Miscellaneous

Question 1

Stage 1 pressure ulcer

Answer 1

heralding lesion, non-blanchable erythema

Question 2

Stage 2 pressure ulcer

Answer 2

partial thickness skin loss with epidermis, dermis or both involved. Typically with abrasion or shallow crater/blister.

Question 3

Stage 3 pressure ulcer

Answer 3

full thickness involving subcutaneous, may exten down to (but not through) underlying fascia

Question 4

Stage 4 pressure ulcer

Answer 4

necrosis and damage to underlying muscle, bone, and/or other supporting structures

Question 5

Chemotherapy induced nausea and vomiting: high emetic risk

Answer 5

> 90%: Cisplatin, Dacarbazine, dose dense AC, AIM, cyclophosphamide

Treat:
Schedule (3-4) antiemetics prior to chemotherapy and continue ppx dosing for 3 days after
-dexamethasone + ondansetron (5HT3)+ fosaprepitant NK1)

Question 6

Chemotherapy induced nausea and vomiting: moderate emetic risk

Answer 6

30-90%: Irinotecan, carboplatin, doxorubicin

Treat:
Schedule 2+ antiemetics prior to chemotherapy and continue ppx dosing for 3 days after

Question 7

Chemotherapy induced nausea and vomiting: low emetic risk

Answer 7

10-30%: paclitaxel, docetaxel, 5-FU, etoposide, gemcitabine

Treat:
Schedule 1 antiemetic prior to chemotherapy

Question 8

Chemotherapy induced nausea and vomiting: minimal emetic risk

Answer 8

<10%: vincristine, bleomycin

Treat:
no routine ppx

Question 9

Chemotherapy side effects: neuropathy

Answer 9

most common with antimicrotubule agents (paclitaxel, vincristine) and platinum agents (cisplatin, carboplatin)

-generally progressive
-no proven preventative therapies

treatment:
-modifications of regimen, chemo holiday
-duloxetine (60gm/d)
-exercise
-acupuncture
-other meds (gabapentin, pregabalin, amitriptyline, cpasaicin, glutamine)

Question 10

Chemotherapy side effects: diarrhea

Answer 10

Most common with antimetabolites (5-FU, capecitabine)

Treatment:
-loperamide 4mg x1 then 2mg after each loose stool (up to 24mg/day)
-octreotide
-etcChemotherapy side effects:

Question 11

Palliative prognostic index (PPI)

Answer 11

Predicts 30 day mortality in advance cancers, at 6 wks.

PPS+ 4 additional factors (oral intake, edema, dyspnea at rest, delirium)

Question 12

Palliative prognostic score (PaP)

Answer 12

stratifies risk for 30 day mortality (groups A, B, C)

KPS+5 additional factors (dyspnea, anorexia, clinical prediction, total WBC, lymphocyte percentage

Question 12

ECOG and PPS associated with prognosis of <6 months?

Answer 12

ECOG 2, PPS<70%

Question 13

Tumor markers in breast cancer

Answer 13

CA 15-3, CA 27.29

Question 14

CA 19-9 is associated with what types of cancer?

Answer 14

Colon, pancreatic

Question 15

CA 125 is associated with what types of cancer?

Answer 15

Ovarian, endometrial, lung, GI

Question 16

CEA is associated with what types of cancer?

Answer 16

GI, cervical, lung

Question 17

CD 117 is associated with what types of cancer?

Answer 17

GI stromal tumor, seminomaS

Question 18

Secondary TCAs vs Tertiary TCAs

Answer 18

(2) Nortriptyline, desipramine: less anticholinergic side effects (urinary retention, dry mouth, confusion, hypotension, hallucinations)

(3) Amitryptiline, imipramine