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BH OCN 2011

OCN study questions

Paraplatin Carboplatin
Platinol Cisplatin
Cytoxan Cyclophosphamide
Ifex Ifosfamide
Xeloda Capecitabine
5-FU Flourouracil
MTX Methotrexate
Blenoxane Bleomycin
Adriamycin Doxorubicin
VP-16 Etoposide
Camptosar Irinotecan
Taxol Paclitaxel
Rituxan Rituximab
Herceptin Trastuzumab
Tykerb Lapatinib
Avastin Bevacizumab
Erbitux Cetuximab
Tarceva Erlotinib
Oncovin Vincristine
Velban Vinblastine
Navelbine Vinorelbine
Normal calcium (Ca) levels 8.5-10.5 meq/L
Cancer patient would be more likely to have high or low serum Ca levels High - Hypercalcemia
Normal serum Potassium K+) levels 3.5-5.3 mEq/l
Normal Hgb levels Adult Male 13.5-18 g/dl / Female 12-16 g/dl
Normal WBC levels 5000-10,000 ul
What class of chemotherapy agents do you never give intrathecally Vinca Alkaloids
1) Cardiotoxic drug that has a lifetime cumulative dose limit. Doxorubicin
Lifetime cumulative limit of Doxorubicin for normal patient 550 mg/m2
Lifetime cumulative limit of Doxorubicin for a patient that has had prior chest irradiation or concomitant cyclophosphamide treatment 450 mg/m2
What chemotherapy is ALWAYS administered with Mesa to prevent Hemorrhagic cystitis? Ifosfamide
High doses are followed by leucovorin and vigorous hydration Methotrexate
Chemotherapy agent that has a very high emetogenic potential - both acute and delayed Cisplatin(>50mg/m2)
Chemotherapy agent that has a high risk of diarrhea Irinotecan
Elevated K+ levels Hyperkalemia
Low K+ levels Hypokalemia
Pulmonary toxicity can develop when the lifetime dose of Bleomycin reaches what level 450-500 units
cancer of originating from epithelial cells carcinomas
cancers that originate in organs that fight infection lymphomas
cancers that originate in organs that form blood leukemias
cancers that originate in connective tissue (bone and muscle) sarcomas
4 main tumor classifications: carcinoma, lymphoma, leukemia, sarcoma
stage of cancer where malignant cells are confined to the tissue of origin Stage I
stage of cancer where cancer has spread to local area (usually the lymph nodes) Stage II
stage of cancer where the tumor is larger or spread to surrounding tissues or both Stage III
stage of cancer where cancer has metastasized to distant body parts Stage IV
WORDWIDE - Leading sites for cancer deaths -in order 1) Lung 2) Stomach 3)Liver
USA - Leading site for cancer death - #1 for both men and women Lung
Skin cancer is a common cause of death - T/F False - it is a common cancer but not leading cause of cancer death
3 types of skin cancer: basal cell carcinoma; squamous cell carcinoma; malignant melanoma
Trigger words for CML? White blood cell count >50,000, Philadelphia chromosome, blast crisis, splenomegaly.
Trigger words for Hodgkin's disease? Reed-Sternberg cells, cervical lymphadenopathy, night sweats
Most effective treatment for cancer is Prevention or early detection
Colonoscopy beginning at age 40 for a high risk individual is an example of what type of prevention Secondary - this is to detect disease before symptoms. (Primary prevention examples are eating healthy)
Clinical Trial Phase 1 20-25 people / Evaluate toxicity / Establish max dose without side effects / Determine route (PO or IV) / Variety of tumor types
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 /
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
Clinical Trial Phase 4 Can it do anything else? / Expand off label use / Assess toxicity and long term effects / Usually after FDA approval
CAUTION 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
Four electrolyte imbalances in TLS Hyperkalemia, Hyperphosphatemia, Hyperuricemia, Hypocalemia
Sodium (Na) normal ranges 135-145 meq/L
Which chemos have greatest potential for producing a secondary malignancy? Alkylating agents
Amifostine chemoprotectant against nephrotoxicity from cisplatin
Principal toxicity of vincristine peripheral neuropathy
Dose limiting toxicity of cisplatin nephrotoxicity
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
PLISSIT Permission to discuss / Limitied Information / Specific Suggestion / Intensive Therapy
Define Apoptosis programmed cell death
Mutations in p53 increases risk of breast, leukemia, sarcoma and adrenal cancer
In-Situ Cancer Noninvasive breast cancer
Most common sites of mets from breast cancer? IN ORDER - Bone - Lung - Liver - Brain
What do biphosphonates do? prevent the loss of bone mass, used to treat osteoporosis, hypercalcemia, bone pain, and prevention of fractures
Which cancers have highest incidence rates? Men - Prostate / Women - Breast
CEA tumor marker used to monitor the treatment of cancer patients, especially those with colon cancer
Most aggressive type of lung cancer small cell lung cancer (SCLC)
Early symptoms of colorectal cancer change in bowel habits / blood in stool
Risk factors for breast cancer No children / First pregnancy after 30 / Early periods / Late menopause / Hormone replacement therapy
Adjuvant therapy treatment given in addition to primary therapy
Neoadjuvant therapy administration of therapeutic agents prior to the main treatment
Most common cancer among women Breast
What age should mammograms start? 40
Primary Prevention protect healthy people from developing a disease / educate / screen / immunize
Tertiary prevention helping people manage complicated, long-term health problems and maximize QOL / Rehab / Support Groups
Secondary Prevention 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
Trigger words for CNS B cell lymphoma HIV positive patients, AIDS
What are the three cancers with the highest mortality in women? (list in order) Lung / Breast / Colon
What are the three cancers with the highest incidence in women? (list in order) Breast / Lung / Colon
What are the three cancers with the highest mortality in men? (list in order) Lung / Prostate / Colon
What is the major modifiable risk factor for cancer? Smoking
What types of paraneoplastic syndromes can be caused by small cell lung cancer? Cushing's syndrome (from ACTH) / SIADH / Eaton-Lambert syndrome
What are the two main risk factors for prostate cancer? Age--it's not seen in pts <40 years old. 60% of men older than 80 years have prostate cancer / Race--black>white>asian
Sx of bladder cancer persistent painless hematuria, older than 40, smoker, worker in rubber or dye industry (aniline dye), h/o shistosomiasis
Explain ABCD's of melanoma A--Asymmetry / B--Border irregularity / C--Color change or multicolor / D--Diameter increase
what cancers are associated with the tumor marker AFP? hepatocellular carcinoma, yolk-sac tumors
what cancers are associated with the tumor marker CEA? colon cancer, pancreas, other GI tumors
what cancers are associated with the tumor marker PSA? prostate
what cancers are associated with the tumor marker CA-125? Ovary
what cancers are associated with the tumor marker CA 19-9? Pancreas
What med can be used to protect heart against effects of doxorubicin Dexrazoxane
For which pulmonary toxicity does bleomycin have a high risk? Pneumonitis
Which chemo has a high risk for pulmonary toxicity? bleomycin (Blenoxane)
Tumors associated with malignant pericardial effusions Lung
Solid tumors at risk for TLS (3) SCLC, breast, neuroblastoma
Most common cancers associated with hypercalcemia (6) Breast, lung, head and neck, MM, renal, lymphoma
Cushings Triad HTN / bradycardia / abnormal respirations
Trigger words for Waldenstrom's macroglobulinemia hyperviscosity, IgM spike, cold agglutinins, Raynaud's phenomenon with cold
Define paraneoplastic syndrome condition caused by a malignancy but not due directly to destruction or invasion by the tumor
Pleural Effusion fluid in pleural space
pneumothorax air in the pleural space
Carcinoembryonic antigen (CEA) Colorectal cancer, check for recurrence and monitoring.
at risk for TLS Leukemia, lymphoma, Small cell lung cancer , multiple myeloma
Define Tumor Lysis Syndrome (TLS) metabolic imbalance that occurs with rapid tumor kill
How does Allopurinol work? decreases uric acid production and decreases uric acid deposits in kidney
How does Rasburicase work? catalyses the conversion of uric acid to allantoin
Method to reduce hair loss There are no research based methods to reduce hair loss
Ethnic group with highest incidence of cancer for all sites combined African American male
Age prostate exams should begin digital rectal exams & PSATest at age... 50 yrs
Men with strong family history of prostate cancer should begin annual screening at 45 yrs
Lactose intolerance in common among these 2 groups. (recommending milk as a nutritional supplement might not be effective) Asian & Pacific islanders / African Americans
Def. Fatalism Belief that one has little control over personal health outcomes & death is inevitable with cancer
Late or long term effects of cancer treatments Cardiomyopathy, pulmonary fibrosis and sterility
What is COBRA Insurance if a person loses his job. Coverage is available foe 18 months for person & 36 months for dependents. Employee assumes payment for premiums
Which regimen is more likely to lead to infertility after chemotherapy - single chemo or combination chemo Combination
What surgery can lead to sexual disfunction Prostatectomy
Anorexia is Wt loss due to decrease in appetite
Cachexia is Fat, muscle and bone mineral content due to a metabolic syndrome associated with cancer
Head & neck patient who has dad surgery & radiation will need what type of therapy Speech therapy rt chewing, swallowing, speech, saliva flow
77% of all cancers occur in what age range >55 years
Blood from an Autologous donor is The patient donated their own blood for use
Gastroparesis Impaired digestion-slowing of gastric contractions
Aminoglycosides are use to treat infections in cancer pts. Their major toxicity is Nephrotoxicity
Some common 5-HT3 antagonist are Ondonsetron (zofran), granisetron (kitril)
Medication given for pt with increased intracranial pressure (ICP) Mannitol
Neutrophils come from what type of stem cell Myeloid stem cells
What chemotherapy in high doses is usually administered with Mesa to prevent Hemorrhagic cystitis? Cyclophosphamide (dose > 1000mg = up to 40% incidence of hemorrhagic cystitis
Patient is taking PO Cyclophosphamide. What time of the day should they take this pill - AM / Noon / PM -- Why? AM - will have time to increase hydration and empty bladder frequently
Can cause ototoxicity Cisplatin - good for pt to have baseline audiogram
Medication that is a renal protectant Anifostine
What antibody does Rituximab bind to? CD20 antibody on B cells
What type of precautions should be taken when handling Tositumomab I-131 Radiation precautions - It is a conjugated MoAb - MoAb joined with radioactive iodine I-131
What antibody does Trastuzumab bind to? Her2 antiboby
define - Autonomy Self determination - Independent decision making
define - beneficence the duty to act in the best interest of the patient
define - justice equal distribution of resources - equal access to healthcare with SS, Medicare, Medicaid
define - nonmaleficence duty to do not harm - example -balance treatment with risks
define - Veracity Truth-telling
define - fidelity Faithful to promises made
Created by: abutcher1