Oncology

Question 1

Cancer is the ____ leading cause of death in the US.

Answer 1

2nd

Question 2

Cancer is the leading cause of death for?

Answer 2

ages 65 and older

Question 3

Begnin tumors

• Grow ____
• Not harmful unless ____
• Remain____

Answer 3

• Grow slowly
• Not harmful unless compressing other organs
• Remain localized

Question 4

Malignant tumors

• Grow____
• Can ____ surrounding tissue and spread to____
• Can survive off ____

Answer 4

• Grow rapidly
• Infilitrate surrounding tissue and spread to ogans
• Can survive off own blood supply

Question 5

Type of solid tumor derived from epithelial tissue?

Answer 5

carcinoma

Question 6

Type of solid tumor derived from connective tissue, bone, and/or muscle

Answer 6

sarcoma

Question 7

Where do liquid tumors develop?

Answer 7

Blood - example, leukemia

Question 8

3 structural changes in cancer cells?

Answer 8

• Polymorphism
• Hyperchromatism- nuclear chromatin more pronounced
• Abnormal chromosome arrangements

Question 9

Normal cells do what when coming into contact with with each other? What kind of cells cant do this?

Answer 9

• Arrest cell growth/multplication

* cancer cells

Question 10

In grade 4, cancers are _____, with the most _____ cells.

Answer 10

• Undifferentiated

* Abnormal

Question 11

Growth characteristics?

Answer 11

• Length of time for tumor to become detectable
• Growth fraction - fraction of proliferating cells in tumor
• Tumor doubling time - time when cancer cells double
• Hormone levels - certain cancers require hormones for growth

Question 12

Tumor growth pattern in which there is an Increase in the number of cells in the tissue.

Answer 12

Hyperplasia (non/pre cancerous)

Question 13

Tumor growth pattern in which there is replacement of 1 mature cell by another.

Answer 13

Metaplasia (non/pre cancerous)

Question 14

Tumor growth pattern in which there is an Alteration of any epithelial cells, loss of uniformity of cells

Answer 14

Dysplasia (non/pre cancerous)

Question 15

Cancerous tumor growth pattern shows malignancy, disorganization of cells.

Answer 15

Anaplasia

Question 16

Three stage theory of Carcinogens?

Answer 16

1 - initiation - dna damaged by carcinogens, permanent change
2 - promotion - cell is altered, multiplication
3 - progression - loss of normal cell function and structure, no contact inhibition, rapidly divide, tumor forms own blood supply

Question 17

Prefix before TNM indicates what?

Answer 17

timing of staging.
C-clinical - before treatment
P-pathologic -after surgical exploration
R - Pretreatment after disease free interval 
A-autopsy

Question 18

replacement of cell or new/continued cell growth that is not part of normal cell development

Answer 18

Cancer

Question 19

anything that will change a cell

Answer 19

carcinogen

Question 20

process of cell change that promotes malignant growth

Answer 20

carcinogenisis

Question 21

the creation of new blood

vessels from existing ones to provide nutrients & remove waste

Answer 21

Angiogenesis - cancer cells can induce this

Question 22

signaling protein

that stimulates angiogenesis

Answer 22

VEGF

Question 23

Warning signs for cancer? CAUTION

Answer 23

C - change in bowel or bladder habits
A - a sore that does not heal 
U - Unusual bleeding or disarge
T-Thickening or lump
I-indigestion or difficulty swallowing
O-obvious change in wart or mole
N - nagging cough or hoarsness

Question 24

Most common sites for distant mestasis?

Answer 24

• Lung
• Bone
• Liver
• CNS

Question 25

Stage 1 - T_, N_, M_ Mass is limited to ___ No ___ or ____ spread

Answer 25

* T1,N0,M0 * organ of origin * Nodal or vascular

Question 26

Stage 2- T__ N__ M___ | ____spread into surrounding tissue and/ or ____

Answer 26

* Tx,N1,M0 * Local * first-station lymph

Question 27

Stage 3 - T__, N__, M___ Operable but not___ ____ invasion and ____

Answer 27

* T3,N2,M0 * Not resectable --some gets left behind * Bone and lymph nodes

Question 28

Stage 4 - T___, N___,M____ ____,extensive primary tumor Distant_____ *In______

Answer 28

* T4,N3,M+ * large * Distant mestastases * Inoperable

Question 29

Pain is

Answer 29

Whatever the client says it is. Subjective.

Question 30

Assessment of Nonverbal patients?

Answer 30

``` FLACC- 0-2 Face Legs Activity Cry Consolability ```

Question 31

- Type of pain that has precipitating cause (surgery, trauma | - Can see physiological changes like increase in heart rate and BP

Answer 31

ACUTE PAIN

Question 32

Pain that persists for 3 months or longer No changes in physiologic signs Poor control can lead to anxiety and depression

Answer 32

CHRONIC PAIN

Question 33

Pain that can be drug induced | Disease related -diabetes, tumor compresion

Answer 33

Neuropathic Pain

Question 34

Treatment for neuropathic pain?

Answer 34

- gabapentin - lyrica - Cymbalta - TCA

Question 35

Pain in Cutaneous and deep musculoskeletal tissues | example - bone mestasis

Answer 35

Somatic pain - a type of nociceptive pain

Question 36

Results from compression or stretching of thoracic or abdominal lining - liver cirrhosis

Answer 36

Visceral pain - a type of nocicpetive pain

Question 37

How long after po meds do you have to reassess for pain?

Answer 37

1 hour

Question 38

How long after IV/IM/Subq meds do you need to assess for pain?

Answer 38

30 minutes

Question 39

3 Iv pca drugs?

Answer 39

Morphine, Hydromorphone, Fentanyl

Question 40

Side effects of pain meds?

Answer 40

- Oversedation/altered mental status - Respiratory depression - Constipation - N/V - Myoclonus - muscle jerks - pruritus - itchy skin

Question 41

Focuses on providing relief from the symptoms & stress of serious illness. What can this be provided with?

Answer 41

Palliative care, can be provided with curative treatment

Question 42

* Eligible with a prognosis of _____ | * Focus is on the last phase of life, aggressive symptom ___

Answer 42

Hospice care * 6 months or less * symptom management

Question 43

- local treatment - remove all of the primary tumor - only treatment required - may be proceeded or followed by other modalities - palliative to decrease symptoms

Answer 43

Surgical treatment

Question 44

- local treatment — a beam is directed at the precise target | - may follow surgery to prevent recurrence of the primary tumor

Answer 44

Radiation treatment

Question 45

- systemic therapies - single agent or more commonly used in combination with other drugs - limited by toxic effects on normal tissues

Answer 45

Chemotherapy

Question 46

- systemic treatments like chemotherapy & hormone therapy - modify the patient’s own immune defenses - may target a single receptor on the surface of tumor cells - may promote tumor regression

Answer 46

Biotherapy