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Oncology > Clinical Manifestations > Flashcards

Clinical Manifestations Flashcards

1
Q

Cancer associated with blood in the stool

A

Colorectal CA

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2
Q

Cancer associated with painless hematuria

A

Bladder CA

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3
Q

How can cancer effect the normal tissue?

A 
Bowel obstruction (abdominal tumor)
Development of effusions
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4
Q

What cancers primarily lead to a pleural effusion?

A

Lung CA
Lymphoma
Breast CA

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5
Q

What cancers primarily lead to peritoneal effusions?

A

Ovarian
Colorectal
Stomach
Pancreatic

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6
Q

What is anorexia due to in cancer?

A

Decreased caloric intake due to decreased desire of food

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7
Q

Reasons for Anorexia in Cancer

A 
Physical obstruction of GI tract
Pain
Depression
Constipation
Malabsorption
Debility or SE of treatment
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8
Q

Where is weight loss typically from in anorexia?

A

Fat stores

Then muscle

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9
Q

Liver Size in Anorexia

A

Decreased

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10
Q

Define Cachexia

A

Involuntary loss of at least 5% body mass

Secondary to hyper metabolic state & altered nutrient metabolism

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11
Q

Why cachexia in cancer?

A

Tumor consume large amounts of glucose & increase lactate formation
Abnormalities in fat & protein metabolism

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12
Q

Liver Size in Cachexia

A

Increased- hepatomegaly

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13
Q

Cancer Anorexia-Cachexia Syndrome

A

Common in solid tumors
Decreased appetite & increase metabolism
More common in young and old

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14
Q

What does cachexia lead to with the weight loss?

A

Shorter median survival
Do no respond well to chemotherapy
More problems with toxicity

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15
Q

Characterization of Cancer Fatigue

A

Tiredness
Weakness
Lack of energy
Not relieved by sleep

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16
Q

Peripheral Fatigue

A

Inability of peripheral neuromuscular apparatus to perform a task in response to stimulus
Anaerobic metabolism

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17
Q

Central Fatigue

A

Difficulty in initiating or maintaining voluntary activities

Secondary to dysregulation of serotonin & pro-inflammatory cytokines

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18
Q

Why poor sleep quality in cancer patients?

A 
Trouble falling asleep
Staying asleep
Nighttime awakenings
Restless sleep
Secondary to pain or SE of treatment (N/V)
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19
Q

Anemia in Cancer

A

Blood loss
Hemolysis
Impaired RBC production
Treatment effects

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20
Q

How do malignancies decrease RBC production?

A

Nutritional deficiencies
Bone marrow failure
Blunted EPO response
Inflammatory cytokines produce by tumors decrease EPO production

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21
Q

Common Malignancies that Present with a Fever

A 
Non-Hodgkin's Lymphoma
Leukemia
Renal cell
Hepatocellular carcinoma
Atrial myxomas
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22
Q

Define Paraneoplastic Syndromes

A

Collections of symptoms that result from substances produced by the tumor & occur remotely from eh tumor itself

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23
Q

Paraneoplastic Syndromes Cause

A

Abnormal increases in hormones secondary to the effects of the cancer cells

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24
Q

Paraneoplastic Syndromes Common in What Cancers

A

Lung
Breast
Hematologic

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25
Q

Mechanisms of Paraneoplastic Syndromes

A

Immune cross-reactivity between malignant & normal tissues
Tumor secretes hormones, peptides, cytokines

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26
Q

What systems can paraneoplastic syndromes affect?

A 
Endocrine
Neurologic
Hematologic
Dermatologic
Rheumatologic
27
Q

Paraneoplastic Endocrine Syndromes

A

SIADH
Hypercalcmia
Cushing syndrome
Hypoglycemia

28
Q

SIADH

A

Increased free water reabsorption

Failure of the negative feed back system that regulates the release of ADH

29
Q

What does SIADH cause?

A

Dilutional hyponatremia

30
Q

Associated Cancers with SIADH

A 
Small cell lung CA
Mesothelioma
Bladder
Urethral
Endometrial
Prostate
Oropharyngeal
Thymoma
Lymphoma
Ewing sarcoma
Brain
GI
Breast
Adrenal
31
Q

Signs/Symptoms of SIADH

A

Hyponatremia
Increase urine osmolality with decreased urine output
Decreased serum osmolality

32
Q

Clinical Manifestations of SIADH

A 
Gait disturbances
Falls
HA
Nausea
Fatigue
Muscle cramps
Anorexia
Confusion
Lethargy
Seizures
Respiratory depression
Coma
33
Q

Associated Cancers with Hypercalcemia

A 
Breast
Multiple myeloma
Renal cell
SCC
Lymphoma
Ovarian
Endometrial
34
Q

Symptoms of Hypercalcemia

A 
Altered mental status
Weakness
Ataxia
Lethargy
Hypertonia
Renal failure
N/V
HTN
Bradycardia
35
Q

Hypercalcemia is due to

A

Secretion of PTH related protein
Osteolytic activity
Tumor secretion of Vitamin D
Ectopic secretion of PTH

36
Q

Most Common Cancer with Hypercalcemia due to PTH Related Protein Secretion

A

SCC (esp. lung)

37
Q

Cancers Common with Hypercalcemia due to Osteolytic Activity

A

Breast
Multiple myeloma
Lymphomas

38
Q

What is high in Cushing Syndrome?

A

Aldosterone

Cortisol

39
Q

Associated Cancers with Cushing Syndrome

A 
Small cell lung CA
Bronchial carcinoid
Thymoma
Medullary thyroid CA
GI
Pancreatic
Adrenal
Ovarian
40
Q

Symptoms of Cushing Syndrome

A 
Muscle weakness
Peripheral edema
HTN
Weight gain
Centripetal fat distribution
41
Q

Lab Findings with Cushing’s Syndrome

A

Hypokalemia
Elevated baseline serum cortisol
Normal to elevated midnight serum ACTH
Not suppressed with dexamethasone

42
Q

Associated Cancers with Hypoglycemia

A

Insulin-producing islet cell tumors

Non-islet cell tumors: IGF-2 or insulin

43
Q

Immune Cross-Reactivity Issues

A

Permanent damage
Treatment of primary tumor doesn’t always result in neurologic improvement
Treatment is immunosuppressive therapy

44
Q

Neurologic Syndromes

A 
Limbic encephalitis
Paraneoplastic cerebellar degeneration
Lambert-Eaton Syndrome
Myasthenia graves
Autonomic neuropathy
Subacute (peripheral) sensory neuroapthy
45
Q

Cancers Associated with Limbic Encephalitis

A

Small cell lung cancer
Testicular germ cell
Breast

46
Q

Cancer Associated with Paraneoplastic Cerebellar Degeneration

A

Small cell lung cancer

47
Q

Cancer Associated with Lambert-Eaton Syndrome

A

Small cell lung cancer

48
Q

Cancer Associated with Myasthenia Gravis

A

Thymoma

49
Q

Cancer Associated with Small Cell Lung Cancer

A

Autonomic neuropathy

50
Q

Cancers Associated with Subacute (peripheral) Sensory Neuropathy

A

Small cell lung cancer

Other lung cancers

51
Q

What is the most common of the neurologic paraneoplastic syndromes?

A

Lambert-Eaton myasthenic syndrome

52
Q

What does myasthenia graves present with?

A

Eye muscle weakness

53
Q

Dermatologic & Rheumatologic Syndromes

A 
Acanthosis nigricans
Pemphigus
Extramammary paget
Ichthyosis
Dermatomyositis
Erythroderma
Hypertrophic osteoarthropathy
Leukocytoclastic vasculitis
Polymyalgia rheumatica
Sweet syndrome (acute febrile neutrophilic dermatosis)
54
Q

Cancers Associated with Acanthosis Nigricans

A

Adenocarcinomas: gastric carcinoma, lung, breast, ovarian

Hematologic cancers

55
Q

Types of Hematologic Paraneoplastic Syndromes

A

Eosinophilia
Granulocytosis
Pure red cell aplasia
Thrombocytosis

56
Q

Define Eosinophilia

A

Tumor production of eosinophil growth factors

57
Q

Associated Malignancies with Eosinophilia

A 
Lymphomas
Leukemias
Lung CA
GI CA
Gynecologic CA
58
Q

Cancers Associated with Granulocytosis (Neutrolphilia)

A 
Lung CA (large cell)
GI CA
Brain CA
Breast CA
Renal CA
Gynecologic CA
59
Q

Cancers Associated with Pure Red Cell Aplasia

A

Thymoma (most common)
Leukemia
Lymphoma
Myelodysplastic Syndrome

60
Q

Associated Cancers with Thrombocytosis

A 
GI
Lung
Breast
GYN
Lymphoma
Renal cell
Prostate
Mesothelioma
Glioblastoma
H&N CA
61
Q

Commonly Associated Conditions with Thrombocytosis

A

Infection
Post-splenectomy
Acute blood loss
Iron deficiency

62
Q

Malignancies Most Common with Paraneoplastic Syndromes

A

Small cell lung cancer
Breast
GYN tumors
Hematologic malignancies

63
Q

Top 3 Paraneoplastic Syndromes

A

SIADH
Cushing Syndrome
Hypercalcemia

Oncology (11 decks)

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