Oncology 1 Flashcards
1
Q
what does TNM stand for
A
tumor, nodes, metastasis
2
Q
what does TX mean
A
tumor can’t. be measured
3
Q
what does T0 mean
A
tumor can’t be found
4
Q
what does Tis mean
A
tumor in situ
5
Q
what does T1-T4 describe
A
tumor size and spread into adjacent structures
6
Q
what does NX mean
A
nodes can’t be found
7
Q
what does N0 mean
A
no nodal involvement
8
Q
what does N1-N3 describe
A
size, location, and/or # of lymph nodes affected
9
Q
what does M0 mean
A
no distant metastasis
10
Q
what does M1 mean
A
there are distant metastases
11
Q
name 3 PE findings of bone metastases
A
- hypercalcemia
- pathologic fx
- spinal cord compression
12
Q
what does PT Barnum Loves Kids describe/stand for
A
common bone metastases
Prostate Thyroid Breast Lung Kidney
13
Q
name 5 possible imaging choices for bone metastases
A
- Xray
- CT
- MRI
- bone scan
- PET/CT
14
Q
when would observation be the tx of choice for bone metastases
A
no pain or fxn loss
15
Q
name 2 drugs used in the tx of bone metastases
A
- opioids
- biphosphonates (Boniva)
16
Q
what class of drug is Boniva
A
biphosphonate
17
Q
what are SREs
A
skeletal related events related to bone metastases
18
Q
name 4 examples of SREs
A
- pathologic bone fx
- spinal cord compression
- orthopedic surgical intervention
- palliative bone radiation
19
Q
what class of drug is used to treat pain AND SREs
A
biphosphonates (Boniva)
20
Q
what type of radiation is analgesic AND shrinks mets
A
external beam radiation
21
Q
what type of radiation is high dose, targeted to specific areas
A
stereotactic body radiotherapy (SBRT)
22
Q
when is surgery indicated in bone metastases
A
for pt w. completed or impending pathological fx
23
Q
what is the most common primary tumor that mets to the brain
A
carcinoma
24
Q
what are 5 other common tumors that met to the brain (besides carcinoma)
A
- lung
- breast
- kidney
- colorectal
- melanoma
many bad kids lack culture
25
what are 4 cancers that RARELY met to the brain
1. prostate
2. esophagus
3. oropharynx
4. non-melanoma skin cancers
26
what is the most common mechanism of spread for brain metastases
hematogenous
27
name 5 symptoms of brain metastases
1. HA
2. focal neurologic dysfxn
3. cognitive dysfxn
4. seizure
5. stroke
28
what is the imaging of choice for brain metastases
MRI w. contrast (gadolinium)
29
when is surgical resection indicated in brain metastases
1. for one large, resectable tumor
2. bx to identify type of tumor
30
what 2 types of radiation are used in brain metastases
1. stereotactic radiosurgery (SRS)
2. whole brain radiation therapy (WBRT)
31
what are 6 side effects of SRS (stereotactic radiosurgery)
1. transient swelling
2. nausea
3. dizziness
4. vertigo
5. sz
6. HA
32
when is WBRT (whole brain radiation therapy) indicated
pt w. multiple large tumors
33
what are 2 early side effects of WBRT
1. alopecia
2. fatigue
34
what are 6 late side effects of WBRT
1. brain atrophy
2. cognitive deterioration/demntia
3. radiation necrosis
4. NPH
5. cerebrovascular dz
6. neuroendocrine dysfxn
35
what is the most common neuroendocrine s.e of WBRT
hypothyroidism
36
what 2 meds are used to treat inflammation and mass effect related to brain metastases
1. steroids
2. anti sz meds
37
what are 4 symptoms of pulmonary metastases
1. cough
2. hemoptysis
3. dyspnea/hypoxia
4. malignant pleural effusion
38
what are common metastases to the lung
almost any primary cancer can metastasize to the lung
39
what are the 3 mechanisms of spread for pulmonary metastases
1. vascular
2. lymphatic
3. direct
40
what are 2 types of tests used in pulmonary metastases
1. chest imaging
2. +/- thoracentesis fluid eval
41
when is a PleurX catheter indicated
chronic pleural effusions related to pulmonary metastases
42
name 5 tx options for pulmonary metastases
1. surgical resection
2. SRS (stereotactic radiosurgery)
3. PleurX catheter
4. radioablation
5. cryotherapy
43
name some symptoms of chemotherapy
n/v, fatigue, neuropathy, pain, mucositis, cytopenias (infxn), cognitive dysfxn, infertility, hair loss
44
name 5 elements of QOL from the SUPPORT study
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
what type of care describes the tx of physical and psychological symptoms of **serious illness**
palliative care
46
can a pt still receive curative medical tx (ex chemo) in palliative care
yes
47
what are the 2 goals of palliative care
1. comfort
2. improving qol
48
what type of care is appropriate for a pt seeking a peaceful, natural death
hospice
49
can a pt still pursue curative tx for terminal dx in hospice
no
50
does hospice include the tx of acute issues
yes
51
for hospice and death w. dignity, __ physicians must certify that a pt has \<
\_\_ months left to live
2; 6
52
which type of care involves a team of multidisciplinary team of caregivers
hospice
53
name 5 qualifications for death with dignity
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
name som physiologic changes of the dying process
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
which class of drugs are the mainstay of the dying process
opioids
56
what class of drug is Roxanol
opioid (liquid morphine)
57
name 4 drugs used to treat nausea in the dying process
1. Zofran (Odansetron)
2. Compazine (Prochlorperazine)
3. Haldol
4. THC
58
what is the 1st line drug used for anxiety/terminal restlessness/delirium in the dying process
Ativan (Lorazepam)
59
what is the 2nd line drug used for anxiety/terminal restlessness/delirium in the dying process
Haldol (Haloperidol)
60
what drug can be used to treat both nausea and anxiety/terminal restlessness/delirium in the dying process
Haldol (Haloperidol)
61
name 4 drugs used to treat xerostomia in the dying process
1. glycerin swabs
2. biotene
3. artificial saliva
4. pilocarpine
62
name 2 drugs used to treat anorexia in the dying process
1. Megace (Megestrol acetate)
2. glucocorticoids
63
T/F: Megace has lots of s.e
T - Megace has lots of s.e
64
T/F: there is evidence for artificial nutrition in the dying process
F! there is no evidence for the use artificial nutrition in the dying process
65
name 4 drugs used to treat secretions in the dying process
1. Atropine Ophthalmic drops
2. Scopolamine (Hyoscine) patch
3. Glycopyrrolate
66
T/F: d/c'ing IVF or TF can help manage secretions in the dying process
T! d/c IVF or TF to help manage secretions
67
name 2 considerations for pacemakers/ICDs in the dying process
1. know brand
2. can be deactivated remotely
68
name 3 considerations for advanced directives
1. pt must have decisional capacity
2. followed when pt loses capacity
3. may be revoked verbally by pt who has capacity
69
name 2 types of advanced directives
1. power of attorney for health care (POA or Health Care Proxy)
2. Living Will
70
what document is used to direct emergency health care professionals for pt. w advanced illness or frailty
POLST/MOST Forms
71
is POST or MOST used in CO
MOST
72
name 3 components of the POLST/MOST Forms
1. CPR
2. medical intervention
3. artificially administered nutrition
73
which nausea drug can be administered rectally
compazine
