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Clin Med II - Exam 1 > Oncology 1 > Flashcards

Oncology 1 Flashcards

1
Q

what does TNM stand for

A

tumor, nodes, metastasis

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2
Q

what does TX mean

A

tumor can’t. be measured

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3
Q

what does T0 mean

A

tumor can’t be found

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4
Q

what does Tis mean

A

tumor in situ

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5
Q

what does T1-T4 describe

A

tumor size and spread into adjacent structures

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6
Q

what does NX mean

A

nodes can’t be found

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7
Q

what does N0 mean

A

no nodal involvement

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8
Q

what does N1-N3 describe

A

size, location, and/or # of lymph nodes affected

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9
Q

what does M0 mean

A

no distant metastasis

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10
Q

what does M1 mean

A

there are distant metastases

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11
Q

name 3 PE findings of bone metastases

A
  1. hypercalcemia
  2. pathologic fx
  3. spinal cord compression
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12
Q

what does PT Barnum Loves Kids describe/stand for

A

common bone metastases

Prostate Thyroid Breast Lung Kidney

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13
Q

name 5 possible imaging choices for bone metastases

A
  1. Xray
  2. CT
  3. MRI
  4. bone scan
  5. PET/CT
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14
Q

when would observation be the tx of choice for bone metastases

A

no pain or fxn loss

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15
Q

name 2 drugs used in the tx of bone metastases

A
  1. opioids
  2. biphosphonates (Boniva)
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16
Q

what class of drug is Boniva

A

biphosphonate

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17
Q

what are SREs

A

skeletal related events related to bone metastases

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18
Q

name 4 examples of SREs

A
  1. pathologic bone fx
  2. spinal cord compression
  3. orthopedic surgical intervention
  4. palliative bone radiation
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19
Q

what class of drug is used to treat pain AND SREs

A

biphosphonates (Boniva)

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20
Q

what type of radiation is analgesic AND shrinks mets

A

external beam radiation

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21
Q

what type of radiation is high dose, targeted to specific areas

A

stereotactic body radiotherapy (SBRT)

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22
Q

when is surgery indicated in bone metastases

A

for pt w. completed or impending pathological fx

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23
Q

what is the most common primary tumor that mets to the brain

A

carcinoma

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24
Q

what are 5 other common tumors that met to the brain (besides carcinoma)

A
  1. lung
  2. breast
  3. kidney
  4. colorectal
  5. melanoma

many bad kids lack culture

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25
Q

what are 4 cancers that RARELY met to the brain

A
  1. prostate
  2. esophagus
  3. oropharynx
  4. non-melanoma skin cancers
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26
Q

what is the most common mechanism of spread for brain metastases

A

hematogenous

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27
Q

name 5 symptoms of brain metastases

A
  1. HA
  2. focal neurologic dysfxn
  3. cognitive dysfxn
  4. seizure
  5. stroke
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28
Q

what is the imaging of choice for brain metastases

A

MRI w. contrast (gadolinium)

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29
Q

when is surgical resection indicated in brain metastases

A
  1. for one large, resectable tumor
  2. bx to identify type of tumor
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30
Q

what 2 types of radiation are used in brain metastases

A
  1. stereotactic radiosurgery (SRS)
  2. whole brain radiation therapy (WBRT)
31
Q

what are 6 side effects of SRS (stereotactic radiosurgery)

A
  1. transient swelling
  2. nausea
  3. dizziness
  4. vertigo
  5. sz
  6. HA
32
Q

when is WBRT (whole brain radiation therapy) indicated

A

pt w. multiple large tumors

33
Q

what are 2 early side effects of WBRT

A
  1. alopecia
  2. fatigue
34
Q

what are 6 late side effects of WBRT

A
  1. brain atrophy
  2. cognitive deterioration/demntia
  3. radiation necrosis
  4. NPH
  5. cerebrovascular dz
  6. neuroendocrine dysfxn
35
Q

what is the most common neuroendocrine s.e of WBRT

A

hypothyroidism

36
Q

what 2 meds are used to treat inflammation and mass effect related to brain metastases

A
  1. steroids
  2. anti sz meds
37
Q

what are 4 symptoms of pulmonary metastases

A
  1. cough
  2. hemoptysis
  3. dyspnea/hypoxia
  4. malignant pleural effusion
38
Q

what are common metastases to the lung

A

almost any primary cancer can metastasize to the lung

39
Q

what are the 3 mechanisms of spread for pulmonary metastases

A
  1. vascular
  2. lymphatic
  3. direct
40
Q

what are 2 types of tests used in pulmonary metastases

A
  1. chest imaging
  2. +/- thoracentesis fluid eval
41
Q

when is a PleurX catheter indicated

A

chronic pleural effusions related to pulmonary metastases

42
Q

name 5 tx options for pulmonary metastases

A
  1. surgical resection
  2. SRS (stereotactic radiosurgery)
  3. PleurX catheter
  4. radioablation
  5. cryotherapy
43
Q

name some symptoms of chemotherapy

A

n/v, fatigue, neuropathy, pain, mucositis, cytopenias (infxn), cognitive dysfxn, infertility, hair loss

44
Q

name 5 elements of QOL from the SUPPORT study

A
  1. symptoms and personal care
  2. being prepared for death
  3. achieving a sense of completion
  4. being treated as a whole person
  5. relating to family, society, care providers, and transcendent
45
Q

what type of care describes the tx of physical and psychological symptoms of serious illness

A

palliative care

46
Q

can a pt still receive curative medical tx (ex chemo) in palliative care

A

yes

47
Q

what are the 2 goals of palliative care

A
  1. comfort
  2. improving qol
48
Q

what type of care is appropriate for a pt seeking a peaceful, natural death

A

hospice

49
Q

can a pt still pursue curative tx for terminal dx in hospice

A

no

50
Q

does hospice include the tx of acute issues

A

yes

51
Q

for hospice and death w. dignity, __ physicians must certify that a pt has <

__ months left to live

A

2; 6

52
Q

which type of care involves a team of multidisciplinary team of caregivers

A

hospice

53
Q

name 5 qualifications for death with dignity

A
  1. 2 physicians must confirm <6 mo left to live
  2. pt must be mentally competent
  3. pt must be an adult
  4. rx must be specifically requested by pt
  5. requires 2 waiting periods
54
Q

name som physiologic changes of the dying process

A

weakness, fatigue, fxn decline, decreased PO, impaired swallowing, diminished blood perfusion, breathing changes (Cheyne Stokes), excretion changes (loss of sphincter control), inability to close eyes

55
Q

which class of drugs are the mainstay of the dying process

A

opioids

56
Q

what class of drug is Roxanol

A

opioid (liquid morphine)

57
Q

name 4 drugs used to treat nausea in the dying process

A
  1. Zofran (Odansetron)
  2. Compazine (Prochlorperazine)
  3. Haldol
  4. THC
58
Q

what is the 1st line drug used for anxiety/terminal restlessness/delirium in the dying process

A

Ativan (Lorazepam)

59
Q

what is the 2nd line drug used for anxiety/terminal restlessness/delirium in the dying process

A

Haldol (Haloperidol)

60
Q

what drug can be used to treat both nausea and anxiety/terminal restlessness/delirium in the dying process

A

Haldol (Haloperidol)

61
Q

name 4 drugs used to treat xerostomia in the dying process

A
  1. glycerin swabs
  2. biotene
  3. artificial saliva
  4. pilocarpine
62
Q

name 2 drugs used to treat anorexia in the dying process

A
  1. Megace (Megestrol acetate)
  2. glucocorticoids
63
Q

T/F: Megace has lots of s.e

A

T - Megace has lots of s.e

64
Q

T/F: there is evidence for artificial nutrition in the dying process

A

F! there is no evidence for the use artificial nutrition in the dying process

65
Q

name 4 drugs used to treat secretions in the dying process

A
  1. Atropine Ophthalmic drops
  2. Scopolamine (Hyoscine) patch
  3. Glycopyrrolate
66
Q

T/F: d/c’ing IVF or TF can help manage secretions in the dying process

A

T! d/c IVF or TF to help manage secretions

67
Q

name 2 considerations for pacemakers/ICDs in the dying process

A
  1. know brand
  2. can be deactivated remotely
68
Q

name 3 considerations for advanced directives

A
  1. pt must have decisional capacity
  2. followed when pt loses capacity
  3. may be revoked verbally by pt who has capacity
69
Q

name 2 types of advanced directives

A
  1. power of attorney for health care (POA or Health Care Proxy)
  2. Living Will
70
Q

what document is used to direct emergency health care professionals for pt. w advanced illness or frailty

A

POLST/MOST Forms

71
Q

is POST or MOST used in CO

A

MOST

72
Q

name 3 components of the POLST/MOST Forms

A
  1. CPR
  2. medical intervention
  3. artificially administered nutrition
73
Q

which nausea drug can be administered rectally

A

compazine

Clin Med II - Exam 1 (7 decks)

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