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PCT4EXAM3
| Question | Answer |
|---|---|
| top 5 cancers | males - prostate, lung, colorectal, bladder, and melanoma; females - breast, lung, colorectal, uterine, and thyroid |
| top 5 cancer causing death | male - lung, prostate, colorectal, pancreas, and liver; female - lung, breast, colorectal, pancreas, ovary |
| what percentage of cancer-related death is due to tobacco use? | 30% |
| ideal cancer screening test | adequate sensitivity and specificity, acceptable cost and simplicity, detect curable malignancies at early stages, decreases mortality |
| without biopsy usually there is no what? | treatment |
| tumor grade IV? III? II? I? | Undifferentiated; Poorly Differentiated; Moderately Differentiated; Well Differentiated |
| staging is critical for what two things? | prognosis and treatment |
| what lab tests indicated bone involvement? | alkaline phosphatase |
| what lab test indicate liver involvement? | AST, ALT, Total Bilirubin, Alkaline Phosphatase |
| what lab tests indicate bone marrow involvement? | CBC (Decreased Neutrophils, RBCs, & Plts) |
| tumor marker in colon cancer | CEA (Carcinoembryonic Antigen) |
| TNM Classification | tumor, node, metastases |
| assessment of a patients overall condition | performance status (PS) |
| what is used to assess performance status (PS) | ECOG |
| Complete Response + Partial Response = | Overall Response Rate |
| tumor neither shrinks or grows by 25% | stable disease |
| >25% Increase in Tumor SIze | Progressive Disease |
| time/survival before cancer recurs | disease-free survival |
| time from start of therapy until cancer progresses | time to progression |
| time from start of therapy until death from any cause | overal survival |
| treatment AFTER primary therapy?; BEFORE primary therapy? | Adjunctive; neoadjunctive |
| treatment to reduce symptoms of disease | palliative treatment |
| what class of chemo agents can NOT be given intrathecally? can't be administered in what at all? | vinca alkaloids; Syringe |
| 5 year survival rate for all types of lung cancer is what percent? | 16% |
| peak age of diagnosis for lung cancer is what? | 50-60 |
| what percent of lung cancers are linked to tobacco use? | >80% |
| what is a possible theory as to why family history can increase risk of cancer? | CYP2D6 Metabolism |
| 2 types of lung cancer | small and non-small cell |
| what is more aggressive small or non-small cell lung cancer? | small cell |
| what is more responsive to treatment small or non-small cell lung cancer? | small cell |
| 3 types of non-small cell lung cancer | squamous, adenocarcinoma, and large cell |
| paraneoplastic syndroms are most commonly seen with which type of lung cancer? | small cell |
| 2 stages in small cell lung cancer | limited and extensive |
| primary treatment for solid tumors is what? | removal |
| SVC Syndrome | tumor causing pressure on superior vena cava which is causing backup |
| what do you base chemo treatment on in stages IIIB/IV non-small cell? | performance status (0-2 = treat) |
| backbone of adjunctive chemo regimens in Non-Small cell lung cancers | heavy metal compound (cisplatin/carboplatin) |
| patients with squamous cell lung cancer should not get what, due to increased risk of bleeding? | bevacizumab (Avastin) |
| in limited & extensive stage SCLC, what is required? | chemotherapy |
| what is the maximum number of cycles of chemo that you can have in SCLC? | 6 |
| if SCLC patient receives a CR from chemo/radiation therapy what should be done prophyalatically? | prophylactic cranial irradiation |
| SCLC patients who relapse or progress after 1st line have a median survival of what? | 4-5 months |
| if you relapse after how long of SCLC can you give 1st line again? | 6 months |
| as ANC decreases, what increases? At what ANC does it increase significantly? | risk of infection; <500cell/mm3 |
| what is the definition of a fever in febrile neutropenia? | >101.0 |
| what other toxicity of myelosuppressive chemo occurs at the same time as neutropenia and further increases risk of infection? | mucositis, stomatitis |
| what is the mortality of pts with untreated febrile neutropenia? | 50% |
| 6 most common microorganisms associated with febrile neutropenia | staphylococcus aureus, staphylococcus epidermis, streptococcus, E. coli, Klebsiella pneumoniae, psuedomonas aeruginosa |
| increase incidence of gram + infections is related to what? | indwelling catheters |
| which has a higher mortality rate, gram - or + infections | gram - |
| what gram + organism is associated with sepsis? | streptococcus |
| what gram - organism is associated with greatest mortality | pseudomonas aeurginosa |
| what is the portal of entry for most gram - infections? | normal flora of GI tract (E. Coli, Kleb.) |
| why are flowers not allowed in cancer patient's rooms? | wet, moist environment promotes growth of pseudomonas aeruginosa and fungi |
| why are chest infiltrates not seen on chest x-ray? | neutrophils cause chest infiltrates |
| why is a fever so important in neutropenic patients? | don't show other s/s of infection |
| 2 reasons febrile neutropenic patients are at risk for invasive fungal infections | broad spectrum abx use and immunosuppression |
| 2 most common species of fungus in febrile neutropenic patients and what tx would you recommend? | candida (fluconazole) & aspergillous (voriconazole, caspofungin, amp b) |
| what fungal species in febrile neutropenic patients have the highest mortality rate? | aspergillous |
| what organism is a patient at risk for with prolonged carbapenam use? Drug of Choice? | strentrophomonas maltophilia; TMP/SMX or Cipro |
| when can you stop abx in febrile neutropenic patients? | >500cells/mm3 x 2 days IF temperature, BP, & Cultures are normal |
| breaks IV chemo agents into 4 categories based on emesis risk | grunberg classification |
Created by:
templets
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