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BH OCN 2011
OCN study questions
| Question | Answer |
|---|---|
| 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
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