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OCN exam

categories of biotherapy cytokines and monoclonal antibodies
Murine MAB derived from mouse antibody, less effective (-momab)
Chimeric MAB derived from a combination of mouse and human antibodies (-ximab)
Humanized MAB derived from small part mouse antibodies fused with human antibodies (-zumab)
Human MAB derived from only human antibodies (-umab)
definition of biotherapy the use of agents derived from biologic sources or agents that affect biologic responses
innate or nonspecific immune response: mechanism of action primary line of defense, nonspecific, no memory
innate or nonspecific immune response: cells involved neutrophils, monocytes, macrophages, lymphocytes
adaptive immune response: mechanism of action secondary line of defense, specific memory
adaptive immune response: cells involved lymphocytes, T cells, B cells
humoral immunity B lymphocytes, memory B cells, and plasma cells - result is production of immunoglobulins
cell-mediated immunity cytotoxic T cells, helper T cells, suppressor T cells, and cytokine products - prevents the onset of immunity to normal tissues of the body and limits the inflammatory response that occurs with infection
types of adaptive immunity humoral and cell-mediated
the only drug class, that if it extravasates, you must apply a warm pack plant alkaloid
types of alkylating agents: platins & (non-platins) Carboplatin, Cispatin, Oxaliplatin, (Cyclophosphamide, Ifosfamide, Temozolomide, nitrogen mustard, Busulfan, Mechlorethamine, Melphalan, Procarbazine, Dacarbazine)
types of antitumor antibiotics (anthracyclines) Bleomycin, Mitomycin, Mitoxantrone,(Doxorubicin, Daunorubicin, Epirubicin Idarubicin)
types of nitrosoureas Carmustine, Lomustine, Streptozocin, Chlorozotocin
types of plant alkaloids - camptothecin Irinotecan, Topotecan
types of plant alkaloids - taxane Docetaxel, Paclitaxel
types of plant alkaloids - epipodophyllotoxin Etoposide, Teniposide
types of plant alkaloids - vinca Vincristine, Vinblastine, Vinorelbine
types of interferons IFN alfa, IFN gamma, IFN beta
types of interleukins IL-2 Aldesleukin, IL-11 Oprelvekin (Neumega)
types of biologic response modifiers Thalidomide, Lenalidomide
chemotherapeutic agents that are cell cycle or phase specific antimetabolites, plant alkaloids
types of antimetabolites Azacitidine, Capecitabine, Cladribine, Cytarabine, Decitabine, Fludarabine, Fluorouracil, Gemcitabine, Methotrexate, Pemetrexed, hydroxyurea
action of alkylating agents breaks DNA helix strand, interfering w/DNA replication
action of antitumor antibiotics binds w/DNA, inhibiting DNA & RNA synthesis
action of nitrosoureas breaks DNA helix, interfering w/DNA replication; crosses the blood brain barrier
action of interferon inhibits viral replication, direct antiproliferation of tumor cells, modulates host immune response
action of interleukin 2 promotes proliferation, differentiation, and recruitment of T & B cells and tumor-inflitrating lymphocytes to enhance fighting capabilites
action of interleukin 11 stimulates megakaryocytopoiesis and thrombopoiesis
action of biologic response modifiers may relate to antiangiogenic or anti-inflammatory properties
stimulates erythropoiesis Darbepoetin (Aranesp), Epoetin alfa (Procrit)
regulates production of neutrophils within the bone marrow Filgrastim (Neupogen), Pegfilgrastim (Neulasta)
purpose of tumor markers used for monitoring response to therapy & detecting disease recurrence
education for neutropenic patients hand hygeine, wear gloves when working in garden, frequent oral care, avoid live vaccines or persons who have had a live vaccine in past 30 days, avoid areas of construction or renovation, clean food, avoid fresh/dried plants, use an electric razor
education for thrombocytopenic patients blow nose gently, use soft toothbrush, no dental floss, tampons, anal, or sexual intercourse if <50K, drink fluids, take stool softeners, soft diet w/non-irritating foods, report bleeding, petechiae, bruising, HA, or change in LOC
primary prevention simple measures taken early to avoid development of cancer - low fat, high fiber foods, smoking cessation, limit exposure to UV light and STDs
secondary prevention targets specific populations; activities such as testing or screening to identify high-risk groups - mammogram, pap test, colonoscopy, PSA
4 stages of cancer cell growth initiation, promotion, progression, metastasis
3 patterns of cancer occurence sporadic, inherited, and familial predisposition
Prostate specific antigen (PSA) tumor marker for prostate cancer
Alpha-fetoprotein (AFP) tumor marker for liver or germ cell cancers
Carcinoembryonic antigen (CEA) tumor marker for colorectal cancer (may be elevated in multiple other cancers)
CA-125 tumor marker for ovarian cancer
CA-15-3 tumor marker for advanced breast cancer
CA-19-9 tumor marker for pancreatic, colorectal, gastric, bile duct
CA-27-29 tumor marker for breast cancer
Human chorionic gonadotropin (HCG) tumor marker for choriocarcinoma (testis, ovary, liver, pancreas, stomach, lung)
families at high risk for hereditary cancer 2 or more generations diagnosed w/same or related forms of cancer, early age of onset, occurrence of rare tumors, bilateral, multifocal, or multiple primary tumors in 1 or more family members
age to start colorectal cancer screening 50
age to start prostate cancer screening 50 (45 if high risk)
age to start breast cancer screening monthly self breast exam - 20, mammogram - 50 (40 if high risk)
factors placing women at high risk of breast cancer positive for BRCA1 or BRCA2, early menarche, late menopause, 1st child after age 30, mother or sister w/breast cancer, history of breast cancer
dietary recommendations to reduce cancer risk avoid overeating, maintain IBW, reduce total fat intake, include fruits & veggies, increase fiber intake with whole grains, minimize intake of foods that are salt-cured, smoked, and nitrite-cured, limit alcoholic beverages
tumor types carcinoma, germ cell, glioma, sarcoma, lymphoma
T characteristic of a given tumor - size, depth of invasion, involvement of surrounding tissues
N presence or absence of involved nodes and size or number of involved nodes
M presence or absence of metastases
Rai system most commonly used classification system for CLL
Ann Arbor classification staging system for lymphomas
types of monoclonal antibodies Rituximab (Rituxan), Trastuzumab (Herceptin), Alemtuzumab (Campath), Cetuximab (Erbitux), Bevacizumab (Avastin), Gemtuzumab ozogamicin (Gleevac), Ibritumomab tiuxetan (Zevalin), Iodine-131 Tositumomab (Bexxar)
Dexrazoxane (Zinecard) cardioprotective agent against doxorubicin
Amifostine (Ethyol) cytoprotective agent for toxic effects of ciplatin-related renal toxicities
drugs that cause pulmonary injury bleomycin, mitomycin, cyclophosphamide, methotrexate, carmustine, procarbazine, cisplatin
drugs that cause ototoxicity cisplatin
drugs that cause hemorrhagic cystits cyclophosphamide, ifosfamide
drugs that cause cardiotoxicity doxorubicin, daunorubicin, epirubicin, idarubicin, mitoxantrone, cyclophosphamide (high dose), 5FU, capecitabine
drugs that cause diarrhea irinotecan
drugs that cause peripheral neuropathy paclitaxel, cisplatin, oxaliplatin, carboplatin
drugs that cause hypotension etoposide
drugs that cause neurotoxicity (central) ifosfamide, methotrexate, vincristine, vinorelbine, vinblastine, cytarabine
drugs that cause neurotoxicity (peripheral) paclitaxel, docetaxel, vincristine, vinorelbine, vinblastine, cisplatin
acute lymphocytic leukemia (ALL) sudden onset, age 4, median survival: adults-2yrs, children-5yrs, lymphoblasts
acute myelogenous leukemia (AML) sudden onset, age 50-60, median survival 10-15mo, myelolasts
chronic myelogenous leukemia (CML) insidious onset, age 49, median survival 3yrs, mature myelocytes
chronic lympocytic leukemia (CLL) insidious onset, age 60, median survival 4-6yrs, small mature or immature lymphocytes
SIADH clincal picture hyponatrema, high urine osmo, low plasma osmo, high urine sodium, intracellular edema
SIADH treatment fluid restriction, hypertonic saline, declomycin
hypercalcemia clinical picture Ca>11, low potassium, high phosphorus, EKG changes
hypercalcemia treatment exercise/weight bearing activity, NS hydration, biphosphonates (pamidronate, zoledronic acid), dialysis
tumor lysis syndrome clinical picture hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia
tumor lysis syndrome treatment IV hydration, alkalinization of urine w/NaHCO3, allopurinol, rasburicase if needed, phosphate-binding aluminum-containing antacids, kayexalate, hypertonic glucose/insulin, dialysis
DIC clinical picture low plt, low finbrinogen, high d-dimer, high FDP titer
DIC treatment treat underlying condition, IV hydration, oxygen therapy, blood components, plasmaphoresis
pericardial effusion clinical picture JVD, distant or muffled heart sound, decreased peripheral pulses, friction rub, maximal impulse shifted to left
pericardial effusion treatment drainage, elevate HOB, minimize activites, oxygen, chemo/xrt
pleural effusion clinical picture tachypnea, diminished or absent breath sounds, friction rub, dry cough, dyspnea, chest pain, fever
pleural effusion treatment drainage vis thoracentesis or chest tube, talc pleurodesis, chemo/xrt
Created by: nabutcher12