Chapter 5 WS Flashcards
what is relative survival rate?
Compares survival among cancer patient with that of people not diagnosed with cancer. It represents the percentage of cancer patients who are alive after a designated time period (usually 5 years) relative to persons without cancer. It includes patients who have been cured and those who have relapsed or are still in treatment.
List the types of imaging modalities:
- nuclear medicine studies
- Positron emission tomography (PET),
- mammography,
- computed tomography (CT),
- magnetic resonance imaging (MRI),
- ultrasound, and
- new molecular imaging technologies
- According to the American Cancer Society (ACS), what two things are the most important and effective strategies of saving lives from cancer, diminishing suffering and eliminating cancer as a major health problem.
prevention and early detection
List 7 cancers that the ACS has early detection recommendations for:
- breast
- colon,
- rectum,
- cervix,
- prostate,
- testes, and
- skin
- What is the relative survival rate for people with cancers for which the ACS has specific early detection recommendations?
81%
What is considered the most preventable cause of death in our society?
smoking
an objective finding as perceived by the examiner (ex. rash, mass that can be felt, unusual color of patient’s skin
sign
a subjective indication of a disease or a change in condition as perceived by the patient (ex. pain, numbness, dysphagia, dyspnea, difficulty sleeping, lack of appetite
symptom
Set of signs or symptoms that arise from a common cause.
syndrome
the identification of a disease or condition
diagnosis
based on the patient’s complaints and medical history and the physician may make a preliminary diagnosis with no hard evidence
subjective diagnosis
type of diagnosis that’s based on results from medical procedures and tests (ex. lab reports, biopsies)
objective diagnosis
“i see”
“i understand”
minimal response
“i se you are very angry”
“it is very scary”
reflecting feelings
“how bad did it hurt?”
“this only bothers you at night?”
clarifications
“you will feel better soon”
“done worry, everything will be alright”
social cliches
“you should not be having sex outside of marriage”
“someone your age should be more responsible”
imposing values
“i wish i had a nickle for every time i heard this”
“this is just part of the aging process”
devaluing the patients feelings or response
age, race, gender, marital status, and current occupation
demographic data
symptoms, current illness, and current condition
chief complaints
childhood illnesses, allergies, immunizations, injuries, prior hospitalizations, psychological problems, medication
medical history
illnesses, causes of death, genetic disorders, and mental disorders
family history
occupation, lifestyle, and sexual activity and preferences
personal history
What is the reason for obtaining demographic data?
Because certain disease conditions are found to be more prevalent for groups according to age, gender, race, and national origin.
what is Gastric Reflux?
the backflow of contents of the stomach into the esophagus
What is a paraneoplastic syndrome?
A collection of symptoms that result from substances or hormones produced by the tumor, and they occur remotely from the tumor. This sometimes occurs with lung cancer
3 cancers that may have a genetic risk.
Leukemia (may develop in more than one sibling), breast cancer (if mother had breast cancer, daughter may be at higher risk), Colon Cancer (increased risk if a family history)
what questions may be asked regarding a patient’s personal history?
Dietary, exercise, alcohol, cigarette, and drug habits. Also, sexual activity, frequency, and preferences. Past occupations.
What would the doctor be interested in the patient’s past occupations?
To determine if the patient was employed in an occupation that carried the risk of exposure to asbestos, disease, certain chemicals or other carcinogens.
the use of sight to observe
inspection
a swelling of the tissue caused by the accumulation of excessive amounts of fluid.
edema
The abnormal accumulation of blood factors in a blood vessel that causes a clot
thrombosis
The abnormal accumulation of blood in tissue from a blood vessel that has ruptured
hematoma
the use of touch to acquire info about the patient
palpation
The act of striking or tapping the patient gently Ex. making a fist and pounding it gently over the kidney area
percussion
The act of listening to sounds within the body. Ex. using a stethoscope to listen to lungs, heart, arteries, stomach, and bowel sounds.
ausculation
what is included in vital signs
Temperature, pulse, respirations, blood pressure and a pain assessment
oral temp
96.8 - 98.6
pulse
60 - 100 bpm
respiration
12-18 breaths per minute
blood pressure
90-140 systolic, 60-80 diastolic
what is systolic bp
The pressure in the blood vessels during the contraction of the heart and is the first sound heard through a stethoscope when blood pressure is taken
what is diastolic bp
It represents the pressure in the blood vessels during the relaxation phase of heart after the contraction. It is the last sound heard through the stethoscope when the blood pressure is taken.
Where is the most common site for taking blood pressure
the upper arm near where the brachial artery crosses he elbow joint
what is considered the 5th vital sign
pain
what is screening
Testing individuals who do not have any symptoms for a particular disease.
4 cancers whose mortality rates have been reduced due to screening
colorectal
breast
uretine cervix
lung
number of new cases of a disease during a period of time.
Probability that a disease will develop in a disease-free patient during an interval.
incidence
the total number of cases of a disease at a certain time.
Probability of disease in the entire population at any point in time.
prevalence
Why would screening for esophageal cancer not be beneficial for the U.S. population?
Because the population at risk for esophageal cancer is very low, it would not be beneficial in terms of outcome and cost effectiveness
what are mass screening based on
Specific results, cost effectiveness, and risk to patient.
recommended an annual mammogram screening at what age?
40 years
most effective technology available for the detection of breast cancer?
high quality mammography
What other technologies and techniques assist with traditional mammography to improve the detection and diagnosis of breast cancer.
Ultrasound,
digital mammography,
MRI, PET, and
image-guided biopsy.
For higher risk women, at what age does the ACS recommend an annual mammogram screening
30 years
And what other imaging modality is recommended along with the mammogram?
MRI
What type of contrast is used with an MRI screening of a breast?
gadolinium
what is the sentinel node
The first lymph node to receive draining fluid from breast tumors and, therefore, the first to collet cancer cells.
What is injected to identify the sentinel node?
blue dye or technetium 99
why are cancers that are estrogen receptor positive and/or progesterone receptor positive associated with a more favorable prognosis?
bc pateint normally respond to hormone therapy
leading cause of cancer deaths in the US
lung cancer
What did the National Lung Screening Trial reveal?
That low-dose CT screening is beneficial for high risk patients (heavy smokers). It showed 20% fewer lung cancer deaths among current and former heavy smokers who were screened with spiral CT compared with standard chest x-ray
what are the two most common methods used to screen for prostate cancer?
digital rectal exam (DRE) and PSA blood test
According to the ACS’s guidelines for prostate screening, at what age should annual PSA testing and DRE be offered?
geginning at age 50
What is the physician able to do with digital mammography that can’t be done with film/screen mammography?
The contrast can be manipulated with digital mammography allowing the physician to lighten or darken a portion of the image as well as magnify areas of concern.
what conditions increase the risk of colon cancer
1) a personal history of colorectal cancer or adenomatous polyps
2) A personal history of inflammatory bowel disease (ulcerative colitis or Crohn disease)
3) A strong family history of colorectal cancer or polyps
4) known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis or hereditary nonpolyposis colon cancer
true or False: The ACS recommends that beginning at age 50, all men should be screened for prostate cancer using a DRE and serum PSA.
false
what age should cervical cancer screening occur
21
how often should women between the ages of 21 and 29 have a pap test
every 3 years
what strains of HPV are responsible for 70% of cervical cancers
HPV 16 and HPV 18
What is the difference between a blood study and a blood chemistry test?
Blood studies are concerned with blood cells, whereas blood chemistry tests examine chemicals in the blood.
white blood cells
5,000 - 10,000
red blood cells
3.90 - 5.40 milliom
platelets
150,000 - 425, 000
hemoglobin
12 - 16 g/dL
hematocrit
37-47%
neutrophils
42-72%
lymphocytes
17-45%
monocytes
3 - 10%
eosinophils
0 - 4%
basophils
0 - 2%
What are radiopharmaceuticals or radionuclides?
An isotope that undergoes radioactive decay. It gives off radiation, often in the form of gamma rays.
How may a radionuclide be administered?
Injected, swallowed, or inhaled, depending on the diagnostic procedure.
What are the three most common imaging devices used with radionuclides
gamma camera, rectilinear scanner, and pet scanner
In addition to showing anatomy, what else does a PET image
Can view organ’s function and blood flow. Chemical changes that take place in tissue.
What is a patient injected with prior to a PET scan?
A combination of sugar (glucose) and a small amount of radioactive material. The radioactive sugar accumulates in the tumor which is then detected by the scanner.
Which is less expensive, a CT scan or an MRI scan?
CT
Does MRI use ionizing radiation
no
which modality is best to use to see bone CT or MRI
CT
which is best to use to see soft tissue
MRI
Does ultrasound use ionizing radiation?
no
What does ultrasound use to create image?
high frequency sound waves
What are exfoliative cells?
Cells that have been scraped off deliberately or sloughed off naturally.
What does “negative margin” mean with regard to an excisional biopsy?
No disease was found at the edges of the biopsy specimen.
What does “positive margin” mean with regard to an excisional biopsy?
Disease was found at the edge of the specimen and that the tumor has directly invaded beyond the area biopsied.
What is a tumor marker?
A molecule that can be detected in serum, plasma, or other body fluid.
What is the difference between histologic type and histologic grade?
Histologic type is the cell type, histologic grade refers to the differentiation of the cell.
ex. histologic type may be squamous cell carcinoma and the histologic grade indicates the closeness of the cells’ resemblance to normal squamous cells.
grade not assessable
GX
well differentiated
G1
moderately differentiated
G2
poorly differentiated
G3
undifferentiated
G4
primary tumor not assessable
TX
no evidence of primary tumor
T0
carcinoma in situ
Tis
increasing size and/or local extent of the primary tumor
T1, T2, T3, T4
regional lymph nodes not assessable
NX
no regional lymp node mets
N0
increasing involvement of regional lymph nodes
N1, N2, N3
presence of distant mets not assessable
MX
no distant mets
M0
distant mets
M1
