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Med Surg > Exam 3: Cellular Function (Cancer) > Flashcards

Exam 3: Cellular Function (Cancer) Flashcards

1
Q

Incidence and death rates of cancer higher in what population? (2)

A

Higher in males than females

Higher in black people

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2
Q

Cancer with the highest incidence for women

Cancer with the highest death rate for women

A

Highest incidence = breast cancer

Highest death rate = lung cancer

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3
Q

Cancer with the highest incidence for men

Cancer with the highest death rate for men

A

Highest incidence = prostate cancer

Highest death rate = lung cancer

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4
Q

Another term for cancer

A

“Malignant neoplasms”

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5
Q

Metastasis definition

A

Cancer cells infiltrate lymph and blood vessels, which carry the mutant cells to other parts of the body.

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6
Q

Surface epithelial tumor:
Benign
Malignant

A

Benign: Papiloma
Malignant: Squamous Cell Cancer

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7
Q

Glandular epithelial cell tumor:
Benign
Malignant

A

Benign: Adenoma

Malignant Adenocarcinoma

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8
Q

Fibrous tumor:
Benign
Malignant

A

Benign: Fibroma
Malignant: Fibrosarcoma

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9
Q

Adipose tumor:
Benign
Malignant

A

Benign:Lipoma
Malignant: Liposarcoma

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10
Q

Cartilage tumor:
Benign
Malignant

A

Benign: Chondroma

Malignant Chondrosarcoma

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11
Q

Bone tumor:
Benign
Malignant

A

Benign: Osteoma

Malignant Ostemosarcoma

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12
Q

Blood vessel tumor:
Benign
Malignant

A

Benign: Hemagioma
Malignant: Hemagiosarcoma

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13
Q

Lymph Vessel tumor:
Benign
Malignant

A

Benign: Lymphangioma

Malignant Lymphangiosarcoma

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14
Q

Lymph tissue tumor
Benign
Malignant

A

Benign —–

Malignant: Lymphosarcoma

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15
Q

Nerve cell tumor:
Benign
Malignant

A

Benign: Neuroma
Malignant: Neuroblastoma

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16
Q

Glial tissue tumor:
Benign
Malignant

A

Benign: Glioma
Malignant: Glioblastoma

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17
Q

Tumor shape:
Benign
Malignant

A

Benign: Regular shape, cells are well-differentiated
Malignant: Irregular shape

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18
Q

Tumor spread to adjacent tissues:
Benign
Malignant

A

Benign: Non-invasive: Does not invade surrounding tissue
Malignant: Invasive: Invades surrounding tissue.

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19
Q

Tumor metastasis:
Benign
Malignant

A

Benign: Localized
Malignant: Metastasizes to distant sites

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20
Q

Tumor encapsulation:
Benign
Malignant

A

Benign: Encapsulated (usually by fibrous capsule)
Malignant: Not encapsulated

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21
Q

Tumor potential for growth:
Benign
Malignant

A

Benign: Decreased potential for growth
Malignant: Increased potential for growth

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22
Q

Tumor recurrence after surgical excision:
Benign
Malignant

A

Benign: Decreased recurrence
Malignant: Increased recurrence

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23
Q

Tumor as the cause of death:
Benign
Malignant

A

Benign: Doesn’t usually cause death unless location interferes with vital function
Malignant: Usually causes death unless growth can be controlled

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24
Q

Three mechanisms of cancer spread:

A

1) Metastasis
2) Invasion
3) Seed

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25
Q

4 Risk categories for cancer

A

1) Environmental
2) Genetic / familial
3) Hormonal agents
4) Age

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26
Q

___% of cancer cases are idiopathic

A

40%

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27
Q

25% of all cancer deaths…

A

are associated with ONE chemical in cigarettes!

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28
Q

Two genes that increase the risk of ovarian cancer

A

Broncho1

Broncho2

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29
Q

What family history should you take when looking at cancer

A

Immediate relatives (parents, siblings)

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30
Q

Three factors that correlate with a higher incidence of breast cancer

A
  • Early onset menses
  • Late menopause
  • Have never given birth
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31
Q

Recommended fruit and vegetable intake

A

5-9 per day

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32
Q

Standard guidelines to detect/screen BREAST CANCER (2)

A
  • Mammogram q 2 years
  • Clinical breast exam:
    q 4 years 20-39
    q 1 year age 40+
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33
Q

Standard guidelines to detect/screen COLON AND RECTAL CANCER (2)

A

If 50 years or older:
Yearly fecal occult blood test and one of the following:
- Sigmoidoscopy every 5 years OR
- Colonoscopy every 10 years

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34
Q

Standard guidelines to detect/screen PROSTATE CANCER (2)

A
  • Yearly digital rectal exam

- PSA as needed

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35
Q

Standard guidelines to detect/screen CERVICAL CANCER

A
  • Yearly GYN exam

- PAP test yearly 21+ (earlier if sexually active) – q 3 years after 3 or more negative PAPs

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36
Q

Five general cancer symptoms (Greenfield)

A
  • Unexplained weight loss
  • Unexplained fever
  • Fatigue
  • Pain
  • Skin clues
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37
Q

Seven common cancer symptoms (American Cancer Society)

A

1) Change in bowel / bladder function
2) Sores that do not heal
3) Unusual bleeding or discharge
4) Thickening, lump
5) Indigestion or difficulty swallowing
6) Recent change or difficulty swallowing
7) Nagging cough or hoarseness

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38
Q

How do tumor markers work?

A

The higher the number, the greater the likelihood of cancer – not definitive. Often used to determine treatment efficacy

39
Q

Tumor markers:

- Prostate

A

PSA

40
Q

Tumor markers:

- Ca 125

A

Ovarian cancer

41
Q

Tumor markers:

- Ca 15-3

A

Breast cancer

42
Q

Tumor markers:

- Ca 19-9

A

Pancreas, liver

43
Q

Tumor markers:

- Alpha-fetoprotein

A

Hepatic, testicular

44
Q

Computed Tomography: Mechanism

A

Very narrow beam of x-ray in successive layers

45
Q

What test would be given before an MRI? Why?

A

CT Scan, shorter duration

46
Q

What does nuclear medicine imaging look at? (3)

A

Looks at oxygen uptake, glucose transport, blood flow

47
Q

What color would a Nuclear Medicine Imaging be?

  • If cancerous:
  • If non-cancerous
A
  • Cancerous: Areas of high metabolic rates → GLOW RED

* Non-cancerous: Non-malignant will glow blue, green

48
Q

What test helps observe if a tumor is shrinking?

A

PET scan

49
Q

Two cytology tests

A
  • PAP smear

- Sputum sample

50
Q

What is a biopsy?

A

Physically removing a piece of tissue

51
Q

What is the most definitive way to diagnose cancer?

A

Biopsy

52
Q

What should you do before treating a tumor?

A

Diagnostic surgery ie biopsy

53
Q

Purpose of staging a tumor

A

Determines the size of tumor and metastasis

54
Q

Three classifications when staging

A

T: Primary tumor
N: Lymph node involvement
M: Metastasis is present

55
Q

Purpose of grading a tumor

A

Classification that predicts the prognosis

56
Q

Four classifications of grading

A

o I: Small, no metastasis
o II: Large, without lymph spread
o III: Larger cancer with lymph node involvement
o IV: Aggressive and less responsive to treatment

57
Q

What type of surgery is the gold standard?

A

LOCAL EXCISION

58
Q

What type of surgery is not really done anymore?

A

Wide or radical treatment, where large portions of the muscle or other tissue are removed.

59
Q

Another term for palliative surgery

A

Debulking

60
Q

Patients who have _____ prior to surgery are at greater risk for complications post-op

A

Chemotherapy and/or

Radiation

61
Q

Three cancer surgery complications

A
  • Infection, wound healing
  • Pulmonary or renal issues
  • DVT
62
Q

What are the benefits of intra-op radiation? (4)

A

o Lower dose
o Less toxicity
o Precisely target radiation
o No localized tissue problems

63
Q

What is pancytopenia?

A

Decreased WBC, RBC and platelets.

64
Q

Radiation toxicity: Digestive ADEs (7)

A
  • NVD
  • Stomatitis
  • Loss of taste
  • Dry mouth
  • Decreased salivation
  • Trouble swallowing
  • Reflux
65
Q

Where are needles / seeds / beads used?

A

Interstitial compartments, such as breast, prostate

66
Q

Benefit of needles / seeds / beads

A

Less likely to become dislodged

67
Q

First two weeks of needles / seeds / beads

A

Can’t be around children or pregnant women

68
Q

What is chemotherapy?

A

Antineoplastic agents

69
Q

Mechanism of chemotherapy

6 categories

A
  • Can be cell-cycle specific
  • Can be phase specific
  • Alkalating agents
  • Antimetabolites
  • Antitumor
  • ABX
  • Hormonal agents
70
Q

What do cell-cycle specific cancer drugs do?

A

Destroy cells that are actively reproducing

71
Q

What portion of the cell cycle does phase specific chemotherapy target?

A

S-PHASE: DNA synthesis

72
Q

Three common side-effects of chemo

A
  • Alopecia
  • Stomatitis
  • Bone marrow suppression
73
Q

What does “Dose-limiting” mean

A

More doses increases effects

74
Q

Six dose-limiting side-effects of chemo

A 
o	Hepatotoxicity
o	Pneumonitis
o	Hemorrhagic cystitis: Affects bladder
o	Tubular necrosis: Renal failure
o	Cardiotoxicity, pericarditis
o	Cumulative: Neurotoxicity, numbness, tingling, “chemo-brain” – Can last about a year after treatment
75
Q

What is a “vesicant”?

A

Blister agent

76
Q

Name an estrogen receptor blocker

A

Tamoxafin

77
Q

When is Herceptin given?

A

If tumor is positive for HER2/nue receptors

78
Q

Another term for Bone Marrow Transplatn

A

HEmatopoitic Stem cell transplant

79
Q

Bone marrow transplant is indicated for ______

A

Bone cancers

80
Q

Three sources of bone marrow transplant – which is the most common?

A

1) Allogenic ** Most common
2) Autologous
3) Synergic

81
Q

What does allogenic mean?

A

Transplant from a selected donor

82
Q

What does autologous mean?

A

Transplant from self

83
Q

What does synergic mean?

A

Transplant from identical twin

84
Q

Before receiving an allogenic transplant, a patient will receive (2):

A

1) Ablative chemo

2) Possibly a total body radiation

85
Q

After receiving ablative chemo / radiation before a bone marrow transplant, patient is at higher risk for (3)

A
  • Infection
  • Respiratory issues
  • Bleeding
86
Q

What is happening with graft-versus-host disease?

A

The donor t-lymphocytes can recognize the recipient as “foreign and attack the recipient

87
Q

What is the most critical time for Graft-versus-Host disease?

A

First 100 days

88
Q

Is Graft-versus-host disease acute or chronic?

A

Can be either

89
Q

Prophylactic immunosuppressant drugs for graft-versus-host disease (2)

A
  • Immuran

- High dose steroids

90
Q

How is a patient prepared for an autologous bone marrow transplant? (3)

A

1) Patient’s marrow is harvested, preserved and treated for chemo
2) After harvest, patient is treated with chemo and possibly full-body radiation
3) Patient’s own marrow is infused, must undergo engraftment

91
Q

Benefit of stem cell transplatn

A

Engraftment occurs faster

92
Q

What type of nursing care is used in a stem cell transplant?

A

REVERSE ISOLATION – isolation to protect the patient from the healthcare team’s germs, not the other way around

93
Q

What does a patient receive before receiving a stem cell transplant?

A

Chemo

Hematopoitic growth factors

Med Surg (13 decks)

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