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Quiz #5 - Cancer

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Term
Definition
What do protooncogenes do?   Promote growth  
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What do tumor suppressor genes do?   Inhibit growth  
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What is contact inhibition?   Inhibits growth  
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What is apoptosis?   Programmed cell death  
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What does "C" mean in caution?   Change in bowel or bladder habits  
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What does "A" mean in caution?   A sore that does not heal  
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What does "U" mean in caution?   Unusual bleeding or discharge from any orifice  
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What does "T" mean in caution?   Thickening or a lump in the breast or elsewhere  
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What does "I" mean in caution?   Indigestion or difficulty swallowing  
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What does "O" mean in caution?   Obvious change in wart or mole  
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What does "N" mean in caution?   Nagging cough or hoarseness  
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What does proliferate mean?   Increase in number  
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What does differentiation refer to?   Function  
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Name three characteristics of malignant neoplasms   Invade and metastasize, poorly differentiated, increased vascularity  
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Name three characteristics of benign neoplasms   Encapsulated, well differentiated, rarely recur  
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What are the three stages of cancer development?   Initiation, promotion, progression  
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How is the initiation stage of cancer development described?   Irreversible mutation caused by a trigger  
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How is the promotion stage of cancer development described?   Reversible proliferation based on promoting factors  
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How is the progression stage of cancer development described?   Increased proliferation, invasiveness and metastasis  
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How is the latent period defined?   The time between genetic change and clinical signs (time between initiation and promotion)  
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What are the most common sites of metastasis?   Brain, bone, adrenals, liver, lungs  
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What is angiogenesis?   Ability to grow new blood vessels  
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Which cells initiate an immune response to tumor associated antigens?   Lymphocytes  
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What are tumor associated antigens?   Abnormal antigens; cells that are different  
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What are oncofetal antigens?   Cells shift back to immature, less differentiated state  
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Name four tumor markers   CEA, AFP, CA-125 and PSA  
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How are tumor markers helpful?   They are used to monitor therapy; if they're present, then therapy needs to continue  
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What type of cancer is indicated with the presence of CEA?   Colorectal cancers  
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What type of cancer is indicated with the presence of AFP?   Liver cancers  
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What type of cancer is indicated with CA-125?   Breast cancer  
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What type of cancer is indicated with PSA?   Prostate cancer  
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From what tissue type do brain, skin, and gland cells come from?   Ectoderm  
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From what tissue type do muscles, bone and connective tissue come from?   Mesoderm  
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From what tissue type do trachea, lungs and epithelium tissue come from?   Endoderm  
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From what tissue type do carcinomas originate?   Ectoderm (skin, glands, mucous membraness)  
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From what tissue type do sarcomas originate?   Mesoderm (connective tissue, muscle, bone and fat)  
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From what tissue type do lymphomas and leukemias originate?   Hematopoietic (blood) system  
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What is anatomic cancer classification based on?   Cancers are named based on tissue they differentiate from  
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What is histologic cancer classification based on?   Do the cells resemble the tissue of origin; based on tissue sampling  
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Which classification system uses Grades?   Histologic cancer classification  
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What is clinical staging classification based on?   Anatomic extent of the disease; degree of spread; guides treatment  
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Which classification system uses stages?   Clinical staging classification  
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How many stages are in the clinical classification system?   Five, stages 0 through 4 with 0 meaning insitu and 4 meaning metastasis  
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How many grades are in histologic cancer classification?   Four, grades I through IV; grade I meaning well differentiated to grade IV meaning completely undifferentiated (Aplasia)  
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What is TNM staging system used for?   Classify SOLID, invasive tumors; anatomic extent of the disease at time of diagnosis  
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What does TNM stand for?   Tumor size, nodes involved, metastasis extent  
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What are the three goals of collaborative treatment of cancer?   Cure, control, palliation  
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What is involved in prevention aspects of surgical therapy goals?   Prophylactic removal of non-vital organs  
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What is involved in cure and control aspects of surgical therapy goals?   Remove all or most of tumor, sparing normal tissue  
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What is involved in palliation aspects of surgical therapy goals?   Maximize body function or facilitate treatment  
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What is involved in rehabilitation aspects of surgical therapy goals?   Enhance body image  
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Name an alkylating chemotherapy agent   Cytoxan  
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Name a platinum drug chemotherapy agent   Cisplatin  
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Name an antitumor antibiotic chemotherapy agent   Doxorubicin  
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Name a corticosteroid chemotherapy agent   Hydrocortisone  
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How are chemotherapy drugs administered most often?   IV  
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What is the hallmark sign of extravasation?   Pain at the site of administration  
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What can vesicants cause?   Tissue necrosis  
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What is the preferred route of chemotherapy administration?   Central venous access  
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Why is central venous access a preferred route of chemotherapy administration?   Decreased venipuncture and extravasation  
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What is the biggest con to the use of central venous access administration of chemotherapy medications?   Risk for infection  
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What does PICC stand for?   Peripherally inserted central catheter  
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What is a PICC line used for?   Multifunctional central line used for IV infusions, blood draws, and blood product infusions  
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What precaution must be taken in regards to a PICC line?   No BP or lab draws in the extremity with the PICC line  
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What is teletherapy?   A form of radiation using an external beam  
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What is brachytherapy?   A form of radiation using an internally placed radioactive seeds  
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Name two examples of biologic response modifiers   Interferon and interleukin  
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What is the major side effect of biologic and targeted therapies?   Flu-like syndrome  
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How can the flu-like symptoms of biologic and targeted therapies be alleviated?   Use Tylenol before the drugs are administered  
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What is the universal symptom of chemotherapy treatment?   Fatigue  
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What is the nadir?   The lowest blood cell counts that occur 7-10 days after start of treatment  
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What can be given in response to neutropenia?   Neupogen  
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What can be given in response to thrombocytopenia?   Platelets  
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What can be given in response to anemia?   Procrit  
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What prophylactic antiemetics can be given prior to chemotherapy?   Ondansetron (Zofran) or Metoclopramide (Reglan)  
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What kind of diet is preferred for the side effect of diarrhea in regards to chemotherapy treatment?   Low fiber, low residue  
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What is xerostomia?   Dry mouth  
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What medications can be used to treat persistent and breakthrough pain associated with cancer pain?   Opioid analgesics and NSAIDs  
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What causes superior vena cava syndrome?   A tumor or clot obstruction of the superior vena cava  
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What are s/s of superior vena cava syndrome?   Facial edema, periorbital edema, JVD  
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What are s/s of spinal cord compression?   Persistent back pain, parasthesias, bowel/bladder changes  
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When can third space syndrome occur?   After treatments or surgical interventions  
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What are s/s of third space syndrome?   Hypotension, tachycardia, decreased urine output; might see edema on the outside, but fluid is not in the vascular space  
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What does SIADH cause?   Water retention causes dilutional hyponatremia  
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What are s/s of SIADH?   Weight gain without edema, weakness, anorexia, seizures  
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What is the treatment for SIADH?   3% NaCl to replace sodium  
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When can hypercalcemia develop?   In cancer of the bone or bone metastasis  
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What are s/s of hypercalcemia?   Apathy, depression, fatigue, muscle weakness  
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What is the treatment for hypercalcemia?   Hydration (to dilute), diuretics to excrete, and bisphosphantes to keep calcium in the bones  
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What is tumor lysis syndrome?   During chemotherapy, the cancer cells lyse and release intracellular contents  
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What are s/s of tumor lysis syndrome?   Hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia  
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What are s/s of hypocalcemia?   Fatigue, extremity numbness, muscle cramps, hyperreflexia (tetany, Chvostek's sign, Trousseau's sign)  
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What treatments are used for tumor lysis syndrome?   Fluids, allopurinol (treat hyperuricemia), electrolyte balance  
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