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Health Assessment Exam 2 > Cancer/Endocrine > Flashcards

Cancer/Endocrine Flashcards

1
Q

What are some hematologic changes that occur with cancer?

A
  • Anemia
  • Thrombocytopenia
  • Neutropenia
  • Bone marrow suppression
  • GI ulcers
  • Reccurrent venous thrombus with pancreatic cancer
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2
Q

What are some musculoskeletal changes that occur with cancer?

A
  • Myofacial pain

- Peripheral neuropathies

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3
Q

What are some musculoskeletal changes that occur with cancer?

A
  • Myofacial pain
  • Peripheral neuropathies
  • Spinal cord compression
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4
Q

What are some pulmonary changes that can occur with cancer?

A

-Pulmonary edema, CHF, recurrent pleural effusions, pneumonitis

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5
Q

What changes can occur with squamous cell lung cancer?

A

-Hypercalcemia

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6
Q

What changes can occur with adenocarcinoma lung cancer?

A

-Hypercoagable state and osteoarthritis

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7
Q

What changes can occur with large cell carcinoma?

A

-Gynecomastia

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8
Q

What changes can occur with small cell carcinoma?

A
  • Inappropriate ADH secretion
  • Corticotropin secretion
  • Eaten-Lambert syndrome (muscle weakness that resembles MG)
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9
Q

What changes can occur with small cell carcinoma?

A
  • Inappropriate ADH secretion
  • Corticotropin secretion
  • Eaten-Lambert syndrome (muscle weakness that resembles MG)
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10
Q

What are some electrolyte/nutritional/hormone changes that can occur with cancer?

A
  • Hypercalcemia due to bone marrow involvement
  • Anorexia, may need hyperalimentation
  • K and Na changes with n/v, diarrhea
  • Adrenal insufficiency-may need corticosteroids
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11
Q

What are some electrolyte/nutritional/hormone changes that can occur with cancer?

A
  • Hypercalcemia due to bone marrow involvement
  • Anorexia, may need hyperalimentation
  • K and Na changes with n/v, diarrhea
  • Adrenal insufficiency-may need corticosteroids
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12
Q

What are some cardiac changes that can occur with cancer?

A
  • Pericardial involvement can cause electric alternans, paroxysmal a fib or a flutter, pericardial tamponade
  • Drug induced cardiomyopathies
  • Compression of SVC- dyspnea, airway obstruction, enlarged veins of upper body
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13
Q

What are the cardiotoxic cancer medications and what are some effects they can cause?

A
  • Doxorubicin and Daunorubicin
  • ECG chances
  • CHF
  • Acute or severe and irreversible cardiomyopathies
  • Can enhance the myocardial depressant effects of anesthesia and cause acute LV under sedation
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14
Q

What are the cardiotoxic cancer medications and what are some effects they can cause?

A
  • Doxorubicin and Daunorubicin
  • ECG chances
  • CHF
  • Acute or severe and irreversible cardiomyopathies
  • Can enhance the myocardial depressant effects of anesthesia and cause acute LV under sedation
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15
Q

What are the pulmonary toxic cancer medications and what are their effects?

A

Methotrexate:

  • Can cause fulminant non-cardiogenic pulmonary edema
  • Progressive inflammation with infiltrates and effusions

Bleomycin:

  • Can cause endothelial damage/pulmonary fibrosis
  • Increased A-a gradient
  • Induced hyperoxic pulmonary injury
  • Want to avoid high FiO2 and use colloids rather than crystalloids
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16
Q

What are the pulmonary toxic cancer medications and what are their effects?

A

Methotrexate:

  • Can cause fulminant non-cardiogenic pulmonary edema
  • Progressive inflammation with infiltrates and effusions

Bleomycin:

  • Can cause endothelial damage/pulmonary fibrosis
  • Increased A-a gradient
  • Induced hyperoxic pulmonary injury
  • Want to avoid high FiO2 and use colloids rather than crystalloids
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17
Q

What cancer medication ca be heme toxic and what are its effects?

A

5-Fluorouacil:

  • Immunosuppression
  • Leukopenia
  • Megoblastic anemia
18
Q

What cancer medication can be renal toxic and what are its effects?

A

Cisplatin

  • Decreased GFR
  • Acute tubular necrosis can progress to acute renal failure and pt may need dialysis
  • Treat with hydration and mannitol diuresis
  • Can also cause dose dependent damage to dorsal root ganglion-large fiber nueropathies
19
Q

What cancer drugs can cause encephalopathy?

A
  • Cyclophosphomide (delerium)

- Methotrexate (dementia)

20
Q

What cancer drugs can cause nueropathies?

A

Vincristine: peripheral and autonomic neuropathies

Cisplatin: large fiber neuropathies

21
Q

What cancer drugs can cause nueropathies?

A

Vincristine: peripheral and autonomic neuropathies

Cisplatin: large fiber neuropathies

22
Q

What effect can alkylating agents have?

A
  • Inhibits cholinesterases

- Can prolong the effects of succ

23
Q

What are some side effects of radiation?

A
  • Cardiomyopathy
  • Cystitis
  • Limited range of motion
  • Fibrosis
  • Diarrhea
24
Q

What lab tests would you want for a cancer patient?

A
  • CBC
  • PT
  • Liver tests
  • BUN/Cr
  • Electrolytes- Na/K/Ca/Mg
  • Blood glucose
  • ABGs
  • CXR
  • ECG
25
Q

What lab tests would you want for a cancer patient?

A
  • CBC
  • PT
  • Liver tests
  • BUN/Cr
  • Electrolytes- Na/K/Ca/Mg
  • Blood glucose
  • ABGs
  • CXR-masses, pulmonary edema, cardiomegaly, tracheal deviation or compression
  • ECG
26
Q

What are some common airway considerations for cancer patients?

A
  • Tracheal deviation or cmpression
  • Dysphagia or difficulty breathing (airway obstruction)
  • Trach
  • Colon obstruction
  • One lung ventilation
27
Q

What are some common airway considerations for cancer patients?

A
  • Tracheal deviation or cmpression
  • Dysphagia or difficulty breathing (airway obstruction)
  • Trach
  • Colon obstruction
  • One lung ventilation
28
Q

What are some clinical manifestations of diabetes?

A
  • Polydypsia
  • Polyuria
  • Polyphagia
  • Weight loss
  • Recurrent infections
  • Vision changes
  • Parasthesias
  • Lethargy and fatigue
29
Q

What are some GU complications associated with diabetes?

A
  • Nephropathy

- Chronic renal failure

30
Q

What are some GI complications associated with diabetes?

A
  • Gastroparesis

- Nocturnal diarrhea

31
Q

What are some CNS complications associated with diabetes?

A
  • Strokes

- Peripheral and autonomic neuropathies

32
Q

What are some CV complications associated with diabetes?

A
  • HTN
  • CAD
  • Retinopathy
  • Cardiomyopathy
33
Q

What are some miscellaneous complications associated with diabetes?

A
  • Infections

- Stiff joint syndrome

34
Q

What are some symptoms of autonomic neuropathies?

A
  • Loss of heart rate variability
  • Orthostatic hypotension
  • Resting tachycardia
  • Cardiac dysrhythmias
  • Altered regulation of breathing
  • Gastroparesis
  • Impotence
  • Sudden death syndrome
  • Peripheral neuropathy
35
Q

What are some miscellaneous complications associated with diabetes?

A
  • Infections

- Stiff joint syndrome- temperomandibular, antlantooccipital, and other c spine joints may be affected

36
Q

What are some symptoms of autonomic neuropathies?

A
  • Loss of heart rate variability
  • Orthostatic hypotension
  • Resting tachycardia
  • Cardiac dysrhythmias
  • Altered regulation of breathing
  • Gastroparesis
  • Impotence
  • Sudden death syndrome
  • Peripheral neuropathy
37
Q

How can diabetes affect the airway assessment?

A
  • 30-40% of Type 1 diabetics can have stiff joint syndrome
  • Can have difficult laryngoscopy due to limited atlanto-occipital and laryngeal mobility
  • Prayer sign
  • 15% association of Type 1 diabetes and autoimmune diseases such as hashimoto thyroiditis and graves disease-assess thyroid gland size
38
Q

What are the signs of DKA?

A
  • Nausea
  • Vomiting
  • Lethargy
  • Signs of dehydration
  • Abdominal pain
  • Fruity breath
  • Kussmaul’s respirations
  • Coma
39
Q

What are the s/s of a pheochromocytoma?

A
  • Hypertension
  • Epigastric pain
  • Chest pain
  • headache
  • Pallor
  • Sweating
  • Palpitations
  • Painless hematuria (rare)
  • Flushing (rare)
  • Tremor
40
Q

What are the s/s of a pheochromocytoma?

A
  • Hypertension
  • Epigastric pain
  • Chest pain
  • headache
  • Pallor
  • Sweating
  • Palpitations
  • Painless hematuria (rare)
  • Flushing (rare)
  • Tremor
41
Q

What are the s/s of Conn’s disease

A
  • Hypertension that may be resistant to treatment

- Hypokalemia-can cause skeletal muscle cramps and weakness, polyuria

42
Q

What is the hallmark of hyperparathyroidism?

A
  • Hypercalcemia
  • Serum calcium of higher than 5.5 mEq/L and ionized calcium greater than 2.5 mEq/L
  • If calcium is greater than 7/5 most likely cancer

Health Assessment Exam 2 (6 decks)

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