Cancer Flashcards
The central OR peripheral nervous system is more susceptible to damage from toxic effects of drugs used to treat cancers.
Peripheral
What is name of common neuro issue that occurs following being treated with vincristine?
Vincristine-Induced Peripheral Neuropathy (VIPN)
First sign of VIPN
Reduced or complete loss of the distal deep tendon reflexes system
Sensory changes that may be found in limbs affected with VIPN
Children may experience numbness or tingling in the affected limb(s) and experience loss of light touch sensation
Child scores 22/24 on pediatric modified total neuropathy score. Does this indicate a lot or little signs of neuropathy?
A lot of signs - higher score shows worse peripheral neuropathy
3 muscle groups most affected by VIPN.
1) DF
2) Intrinsic hand muscles
3) Intrinsic foot muscles
Pair the recommended exercise with the platelet count number:
1) >50,000 platelets
2) 20,000-50,000 platelets
3) <20,000 platelets
a) AROM/PROM, stretching, and light exercise
b) Active exercise
c) Resisted exercise
1C
2B
3A
Pair the recommended exercise with the while blood cell count number:
1) <5,000 with fever
2) >5,000
1) No exercise
2) Light exercise and resisted exercise as tolerated
Pair the recommended exercise with the hemoglobin count number:
1) <8
2) 8-10
3) >10
1) No exercise
2) Light exercise
3) Resistive exercise
Pair the recommended exercise with the hematocrit count number:
1) >30%
2) 25-30%
3) <25%
1) Resistive exercise
2) Light exercise
3) No exercise
When children receive bone marrow transplant or stem cell transplant, they are at risk of what 3 things during treatment period?
1) Infection
2) Fatigue
3) brusing
Recommended % of heart rate max to perform exercise at AND how do you calculate age appropriate heart rate max.
1) 70%
2) 220-age = heart rate max
A PT is evaluating a 5-year-old boy diagnosed with acute lymphoblastic leukemia (ALL) three months ago, now being evaluated in an acute care setting. He received his first round of chemotherapy, including vincristine, upon diagnosis, and he just received another round of chemotherapy two days ago. Assuming lab values are in safe ranges, which physical therapy outcome measure would be the most appropriate to best assess the child’s need for physical therapy given his current medical status?
1) Manual muscle testing
2) Test of Gross Motor Development-2 (TGMD-2)
3) Pediatric-Modified Total Neuropathy Scale (PED-M TNS)
4) 6MWT
3) PED-M-TNS
The Pediatric-Modified Total Neuropathy Scale was developed to assess all three areas of neuropathy in children who are at risk for CIPN and would indicate a need for PT, and is valid and reliable for children with non-CNS cancers.
A 5-year-old boy with acute lymphoblastic leukemia (ALL) is enrolled in a general education kindergarten class in his home school. After his first round of chemotherapy three months ago, he now walks slower than his peers, has difficulty running, needs help with toileting, and needs more time to complete fine motor activities. He is eager to play on the playground and learn how to ride a bike with his peers. What support do you anticipate he may need at school to address his physical needs, based on his history?
1) None
2) An individualized education plan (IEP)
3) A 504 plan
4) 1:1 aide
3) 504 plan
A 7-year-old boy with a diagnosis of acute lymphoblastic leukemia (ALL) has relapsed two years after his initial diagnosis. His medical team decides it is appropriate to proceed with a bone marrow transplant. It is now day 10 after his bone marrow transplant, and he is being seen on the acute care floor of the hospital. What lab value would be most indicative to prompt the PT to consult with the medical team prior to initiating physical therapy intervention today?
1) Absolute neutrophil count (ANC): 1000 109/L
2) Hemoglobin: 8.5 g/dL
3) Platelets: 20,000
4) Hematocrit: 23%
4) Hematocrit
While all lab values are low, based on the child’s recent medical treatment, the hematocrit is not within a safe range for exercise. The hematocrit should be above 25% to safely exercise. An ANC of 100 would mean that the child is moderately neutropenic and may be unable to leave the unit or room due to his weakened immune system but could still receive treatment in his room/on the unit. Platelets of 20,000 indicates that light exercise without resistance is ok if closely monitored, but a symptoms-based approach is important. The hemoglobin is also low but should be above 8 g/dL to exercise.
