OCN exam
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| categories of biotherapy | cytokines and monoclonal antibodies
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| Murine MAB | derived from mouse antibody, less effective (-momab)
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| Chimeric MAB | derived from a combination of mouse and human antibodies (-ximab)
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| Humanized MAB | derived from small part mouse antibodies fused with human antibodies (-zumab)
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| Human MAB | derived from only human antibodies (-umab)
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| definition of biotherapy | the use of agents derived from biologic sources or agents that affect biologic responses
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| innate or nonspecific immune response: mechanism of action | primary line of defense, nonspecific, no memory
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| innate or nonspecific immune response: cells involved | neutrophils, monocytes, macrophages, lymphocytes
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| adaptive immune response: mechanism of action | secondary line of defense, specific memory
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| adaptive immune response: cells involved | lymphocytes, T cells, B cells
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| humoral immunity | B lymphocytes, memory B cells, and plasma cells - result is production of immunoglobulins
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| 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
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| types of adaptive immunity | humoral and cell-mediated
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| the only drug class, that if it extravasates, you must apply a warm pack | plant alkaloid
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| types of alkylating agents: platins & (non-platins) | Carboplatin, Cispatin, Oxaliplatin, (Cyclophosphamide, Ifosfamide, Temozolomide, nitrogen mustard, Busulfan, Mechlorethamine, Melphalan, Procarbazine, Dacarbazine)
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| types of antitumor antibiotics (anthracyclines) | Bleomycin, Mitomycin, Mitoxantrone,(Doxorubicin, Daunorubicin, Epirubicin Idarubicin)
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| types of nitrosoureas | Carmustine, Lomustine, Streptozocin, Chlorozotocin
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| types of plant alkaloids - camptothecin | Irinotecan, Topotecan
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| types of plant alkaloids - taxane | Docetaxel, Paclitaxel
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| types of plant alkaloids - epipodophyllotoxin | Etoposide, Teniposide
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| types of plant alkaloids - vinca | Vincristine, Vinblastine, Vinorelbine
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| types of interferons | IFN alfa, IFN gamma, IFN beta
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| types of interleukins | IL-2 Aldesleukin, IL-11 Oprelvekin (Neumega)
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| types of biologic response modifiers | Thalidomide, Lenalidomide
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| chemotherapeutic agents that are cell cycle or phase specific | antimetabolites, plant alkaloids
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| types of antimetabolites | Azacitidine, Capecitabine, Cladribine, Cytarabine, Decitabine, Fludarabine, Fluorouracil, Gemcitabine, Methotrexate, Pemetrexed, hydroxyurea
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| action of alkylating agents | breaks DNA helix strand, interfering w/DNA replication
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| action of antitumor antibiotics | binds w/DNA, inhibiting DNA & RNA synthesis
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| action of nitrosoureas | breaks DNA helix, interfering w/DNA replication; crosses the blood brain barrier
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| action of interferon | inhibits viral replication, direct antiproliferation of tumor cells, modulates host immune response
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| action of interleukin 2 | promotes proliferation, differentiation, and recruitment of T & B cells and tumor-inflitrating lymphocytes to enhance fighting capabilites
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| action of interleukin 11 | stimulates megakaryocytopoiesis and thrombopoiesis
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| action of biologic response modifiers | may relate to antiangiogenic or anti-inflammatory properties
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| stimulates erythropoiesis | Darbepoetin (Aranesp), Epoetin alfa (Procrit)
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| regulates production of neutrophils within the bone marrow | Filgrastim (Neupogen), Pegfilgrastim (Neulasta)
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| purpose of tumor markers | used for monitoring response to therapy & detecting disease recurrence
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| 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
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| 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
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| 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
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| secondary prevention | targets specific populations; activities such as testing or screening to identify high-risk groups - mammogram, pap test, colonoscopy, PSA
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| 4 stages of cancer cell growth | initiation, promotion, progression, metastasis
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| 3 patterns of cancer occurence | sporadic, inherited, and familial predisposition
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| Prostate specific antigen (PSA) | tumor marker for prostate cancer
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| Alpha-fetoprotein (AFP) | tumor marker for liver or germ cell cancers
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| Carcinoembryonic antigen (CEA) | tumor marker for colorectal cancer (may be elevated in multiple other cancers)
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| CA-125 | tumor marker for ovarian cancer
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| CA-15-3 | tumor marker for advanced breast cancer
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| CA-19-9 | tumor marker for pancreatic, colorectal, gastric, bile duct
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| CA-27-29 | tumor marker for breast cancer
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| Human chorionic gonadotropin (HCG) | tumor marker for choriocarcinoma (testis, ovary, liver, pancreas, stomach, lung)
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| 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
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| age to start colorectal cancer screening | 50
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| age to start prostate cancer screening | 50 (45 if high risk)
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| age to start breast cancer screening | monthly self breast exam - 20, mammogram - 50 (40 if high risk)
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| 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
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| 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
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| tumor types | carcinoma, germ cell, glioma, sarcoma, lymphoma
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| T | characteristic of a given tumor - size, depth of invasion, involvement of surrounding tissues
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| N | presence or absence of involved nodes and size or number of involved nodes
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| M | presence or absence of metastases
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| Rai system | most commonly used classification system for CLL
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| Ann Arbor classification | staging system for lymphomas
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| types of monoclonal antibodies | Rituximab (Rituxan), Trastuzumab (Herceptin), Alemtuzumab (Campath), Cetuximab (Erbitux), Bevacizumab (Avastin), Gemtuzumab ozogamicin (Gleevac), Ibritumomab tiuxetan (Zevalin), Iodine-131 Tositumomab (Bexxar)
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| Dexrazoxane (Zinecard) | cardioprotective agent against doxorubicin
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| Amifostine (Ethyol) | cytoprotective agent for toxic effects of ciplatin-related renal toxicities
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| drugs that cause pulmonary injury | bleomycin, mitomycin, cyclophosphamide, methotrexate, carmustine, procarbazine, cisplatin
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| drugs that cause ototoxicity | cisplatin
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| drugs that cause hemorrhagic cystits | cyclophosphamide, ifosfamide
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| drugs that cause cardiotoxicity | doxorubicin, daunorubicin, epirubicin, idarubicin, mitoxantrone, cyclophosphamide (high dose), 5FU, capecitabine
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| drugs that cause diarrhea | irinotecan
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| drugs that cause peripheral neuropathy | paclitaxel, cisplatin, oxaliplatin, carboplatin
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| drugs that cause hypotension | etoposide
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| drugs that cause neurotoxicity (central) | ifosfamide, methotrexate, vincristine, vinorelbine, vinblastine, cytarabine
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| drugs that cause neurotoxicity (peripheral) | paclitaxel, docetaxel, vincristine, vinorelbine, vinblastine, cisplatin
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| acute lymphocytic leukemia (ALL) | sudden onset, age 4, median survival: adults-2yrs, children-5yrs, lymphoblasts
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| acute myelogenous leukemia (AML) | sudden onset, age 50-60, median survival 10-15mo, myelolasts
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| chronic myelogenous leukemia (CML) | insidious onset, age 49, median survival 3yrs, mature myelocytes
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| chronic lympocytic leukemia (CLL) | insidious onset, age 60, median survival 4-6yrs, small mature or immature lymphocytes
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| SIADH clincal picture | hyponatrema, high urine osmo, low plasma osmo, high urine sodium, intracellular edema
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| SIADH treatment | fluid restriction, hypertonic saline, declomycin
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| hypercalcemia clinical picture | Ca>11, low potassium, high phosphorus, EKG changes
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| hypercalcemia treatment | exercise/weight bearing activity, NS hydration, biphosphonates (pamidronate, zoledronic acid), dialysis
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| tumor lysis syndrome clinical picture | hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia
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| 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
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| DIC clinical picture | low plt, low finbrinogen, high d-dimer, high FDP titer
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| DIC treatment | treat underlying condition, IV hydration, oxygen therapy, blood components, plasmaphoresis
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| pericardial effusion clinical picture | JVD, distant or muffled heart sound, decreased peripheral pulses, friction rub, maximal impulse shifted to left
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| pericardial effusion treatment | drainage, elevate HOB, minimize activites, oxygen, chemo/xrt
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| pleural effusion clinical picture | tachypnea, diminished or absent breath sounds, friction rub, dry cough, dyspnea, chest pain, fever
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| pleural effusion treatment | drainage vis thoracentesis or chest tube, talc pleurodesis, chemo/xrt
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