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Ch. 16
Oncology
| Question | Answer |
|---|---|
| what is cancer | abnormal cell transformed by genetic mutation of cellular DNA |
| what is metastsis | primary site then travels to other tissues. Lymphatic, hematogenous, angiogenesis spread |
| what are malignant cancer cells | uncontrolled growth that does not follow physiologic demand |
| what is leading cancer for males? females? Cancer deaths for males/females | Prostate 29%, Lung 15% Breast 26%, Lung 15% Lung and bronchus |
| what are oncogenes | tumor inducing genes |
| what are carcinogens | agents that cause cancer - chemical radiation, viral |
| what is carcinoma | ectoderm/endoderm(skin,glands,mucus membranes) |
| what is sarcoma | mesoderm(connective tissue) |
| what is leukemia, lymphoma | hematopoietic tissue |
| what is difference in benign and malignant tumors | benign: differentiated, grows encapaulated malignant: nondefined, nonfx, grows sending out fingers, destruction |
| what is 3 step process for carcinogenesis | initiation, promotion, progression(malignant behavior) |
| what are some factors that can cause cancer | viral/bacteria, physical(sun), chemical(tobacco), genetic, diet(cured meats, nitrates), hormones(DES), immunosuppression(rheumatoid arthritis) |
| what is primary prevention of cancer? secondary? | primary: education(lifestyle, avoid) secondary: screening(mammogram, SBE, pap smear) |
| what are seven warning signs of cancer | C-change in bowel/bladder habits A-a sore that doesn't heal U-unusual bleeding or discharge T-thickening or lump in breast I-indigestion/dysphagia(trouble swallowing) O-obvious change in wart/mole N-nagging cough/hoarseness |
| what are steps to minimize cancer | incr: veg/fruits, fiber, vit C decr: wt, cured meat, sale, high fat, alcohol, sun |
| Prostate exam should begin at age? rectal? BSE mo? mammography? pap smear yearly | prostate/rectal >50 mammography >40 BSE>20 pap smear >18 if sex |
| what are some diagnostic studies for cancer | PSA, 1st descendents, fluoroscopy(contrast), ultrasound, biopsy, CBC, CT, PET, MRI |
| what is tumor staging | determine size of tumor, existence of metastasis |
| what is tumor grading | classification of tumor cells |
| what is method for staging and grading | T: extent of size of tumor N: lymph node involvement M: extent of metastasis Sentinel lymph node |
| T1,N1,M1 = Tis,N0,Mx = | size1, 1node, metastasized ca in situ, no evidence, cannot be determined |
| What is Stage 0? I,II,III? IV? | 0: Ca in situ(early on top layer) I,II,III: more, gr. size, more metastasis IV: Spread to another organ |
| what is Cancer management possibilities | cure, control, palliative |
| what is most ideal tx of ca? what is debulking | surgery, local/wide incisions debulking: remove all tumor and surrounding tissues and nodes. |
| what is prophylactic, palliative, reconstructive, salvage surgeries | prophylactic: colectomy, mastectomy, oophorectomy palliative: relieve complications reconstructive: may follow other surgery Salvage: treat local recurrence(mastectomy after lumpectomy) |
| what are three types of biopsy | incisional(lg tumor too lg to remove), excisional(sm tumor), needle aspiration |
| What is simulation in radiation therapy | process to define and aim radiation beam. Deliver lethal dose(95% of tumor killed) |
| what is brachytherapy? teletherapy? | implant radioactive device inside body cavity external radiation |
| which kind of tissue is affected most by radiation | faster growing tissue: bone marrow, lymph, hair, gonads, gastric, epithelium |
| what is protocol for workers and brachytherapy | time/distance/shielding: 30min visitors, 6ft away Wear film badge(measures dosimeter) no preggies |
| what should be done to preserve skin integrity for radiation pts | avoid soaps/lotions..., rubbing, shaving with straight edge razor, sunlight, tight clothing. Use Vit A & D |
| what is wet desquamation and how tx | blisters Avoid too much washing, use Telfa(waxy) dsg if weepy. Hydrocolloids, hydro gels |
| what are some GI SE? TX? | stomatitis, xerostomia(dry mouth), anorexia, N/V/D Tx: cold meals, bland, small, anti-emetics b4 |
| How are chemo agents classified? | cell cycle, chemical group, vesicants |
| what is a vesicant and what does it cause | very strong chemo agent that kills tissue and can cause extravasation. Use central lines, not peripheral s/s: absence of blood return from IV, swelling, pain, redness at site |
| what are cell cycle non-specific chemo drugs? | effect cell during all cycles. Alkylating agents, nitrosureas, antitumor antibiotics, hormone therapy |
| what are cell cycle specific drugs | antimetabolites (S), Mitotic inhibitors(M), Topoisomerase inhibitors: (S), Mitotic spindle poisons(M) S = synthesis, M = cell division |
| what is important about intrathecal route of chemo | Helps attack CNS tumors |
| what is a tunneled catheter and what are examples | central line threaded under skin and brought to suface distal to vessel. Hickman(3-lines)/Groshong |
| what is nadir | lowest level of neutrophil count, so may hold off on chemo til rises |
| what are some nsg mgmt in chemo | fluid lvls, stomatitis, N/V, pain, altered taste Modify risk for inf, bleeding, safe adm of chemo, protect caregivers |
| how long can you give bone marrow transplant after immunosuppression | 48-72hrs |
| what are types of BMT(bone marrow transplants) | allogenic: clost match autogenic: self syngeneic: twins |
| what r some complications to BMT | graft vs host disease, venous occlusive dis |
| what are some nsg interventions of pt w/ Ca | help SE, nutrition, pain(break through pain-eleavil), fatigue, inf, shock, bleeding(avoid NSAIDS, IM, supp, enemas, constipation). Educate |
| what is alopecia and when will it start/stop? | hair loss begins 2-3wks after tx begins and hair growth 8 wks after tx ends. |
| Neupogen is a hematopoiectic growth factor for what? | bone pain SE, boost WBC, Procrit,Epogen,Aranesp- RBCs |
| what are s/s of shock | alterend mental status, temp change, cool clammy skin, decr UO, hypotension, tachy, tachypnea |
| what are cytokines and examples | produced by cells of immune system: interferons, interleukins, coly-stimulating factors, tumor necrosis factors |
| what temp should pt call dr about | >100.4 |
| thrombocytopenia is a platelet count of what? | <100,000 |
| what are some oncologic emergencies | infection, superior vena cava syndrome(elevate HOB), spinal cord compression, third space syndrome, cardiac tamponade(fluid in percardial sac), pulsus paradoxus, SIADH(most commonly caused by Ca), hypercalcemia, tumor lysis syndrome |
Created by:
palmerag
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