Module 3 Flashcards
What is leukemia?
Abnormal production of immature white blood cells (WBCs) in the bone marrow
These immature WBCs replicate uncontrollably instead of undergoing normal mitosis.
What happens to healthy WBCs in leukemia?
Immature WBCs accumulate, replacing healthy WBCs and weakening the immune response
This increases susceptibility to infections.
What are the main types of blood cells affected by leukemic cells?
- Red Blood Cells (RBCs)
- Platelets
RBCs lead to anemia; platelets cause abnormal bleeding and bruising.
What distinguishes acute leukemia from chronic leukemia?
Acute leukemia has rapid onset and aggressive progression with immature (blast) cells; chronic leukemia has slow progression with abnormal but mature-looking WBCs.
What are the two main classifications of leukemia by cell type?
- Lymphocytic Leukemia
- Myeloid Leukemia
Lymphocytic leukemia affects lymphocytes, while myeloid leukemia disrupts myeloid stem cells.
What is the most common type of leukemia in children?
Acute Lymphoblastic Leukemia (ALL)
What are potential risk factors for developing leukemia?
- Environmental factors (e.g., radiation, chemical exposure)
- Infection (certain viruses)
- Genetics (inherited conditions)
These factors can contribute to an increased risk of leukemia.
What is the average age at diagnosis for Acute Myeloid Leukemia (AML)?
68 years
What are common symptoms of Neutropenia in AML?
- Recurrent severe infections
- Mucous membrane ulceration
- Pneumonia
- Septicemia
- Abscesses
What is the Philadelphia chromosome associated with?
Chronic Myeloid Leukemia (CML)
It results from the translocation of chromosome 22 to chromosome 9.
What are the phases of Chronic Myeloid Leukemia (CML)?
- Chronic Phase
- Accelerated Phase
- Acute Phase (Blast Crisis)
Each phase has distinct symptoms and levels of disease progression.
What are early symptoms of Acute Lymphocytic Leukemia (ALL)?
- Fever
- Bleeding
- Lymphadenopathy
- Bone pain
What is the average age at diagnosis for Chronic Lymphocytic Leukemia (CLL)?
70 years
What are common clinical manifestations of CLL?
- Lymphadenopathy
- Splenomegaly
- Hepatomegaly
What is the 5-year survival rate for CLL?
85%
What are the goals of treating leukemia?
- Kill cancerous cells
- Change how the body responds to cancerous cells
What is the role of chemotherapy in leukemia treatment?
Eradicates leukemic cells and produces remission
Combination therapies interrupt cancer cell growth at various stages.
What is Graft-Versus-Host Disease (GVHD)?
A condition that can occur after a bone marrow transplant where donor cells attack the recipient’s body
What is the common treatment for children with ALL?
Chemotherapy
What is the function of Colony-Stimulating Factors (CSFs) in leukemia treatment?
Used to rescue bone marrow after chemotherapy
Common side effects include bone pain, fever, chills, and muscle aches.
Fill in the blank: The average age at diagnosis for Chronic Myeloid Leukemia (CML) is _______.
65 years
True or False: Acute leukemia is characterized by the presence of mature WBCs.
False
What are the two types of Bone Marrow Transplants (BMT)?
- Allogeneic BMT
- Autologous BMT
What are common symptoms of thrombocytopenia?
- Ecchymoses (bruising)
- Petechiae (red/purple spots)
- Purpura (subcutaneous bleeding)
- Epistaxis (nosebleeds)
- Hematuria (blood in urine)
What is breast cancer?
Unregulated growth of abnormal cells in breast tissue
It is the 2nd most commonly occurring cancer in women and the 2nd leading cause of cancer death in women in the USA.
What is the pathophysiology of breast cancer?
Begins as a single transformed cell and is often hormone-dependent. Classified as noninvasive (in situ) or invasive, depending on tumor penetration.
What can breast cancer metastasize to?
- Bone
- Brain
- Lung
- Liver
- Skin
- Lymph nodes
Why is staging important in breast cancer?
Essential for treatment decisions and prognosis.
What are the main etiological factors for breast cancer?
- Environmental
- Hormones
- Reproductive factors
- Hereditary factors
What are the two breast cancer susceptibility genes identified?
- BRCA1 on chromosome 17
- BRCA2 on chromosome 13
What types of breast cancer exist?
- Adenocarcinoma
- Carcinoma
- In Situ
- Invasive
- Triple Negative
- Inflammatory
Do men have breast cancer?
Yes, males do have breast tissue and it can include ducts and may or may not have lobules.
What is Infiltrating Ductal Carcinoma?
Also called Invasive Ductal Carcinoma, accounts for approximately 80% of all breast cancers and starts in the cells that line the milk ducts.
What characterizes Inflammatory Carcinoma?
Most malignant form of breast cancer with edema and skin dimpling resembling an orange peel (peau d’orange).
What are common symptoms of Inflammatory Carcinoma?
- Edema and redness
- Pitting or thickening
- Inverted or retracted nipple
- Size differences
- Tender, painful, itchy breast
- Swelling of the axillary and/or supraclavicular lymph nodes
What symptoms are associated with Paget disease?
- Itching or burning in the nipple area/areola
- Pain and sensitivity
- Flattening of the nipple
- Yellow or bloody nipple drainage
- A lump
- Only one breast affected
What are the non-modifiable risk factors for breast cancer?
- Age
- Gender – women > men
- Genetic factors (mutations in BRCA1 or BRCA2 increase risk 5-6X)
- Family history (1st degree relative with breast cancer)
- Personal history (previous chest radiation)
- Menstrual history (menstruation before age 12 or menopause after age 53)
What are the modifiable risk factors for breast cancer?
- Oral contraceptives
- Not having children or having them after age 30
- Hormone replacement therapy for more than 5 years
- Not breastfeeding
- Drinking alcohol
- Obesity
- High-fat diet
- Physical inactivity
- Possible environmental pollution
What are some prevention strategies for breast cancer?
- Actively limiting exposure to risk factors
- Limit alcohol to one drink per day
- Maintain body weight within normal limits
- Get physically active
- Refrain from smoking
- Avoid exposure to environmental pollution and radiation
- Limit hormone therapy
- Early detection
When should monthly breast exams be performed?
3-5 days after the period starts or the same day each month for post-menopausal women.
What is the most common manifestation of breast cancer?
A nontender lump in the breast, often in the upper outer quadrant.
What are common nipple changes associated with breast cancer?
- Abnormal discharge
- Rash
- Retraction
- Dimpling
- Pain
- Scaliness
- Ulceration
- Irritation
What detection methods are used for breast cancer?
- Clinical breast examination
- Mammography
- Biopsy
At what age does the ACS recommend beginning mammograms?
Age 45
What is a radical mastectomy?
Removal of entire affected breast, chest muscles, and the lymph nodes under the arms.
What is the purpose of sentinel lymph node biopsy?
Helps determine lymph node involvement by identifying the first lymph node affected.
What percentage of breast cancers are hormone receptor-positive?
About 70%
What is Tamoxifen?
The most common hormone therapy, a selective estrogen receptor modulator (SERM) that blocks estrogen from attaching to cancer cells.
What is the primary treatment for late-stage breast cancer?
Chemotherapy
What are the side effects of radiation therapy?
- Short Term: Swelling in the breast, skin changes, fatigue
- Long Term: Radiation dermatitis
What is lymphedema?
Accumulation of fluid in the soft tissue of the arm caused by removal of lymph channels.
What is ‘chemo brain’?
Thinking and memory loss that may follow chemotherapy.
What emotional support strategies are important for caring for clients with breast cancer?
- Provide education
- Emotional support
- Treatment related care
What are some prioritized risks for breast cancer patients?
- Risk for infection
- Risk for injury
- Acute pain
- Anxiety
- Decisional conflict
- Grieving
- Disturbed body image
What is a key method to prevent skin cancer?
Limit time in the sun, seek shade, avoid tanning beds, and protect skin with clothing, sunglasses, and hats.
SPF clothing and broad-spectrum sunscreen are recommended.
What type of sunscreen should be applied and when?
Broad spectrum sunscreen should be applied 30 minutes before exposure and reapplied every 2 hours during sun exposure.
Use SPF 15+ daily and 30+ for extended outdoor activities.
What should individuals under 6 months avoid?
Infants under 6 months should not be exposed to direct sunlight.
Their skin is particularly sensitive to UV radiation.
What are melanocytes?
Melanocytes are cells that produce melanin to protect the skin from UV radiation and are located in the basal layer of the epidermis.
What is the difference between early-stage and invasive melanoma?
Early-stage melanomas remain within the epidermis and appear flat, while invasive melanomas penetrate the dermis and can metastasize.
What factors affect melanoma survival rates?
Tumor thickness, ulceration, metastasis, location, age, and sex.
Women and younger patients generally have better outcomes.
Where do melanomas often have a poorer prognosis?
Melanomas on the hands, feet, and scalp due to late detection.
What are the four main types of skin cancer?
- Basal cell carcinoma
- Squamous cell carcinoma
- Melanoma
- Merkel Cell Carcinoma
What are congenital nevi?
Congenital nevi are present at birth, vary in size and color, and have a greater risk of melanoma if larger.
What characterizes dysplastic nevi?
Dysplastic nevi exhibit asymmetry, irregular borders, and varied pigmentation, often resembling melanomas.
What is lentigo maligna?
A slow-growing tan or brown patch that darkens and thickens over time, primarily found on sun-exposed areas of older adults.
What is the most common type of melanoma?
Superficial spreading melanoma, accounting for about 70% of cases.
What is nodular melanoma known for?
Nodular melanoma is the most aggressive type, characterized by black, polypoid growths that quickly enter the vertical growth phase.
What are the characteristics of basal cell carcinoma?
Basal cell carcinoma originates in the basal layer of the epidermis, is the most common skin cancer, and rarely metastasizes.
What is actinic keratosis?
A premalignant lesion caused by chronic sun exposure, with the potential to develop into squamous cell carcinoma.
What are common treatments for melanoma?
- Surgical excision
- Chemotherapy
- Immunotherapy
- Radiation therapy
What does the ABCDE rule for melanoma detection stand for?
- Asymmetry
- Borders
- Color
- Diameter
- Evolving
What is the purpose of the Breslow system?
The Breslow system measures tumor thickness from the granular epidermis to the deepest tumor invasion point.
What is the role of surgery in melanoma treatment?
Surgical excision removes the full thickness of skin and subcutaneous tissue, and may include regional lymph node dissection.
What should be monitored in actinic keratosis lesions?
Changes or abnormalities, such as enlargement or ulceration, which may indicate progression to malignancy.
What is a common characteristic of squamous cell carcinoma?
It begins as a small, firm, red nodule that may ulcerate and bleed, with a higher risk of metastasis if untreated.
What are the treatment options for nonmelanoma skin cancers?
- Surgical excision
- Curettage and electrodesiccation
- Cryotherapy
- Radiation therapy
- Chemotherapy
- Immunotherapy
What are the lifespan considerations for melanoma in children?
Melanoma is rare in children but is the most common pediatric skin cancer, often linked to sun exposure and tanning beds.
What is the impact of UV exposure on skin cancer risk?
Increased UV exposure due to ozone layer depletion raises the risk of both melanoma and nonmelanoma cancers.
What factors influence the aggressiveness of squamous cell carcinoma?
It is more aggressive in UV-exposed areas and can develop on burned or chronically inflamed skin.
What is the significance of regular skin checks?
Frequent self-checks and annual checks by a provider are crucial for early detection and prevention of skin cancers.
What is the leading cause of cancer-related death?
Lung cancer
Significant health threat despite advances in treatment.
How many deaths were attributed to lung cancer in 2020?
135,720 deaths
What percentage of cancer deaths in men is due to lung cancer?
23%
What percentage of cancer deaths in women is due to lung cancer?
22%
How many new lung cancer diagnoses are estimated annually?
229,000 new diagnoses
What is the primary origin of lung cancer?
Mucosal lesions in bronchi
Which routes does lung cancer frequently spread?
Lymphatic and hematogenous routes
Common metastasis sites include brain, bones, and liver.
What are the two main classifications of lung cancer?
Non-Small Cell (NSCLC) and Small Cell (SCLC)
NSCLC accounts for ~84% and SCLC for ~13% of cases.
What is the leading cause of lung cancer?
Tobacco smoking
What percentage of lung cancer cases are attributed to tobacco smoking?
~90%
What harmful substances are present in cigarette smoke?
7,000+ chemicals; 70+ known carcinogens
What type of genetic changes can increase lung cancer risk?
Inherited and acquired changes
What is the most common age demographic for lung cancer incidence?
Individuals over 50
What is the strongest risk factor for lung cancer?
Smoking
What is the dose-response relationship regarding smoking?
More smoking = Higher risk
What is the effect of smoking cessation on lung cancer risk?
Significantly reduces risk over time
What is the initial screening method for lung cancer?
Chest X-ray
What is the primary treatment for non-small-cell lung cancer (NSCLC)?
Surgery
What are the types of surgical procedures for lung cancer?
- Wedge Resection
- Segmentectomy
- Lobectomy
- Pneumonectomy
What is the treatment of choice for small cell lung cancer (SCLC)?
Chemotherapy
What role does radiation therapy play in lung cancer treatment?
Used for cure or symptom relief
What are the common types of radiation therapy?
- External Beam Radiation
- Brachytherapy
What are the age-related considerations for lung cancer treatment in older adults?
Individualized, multidisciplinary approach considering comorbidities
What are the early signs and symptoms of lung cancer?
- Chronic cough
- Hemoptysis
- Wheezing
- Shortness of breath
- Chest pain
What is a key component in the diagnosis of lung cancer?
Tumor location and cell type
What may systemic manifestations of advanced lung cancer include?
- Weight loss
- Anorexia
- Fatigue
- Bone pain
What is the importance of paraneoplastic syndromes in lung cancer?
Indicates possible small-cell lung cancer (SCLC) and requires additional work-up
What should be prioritized in cases of advanced lung cancer?
Management of systemic effects and life-threatening issues
What is the role of palliative care in lung cancer?
Alleviates symptoms and improves quality of life
What should be monitored for treatment outcomes in lung cancer?
- Tumor response
- Symptom improvement
- Side effects
What is the significance of long-term monitoring in lung cancer survivors?
Detect recurrence or new metastasis
What is Sickle Cell Disease characterized by?
Replacement of normal hemoglobin with abnormal Hemoglobin S
Sickle Cell Disease is a hereditary hemoglobinopathy.
What is the most common type of Sickle Cell Disease?
Sickle Cell Anemia
It is characterized by chronic hemolytic anemia.
How many people are affected by Sickle Cell Disease in the US?
Approximately 100,000
The prevalence is 1 in 365 in African Americans and 1 in 16,300 in Hispanic Americans.
What causes RBCs to become rigid and deformed in Sickle Cell Disease?
Deoxygenation of hemoglobin S (HbS)
This process leads to sickled RBCs that impair circulation.
What are the consequences of repeated sickling in Sickle Cell Disease?
Shortened RBC lifespan to 10-20 days, leading to anemia
Normal RBC lifespan is 120 days.
What is a Sickle Cell Crisis?
A painful episode caused by ischemia from vascular occlusion
Also known as Vaso-Occlusive Crisis.
What triggers a Sickle Cell Crisis?
Increased oxygen demand, acidosis, environmental stressors
Examples include fever, dehydration, and cold exposure.
How is Sickle Cell Disease inherited?
As an autosomal recessive disorder
Both parents must carry the sickle cell trait for a child to inherit SCD.
What is the chance of a child inheriting Sickle Cell Disease if both parents carry the trait?
25% chance of inheriting SCD, 50% chance of inheriting the trait, 25% chance of inheriting normal hemoglobin
This reflects the genetic inheritance pattern.
What are general symptoms of hemolytic anemia?
Pallor, fatigue, jaundice, irritability
These symptoms arise due to rapid RBC destruction.
What complications can arise from repeated organ infarcts in Sickle Cell Disease?
Enlarged spleen, liver dysfunction, renal insufficiency, gallstones
These are due to trapped sickled cells and increased bilirubin.
What is splenic sequestration?
Pooling of blood in the spleen, leading to life-threatening anemia
Can occur in children with Sickle Cell Disease.
What is the role of hydroxyurea in Sickle Cell Disease treatment?
Interferes with DNA synthesis, improves RBC characteristics
It may reduce SCD crises and transfusion needs.
What is the recommended diet for individuals with Sickle Cell Disease?
High-calorie, high-protein diet
This is to meet increased metabolism needs.
What is the purpose of genetic counseling for Sickle Cell Disease?
To understand inheritance risks and reproductive options
Couples with a family history of SCD are advised to seek counseling.
What is the significance of neonatal screening for Sickle Cell Disease?
Mandatory in the United States for early intervention
It is done through blood work from heel stick or amniocentesis.
What are the signs of acute chest syndrome in Sickle Cell Disease?
Fever, cough, chest pain, dyspnea, hypoxemia
It can lead to pulmonary infections and fat embolism.
What are the key components of managing Sickle Cell Disease?
Oxygen therapy, hydration, pain management, prophylactic antibiotics
These strategies aim to minimize complications and improve quality of life.
What is the expected lifespan of children with Sickle Cell Disease?
Usually asymptomatic until 4 to 5 months of age
Due to high levels of fetal hemoglobin.
What is the role of blood transfusions in Sickle Cell Disease treatment?
Core treatment to increase hemoglobin levels and improve oxygenation
It helps prevent stroke and reduces sickling.
What is Voxelotor (Oxbryta)?
A medication that increases hemoglobin’s oxygen affinity and reduces sickling
It improves oxygen delivery in Sickle Cell Disease.
What are common psychosocial assessments for Sickle Cell Disease patients?
Observation of pain, past crises, and family dynamics
These assessments help in planning care.
What is the importance of hydration in Sickle Cell Disease management?
Maintains urine output and reduces blood viscosity
It is essential for preventing crises.
True or False: Individuals with Sickle Cell Trait (HbAS) are usually symptomatic.
False
They are typically asymptomatic but may have complications under extreme conditions.
Fill in the blank: Sickle Cell Disease is caused by a mutation in the _______.
HbS gene
This mutation affects the beta chain of hemoglobin.
What is stroke?
Abrupt decrease in brain blood flow leading to neurological deficits
Also known as cerebrovascular accident (CVA) or brain attack.
What are the two main types of stroke?
Ischemic and Hemorrhagic
Ischemic accounts for approximately 87% of strokes.
What causes ischemic stroke?
Clot, embolus, or vessel narrowing.
What causes hemorrhagic stroke?
Vessel rupture and bleeding into the brain.
What are the consequences of stroke?
Brain cell death due to loss of blood flow, with outcomes ranging from minimal deficit to disability or death.
What is the epidemiology of stroke in the U.S.?
4th leading cause of death, 795,000 strokes annually, 160,000 deaths/year.
How often does a stroke occur in the U.S.?
Every 40 seconds.
What are some at-risk populations for stroke?
- Age > 65 years
- Pregnant women and early postpartum (first 6 weeks)
What does the acronym FAST stand for in stroke recognition?
- Face drooping
- Arm weakness
- Speech slurred
- Time to call 911
What are some other stroke symptoms?
- Sudden numbness/weakness (especially one side)
- Sudden confusion, speech issues
- Sudden vision changes
- Dizziness, loss of coordination
- Sudden severe headache
What is the NIH Stroke Scale used for?
To assess the severity of stroke.
What is the purpose of carotid endarterectomy?
To remove plaque from the carotid artery to prevent stroke.
When is carotid endarterectomy indicated?
In TIAs or high-risk stenosis.
What is the purpose of extracranial-intracranial (EC-IC) bypass?
To bypass occluded cerebral artery and restore flow to ischemic brain regions.
What does carotid angioplasty and stenting involve?
Balloon and stent to open narrowed carotid artery.
What is a benefit of carotid angioplasty and stenting compared to endarterectomy?
It is less invasive.
What is the nursing process in providing care to patients with stroke?
Apply culturally competent care.
True or False: Stroke can lead to long-term effects such as disability.
True.
