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Acute > Oncology > Flashcards

Oncology Flashcards

1
Q

benign tumor

A
  • differentiated cells that reproduce at high rate and are encapsulated
  • expand but do not spread to other tissues
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2
Q

malignant tumor

A
  • undifferentiated cells
  • uncapsulated and grow uncontrollable
  • invade other tissues and cause destruction to surrounding tissue
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3
Q

primary vs secondary

A

primary - original tumor in original location

secondary - metastases that have moved from primary site

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4
Q

dysplasia

A

variability of cell size and shape w/ increased rate of cell division
- can be precancerous change or result from chronic infection

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5
Q

metaplasia

A

replacement of 1 mature cell type by a different mature cell type

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6
Q

hyperplasia

A

increased number of cells resulting in enlarged tissue mass

- can be because of increased demand or pathological

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7
Q

differentiation

A

cell resembles mature morphology and function

  • well differentiated = physiological and functions as intended
  • poorly differentiated = cell does not resemble a mature cell in both morphology and function
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8
Q

S&S of cancer

A
  • unusual bleeding or discharge
  • unexplained weight loss of 10 lbs or more
  • fever
  • fatigue
  • pain
  • persistent cough or hoarseness w/o known cause
  • skin changes
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9
Q

stool guaiac

A

detects small quantities of blood in stool

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10
Q

pap smear

A

type of biopsy in which cells from cervix are removed and examinated

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11
Q

sputum cytology

A

sputum specimen is inspected for cancerous cells

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12
Q

sigmoidoscopy

A

sigmoid colon is examined w/ sigmoidoscope

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13
Q

colonoscopy

A

upper portion of the rectum is examined w/ colonoscope

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14
Q

PET scan

A

dye injected to detect subtle changes in metabolic and chemical activity in body
- detect biopsy location, benign vs malignant, stage, cancer recurrence

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15
Q

TNM system

A

T - extent (size/number) of primary tumor
N - lymph nodes involvement
M - presence or absence of metastasis

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16
Q

TX, T0, Tis, T1-T4 meaning

A

TX - primary tumor cannot be assessed
T0 - no evidence of primary tumor
Tis - carcinoma in situ (site of origin)
T1-T4 - progressive increase in tumor size and local involvement

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17
Q

NX, N0, N1-N3 meaning

A

NX - nodes cannot be assessed
N0 - no metastasis to local lymph nodes
N1-N3 - progressive involvement of local lymph nodes

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18
Q

MX, M0, M1 meaning

A

MX -presence of distant metastasis cannot be assessed
M0 - no distant metastasis
M1 -presence of distant metastasis

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19
Q

low grade vs high grade tumors

A

low grade - highly differentiated cells that more closely resemble original cells (less aggressive tumor)

high grade - less differentiated cells that are like original cells (more aggressive)

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20
Q

GX, G1, G2, G3, G4 meaning

A

GX - undetermined grade, cannot be assessed
G1 - low grade, well-differentiated
G2 - intermediate grade, moderately differentiated tumor
G3 - high grade, poor differentiated tumor
G4 - high grade, undifferentiated tumor

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21
Q

Undifferentiated cells have a _______ prognosis

A

poorer

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22
Q

palliation

A

decreased tumor burden, improve QoL, relieve pain

  • cure nor control possible
  • focus on making patient as comfortable as possible
23
Q

adjuvent vs neoadjuvent

A

adjuvent - given in addition to primary treatment

neoadjuvant - given prior to “main” treatment to reduce size as much as possible

24
Q

What type of patient has the best chance of cure?

A

patient who has no lymph involvement (N0) and no metastases (M0)

25
Q

What type of patient has a poor chance of cure?

A

patient who has widespread lymph involvement (N2-3) and metastases (M1)

26
Q

indications for surgical management

A
  • removal of precancerous or primary cancer
  • establish diagnosis by biopsy
  • assist in staging by sampling lymph nodes
  • reconstruction of limb or organ
  • palliative care - decompressive or bypass procedures
27
Q

primary objective to radiation

A

eradicate tumor while minimizing damage to healthy tissue

28
Q

3 options for radiation

A
  • external beam radiation therapy (EBRT) - most common
  • brachytherapy
  • intraoperative radiation therapy (IORT)
29
Q

indications for radiation

A
  • definitive treatment w/ intent to cure
  • neoadjuvant treatment
  • adjuvant treatment
  • prophylactic treatment - prevent growth of cancer
  • control to limit growth of existing cancer cells
  • palliation to relieve pain, prevent fracture, and enhance mobility when cure is not possible
30
Q

radiation considerations

A
  • side effects
  • site-specific toxicities
  • antiemetics
  • use caution w/ skin that it has become fragile from radiation
31
Q

purpose of chemotherapy

A

inhibit various signaling pathways that control cancer proliferation, invasion, metastasis, angiogenesis, and cell death

32
Q

why does chemo affect multiple areas of the body?

A

Targeting replicating cells which is why hair loss, N&V (GI cells), and reproductive issues occur after chemo because they are affected as well

33
Q

chemotherapy PT considerations

A
  • N/V may limit participation
  • nutritional status - decreased ability to consume/absorb nutrients
  • modifications in activities - fatigue
  • monitor vitals
  • nadir - 10-28 days after chemo and WBC are lowest - high risk for infection
34
Q

At what point does neutropenic precautions kick in?

A

< 1500 mm^3

35
Q

At what platelet level do you hold PT?

A

< 10,000 hold PT

36
Q

At what platelet level is no resisted exercise appropriate?

A

10k - 20k

37
Q

At what platelet level can the patient exercise w/ or w/o resistance?

A

> 20k

38
Q

specific chemo considerations

A
  • neutropenia
  • lymphedema
  • memory problems
  • peripheral neuropathy
  • pain
39
Q

When should you withhold or stop exercise for patients on chemo?

A
  • rest HR > 100 bpm
  • dyspnea
  • low diastolic BP
  • during exercise - abnormal BP response, abnormal fatigue, dizziness, nausea, pallor, excessive sweating
40
Q

What is biotherapy?

A

aka immunotherapy

  • uses the patient’s native host defense as mechanisms to treat cancer
  • including cytokines, monoclonal antibodies, and vaccines
41
Q

Pain is a ______ risk for cancer patients

A

fall risk

42
Q

Why would a cancer patient have a deficit in ROM?

A
  • scar formation after surgery
  • disuse of a joint following chemotherapy or surgery
  • fibrosis caused by irradiation
43
Q

______ leads to muscle weakness that is linked to poor balance and falls

A

sarcopenia

44
Q

Decreased endurance can lead to decreased ability to complete_______ related tasks

A

balance

45
Q

What Increases risk of postural control impairments, falls, and gait alterations in cancer patients?

A

sensory impairments from chemotherapy-induced peripheral neuropathy

46
Q

What is a predictor of falls in older cancer survivors?

A

limitations in full tandem stance

47
Q

________ is a leading cause of emotional distress in cancer survivors

A

physical disability

48
Q

_______ is more strongly related to level of disability than to the cancer diagnosis itself

A

distress

49
Q

general PT guidelines for cancer patients

A
  • optimize functional mobility
  • minimize or prevent cancer-related fatigue
  • prevent joint contracture and skin breakdown
  • prevent or reduce limb edema
  • prevent postoperative pulmonary complications
50
Q

What should be done before and during exercise treatment for cancer patient? What kind of exercise should be done?

A

aerobic and resistive exercise

before - rule out instability or decline in medical status

before and during - monitor vitals

51
Q

Basal vs squamous cell cancer

A

basal - noduloulcerative lesion from sun on head, ears

squamous - variable presentation of pink lesions to scaly plaques

52
Q

ABCDE rules

A 
Asymmetry
Border - irregular
Color - varied
Diameter - > 6mm
Evolving - appearance changes
53
Q

What is the gold standard treatment for stage 1 and 2 lung cancer?

A

lobectomy

54
Q

What results in a very painful incision?

A

thoracic surgery for lung cancer

Acute (14 decks)

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