Cancer of Body Systems
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| In 60% PTs with carcinoma of the oral cavity, it already spread to where by the time of diagnosis? | The neck
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| What is the characteristic sign of carcinoma of the oral cavity? | Leukoplakia
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| What is leukoplakia? | white, firmly attached patch on the mouth and tongue mucosa
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| What are the S/Sx of carcinoma of the oral cavity? | *Lesion, lump leukoplakia > 2 wks *Pain, soreness, bleeding *Numbness, dysphagia, loss of feeling
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| What is the Tx of stage 1-3 carcinoma of the oral cavity? Stage 4? | Surgery and/or Radiation, Palliative
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| 90% of carcinomas of the esophagus are what type? | Squamous cell carcinomas
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| When is carcinoma of the esophagus usually detected? | In the late stage
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| What is the characteristic sign of carcinoma of the esophagus? | Dysphagia
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| What diets put a PT at increased risk for cancer of the stomach? | *Food preserved with nitrates *Frequent meals cooked over charcoal *Diets high in salt
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| Fill in the blanks: A PT is diagnosed with cancer of the stomach and is complaining of pain. As a nurse you know that pain is a _____ symptom | Late
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| What is the only curative approach/therapeutic management of stomach cancer ? | subtotal or total gastrectomy
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| What virus is liver cancer often associated with? | Hep B and C
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| List 4 S/Sx of liver cancer: | *Hepatomegaly, ascites, portal hypertension *WT loss *Peripheral edema *Dull ABD pain-RUQ *Jaundice *Anorexia *Frequent pulmonary emboli *Positive AFP
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| Only what percentage of PTs with liver cancer are surgically resectable? | 30 - 40%
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| What is the Tx for PTs with liver cancer? | *Treatment is largely palliative *Chemotherapy has a poor responce *Lobectomy for localized tumors
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| Symptoms of cancer of the gall bladder are similar to what? | Cholecystitis
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| What condition of the liver is liver cancer difficult to differentiate from? | Cirrhosis
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| What diet is pancreatic cancer linked to? | diet high in meat, fat and coffee consumption
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| What is the estimated life span of PTs diagnosed with liver cancer? | 4 - 7 months
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| What is the estimated life span of PTs diagnosed with pancreatic cancer? | 4 - 8 months
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| What S/Sx is present in 85% of pancreatic cancer cases? | Pain
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| What are the S/Sx of pancreatic cancer? | *Steady, dull and aching pain in the epigastrium or referred to the back; usually worse at night *Weight loss *Jaundice *Pruritis
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| Why are total pancreatectomies prefered over subtotal pancreatectomies in PTs with pancreatic cancer? | Subtotal pancreatectomy has complications of postoperative pancreatic fistulas and is not recommended
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| What is a Whipple procedure? | Total pancreatectomy with stomache anastomized to intestine
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| What will a PT with late stage colon cancer C/O of? | of abd pain, nausea, and cachexia ( weakness and emaciation with general ill health and malnutrition)
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| What are the S/Sx of colon cancer? | *Vomiting *Weight loss *Abd distention, ascites *Chronic blood loss and anemia
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| What is the MOST common clinical manifestation of colon cancer? | chronic blood loss and anemia
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| What is the most reliable tool for diagnosing colon cancer? | A fecal occult blood exam followed by a proctosigmoidoscopy
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| What is found in the serum of PTs with cancer? | carcinoembryonic antigen (CEA) (a glycoprotien found in a malignant and non malignant growths)
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| True or False: carcinoembryonic antigen (CEA) is a defining diagnostic finding of malignant carcinomas | False. It can be elevated in benign and malignant diseases.
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| When is surgical anastomosis of the bowel NOT done as Tx for colon cancer? | If obstruction is present
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| What surgical procedure for colon cancer done if obstruction is present? | one stage resections with anastomosis or a two stage resection bringing the ends of the bowel to the surface of the abdomen for closure later
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| What is done in a right hemicolectomy? | resection of ascending colon and hepatic fixture. The ileum is anastomosed to the transverse colon
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| What is done in a left hemicolectomy? | resection of splenic flexure, descending colon and sigmoid colon. The transverse colon is anastomosed to the rectum
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| What is done in an Anterior rectosigmoid resection? | resection of part of the descending colon, the sigmoid colon, and the upper rectum. The descending colon is anastomosed to the remaining rectum
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| Fill in the blanks: “In carcinoma of the rectum, every effort is made to preserve the _________” | Sphincter
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| What is done pre-op to prep the PT with colon cancer for surgery? | *Bowel prep with 2-3 days of liquid diets; laxatives to include GoLYTELY or enemas *Oral antibiotics to sterilize bowel
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| Why is it important to auscultate bowel sounds post-op colon cancer surgery? | Paralytic ileus is a common complication of abdominal surgery
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| What is Mitrolan? | Antidiarrheal, laxative, bulk forming agent; used in the treatment of diarrhea or constipation
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| You should avoid giving antacids within 2 hours of what? | Other medications
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| What does Cimetidine (Tagamet) and Ranitidine (Zantac) do? | Inhibits gastric acid
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| How does Metamucil (Psyllium) work? | On contact with water this drug produces a bland, lubricating, gelatinous bulk, which promotes peristalsis and natural elimination
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| Metamucil (Psyllium) should be used with caution in whom, and why? | Use Caution with elderly, may aspirate the mixture
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| Within how long does Metamucil (Psyllium) have a laxative effect, and within how long is regularity established? | Laxative effect in 12- 24 hours. Give for 2-3 days to establish regularity
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| Retrosternal pain in a PT on Metamucil (Psyllium) may indicate what? | the drug is lodged as a gelatinous mass in the esophagus
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| Why may Metamucil (Psyllium) be contraindicated for DM and patients on low Sodium diets? | because of its sugar and sodium content
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| Fill in the blanks: Most skin tumors are _______, but they can predispose the person to ______ _______ | Benign, Malignant tumors
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| What is a Verruca? | Viral lesion that is contagious; rough papillomatous growth (Wart)
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| What is an Angioma? | a group of blood vessels dilate and form a tumor like mass that appear as a non-elevated stain on the skin. An example of an angioma is a birthmark
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| What is an Osteogenic Sarcoma? | A primary malignant bone tumor that is seen in young people, fast growing and aggressive tumor that affects the long bones. Seen primarily between the ages of 10 and 25
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| What is an Osteochondroma? | The MOST common benign osteogenic tumor, usually affect the humerus, tibia, and femur
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| What are the clinical manifestations of osteochondroma? | *Spontaneous fractures - cancer cells cause a decrease in the strength of the bone *Anemia – caused by cancer invasion into the long bone which disrupts the production of red blood cells bone marrow
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| What is Hypertrichosis? | Excessive growth of hair, including areas where hair normally doesnt grow.
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| What is Hypotrichosis? | The absence of hair or a decrease in hair growth
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| What is Paronychia? | A disorder where the nails get soft or brittle
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