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PCT4EXAM3

QuestionAnswer
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