Oncologic Conditions Flashcards
Cardinal signs of cancer
Unusual mass or swelling, unexplained paleness or loss of energy, sudden tendencies of bruising or bleeding, persistent localized pain or limping, prolonged unexplained fever or illness, frequent headaches, vision changes, weight loss
Oncologic emergencies (6)
Acute tumor lysis syndrome Hyperleukocytosis Superior vena cava syndrome Septic shock Bone marrow suppression (if severe) Disseminated intravascular coagulation (DIC)
Acute tumor lysis syndrome
Results from rapid release of intracellular metabolites during initial treatment of cancer - causes hypercalcemia, hyperuricemia, hyperphosphatemia, hyperkalemia
Acute tumor lysis syndrome signs
Altered LOC, lethargy, nausea, vomiting, pruritus, flank pain, oliguria, tetany
Acute tumor lysis syndrome treatment
Includes administration of allopurinol
Hyperleukocytosis
WBC > 100,000
Can lead to capillary obstruction, micro-infarction, organ dysfunction
Hyperleukocytosis signs
Cyanosis, respiratory distress, altered LOC, vision disturbances, ataxia, delirium
Hyperleukocytosis treatment
Massive cytoreduction with chemotherapy, hydration, urinary alkalinization, allopurinol
Leukophoresis or exchange infusion may be warranted
Superior vena cava syndrome
Results from compression of mediastinal structures - space-occupying lesions
Causes cyanosis of face, neck, and upper torso, upper extremity edema, jugular vein distention
Disseminated intravascular coagulation (DIC)
May occur due to release of procoagulant material in blood
DIC signs
Clots, chest pain, SOB, headaches, dizziness, paralysis
Leukemia
Proliferation of abnormal WBCs - leukemic cells invade and cause bone barrow suppression, resulting in anemia, neutropenia, and thrombocytopenia
Types - acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML)
Leukemia signs
Anemia - fatigue, pallor, tachycardia
Neutropenia - fever, infection, poor wound healing
Thrombocytopenia - petechiae, purpura, hematuria, epistaxis, tarry stools
Enlarged of reticuloendothelial organs (spleen, liver, lymph glands) due to infiltration, eventually causes fibrosis
Brain tumors
Intracranial, space occupying lesions - obstructs circulation of CSF when tumor enlarges, resulting in increased ICP
Brain tumor signs
Most common = headache, usually after waking up or with sneezing/coughing/straining
Projectile vomiting, usually occurring in the morning
Ataxia, hypotonia, decreased reflexes, dexterity, weakness, spasticity, paralysis, slurred speech, seizures, increased BP, decreased pulse rate, vision problems
Lymphomas
Neoplastic diseases that develop from the lymphoid and hemopoietic systems
Humoral immunity remains normal but cellular immunity is altered
Spreads from lymph nodes to non-lymph node sites such as spleen, liver, bone, bone marrow, lungs, and mediastinum
Types - Hodgkin’s lymphoma, non-Hodgkin’s lymphoma
Hodgkin’s lymphoma
Begins in single lymph node or group of lymph nodes, usually in the neck, chest, or underarms
Characterized by giant, multi-nucleated Reed-Sternberg cells - unusually large mature B cells
Non-Hodgkin’s lymphoma
Proliferation of B or T cells, can occur in any lymph nodes throughout the body
Lymphoma signs
Painless enlargement of lymph nodes - firm, non-tender, mobile nodes
Fever, anorexia, nausea, weight loss, night sweats, pruritus
Metastasis to bone narrow or CNS (more common in non-Hodgkin’s) may produce symptoms of leukemia
Lymphoma stages
Stage I - one lymph node affected
Stage II - 2 or more lymph nodes affected on the same side of the diaphragm
Stage III - Lymph nodes affected on both sides of the diaphragm
Stage IV - Bone marrow or organs outside of lymphatic system affected
Wilm’s tumor
Malignant neoplasm of the kidney
Associated with genitourinary anomalies - cryptorchidism (undescended testicle), hypospadias, double collecting system
Wilm’s tumor stages
Stage 1 - confined in one kidney and has intact capsule, can be resected
Stage 2 - extends beyond kidney into surrounding fat, soft tissue, or blood vessels - can be resected
Stage 3 - confined within the abdomen, cannot be removed in one piece
Stage 4 - distant metastases - lungs, liver, brain, bones, lymph nodes beyond the abdomen
Stage 5 - involves both kidneys (each tumor staged differently)
Wilm’s tumor signs
asymptomatic abdominal mass (usually discovered during routine assessment), fever, abdominal pain, hematuria, hypertension
Do not ____ the abdomen if Wilm’s tumor is suspected
Palpate - can rupture encapsulated tumor and cause dissemination to adjacent and distant sites
