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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
What lab tests would you want for a cancer patient?
- 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
What are some common airway considerations for cancer patients?
- Tracheal deviation or cmpression - Dysphagia or difficulty breathing (airway obstruction) - Trach - Colon obstruction - One lung ventilation
27
What are some common airway considerations for cancer patients?
- Tracheal deviation or cmpression - Dysphagia or difficulty breathing (airway obstruction) - Trach - Colon obstruction - One lung ventilation
28
What are some clinical manifestations of diabetes?
- Polydypsia - Polyuria - Polyphagia - Weight loss - Recurrent infections - Vision changes - Parasthesias - Lethargy and fatigue
29
What are some GU complications associated with diabetes?
- Nephropathy | - Chronic renal failure
30
What are some GI complications associated with diabetes?
- Gastroparesis | - Nocturnal diarrhea
31
What are some CNS complications associated with diabetes?
- Strokes | - Peripheral and autonomic neuropathies
32
What are some CV complications associated with diabetes?
- HTN - CAD - Retinopathy - Cardiomyopathy
33
What are some miscellaneous complications associated with diabetes?
- Infections | - Stiff joint syndrome
34
What are some symptoms of autonomic neuropathies?
- Loss of heart rate variability - Orthostatic hypotension - Resting tachycardia - Cardiac dysrhythmias - Altered regulation of breathing - Gastroparesis - Impotence - Sudden death syndrome - Peripheral neuropathy
35
What are some miscellaneous complications associated with diabetes?
- Infections | - Stiff joint syndrome- temperomandibular, antlantooccipital, and other c spine joints may be affected
36
What are some symptoms of autonomic neuropathies?
- Loss of heart rate variability - Orthostatic hypotension - Resting tachycardia - Cardiac dysrhythmias - Altered regulation of breathing - Gastroparesis - Impotence - Sudden death syndrome - Peripheral neuropathy
37
How can diabetes affect the airway assessment?
- 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
What are the signs of DKA?
- Nausea - Vomiting - Lethargy - Signs of dehydration - Abdominal pain - Fruity breath - Kussmaul's respirations - Coma
39
What are the s/s of a pheochromocytoma?
- Hypertension - Epigastric pain - Chest pain - headache - Pallor - Sweating - Palpitations - Painless hematuria (rare) - Flushing (rare) - Tremor
40
What are the s/s of a pheochromocytoma?
- Hypertension - Epigastric pain - Chest pain - headache - Pallor - Sweating - Palpitations - Painless hematuria (rare) - Flushing (rare) - Tremor
41
What are the s/s of Conn's disease
- Hypertension that may be resistant to treatment | - Hypokalemia-can cause skeletal muscle cramps and weakness, polyuria
42
What is the hallmark of hyperparathyroidism?
- 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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