Cancer and Hematology

Question 1

Which of the following are characteristics of benign tumor cells? SATA

A. Encapsulated
B. Proliferate rapidly
C. Compress nearby organs and cause damage
D. Cells look and may function as normal cells
E. infiltrate, invade and metastisize

Answer 1

Answers: A,C,D

Rationale: These are the characteristics of benign tumors, the other options would be indicative of a malignant tumor

Question 2

Define oncogenesis

Answer 2

The transformation of normal cells to cancer cells

Question 3

Define the steps seen in carcinogenesis

• Initiation
• Promotion
• Progression

Answer 3

Initiation: Damage to cell DNA (Where it starts)
Promotion: Tumor begins to develop
Progression: Proliferation and Angiogenesis

Question 4

Define Angiogenesis

Answer 4

Formation of new blood blood vessels

Why does cancer need this?

Question 5

Why do we stage cancer?

A. To diagnose the type of cancer present
B. To determine prognosis and treatment
C. To determine see where the cancer is
D. To determine what caused the cancer

Answer 5

Answer: B

Rationale: The purpose behind staging the cancer is to determine treatment and prognosis.

Question 6

What are some possible manifestations of cancer? SATA

A. Effusions
B. Bleeding
C. Anorexia
D. Unexplained Fatigue

Answer 6

Answer: all of these are possible manifestations of cancer

Question 7

Which of the following is not a goal of cancer treatment?

A. Palliation/Comfort care
B. Cure
C. Control
D. Proliferation

Answer 7

Answer: D

Rationale: Proliferation is the growth process of the disease. We want to minimize the growth and stop it if at all possible

Question 8

What is the primary risk factor for colon and breast cancer?

A. Smoking
B. Poor Diet
C. Family History
D. UV Sunlight

Answer 8

Answer: C

Rationale: these specific cancers have a strong genetic connection. If you see a family history or BRCA gene with genetic testing, know that they are at an increased risk

Question 9

Why is it important to understand the risk factors associated with cancer?

Answer 9

Because the best prognosis comes with early detection.

Question 10

Where are all blood cells created?

Answer 10

Answer: the bone marrow

Question 11

What body system will likely be affected with a WBC count that is out of range?

A. Clotting System
B. Immune System
C. Digestive System
D. Cardiovascular System

Answer 11

Answer: B

Rationale: WBCs primary role is in immune function. If we see a WBC lab out of range we focus on the immune system first?

Question 12

What are possible CM you will see with Acute Leukemia? SATA

A. Increased energy levels
B. Fever and night sweats
C. Bone Pain
D. Frequent infections
E. Bleeding

Answer 12

Answer: B,C,D,E

Bonus Question: Why would we see each of these?

Question 13

Which lymphoma has a higher survival rate?

A. Hodgkin’s
B. Non Hodgkin’s

Answer 13

Answer: A

WHY?

Question 14

Which disease is associated with a cancer of the stem cells?

A. Primary Polycythemia Vera
B. Anemia
C. Sickle Cell Disease
D. Immune Thrombocytopenic Purpura

Answer 14

Answer: A

Rationale: This is an OVERGROWTH of all blood cells - remember that cancer is an overgrowth of cells.

Polycythemia = many blood cells

Question 15

A patient with PPV is at increased risk for which of the following? SATA

A. Blood clots
B. MI
C. Hemorrhage
D. Ischemic CVA
E. GI Bleed

Answer 15

Answer: A,B,D

Rationale: Too many blood cells = RF increased clotting

Question 16

What is the most common anemia worldwide?

A. Blood loss anemia
B. Iron deficiency anemia
C. Pernicious anemia
D. Sickle Cell anemia

Answer 16

Answer: B

Question 17

Which of the following patients are at an increased risk for blood loss anemia? SATA

A. Pt with a family history of anemia
B. Pt with a GSW to the abdomen
C. Pt with a heavy period
D. Pt with destroyed gastric mucosa

Answer 17

Answer: B,C

Rationale: Blood loss anemia is caused when a pt is losing blood faster than it can be produced.

Question 18

What is the treatment for pernicious anemia?

A. Transfusion <7
B. Iron supplements
C. No treatment is necessary
D. Lifelong B12 injections

Answer 18

Answer: D

Question 19

Which of the following patient diagnoses should be educated about reducing their risks for bleeding? SATA

A. Hemophilia
B. ITP
C. PPV
D. Lymphoma

Answer 19

Answer: A,B

Rationale: These are disorders of clotting and patients should be placed on bleeding precautions due to increased risk for blood loss

Question 20

Place the chain of infection in order

A. Portal of entry
B. Reservoir
C. Susceptible host
D. Mode of transmission
E. Causative Agent
F. Portal of exit

Answer 20

Answer: E,B,F,D,A,C

Question 21

If a nurse contracts a MRSA off a keep board that was previously used by another nurse what is the mode of transmission?

A. Contact
B. Airborne
C. Vector
D. Vehicle

Answer 21

Answer: D

Rationale: There is no human to human contact and the transmissible device is non-living

Question 22

Define acute vs chronic

Answer 22

Acute: short term
Chronic: long term

Question 23

Which of the following patients is at an increased risk of developing nosocomial pneumonia?

A. Catheterized patient who is a stand by assist
B. Patient sedated and on a ventilator
C. Post op patient who is ambulating well
D. Patient with a central line in place receiving chemotherapy

Answer 23

Answer: B

Rationale: All patient’s are at risk of developing nosocomial infections, this patient has a tube in their lungs and is completely sedated in bed. You want to monitor for pneumonia closely

Bonus Q: What else is this patient at risk for developing?