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Med-Surg NU 207 spring 2015 > BRCA > Flashcards

BRCA Flashcards

1
Q

7 warning signs

A 
sore that won't heal
nagging cough/ hoarseness
indigestion/difficulty swallowing
obvious change in wart or mole
thickening lump
bowel/bladder changes
unusual bleeding/discharge
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2
Q

second most common cause of CA related deaths in women

A

breast CA

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3
Q

if diagnosed early what percentage is the 5-year survival rate?

A

93%

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4
Q

give the pathophysiology of brca

A

lobular (milk-producing glands) carcinoma
(epithelial lining ducts) ductal carcinoma
in situ (still localized, not yet broken through basement membrane)
invasive
metastatic

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5
Q

most common type of brca

A

invasive ductal carcinoma

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6
Q

most harmful/aggressive type of brca

A

inflammatory brca

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7
Q

type of brca that has persistent lesions in breast tissue

A

Paget’s disease

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8
Q

2 non-invasive brca

A

pagets dx & inflammatory breast CA

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9
Q

risk factors (name drugs)

A

hormonal replacement therapy (HRT) and oral contraceptives

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10
Q

risk factors (genetics)

A

family history

BRCA 1 & BRCA 2

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11
Q

risk factors (age and menopause)

A

> 60 years of age

menopause before age 55

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12
Q

risk factors (regarding child bearing process)

A

nulliparity (never having children)

first child born after age 30

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13
Q

risk factor (regarding menarche)

A

beginning menstrual cycle before age 12

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14
Q

environment risk factor for breast CA

A

radiation exposure

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15
Q

modifiable risk factors for BRCA

A

sedentary lifestyle
obesity
increased fat diet
ETOH excessive intake

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16
Q

common locations BRCA tends to occur (specific name)

most commonly occurs in which breast?

A

upper outer quadrant (Tail of spence)

left breast

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17
Q

S&S-BRCA regarding lump in breast

A 
lump in breast that's hard
irregular shaped
poorly delineated (abnormal outer edges)
fixed
non-tender
asymmetry of breasts
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18
Q

S&S regarding skin & pain (3)

A

dimpled skin (small retractions) (peau d’ orange)
nipple retention
pain (late sign)

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19
Q

screening for BRCA

A 
self breast exam
clinical breast exam 
mammogram
MRI (if high risk)
ultrasounds
20
Q

how often should clinical breast exams be performed

A

q3yrs at ages 20-30

qyr at age 40

21
Q

how frequently should mammograms be performed?

A

qyr starting at age 40

22
Q

name 3 diagnostic tests for BRCA

A

fine needle aspiration (FNA)
Excisional (open) biopsy also called lumpectomy
sentinel node biopsy

23
Q

staging roman numeral in which it is ipsilateral (on the same side of the body) axillary lymph nodes

A

stage II

24
Q

staging in BRCA: local and encapsulated

A

stage I

25
Q

staging: contralateral axillary or mammary lymph nodes

A

stage III

26
Q

staging: distant metastasis

A

stage IV

27
Q

surgical tx (3)

A

radical mastectomy
lumpectomy
modified radical mastectomy

28
Q

surgical tx that involves the removal of the entire breast, all, lymph nodes, and most of pectoral muscles removed

A

radical mastectomy

29
Q

the surgical tx in which area around the tumor removed muscle and some lymph nodes spared, and may involve axillary node dissection

A

lumpectomy

30
Q

surgical tx: breast removed, muscle spared

A

modified radical mastectomy

31
Q

post mastectomy care discharge teaching

A

wash cuts stat
avoid sunburns
use electric razor
avoid elastic cuffs/BP cuffs

32
Q

post mastectomy discharge follow-up

A

2 weeks after
q2-3 month x 2 yrs
q6 months x 5 yrs
qyr after that

33
Q

risk of metastasis that is the most common

A

bone

34
Q

risk of metastasis: other locations other than the most common

A

liver
lungs
brain

35
Q

S&S of metastasis

A 
HA/visual changes
cough/SOB
RUQ tenderness
lumps
back/bone pain
36
Q

adjuvant therapy

A

chemo
hormonal therapy
Herceptin
radiation

37
Q

purpose of chemo

A

stop micro metastic spread of abnormal cells

38
Q

combination of drugs with chemo tx

A 
cyclophosphamide (Cytoxan)
doxorubicin (Adramycin) "Red Devil"
5-Fluorouracil
Methotrexate 
paclitaxel (Taxol)
39
Q

hormonal therapy:purpose

A

used for tumors with estrogen receptors

blocks source of estrogen

40
Q

hormonal therapy meds:

A

tamoxifen
femara
trastuzumab (Herceptin)

41
Q

Tamoxifen (duration of tx, risks, S&S)

A

PO x 5yrs
risk of eye damage/other CA
HA, hot flushes, “menopause”

42
Q

Femara (its use and stops what?)

A

used in post-menopausal women & stops reproductivity

43
Q

Trastuzumab (Herceptin)

A

monoclonal antibody
targets only CA cells with HER-2 receptors
adjunct tx with chemo

44
Q

Radiation (primary or secondary?)

A

can be primary

45
Q

Radiation will be given how?

A

normally will be at a very HIGH dose

46
Q

Radiation will include what therapy?

A

brachytherapy

47
Q

what is brachytherapy

A

small radioactive seeds physically implanted in middle of tumor

Med-Surg NU 207 spring 2015 (6 decks)

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