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HLSG-onc > Cumulative Deck > Flashcards

Cumulative Deck Flashcards

1
Q

2/3 Esophageal cancers are which type vs 1/3rd

A

SCC (squamous cell cancer) vs adenocarcinomas

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2
Q

7th Day Aventist Diet

A

vegan with possible egg/milk/fish; no shellfish, no pork, no caffeine. Kosher OK

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3
Q

Acupuncture can help with which signs and symptoms?

A

hot flashes, xerostomia, muscoskeletal issues, peripheral neuropathy

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4
Q

Anemia is most evident using which lab

A

Hgb (hemoglobin)

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5
Q

Aside from folate levels, what is another way of determining low folate?

A

RBC (red blood cells)

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6
Q

Assessing for malnutrition in children under 24 months

A

age, length, occiptal frontal

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7
Q

Assessing malnutrition in palliative care is done through-

A

PG-SGA + MUST, MNA

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8
Q

At what time should you try to push PO intake in post-op bowel surgeries

A

within 24h, full PO intake in 6-9 days

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9
Q

At which dose can Omega 3 cause bleeding?

A

4000mg/day

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10
Q

Avoid enteral nutrition when?

A

ascites, peritoneal mets, inoperative obstructions

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11
Q

Avoid alcohol with which cancers?

A

H&N (head and neck), esophageal

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12
Q

B12 is absorbed in the -

A

terminal ileum

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13
Q

Billroth I vs Billroth II

A

gastroduodenal vs gastrojejunal

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14
Q

Cause of dysmotility after surgeries

A

Denervation = loss of nerve fx

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15
Q

Characteristics of Cachexia and protein recommendations

A

80% cancer patients, decrease in skeletal muscle, 1.5-2.5g/kg Protein

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16
Q

Common complaints in those under palliative care

A

Loss of Appetite, constipation, xerostomia

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17
Q

Common side effects of: Aromasin, Femara, Faslodex

A

Nausea/vomiting, hot flashes

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18
Q

Complicated diarrhea is treated by:

A

octreotide, IV Fluids

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19
Q

Correcting Platelet counts

A

B12, folate

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20
Q

Decreased ovarian risk in post-menopausal women is r/t

A

increased hip circumfrence

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21
Q

diarrhea increases the need for which nutrients?

A

electrolytes, zinc

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22
Q

Diet progression for Stem Cell Treatment

A

NPO, low residue, solid, low lactose, regular

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23
Q

ECOG Reference Status and Indications

A

Fully Active: 0;
OOB 50%: 2;
Disabled: 3-4,
Death is 5

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24
Q

Enteral nutrition guidelines for head and neck cancer

A

Perioperative GTube ending at 6-8 wks post tx

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25
Q

Estimated calorie/protein needs in Lung Cancer

A

30-35kcal/kg, 1.2-1.5g/kg Protein

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26
Q

Familial Adenomatous Polyposis increases which cancer risk, inhibited by what?

A

colorectcal cancer, curcumin/quercetin

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27
Q

Fatness is associated with which cancers?

A

esophageal, pancreatic, colorectal, post-men breast, endometrial, renal, thyroid

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28
Q

Fatness may PROTECT against which cancer?

A

pre-menopausal breast

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29
Q

Fiber recommendations

A

21-25g/day (F), 30-38g/day (M)

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30
Q

Flaxseed is beneficial for which type of cancer and which chemo treatment?

A

protective against post-menopausal breast cancer; may enhance tamoxifen

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31
Q

For moderate/severe malnutrition, perioperative enteral nutrition should be provided within

A

7-14 days

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32
Q

Glutamine can offset which tx related symptom?

A

peripheral neuropathy

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33
Q

Goals of the RD in palliative care

A

reduce stress of PO intake and prevent dehydration

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34
Q

Hold EN when gastric residuals exceed

A

500cc

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35
Q

How do you assess central adiposity?

A

waist circumference

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36
Q

How do you manage fat in pancreatic cancer?

A

low fat (75g or less) unless patient has pancreatic enzyme replacement therapy to avoid biliary obstruction

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37
Q

How does one grade the severity of mucositis?

A

Oral toxicity scale, grade 0-4 with 4 being the worst

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38
Q

How long does neutropenia last following stem cell treatment?

A

2-3 weeks

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39
Q

How much weight loss can decrease survival in lung cancer

A

5%

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40
Q

How much weight loss would be indicated in a woman with breast cancer (and what to avoid)

A

2# per week with physical exercise; avoid linoleic acid; lignans OK

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41
Q

How to avoid Refeeding Syndrome

A

replete e- THEN provide 25% needs over 3-5 days

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42
Q

In an anastomosis, you should feed ________ to the site

A

proximally

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43
Q

In Liver Cancer, you can use what to build LBM (lean body mass)

A

BCAA (branched chain amino acids)

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44
Q

In malignant bowel obstructions (r/t tumor progression or compression), MNT is:

A

NG for suction or GTube for drainage

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45
Q

In post-men breast CA, how much weight loss is considered beneficial?

A

2lb per week

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46
Q

Inititating Tube Feeds via infusion and bolus/gravity

A

Infusion: 10-50mL/hr; Bolus: 60-120mL

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47
Q

Inpatient nutrition assessments should be done within ? hours of admission

A

24

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48
Q

Isothiocyanate is found in which foods and can decrease which cancer risk?

A

cruciferous veggies, decrease lung cancer risk

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49
Q

Karnofsky Performance Scale Ranges and Indications

A

Normal: 100-80%, Limited to home: 70-50%, Disabled/Dying: 40-10%

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50
Q

Lack of exercise can cause which 3 cancers?

A

breast, colon, endometrial

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51
Q

Li Fraumeni Syndrome

A

increases risk of breast, leukemia, bone/muscle sarcomas

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52
Q

Long Term implications of Bladder Cancer

A

change in bowel movements

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53
Q

Long Term implications of Breast Cancer

A

bone health, weight, heart issues

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54
Q

Long Term implications of Colorectal Cancer

A

increased LFTs, malabsorption, weight changes, bowel obstructions/change in bowel movements

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55
Q

Long Term implications of Leukemia

A

kidney stones, bone health, metabolic syndrome, hypothyroid

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56
Q

Long Term implications of Lung Cancer

A

respiratory decline, esophageal function/dysphagia

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57
Q

Long Term implications of NHL (Non-Hodgkin’s Lymphoma)

A

hypothyroid, metabolic syndrome

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58
Q

Long Term implications of Oropharyngeal Cancer

A

tooth decay, xerostomia, dysphagia

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59
Q

Long Term implications of Ovarian Cancer

A

bone health

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60
Q

Long Term implications of Pancreatic Cancer

A

anorexia, malabsorption, change in BM

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61
Q

Long Term implications of Prostate Cancer

A

bone health, diarrhea

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62
Q

Long Term implications of Renal Cancer

A

HTN, CKD/ARF, increased Creatinine

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63
Q

Long Term implications of Uterine Cancer

A

bone health

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64
Q

Low Vitamin D can increase risk of which 3 cancers?

A

breast, prostate, colorectal

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65
Q

Lynch Syndrome

A

impacts colon Cancer, increases genetic risk

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66
Q

Main side effects of Abd/Stomach Radiation Therapy?

A

fatigue, hair loss, diarrhea, N/V, bladder changes

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67
Q

Main side effects of Breast Radiation Therapy?

A

fatigue, hair loss

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68
Q

Main side effects of Chest Radiation Therapy?

A

fatigue, hair loss, N/V, throat changes

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69
Q

Main side effects of H&N Radiation Therapy?

A

fatigue, hair loss, thoat changes

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70
Q

Main side effects of Pelvic Radiation Therapy?

A

fatigue, diarrhea, bladder changes

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71
Q

Main side effects of Rectal Radiation Therapy?

A

fatigue, hair loss, diarrhea, bladder changes

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72
Q

Main 3 side effects of Tamoxifen

A

menstrual s/s, fluid retention, thromboembolic issues

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73
Q

Main treatment side effects of Colorectal Cancer

A

mucositis, nausea, vomiting, diarrhea

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74
Q

Micronutrients at risk of loss with alcoholic liver disease

A

folate, thiamine, pyridoxine, Vitamin A

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75
Q

Micronutrients at risk of loss with GI fistulas

A

zinc, selenium

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76
Q

Micronutrients at risk of loss with inflammation

A

Zinc, Iron, Copper, Selenium

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77
Q

Micronutrients at risk of loss with surgery

A

Thiamin, Riboflavin, B12, folate

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78
Q

Micronutrients at risk of losses with diarrhea

A

electrolytes, zinc, selenium

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79
Q

MNT for ascites

A

2g Na rx, 1.5g/kg PRO

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80
Q

MNT for gastric/duodenal obstruction

A

stenting with low fiber PO diet OR Gtube for draining, JTube for feeding

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81
Q

Recommend supplements in HCT (Stem Cell Tx) and LBM assessment

A

glutamine, Ca/D supplements, NO IRON SUPPLEMENTS, and measure muscle/adipose using arm anthropometrics

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82
Q

Moderate Acute Malnutrition

A

1-2% weight loss in 1 week, 5% loss in 1 mos, 7.5% loss in 3 mos; <75% intake of needs in 1 week

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83
Q

Moderate Chronic/Social Malnutrition

A

5% loss in 1 mos, 7.5% loss in 3 mos, 10% loss in 6 mos; <75% intake of needs in 1 month

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84
Q

Neutropenia means neutrophils are

A

<1500

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85
Q

Normal Range for MCV

A

80-100

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86
Q

Normal Range for Platelets

A

150-400

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87
Q

Nutrient of interest when on 5FU, Xeloda (and why?)

A

B6 for Hand Foot Syndrome

88
Q

Nutrients of interest when on Cetuximab and Oxaliplatin

A

Mg, Ca

89
Q

Nutrient of interest when on Panitumumab

A

Mg

90
Q

Nutrients of interest when on Pemetrexed

A

Folic Acid/B12

91
Q

Nutrients of interest when on Tacrolimus

A

Mg, Potassium

92
Q

Nutrients of interest when on Velcade

A

avoid green tea

93
Q

Nutrients of interest when on Zometa

A

Ca, D

94
Q

Nutrition Goals of Prostate Cancer

A

protect bone health and LBM, decrease sat fat, promote genistein (soy), plant based eating to focus on allium veggies

95
Q

Nutrition impact of Gallbladder Cancer

A

abd pain, jaundice, Loss of Appetite, dysgeusia

96
Q

Nutrition interventions for SIADH

A

3% saline and fluid rx

97
Q

Nutrition issues for treatment of brain tumors

A

N/V, dysphagia, oral/gut complaints, vertigo

98
Q

Nutrition side effects of: Paclitaxel

& which 3 nutrients are at risk of deficiency?

A

N/V/D, mucositis, decreased Mg, K, Vit D

99
Q

Nutrition side effects of: 5FU

A

N/V/D, mucositis

100
Q

Nutrition side effects of: Abraxane

A

N/V/D, mucositis, LE edema, increased LFTs; used as second line therapy for met breast cancer

101
Q

Nutrition side effects of: Anastrozole

A

NVDC, hot flashes

102
Q

Nutrition side effects of: Avastine, Pertuzumab

A

NVDC, mucositis

103
Q

Nutrition side effects of: Carboplatin

A

N/V, renal toxicity

104
Q

Nutrition side effects of: Cytoxan

A

N/V, SIADH

105
Q

Nutrition side effects of: Decarbazine

A

N/V, flu like s/s

106
Q

Nutrition side effects of: Etoposide

A

may enhance coumadin, N/V, hypersentivity

107
Q

Nutrition side effects of: Gemzar

A

N/V, flu like s/s

108
Q

Nutrition side effects of: Herceptin

A

N/V/D, flu like symptoms, anemia

109
Q

Nutrition side effects of: Ifosfomide

A

N/V, loss of appetite, renal toxic so use Mesna (chemoprotectant)

110
Q

Nutrition side effects of: Irinotecan

A

diarrhea, N/V, loss of appetite

111
Q

Nutrition side effects of: Kadcyla

A

Toxic to cardiac, liver, lung + constpation + thrombocytopenia

112
Q

Nutrition side effects of: Lupron

A

NVDC

113
Q

Nutrition side effects of: Navelbine

A

N/V/C, loss of appetite

114
Q

Nutrition side effects of: Oncovin

A

constipation and renal toxicity

peripheral neuropathy

115
Q

Nutrition side effects of: Oxaliplatin

A

cold sensitivity, N/V/D

116
Q

Nutrition side effects of: Taxotere

A

fluid retention, N/V

117
Q

Nutrition side effects of: Xeloda

A

N/V/D, Hand Foot Syndrome, Mucositis

118
Q

Nutrition side effects of: Zoladex

A

N/V/C

119
Q

Nutrition support for myeloablative transplant

A

TPN with high dose chemoRT

120
Q

Nutrition support for nonmyeloablative transplant

A

Enteral with low dose chemoRT

121
Q

Ovarian cancer may mets to:

A

liver, lung, GI, urinary

122
Q

Pancreatic cancer may be associated with these other issues

A

gastroparesis, malansorption, blockage of bile duct or duodenum

123
Q

Pancreatic surgeries can lead to these nutrition issues:

A

DM, EPI, possible dumping, lactose intolerance, gastroparesis

124
Q

Pareve Kosher focuses on

A

any food that is NOT: meat/dairy SO they can be eaten with all foods

125
Q

PERT guidelines for pancreatic cancer

A

10-40K lipase/meal, use MCT oil, monitor B12, use PPI/H2B

126
Q

Physical activity beneficial for which cancer?

A

breast, colon, ovarian, prostate

127
Q

Preferred Malnutrition Screening Tool

A

PG-SGA or SGA. MSTC/MUST is for inpatients only

128
Q

Preventing Refeeding

A

25% needs or 20kcal/kg

129
Q

Prophylactic cranial radiation occurs with which cancer

A

SCLC/lung cancer d/t increased risk of mets

130
Q

Protein for Frailty

A

1.2g/kg

131
Q

Proven mind-body-medicine techniques

A

stress reduction, biofeedback, hypnosis, guided imagery, art/music therapy, yoga/taichi

132
Q

RAI tx for thyroid cancer can cause

A

Nausea/xerostomia/dysgeusia

133
Q

Recommended physical activity for cancer risk reduction

A

30 minutes per day / 150min moderate/wk, 75min vigorous/wk, weights 2x/wk

134
Q

Reference Range for: Calcium

A

8.5-10.5

135
Q

Reference Range for: Chloride

A

97-107

136
Q

Reference Range for: Mg

A

1.5-2.5

137
Q

Reference Range for: Potassium

A

3.5-5.3

138
Q

Reference Range for: Sodium

A

136-145

139
Q

Risk Factors for adenocarcinoma of esophagus

A

GERD/Barretts

140
Q

Risk Factors for SCC Esophageal cancer

A

ETOH, HPV, esophageal achalasia

141
Q

S/S of GVHD and nutrition recs

A

N/V, abd pain, diarrhea, loss of appetite; low: lactose, fiber, acid, fat

142
Q

Sarcopenia incidence and assessment

A

50% in advanced cancer; characterized by increased fat / decreased muscle; assess with BIA, DXA

143
Q

Selenium is protective against which cancer

A

prostate cancer

144
Q

Selenium may help which cancer treatment?

A

may benefit Paclitaxel

145
Q

Sinosoidal Obstructive Syndrome: clinical implications and nutrition treatment

A

hepatic veno-occlusive disorder, a post treatment complication that may present with thrombocytopenia, weight gain, ascites.

Treatment includes glutathione, cysteine, IVF, e-, correct hypotension, monitor TG, low-fat/low protein

146
Q

Special areas of concern in liver cancer

A

hypercalcemia, hypoglycemia

147
Q

Supplements bad for prostate cancer

A

Calcium over 1500mg, Vitamin E

148
Q

Supplements: Beta Carotene

A

may decrease CRC risk

149
Q

Supplements: CoQ10

what does it do and for which cancer treatment?

A

limits cardiac/renal toxicity of doxorubicin

150
Q

Supplements: Milk Thistle

A

may benefit Cisplatin

151
Q

Supplements: Oleic Acid

May benefit which chemo? Food sources?

A

may benefit Herceptin (found in avocados, nuts/seeds, oils)

152
Q

Supplements: Theanine

May benefit which 2 chemos

A

may benefit doxorubicin, idarubicin

153
Q

Systemic Inflammation is best measured by

A

CRP

154
Q

The compound in tea is called ? and which cancers is it beneficial toward?

A

EGCG, breast/ovarian/endometrial

155
Q

Thrombocytopenia means platelets are ?

A

<100K

156
Q

Tube Feeding for H&N, GE, and Panc cancer requires

A

100cm Jejunum, 150cm Ileum with valve

157
Q

Tumor Lysis Syndrome causes?

A

hyper-Phosp/kalemia/uremia, hypo-Ca;

it is a metabolic issue r/t tumor destruction

158
Q

Turmeric is good for (1) which cancers (2) which chemo (3) combined with?

A

panc and colorectal
cisplatin
fat and black pepper

159
Q

Types of Thyroid Cancer and Commonality

A
  1. Follicular, 2. Papillary 3. Anaplastic (stage IV), Medullary
160
Q

Typical mets from CRC is to

A

liver

161
Q

Uncomplicated diarrhea is treated by:

A

fiber, water, low lactose

162
Q

Under palliative chemoRT, which nutrition support is best

A

TPN

163
Q

What % weight loss can reduce treatment response?

A

6%

164
Q

What chemos can cause hypoalbuminemia

A

cisplatin, paclitaxel

165
Q

What 5 chemotherapies can benefit from Omega 3?

A

paclitaxel, cisplatin, irinotecan, doxorubicin, vincristine

166
Q

What do you do with protein needs r/t encephalopathy

A

decrease

167
Q

What is ablation?

A

destruction of tumor

168
Q

What is achlorydria and what is the main concern?

A

decrease of gastric acid; bacterial overgrowth

169
Q

What is biofeedback?

A

meditation, relaxation techniques

170
Q

What is embolization?

A

restriction of blood flow to tumor

171
Q

What is RECIST?

A

tumor progression scale that considers location and extend of progression/mets

172
Q

What is the gold standard for assessing LEVEL of malnutrition?

A

indirect calorimetry

173
Q

What non-obvious foods are avoided in the immunosuppressed diet?

A

lunchmeat, tofu, blue and uncooked soft cheeses, unpasterized juice/honey, veggie sprouts

174
Q

What nutrients are of concern in gastric surgeries?

A

Zn, B12, folate, iron

175
Q

What nutrition support do you provide in GVHD?

A

TPN

176
Q

What osmolarity is the limit for PPN

A

900mosm/L

177
Q

What should the RD be concerned with re: Cisplatin

A

increasing water needs,
check renal fx and electrolytes (provide selenium to reduce kidney toxicity),
SIADH, N/V/D, dysgeusia, HLD/CVD risk

178
Q

What type of EN to provide with esophageal surgeries

A

J Tube

179
Q

When to provide post-pyloric EN feeds

A

gastroparesis, gastric outlet/duodenal obstruction, fistulas

180
Q

When to use TPN in Stem Cell Tx

A

GI toxicity, refractory gut GVHD

181
Q

where do you report adverse effects of dietary supplements?

A

medwatch

182
Q

Which cancer is most common in PEDS

A

leukemia

183
Q

Which cancer is the second leading cause of cancer and cancer death in women?

A

breast

184
Q

Which cancer therapies can cause thromboembolic issues and hot flashes?

A

tamoxifen, aromasin, femara, anastrozole

185
Q

which dietary supplemnets are considered unsafe/illegal?

A

chaparral, ephedra, comfrey

186
Q

Which foods may benefit Tamoxifen?

A

soy, flax

187
Q

Which growth chart do you use for PEDS (0-2 years) and (2-20 years)

A

(0-2) WHO ht/age, weight/ht (2-20) CDC charts

188
Q

Which is the detoxifying enzyme?

A

glutathione S transferase

189
Q

Which malnutrition assessment tool is used in PEDS?

A

subjective global nutrition assessment (SGNA)

190
Q

Which nutrients are of most concern in PEDS

A

Ca, D

191
Q

Which surgery can increase the risk of bacterial overgrowth

A

colon

192
Q

Who accredits CA centers?

A

ACOS (Commission on CA)

193
Q

Whole grains can help prevent which cancer?

A

colorectal

194
Q

Nutrition side effects of: Adriamycin

A

N/V/D, loss of appetite, mucositits

195
Q

Nutrition side effects of: Bleomycin

A

N/V, loss of appetite, wt loss, mucositis

196
Q

Nutrition side effects of: Cetuximab

A

N/V/D, loss of appetite, low Mg, cardiac/respiratory distress

197
Q

Nutrition side effects of: Mitomycin

A

N/V/D, loss of appetite, mucositis, shortness of breath, renal/lung toxicity, discolored urine

198
Q

Nutrition side effects of: Sorafenib

A

N/V/D, loss of appetite

199
Q

Nutrition side effects of: Topotecan

A

N/V/D, loss of appetite, mucositis

200
Q

Nutrition side effects of: Aletuzumab

A

Hypotension, Anemia; given for B-Cell Lymphoma

201
Q

Nutrition side effects of: Taxol

A

may decrease Mg, K levels; may cause N/V, fatigue

202
Q

Nadir

A

typically refers to low white blood count

203
Q

FOLFIRINOX: what type(s) of cancers, what treatments compromise this regimen, micronutrient concerns?

A

Pancreatic; Folinic Acid + 5FU + Irinotecan + Oxaliplatin. Check for Calcium, Magnesium.

204
Q

Name the 3 most common medicinal mushrooms beneficial to the cancer population.

A

maitake, shittake, enokitake

205
Q

What is the Budwig Diet?

A

flaxseed, cottage cheese; avoids meat/poultry/overt animal products

206
Q

What is the Essiac Plan?

A

essiac tea 1-3x daily; may include laxatives

207
Q

What is the Gerson Protocol?

A

15-20lbs fruit and vegetable juice consumed daily, up to 5 coffee enemas daily, use of digestive enzymes

208
Q

What is the Gonzalez Diet?

A

extracts from animal organs; use of digestive enzymes; coffee enemas

209
Q

What is the Livingston-Wheeler Diet?

A

Uses a “vaccine” made from patient’s own blood/urine; mostly vegetarian

210
Q

What is the Macrobiotic Diet?

A

organic, plant-based, fish/seafood acceptable

211
Q

What is the Raw Diet?

A

foods may be heated no more than to 105 degrees F; Vegan diet

212
Q

Primary Role of Protein Target Therapies

A

Therapies that signal internal cellular pathway targets to cause cell apoptosis

213
Q

Primary Role of Cytokines

A

Stimulates a broad immune response to encourage cell growth and destroy target (cancer) cells

214
Q

Primary Role of Angiogenesis Inhibitors

A

Hinders the formation of new blood vessels to tumors

215
Q

Primary Role of Monoclonal Antibodies

A

Signal external cellular pathway targets (outside of cell) to activate internal pathways to cause cell apoptosis

216
Q

Components of R-CHOP

A

Rituxan, Cyclophosphamide, Doxorubicin, Oncovin, Prednisone

HLSG-onc (1 decks)

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