Adult Hematology/Oncology

Question 1

DIC

Answer 1

• abnormal clotting
• depletes clotting factors and platelets
• extensive bleeding from many sites
• emergency

Question 2

DIC caused by

Answer 2

• eclampsia
• gram-negative sepsis
• cancer

Question 3

DIC results in

Answer 3

• stroke like symptoms
• ischemia = reduced blood flow
• pain
• dyspnea
• tachycardia
• reduced kidney function
• bowel necrosis

Question 4

DIC treatment

Answer 4

• red blood cells + plasma transfusions
• Heparin

Question 5

Tumor lysis syndrome (TLS)

Answer 5

• rapid destricton of tumor cells
  
  • by-products release into blood faster than body can remove
• causes
  
  • hyperkalemia
  • hyperphosphatemia
  • hyperuricemia
  • hypocalcemia
• CAN CAUSE ACUTE KIDNEY INURY (AKI)
  
  • MONITOR CREATINE

Question 6

Tumor lysis syndrome (TLS) care

Answer 6

• three to five liters of water daily
• allopurinol (decrease uric acid)
• may lead to dangerously high potassium levels and an acute kidney injury
  
  • MONITOR CREATINE
    
    • SHOWS EVIDENCE OF KIDNEY FUNCTION

Question 7

D-dimer

Answer 7

• protein fragment obtained after clot breakdown
• elevated in
  
  • pulmonary embolism!!!!
  • DVT (not accurate)
  • DIC

Question 8

Ankle-brachial index (ABI)

Answer 8

• used to assess vascular status of lower extremities
• determines distal arterial blood flow

Question 9

Venous duplex ultrasonography

Answer 9

• diagnose DVT

Question 10

Transillumination device

Answer 10

• helps locate vein if dark-skinned or obese

Question 11

Doppler

Answer 11

• auscultate pulses

Question 12

Acute lymphoblastic leukemia (ALL)

Answer 12

• vascular acces device
• bruising is common
• blood cultures (d/t risk of infection)
• isotonic fluids
• antibiotics
• infection (top priority)

Question 13

Colorectal cancer

Answer 13

• Positive factors
  
  • excercise
  • fiber
  • screening at 45
• Risk factors
  
  • over 50 years old
  • African American
  • HPV (vaccine recommened)
  • ulcerative colitis
  • low fiber
  • family history
  • smoking/drinking
  • overweight

Question 14

Ruptured/rupturing abdominal aortic aneursym

Answer 14

• tight blood pressure control is essential!
• give beta blocker to control BP
  
  • atenolol
• monitor vital sigs
• give pain med

Question 15

Sickle cell

Answer 15

• high risk for stroke (CVA)
  
  • headaches may indicate stroke
• place in semi-fowlers
• extremities straightened

Question 16

Subarachnoid hemorrhage (SAH)

Answer 16

• risk for hyponatremia
• worst headache of my life
• LOC
• photophobia
• nauesea/vomitig
• stiff neck
• Kernig sign

Question 17

PET scan

Answer 17

• used to detect cancer and response to treatment
• NPO 4-6 hours prior
• must have glucose levels 60-150

Question 18

External beam radiation therapy (EBRT)

Answer 18

no limitation in their ambulation

Question 19

Wedge resection

Answer 19

• small, localized portion of lung is removed near the surface

Question 20

Cervical cancer

Answer 20

• diagnose through PAP smear
• mean age is 50
  
  • peak age is 60-64
• dyspareunia
  
  • painful intercourse
• urination and menstrual irregularities
• no affect in urination or fertility
• not cyclical like endometriosis

Question 21

Endometrial biopsy

Answer 21

• tests for endometrial cancer

Question 22

Pelvic exam

Answer 22

• tests for ovarian cancer
• bimanual
• press on abdomen

Question 23

Kaposi’s sarcome (KS)

Answer 23

• cancer that grows in blood vessel lining
• caused by oppurtunistic infection
  
  • Human Herpes Virus (HHV-8)

Question 24

Transfusion of plasma

Answer 24

• INR will decrease
• aPTT labs not needed
• hematocrit not needed
• provides clot factors
• ensure ABO compatibility

Question 25

Transfusion of platelets

Answer 25

• ABO compatibility not required

Question 26

Prostate cancer risk factors

Answer 26

• African American
• over age of 40
• diet high in animal fat
• red meat

Question 27

Kernig sign

Answer 27

• subarachnoid hermitage
• bacterial meningitis
• supine, hip flexed 90 degrees
• pull on neck
• positive if pain occurs upon extension of knee

Question 28

Breast cancer risk factors

Answer 28

• high BMI/obesity
• early menarche/post-menopause
• 50+ years old
• white
• family history
• NULLIPARITY
  
  • not known why
• smoking and alcohol
• high estrogen levels

Question 29

Multiple myeloma

Answer 29

• bone pain
• shortness of breath
• weakness
• C.R.A.B
  
  • Calcium —> hign
  • Renal (kidney) problems
  • Anemia (low RBC)
  • Bones —> weak, fractures