÒpearlyÓ, with overlying telangiectasia; erosion, ulceration, and depression of center; normal skin markings los
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BASAL CELL CARCINOMA
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how is basal cell dx?
Tx and prognosis? |
biopsy
excisional surgery, chemosurgery, electrosurgery, cryosurgery; 95% cure rate |
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where does basal cell carcinoma usually appear
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face between hairline and upper lip
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T/F in basal cell metastasis rare, but it must still be treated to avoid it spreading
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T
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who gets squamous cell the most?
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is caucasian males over the age of 60
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_____grows faster than basal cell carcinoma and first appear as scaly eczema
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Squamous cell
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risk factors for squamous cell?
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: sun exposure, x-ray therapy, arsenic ingestion (gardener), carcinogen exposure (tar and oil) and chronic skin irritation and inflammation
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Tx for squamous cell?
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chemosurgery, radiation, electrodesiccation and curettage and excision
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which squamous cell lesions have a poor prognosis(2)?
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lower lip and ears
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who gets basal cell?
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40 y/o blond, fair-skinned, caucasian males
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largest risk factor for basal cell
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Prolonged sun exposure
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in ____ the lesions appear as small, smooth, pink, translucent papules that progress to firm raised bordered lesions with depressed centers.
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Basal cell
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originates in melanocytes, the cells which produce the pigment melanin? who gets more?
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melanoma. females
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Risk factors include sun exposure, fair skin type, pregnancy (hormones increase both growth and incidence), family history
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melanoma
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most common places for melanoma?(4)
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head, neck, legs, and back
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_____ that change in color, size, texture, have drainage or bleed should be investigated for melanoma
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moles(nevi)
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what are the Tx for melanoma?
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surgical tumor removal with wide resection, lymphadenectomy, chemotherapy and radiation
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____ CA caused by degenerative changes in gastric ulcers
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stomach
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who gets stomach CA more? why?
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Middle-aged Men in the low socioeconomic group
diet high in starch, with few fresh vegetables and fruits |
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how is stomach CA dx? good or poor prognosis?
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x-ray exam, gastric analysis and biopsy via gastroscopy.
poor |
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what race gets stomach CA more?
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japanese
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Cancer of the esophagus- epidermoid carcinoma is rare and affects people over the age of 60.
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INFORMATION ONLY
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_____ CA occurs in middle-aged adults, with low-residue diets of refined carbohydrates and fats
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intestinal
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what 3 diseases are risk for intestinal CA?
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ulcerative colitis, diverticulitis and polyps
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how is intestinal CA dx(3)
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guaiac stool tests, digital rectal exam and sigmoidoscopy
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____ is unreliable, can be elevated in inflammation and other diseases when dx intestinal CA?
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CEA (carcinoembryonic antigen)
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A CEA titer less than ___ng/ml is considered normal?
A CEA greater than ____ ng must be investigated |
5
10 |
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Tx for intestinal CA?
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surgery, radiation and chemotherapy
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what 2 foods reduce colostomy odor
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Spinach and parsley
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Up to____% of the liver can be removed with no loss of function; the liver can regenerate
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90
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Portal vein obstruction (liver cancer or cirrhosis) =
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ascites
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if the large bile duct becomes obstructed, the result will be
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obstructive jaundice
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what test to monitor for liver CA?
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alk phos
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Meds to prevent liver transplant rejection are(4)
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azathioprine, cyclosporine, corticosteroids (such as prednisone), and OKT2 monoclonal antibodies
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what are the early s/s of prostate CA similar to?
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BPH?
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what is the normal PSA?
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0-4
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_____ is specifically indicative of cancer of the prostate
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PAP
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An increased _____may signal metastic cancer of the prostate
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alkaline phosphatase
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what prostate ca depend on to grow? so what is Rx?
SE? |
androgens
estrogens(DES) gynecomastica, feminization, decreased libido |
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what meds are given by monthly SQ or IM injections for prostate ca?
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Premarin, Zoladex, Lupron
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