CSO Test Flashcards
———— is a protective hormone that decreases insulin resistance and inflammation and promotes apoptosis
Adiponectin
What 2 dietary supplements are associated with increased risk for cancer, especially in smokers?
Selenium and Beta Carotene
Second to not using tobacco products, —————- may be the most important lifestyle factor to reduce cancer risk?
Maintaining a healthy weight throughout life
Red meat is associated with the risk of colorectal cancer. Explanations include…
Red meats potential to produce heterocyclic amines when cooked at high temperatures and red meat heme iron content
Garlic and high fiber foods has been shown to protect against what type of cancer?
Colorectal
In the colon, intestinal bacteria act on——————- and —————— to produce butyrate, a short chain fatty acid that promotes normal cell development and may reduce inflamation
Fermentable fiber and resistant starch
AICR recommends that waist circumference be no larger than —— inches for men and —— inches for women.
37, 31.5
You initiate TPN on a malnourished oncology patient who is at risk for refeeding? What would you recommend for calorie requirements?
20 kcal/kg or no more than 1,000 kcal per day and advance as tolerated while monitoring electrolyte levels
2 best suited predictive formulas for the oncology population
Penn State 2003, swinamer and Ireton-jones 1992 and 1997, mifflin-St. Jeor
What is an individual’s protein requirement with cancer cachexia?
1.5-2.5
Zinc, iron, selenium, vitamins A, B and C are commonly deficient in individuals who are ill. How should these be restored?
A daily multivitamin that provides around 100% RDA.
—— % of cancer patients experience anorexia and weight loss prior diagnosis.
40%
Name 4 things that correlate with unintentional weight loss during cancer treatment:
- Lower performance status
- Reduce response to treatment
- Lower survival rates
- Lower quality of life
Hypocaloric feeds have been shown to positively affect protein anabolism
True or false
True
List 3 negative outcomes associated with weight loss during cancer treatment.
- Increased toxicity from chemotherapy
- Incomplete cancer therapies
- Decreased survival rates
Calorie restriction during chemo therapy is defined as a reduction in caloric intake by:
20 - 40%
Malnutrition is reported in approximately _______% of cancer patients at the time of diagnosis and up to _____% over the course of care
15-20%; 80%
What are some of the positive effects of calorie restriction (CF) before or during chemo reported in the literature
Less fatigue, less weakness, less GI issues
What are some of the proposed mechanisms of CF (calorie Restriction)
Modulation of insulin, IGF, proinflamatory cytokines, adiponectin, leptin, increased antioxidant effects and DNA repair mechanisms
What are the ACSM American Collage of Sports Medicine exercise guidelines for cancer survivors, who are cleared (no neuropathy, high bone fracture, muscle tear risk, etc.)
150 minutes mod or 75 min vigorous aerobic exercise plus weight training all muscle groups 2 times per week
Consumption of no more than_____ cups of green tea daily is likely adequate for desired benefits with low risk of adversed effects
5
The contraindication of st. John’s wort and imatinib and irinotecan is explain by which shared pharmacokinetic pathway?
Cytochrome p450
What is Zometa?
Zometa- zoledroic acid- is used to reduce bone complications and bone pain caused by advanced stage breast cancer that has spread to the bone.
How often Zometa infusions are prescribed?
Every 4 to 12 weeks
T or F Does the patient needs calcium supplementation while being treated with zometa?
True
What is Torisel?
Targeted therapy also referred as mTor inhibitor.
What are the food and drug interactions of Torisel?
Grapefruit and St John’s wort may increase amount of medication in your body
What type of cancer Torisel treats?
Advance kidney cancers in Adults
What is NADIR?
Nadir means low point. When a patient reaches their nadie following each chemo cycle, it means that their blood cell counts are at the lowest they will be during that treatment cycle. They refer mostly to WBC.
What are the 4 areas of Integrative Oncology?
- Mind Body- yoga
- Manipulation- massage
- Energy Based- Reiki
- Natural Products- probiotics
What are the chemoprotective properties of green tea?
Green tea contains EGCG this has pro- apoptotic effects, inhibits signaling molecules and has anti metastatic and antioxidant effects.
Provides relationship centered care with an emphasis on addressing the needs of the whole person body, mind, spirit and community …
Integrative Medicine
What alternative diet includes the quark recipe( flax seed oil and cottage cheese)?
Budwig Diet
What alternative diet includes a vaccine usually derived from the patients own blood or urine?
Livingston-Wheeler
What are functional foods?
Conventional foods that have been enhanced to benefit health beyond the effect of basic nutrition, can provide versatile options for meeting nutrition and health needs of cancer survivors and when someone is unable to consume certain foods.
What foods to avoid on the Budwig diet?
Milk, seafood
The raw food diet may be deficient on the following nutrients:
Calcium, B12, Zinc
What is a component of the Gonzales Regimen?
Metabolic therapy including Pancreatic enzyme supplements and coffee enemas
What is a component of the Gonzales Regimen?
Metabolic therapy including Pancreatic enzyme supplements and coffee enemas
What are the levels of 25(oh)D that the Institute of Medicine determined for bone health?
> 20 ng/ml
What are the levels of 25(oh)D that the Institute of Medicine determined for bone health?
> 20 ng/ml
What are 2 types of epigenetic changes?
Methylation- addition of methyl groups to DNA and Acetylation- modification of histones by attachment of acetyl groups
What are 2 mayor ways in which diet impacts epigenetics?
Host somatic cell mitosis and germ cell transgerenational inheritance
Supplementation of beta-carotene in colorectal cancer patients can reduce survival if the patient is also ________and _________?
Smoking cigarettes and drinking alcohol
How many Americans are living with a history of cancer diagnosis?
13 million (13.6 million)
Body composition changes in cancer survivors
Reduction in skeletal muscle mass
Metabolic syndrome can present in survivors of all the following cancers: breast, non-hodgkin Lymphoma, leukemia… except:
Thyroid
When starting total or central PN, it is prudent to initiate with_____goal dextrose and then titrate up as tolerated.
25-50%
What are the dose limits for PPN?
Final concentration < 900 mOsm/L
Lower dex conc 5-10%
Which molecular variant of hormone receptive cancers are most common and which have the poorest prognosis?
ER-/PR-/HER2 AKA Triple negative
20% BR CA
Main treatment for ER+ and PR+ Breast Cancer
SERMs -Tamoxifen
Aromatase inhibitors - Aromasin in postmenopausal women
ERDs -Faslodex
LHRHs- Lupron
What are the main treatments for ER+/PR-, ER-/PR+, ER-/PR- Breast cancers?
Do not respond as well to hormone tx but chemo is available
What is the main treatment for HER2+ Breast cancer?
Monoclonal antibodies -Herceptin
What is the main treatment for ER-/PR-/HER2- AKA triple negative breast cancer?
Hormone treatment is generally ineffective but chemo is avsilable
