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ACVN - SURGICAL NURSING > Intro to Oncologic Surgery > Flashcards

Intro to Oncologic Surgery Flashcards

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1
Q

What are some examples of haemopoietic tumours?

A

lymphoma and leukemia

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2
Q

What are some examples of solid tumours?

A
  • sarcoma - skeletal and connective tissue
  • carcinoma - organs
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3
Q

What are some examples of round cell tumours?

A

mast cell tumour and melanomas

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4
Q

What is a benign tumour?

A

one that does not spread

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5
Q

What are malignant tumours?

A

ones that are at risk of spreading

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6
Q

What are metastatic tumours?

A

secondary tumours that frow in a different location to the primary tumour

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7
Q

What is a haemoatopoietic tumour also known as?

A

liquid tumour

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8
Q

Where do acute and chronic leukemia tumours occur?

A

in the blood forming tissues

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9
Q

Where do lymphoma tumours occur?

A

in cells that makeup part of the immune system

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10
Q

What type of cells are lymphomas?

A

B-cell and T-cells

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11
Q

How do you treat haemopoietic tumours?

A

chemotherapy

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12
Q

How are sarcomas classified?

A

according to their parent tissue

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13
Q

How do you treat osteosarcomas?

A

chemotherapy, bisphosphonates, radiation therapy, surgery to remove affected limb

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14
Q

Where are osteosarcomas often found?

A

distal radius or the top of the femur

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15
Q

How are haemoangiosarcomas treated?

A

combination of surgeyr and chemotherapy

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16
Q

Where are haemangiosarcomas found?

A

spleen, heart (blood vessels)

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17
Q

Where are soft tissue sarcomas found?

A

different places, muscle tendon

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18
Q

Where are carcinomas found?

A

tissue that covered the body surfaces, lines a body cavity or makes up an organ

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19
Q

What species are squamous cell carcinomas common in?

A

cats

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20
Q

Where are squamous cell carcinomas often found?

A

nose, mouth and ears

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21
Q

How do you treat squamous cell carcinomas?

A

surgery, radiation therapy or chemotherapy

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22
Q

What are mast cells tumours?

A

most common malignant tumour in dogs, involved with inflammatory and allergic mechanisms

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23
Q

What do mast cell tumours range from?

A

highly malignat with a high rate of spread or almost benign

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24
Q

How do you treat mast cell tumours?

A

surgery to remove with appropriate margins or chemotherapy or radiation therapy

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25
Q

How can melanomas look?

A

pigmented black

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26
Q

Where can you often find melanomas?

A

mouth, toes or skin

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27
Q

How do you slow down the spread of melanomas?

A
  • melanoma vaccine
  • human melanoma proteins given transdermally
  • immune system develop antibodies to melanoma proteins
  • immunotherapy
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28
Q

What are benign tumours?

A

slow growing

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29
Q

What are examples of benign tumours?

A

lipoma, haemangioma, adenoma

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30
Q

What is paranneoplasic syndrome?

A

cancer associated with alterations not directly related to the tumour or metastesis

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31
Q

What can you expet to see with patients that have a lymphoma?

A

hypercalcaemia, anaemia, neutrophilic leucocytosis, thrombocytopaenia

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32
Q

What does reucrrence of paraneoplastic sydrome signify?

A

return of tumour

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33
Q

What does occurence of paraneoplastic sydrome signify?

A

malignancy

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34
Q

How might a tumour affect treatment?

A
  • if it is benign or malignant
  • if surgery is the best option
  • the staging and grading of the tumour
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35
Q

Which tumours have high sensitivity to chemotherapy?

A

lymphoma and some leukaemias

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36
Q

Which tumours have moderate sensitivity to chemotherapy?

A

high grade sarcomas and mast cell tumours

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37
Q

What tumours have low sensititivy to chemotherapy?

A

slow grading sarconomas, carcinomas and melanomas

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38
Q

What does a low sesnitivity to chemotherapy mean??

A

not responsive to chemotherapy and may opt for surgery instead

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39
Q

How might the different tumours affect treatment?

A
  • location
  • resectable or non-resectable
  • owner expectations
  • disfiguring surgery
  • cost of treatment
  • patient temperament
  • ability to cope with repeated therapies such as chemotherapy administration or repeated anaesthetics for radiation therapy
40
Q

How can you provide chemotherapy?

A

on its own or in conjunction with other therapies

41
Q

What can the patient get if they are given chemotherapy?

A

chemosensitivities

42
Q

What are the disadvantages of giving radiation therapy?

A
  • rediation induced cellular injury
  • dividing cells more susceptible to injury
  • requires specific equipment
43
Q

What options other than chemotherapy and radiation therapy are there?

A
  • cryotherapy
  • hyperthermic therapy
  • photodynamic therapy
  • immunotherapy
44
Q

What are the surgical options for removing a tumour?

A
  • complete excision, wide, radical
  • excisional biopsy
  • incisional biopsy
  • trucut biopsy
  • fine needle aspirate
45
Q

What are some examples of emergency surgery?

A

bleeding, pathologic fracture, infection, bowel perforation, bowel obstruction

46
Q

What is excisional biopsy?

A

debulking surgery, taking away the main mass of the tumour but potentially leaving behind the local invasion into the surrounding tissues

47
Q

What is incisional biopsy?

A

wedge of tissue taken from the tumour

48
Q

What is a trucut biopsy?

A

core of tissue taken from the mass

49
Q

What is a fine needle aspirate?

A

cells collected from the mass using a needle and syringe

50
Q

Why might surgery be done?

A

to be curative, to debulk and palliative surgery for comfort

51
Q

What is an example of a preventative surgery?

A

testicular removal or pinnae removal

52
Q

Why might you stage a tumour?

A
  • to find out how much tumour there is present in the body at that particular moment
  • gives a picture of patients overall health e.g concurrent conditions or paraneoplastic conditions
  • forms decisions for treatment
53
Q

What is the TNM system?

A

T = primary tumour size
N = level of lymph node involvement
M = presence of metastesis

54
Q

When does staging occur?

A

before treatment, to assess response to treatment or before recommencing treatment after relapse

55
Q

How do you stage a tumour?

A
  • perform physical exam of the patient and take history
  • urinalysis
  • bloods - complete blood count, chemistry profile and specialised bloods
  • chest x-ray
  • abdominal ultrasound - aspirate the liver,spleen,lymph nodes
  • specialised imaging such as CT, MRI, echocardiogram
56
Q

What does grading a tumour depend on?

A
  • histological findings
  • appearance under microscope
  • mitotic index
  • how well organised the cells are
  • evidence of cancer cells invading blood vessels
  • low, intermediate, high
  • important prognostic indicator
57
Q

What are the 3 grades for grading a tumour?

A

low, intermediate, high

58
Q

What is mitotic index?

A

number of cells currently dividing that are in mitosis

59
Q

How would you form a nursing care plan for an oncologic patient?

A

(everything in a normal care plan)
- set goals for the patient
- specific, measureable, attainable, relevent and timely
- prioritise nursing interventions
- be really specific about what you are documenting

60
Q

What is the normal cell life cycle?

A

interphase, mitosis phase, mitosis-metaphase, mitosis-anaphase, mitosis-telophase, mitosis-cytokenesis and starts over again

61
Q

What is cancer?

A

phenotypic end result of a whle series of changes that may have taken a long time to develop

62
Q

How does cancer arise?

A

it is a slow process of genetic mutations that may not arise in the lifetime of the animal, they eleminate normal cell constraints

63
Q

What are the chemical carcinogen environmental causes of cancer?

A

tobacco smoke, pesticides, herbicides and insecticides and clycophasphamide

64
Q

What are the physical environmental causes of cancer?

A

sunlight, trauma/chronic inflammatio, magnetic fields, radiation, surgery and implanted devices, asbestos

65
Q

What are cancer causing viruses?

A

papilloma virus and retrovirus (FeLV)

66
Q

What is the normal cell cycle?

A
  1. sustain proliferative signalling
  2. evade growth suppressors
  3. resist cell death
  4. enable replicative immortality
  5. induce angiogenesis
  6. activate invasion and metastisis
67
Q

What is the minimum critical mutations required to cause cancer?

A

5-6

68
Q

What does the word “tumour” mean?

A

refers to neoplasm, benign or malignant (inflammatory: latin)

69
Q

What does the word “neoplasia” mean?

A

formation of new abnormal growth that is not responsive to normal physiologic control mechanisms, malignant or benign

70
Q

What does the word “cancer” mean?

A

metastatic neoplasms

71
Q

What is a “benign tumour”?

A

space occupying and can cause tissue distortion

72
Q

What is a “malignant tumour”?

A

locally destructive and may metastesise and cause death if untreated

73
Q

What is the national cancer institute 1955?

A

they set the framework for cancer chemotherapy development

74
Q

What does chemotherapy do?

A
  • targets dividing cells
  • classes of drugs work at various stagesin cellular DNA replication and cell division
  • other agents interfere with cell signalling
75
Q

What are the goals for chemotherapy?

A
  • primary induction chemotherapy
  • primary neoadjuvant chemotherapy
  • adjuvant chemotherapy
  • consolidation chemotherapy
  • maintenance chemotherapy
  • rescue or salvage chemotherapy
  • palliative chemotherapy
76
Q

What are multimodal treatment plans?

A
  • maximal cell kill within the range of tolerable host toxicity
  • broader range of interaction between drugs and tumour cells
  • slows development of tumour drug resistance
  • only drugs with single use efficacy against tumour type
    -preferabledrug with no overlapping toxicities
  • use drugs at optimal doses and schedule
  • use consistent intervals
77
Q

What are alkylating agents made of?

A

action binds alkyl groups to cellular macromolecules cross linking DNA

78
Q

What are examples of alkyating agents?

A

chyclophasphamide, chlorambucil, lomustine

79
Q

What are antitumour antibiotics used for?

A

multimodal action of cellular toxicity

80
Q

What are examples of antitumour antibiotics?

A

doxorubicin and mitoxantrone

81
Q

What do antimetabolites do?

A

inhibit use of cellular metabolites in cellular growth and division

82
Q

What do antimicrotubule agents do?

A

interfere with cellular function and replication

83
Q

What are examples of antimicrotubule agents?

A

vinca alkalooids such as vincristine and vinblastine

84
Q

What are corticosteroids?

A

induction of apoptosis in haematologic cancers

85
Q

What is an example of a corticosteroid?

A

prednisolone

86
Q

What does platinum bind to?

A

DNA

87
Q

What are examples of platinum?

A

cisplatin and carboplatin

88
Q

What is L-Asparginase used for?

A

induction of apostosis in tumour cells

89
Q

What are Targeted agents?

A

tyrosine kinase inhibitors

90
Q

What do targeted agents do?

A

block receptors on the cell surface

91
Q

What are examples of targented agents?

A

palladia and masivet

92
Q

What is a lymphoma?

A

a diverse group of neoplasma common origin from lymphocytes

93
Q

Where are lymphomas commonly found?

A

lymph nodes, spleen and bone marrow, any tissue in the body

94
Q

What form of lymphoma do 80% of dogs have?

A

multicentric form

95
Q

What presentation do cats normally have with lymphoma?

A

intestinal

96
Q
A

ACVN - SURGICAL NURSING (17 decks)

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