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Internal Medicine > Oncologic Disorders > Flashcards

Oncologic Disorders Flashcards

1
Q

Papillary carcinoma accounts for

A

About 60% of thyroid cancer cases in adults.

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2
Q

Follicular carcinoma accounts for

A

About 20% of thyroid cancer cases in adults.

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3
Q

Anaplastic carcinoma accounts for

A

About 15% of thyroid cancer cases in adults.

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4
Q

Medullary carcinoma accounts for

A

About 5% of thyroid cancer cases in adults.

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5
Q

Leucovorin (Wellcovorin) is administered with methotrexate (mexate) to

A

Protect normal cells which methotroxate could destroy if given alone.

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6
Q

Probenecid (Benemid) should be avoided

A

In clients receiving methotrexate because it reduces renal elimination of methotrexate (mexate), increase the risk of methotrexate toxicity.

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7
Q

Horner’s syndromeoccurs when …

A

A lung tumor invades the ribs and affects the sympathetic nerve ganglia.

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8
Q

Horner’s syndromeoccurs is characterized

A

by miosis, partial eyelid ptosis and anhidrosis on the affected side of the face.

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9
Q

Chest pain, dyspnea, cough, weight loss, and fever are associated with

A

Pleural Tumors.

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10
Q

Arm and shoulder pain and atrophy of the arm and hand muscles on the affected side suggest

A

Pancoast’s Tumor.

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11
Q

Pancoast’s Tumor

A

A lung tumor involving the first thoracic and 8th cervical nerves within the brachial plexus.

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12
Q

Hoarseness in a client with lung cancer suggest

A

That the tumor has extended to the recurrent laryngeal nerve.

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13
Q

Dysphagia in a client with lung cancer suggest

A

That the lung tumor is compressing the esophagus.

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14
Q

A client is receiving the cell cycle-nonspecific alkylating agent thiotepa (thioplex) 60mg weekly for 4 weeks by bladder instillation as part of a chemo regimen to treat bladder cancer. How does thiotepa exert its therapeutic effects?

A

Thiotepa interferes with DNA replication and RNA transcription. It doesn’t destroy the cell membrane.

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15
Q

Sigmoidoscopy and proctoscopy are used to visualize the lower GI tract and aid in the detection of 2/3 of …

A

All colorectal cancers.

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16
Q

An abdominal CT scan is used to stage the presence of …

A

Colorectal Cancer.

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17
Q

A low-fat diet – one that maintains weight within 20% of recommended body weight – has been found to decrease

A

A woman’s risk of breast cancer.

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18
Q

A baseline mammogram should be done between

A

Ages 30 and 40.

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19
Q

Probenecid (Benemid) inhibits Methotrexate (mexate) excretion with increase the risk of

A

Methotrexate Toxicity.

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20
Q

When taking Tamoxifen (Nolvadex) for breast ca, the client must report change in …

A

Visual acuity immediately because this adverse effect may be irreversible.

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21
Q

Tamoxifen isn’t associated with …

A

Hearing Loss.

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22
Q

Cryptorchidism

A

Fail of one or both testes to descend into the scrotum.

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23
Q

Cryptorchidism appears to play a role in …

A

Testicular ca, even when corrected surgically.

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24
Q

Sign history findings for testicular cancer include

A
  • Mumps orchitis;
  • Inguinal hernia during childhood;
  • Maternal use of diethylstilbestrol or other estrogen-progestin combinations during pregnant.
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25
Q

Fluorouracil, doxorubicin (Adriamycin PFS), methotrexate (Mexate), cyclophosphamide (Cytoxan) and Vincristine (Oncovin) may be used to treat

A

Liver Cancer.

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26
Q

Fluoxymesterone (Halotestin), Tamoxifen (Nolvadex), Megestrol acetate (Megace) are

A

Hormonal Antineoplastic Agents

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27
Q

Hormonal Antineoplastic Agents

A

Are used to treat advance breast cancer.

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28
Q

Megestrol acetate may be used to treat

A

Advance endometrial and renal cancer.

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29
Q

Dysplasia

A

Refers to an alteration in the size, shape and organization of differentiated cells.

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30
Q

The presence of completely undifferentiated tumor cells that don’t resemble cells of the tissue of their origin is called

A

Anaplasia.

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31
Q

An increase in the size of normal cells in a normal arrangement in a tissue or an organ is called

A

Hyperplasia.

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32
Q

Metaplasia

A

Replacement of one type of fully differentiated cell by another in tissue where the second type normally isn’t found.

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33
Q

An aminoglycoside may cause nephrotoxicity and ototoxicity when given concomitantly

A

With cisplastin.

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34
Q

Cisplastin (Platinol) is used to treat

A

Ovarian Cancer.

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35
Q

ABCD method to assess skin lesions.

A

A= asymmetry;
B=border irregularity;
C=color variant;
D=diameter

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36
Q

Muscle rigidity and spasms may follow administration of several of the injection anesthetics including

A

ketamine and the opioids.

The reaction seems to be directly proportional to the infusion rate

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37
Q

Extrapyramidal manifestations are the most prominent adverse reactions to

A

Droperidol.

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38
Q

Thiopental, etomidate and propofol can produce airway reflex hyperactivity with

A

Hiccoughs, coughing and muscle twitching and jerking.

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39
Q

The barbiturates and propofol causes

A

Respiratory Depression.

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40
Q

Risk factors for gastric cancer

A
  • People with type A blood have a 10% greater risk;
  • History of gastritis with gastric atrophy;
  • Family history of gastric cancer.
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41
Q

A class V finding in a papillary test suggests

A

Probable cervical cancer (the client

should have a biopsy ASAP).

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42
Q

A class II finding in a papillary test suggests

A

Inflammation and calls for a pap in 3 months.

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43
Q

A class III finding in a papillary test suggests

A

Mild to moderate dysplasia and calls for a repeat pap in 6 weeks to 3 months.

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44
Q

A class IV finding in a papillary test suggests

A

Possible cervical cancer and warrants a biopsy ASAP.

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45
Q

A class I finding in a papillary test suggests

A

Requires no action.

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46
Q

A client receiving a subarachnoid block requires

A

Special positioning to prevent CSF leakage and HA and to ensure proper anesthetic distribution.

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47
Q

Bone marrow suppression becomes noticeable after how much time after floxuridine (FUDR) administration. And the recovery occurs in …

A
  • Suppression becomes noticeable 7-14 days;

- The recovery occurs in 21-28 days.

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48
Q

The usual adult dose of morphine sulfate is based on

A

10mg/70kg of body weight when given parenterally.

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49
Q

Colon cancer risk factors

A
  • obesity;
  • low-fiber diet;
  • high fat diet;
  • increase age;
  • sedentary lifestyle;
  • family dispostion;
  • history of ulcerative colitis;
  • colon ca;
  • colorectal adenoma;
  • bladder ca;
  • breast or female genital ca.
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50
Q

Smoking is a risk factor for

A
  • Lung;
  • Bladder;
  • oral ca.
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51
Q

Heavy alcohol consumption is a risk factor for

A
  • breast and liver ca
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52
Q

Saccharin consumption is a questionable risk factor for

A
  • bladder ca.
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53
Q

Chlorambucil (Leukeran)

A

Is used to treat malignant lymphoma.

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54
Q

Chlorambucil-induced alopecia how much time after the therapy begins?

A

Occurs 2-3 wks after therapy begins.

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55
Q

Tactile agnosia

A

Inability to identify objects by touch.

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56
Q

… Is a symptom of parietal lobe tumor.

A

Tactile agnosia

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57
Q

Short term memory impairment occurs with a tumor.of …

A

Frontal lobe.

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58
Q

Seizures may result from a tumor of …

A

The frontal, temporal or occipital lobe.

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59
Q

Contralateral homonymous hemianopia suggest an …

A

Occipital lobe tumor.

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60
Q

To the management of stomatitis

A

Give solution of hydrogen peroxide and water as mouth rinse. Stomatitis occurs 7-10 days after chemo begins.

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61
Q

Difficulty swallowing suggests

A

Medullary dysfunction.

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62
Q

Impaired balance suggests

A

Cerebellar brain tumor.

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63
Q

Psychomotor seizures suggest

A

Temporal lobe dysfunction.

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64
Q

The liver fails to convert NH3 to urea, is a characteristics of …

A

Cirrhosis.

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65
Q

High concentrate of NH3 on the blood stream can cause …

A

Cerebral dysfunction.

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66
Q

To improves cerebral function caused by NH3 is used …

A

Lactulose is administered to promote NH3 excretion in the stool and this improves cerebral function.

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67
Q

Lactulose is used for

A

Ammonia and also used to treat constipation because it

produced osmotic diarrhea.

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68
Q

A Bernstein test reveals

A

Whether a client’s chest pain results from acid perfusion of the esophageal mucosa.

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69
Q

How Bernstein test is performed?

A

It is performed by inserting an NG tube and aspirating the gastric contents. Alternatively NS solution and 0.1% HCl acid may be instilled into the lower esophagus. If the client doesn’t experience pain, the test is negative.

70
Q

Pancreatitis

A

Elevation of serum lipase.

71
Q

Renal dysfunction

A

Elevation of BUN (Blood urea nitrogen).

72
Q

Liver dysfunction

A

Elevation of AST (Aspartate aminotransferase).

73
Q

Cardiac muscle

A

Elevation of LD (lactate dehydrogenase).

74
Q

Atropine, when used as preanesthesia medications, thus helping to prevent

A

Aspiration of secretions during surgery.

75
Q

An increase PT with indicates clotting time …

A

Increase the risk of bleeding.

76
Q

MAO (Monoamine oxidase) inhibitor increases the effects of meperidine and can cause

A

Rigidity, hypotension, and excitant.

77
Q

The clients shouldn’t receive meperidine within …

A

… 14 days after administration of an MAO inhibitor.

78
Q

Hypoactive Bowel sounds

A

hunger, intestinal obstruction or diarrhea.

79
Q

High pitched Bowel sounds

A

Dilated bowel.

80
Q

Blowing Bowel sounds

A

Bruit from a partially obstructed abdominal aorta.

81
Q

Kussmaul’s respirations suggests

A

Diabetic ketoacidosis.

82
Q

A decrease appetite and diaphoresis suggest

A

Hypoglycemia.

83
Q

When the renal threshold for glucose reabsorption is exceeded

A

Hyperglycemia results, osmotic diuresis occurs, causing an increase urine output.

84
Q

Dyspnea and fatigue suggest

A

Anemia.

85
Q

Gynecosmatia and testicular atrophy result from decrease estrogen metabolism by

A

The diseased liver.

86
Q

A hepatic disorder, such as cirrhosis may disrupt liver’s normal use of Vitamin K to produce prothrombin (a clotting factor). Consequently the nurse should monitor the client for …

A

Symptoms of bleeding, including purpura and petechiae.

87
Q

Signs and Symptoms of Hepatitis A

A

Anorexia, nausea, vomiting, fatigue, weakness.

88
Q

Gallbladder disease

A

Eructation, constipation.

89
Q

Sign of Advance hepatic disease

A

Abdominal ascites.

90
Q

Duodenal ulcers are more common in people with …

A

Type O blood, suggesting a genetic basis.

91
Q

Risk factors for peptic (gastric and duodenal) ulcers including

A

Alcohol abuse and Stress.

92
Q

Chronic renal failure is associated with

A

duodenal ulcers.

93
Q

Infectious mononucleosis

A
  • Antibodies to Epstein-Barr virus;
  • HA;
  • Malaise;
  • Throat that has gotten worse over the past 10 days;
  • Temp 102.6;
  • Enlarged spleen and liver and exudative tonsillitis;
  • Leukocyte count 20,000/mm3.
94
Q

Mumps cause

A

Earache and fever from parotid gland.

95
Q

Herpangina

A

Is an acute viral infection that cause seizures, vomiting, stomach pain, and grayish papulovesicles on the soft palate.

96
Q

Morphine worsens pancreatitis by

A

Inducing spasms of the pancreatic and biliary ducts.

97
Q

Demerol (meperidine) is used to

A

Treat pancreatic pain.

98
Q

Client with pancreatitis is most comfortable …

A

Lying on the side with knees flexed.

99
Q

Clindamycin may enhance the action of neuromuscular blocking agents by

A

Blocking neuromuscular transmission.

100
Q

Barbiturate are used for

A

Sedation.

101
Q

Phenobarbital (Luminal) should be injected …

A

Into a large muscle mass.

102
Q

Why the IM route of administration of Phenobarbital (Luminal) is usually avoided?

A

Because the alkalinity of the soluble preps cause pain and necrosis at the injection site.

103
Q

Cimetidine (Tagamet) IV given rapidly cause …

A

Profound Bradycardia and other cardiotoxic effects.

104
Q

Propantheline bromide

A

Is a GI anticholinergic.

105
Q

Propantheline bromide inhibit …

A

Contraction of the bile duct and gallbladder. It has an antispasmodic effect on the bile duct and gallbladder.

106
Q

Gastroenteritis

A

Inflammation of the lining of the stomach and intestines that accompanies numerous GI disorders.

107
Q

Gastroenteritis is characterized by

A

Anorexia, weakness, abdominal pain, nausea and diarrhea.

108
Q

Gastroenteritis is treated by

A

Kaolin and pectin mixture (KAOPECTATE).

109
Q

Apthous stomatitis

A

Refers to cancer sore of the oral soft tissue, including lips, tongue and inside of the cheeks.

110
Q

Pseudomembranous colitis may result from …

A

A superinfection with Clostridium difficile during clindamycin therapy.

111
Q

Ulcerative colitis is more common in …

A

People who have a family members with the disease.

112
Q

Intestinal bacteria synthesize such nutritional substances as …

A
  • Vitamin K;
  • Thiamine;
  • Riboflavin;
  • Vitamin B12;
  • Folic acid;
  • Biotin;
  • Nicotinic acid.
113
Q

Intestinal bacteria don’t synthesize …

A

Vitamin A, D or E.

114
Q

Hepatic Encephalopathy

A

A serious complication of liver failure affecting a client’s neurological status; believed to result from the accumulation of toxins, such as NH3, in the blood.

115
Q

Propantheline bromide is used

A

To reduce secretions and spasms of the GI tract in clients with diverticulitis, a condition characterized by bowel inflammation and colonic irritability and spasticity.

116
Q

An NG tube that fails to drain during the postoperative period is important for …

A

It may be clogged, which could increase pressure on the suture site because fluid isn’t draining adequately.

117
Q

Acute pancreatitis can cause decrease …

A

Urine output, with results from the renal fail that sometimes accompanies this condition. Tachycardia usually is associated with pulmonary or hypovolemic complications of pancreatitis. Hypotension can be cause by a hypovolemic complication.

118
Q

If abdominal distention is accompanied by nausea, the nurse must first …

A

Auscultate bowel sounds.

119
Q

If bowel sounds are absent, the nurse should suspect …

A

Gastric or small intestine dilation with abdominal distention.

120
Q

Why Pancreatitis is most likely to have a nursing diagnosis of fluid volume deficit.

A

Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis.

121
Q

Injury to the gastric mucosa cause gastric atrophy and impaired function of the parietal cells. This results …

A

In reduced prod of intrinsic factor, which is necessary for the absorption of vitamin B12. Eventually pernicious anemia will occur.

122
Q

Docusate NA (Colace)

A

Is a laxative used to treat constipation. (It softens the

stool by stimulating the secretions of intestinal fluid into the stool).

123
Q

Lorazepam

A

An antianxiety agent, has no laxative effect.

124
Q

Flurbiprofen (Ansaid)

A

is a NSAID.

125
Q

Metronidazole (Flagyl)

A

Used to treat clients with amebiasis and intestinal infection.

126
Q

Metronidazole (Flagyl)

A

commonly cause a metallic taste. Other adverse reactions including nausea, anorexia, HA and dry mouth.

127
Q

Gentamycin adverse reactions

A
  • ototoxicity (indicated by vertigo, tinnitus and hearing loss);
  • Nephrotoxicity (indicated by urinary cells or casts, oliguria, proteinuria, reduced creatinine clearance).
128
Q

Intertrigo

A

Is dermatitis that occurs at moist, warm sites where the skin surfaces rub together, such as the armpits, inner surf of the thighs and between the buttocks, cause by an overgrowth of normal flora.

129
Q

Client should apply topical acyclovir ointment in sufficient quantity to cover the lesions q3h, 6x/day for 7 days.

A

Genital Herpes.

130
Q

Terconazole and tioconazole are used to treat

A

Vulvovaginal candidiasis.

131
Q

Sulconazole nitrate is used to treat

A

Tinea versicolor.

132
Q

Sudoriferous glands secrete

A

Sweat.

133
Q

Sebaceous glands secrete

A

Oil.

134
Q

Endocrine glands secrete

A

hormones.

135
Q

Together ceruminous and sebaceous glands

secrete

A

Cerumen.

136
Q

Pressure point control is used

A

For severe bleeding.

137
Q

Pressure point are

A

those areas where large blood vessels can be compressed against bone, femoral, brachial, facial, carotid, temporal artery sites.

138
Q

Zovirax (acyclovir) cause adverse GI effects as

A

diarrhea, nausea, vomiting.

139
Q

Layers of skin

A
  • stratum basale;
  • stratum spinosum;
  • stratum granulosum,
  • stratum lucidum;
  • outermost layer is the stratum corneum
140
Q

Tretinoin (Retinoic acid) used to

A

Treat acne vulgaris.

141
Q

Minoxidil used to promote

A

Hair growth.

142
Q

Zinc oxide gelatin used for abrasions on

A

The lower arms and legs, the affected area must be covered with a bandage for 1 wk.

143
Q

Fluorouracil

A

An antineoplastic topical agent used to treat superficial basal cell carcinoma.

144
Q

Paronychia

A

Refers to an inflammation of the skinfold at the nail margin.

145
Q

Intertrigo

A

Refers to irritant of opposing skin surfaces cause by friction

146
Q

Cellulitis is characterized by

A

local heat, pain,redness and swelling.

147
Q

A topical antibiotic ointment prescribed to prevent infection in clients with 2nd and 3rd degree burns.

A

Sulfamylon (mafenide acetate).

148
Q

pyridoxine, riboflavin and thiamin are necessary

for …

A

Wound healing.

149
Q

Adequate protein intake is necessary for improving

A

skin integrity.

150
Q

Vitamin D, Ca are necessary for

A

Bone healing.

151
Q

When assessing a clients response to pain, begin with least noxious stimulant (speak to client) and proceed to more painful stimulant:

A
  • Trapezius squeeze, supraorbital press, manipulation press, and sternal rub are central stimulant;
  • If no response to central stimulant demonstrating brain function, apply peripheral stimulus to the extremities;
  • Clients finger or toe should be braced on nurse’s thumb
    and pencil placed sideways on top of nail bed at base of cuticle and pushed down hard;
  • Use peripheral assessment only on extremity that did not move.
152
Q

Fluorescein angiography

A

Is a series of photographs that detail the eye’s circulation.

153
Q

Prolonged use of aspirin and other salicylates sometimes cause

A

Bilateral hearing loss of 30 to 40 decibels. (Usually this adverse effect resolves within 2 wks after the therapy is discontinued.)

154
Q

Cryptosporidium the protozoan enteric infection which results in

A

Profuse watery diarrhea.

155
Q

Adaptive immunity is mediated by

A

B and T lymphocytes and can be acquired actively or passively.

156
Q

The neutrophil is crucial to

A

Phagocytosis.

157
Q

The basophil plays an important role in

A

The release of inflammatory mediators.

158
Q

The monocyte functions in

A

Phagocytosis and monokine production.

159
Q

Basophils are responsible for

A

Releasing histamine.

160
Q

Eosinophils major function is

A

Phagocytosis of antigen-antibody complexes that are formed in allergic reactions.

161
Q

Monocytes and neutrophil are predominantly

A

Phagocytic.

162
Q

Systemic Lupus Erythematosus (SLE), signs and symptoms

A

Facial erythema, profuse proteinuria, pleuritis, fever, weight loss.

163
Q

Transfusion of more than 100ml of incompatible blood

can cause

A

severe and permanent renal damage, circulatory shock and even death.

164
Q

Lymphangiography may turn the urine

A

Blue temp.

165
Q

Vitamin B12 cause

A

Megaloblastic anemia.

166
Q

Iron deficiency signs and symptoms include

A

Dyspnea, tachycardia, pallor, fatigue, listlessness, irritability, HA.

167
Q

AIDS signs and symptoms

A

Night sweats, weight loss, diarrhea.

168
Q

Hepatitis B signs and symptoms

A

N/V anorexia.

169
Q

Allergic or hemolytic reaction

A

itching, rash, jaundice.

170
Q

An acute hemolytic reaction occurs when there is

A

An ABO or Rh incompatibility.

171
Q

Sjogren’s syndrome

A

Is an autoimmune disorder leading to progressive loss of lubricant of the skin, GI tract, ears, nose and vagina. Moisture replacement is the mainstay of therapy.

Internal Medicine (7 decks)

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