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