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oncology Flashcards

1
Q

Radiation side effects

A 
Alopecia
Desquamation
Ulceration
Stomatitis
Xerostomia
Bone marrow suppression
Anemia
Leukopenia
Thrombocytopenia
fatigue/malaise
Anorexia
Radiation burns
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2
Q

Tx of radiation side effects

A 
Cleanse area with lukewarm water
No harsh soaps, talc powder, perfumes, or alcohol wipes
-Can use very thin layer of A&D ointment
Dont shave area
dont expose to the sun
Don't use bandaids or tape
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3
Q

Problems with extravasations

A

compartment syndrome

peripheral neuropathy

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4
Q

mediports

A

SASH

if no blood return, turn head to side and cough

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5
Q

Chemotherapy S/E

A 
-N/V/D/A (Zofran around the clock, corticosteroids increases appetite)
Mylosupression-leukopenia, anemia, thrombocytopenia, -anemia. (Neupogen, Epogen, Neumega)
-Renal toxicity
-Renal failure
-Electrolyte imbalance
-Irreversible cardiac toxicity
-Rt and Lt sided heart failure
-Pulmonary fibrosis
-Early menopause
-Sterility
-Peripheral neuropathies
-Fatigue
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6
Q

Absolute neutrophil count

A

WBC (%neutrophils+%bands)/100
normal >1500
moderate 1000-1500
<500: severe neutropenia!!

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7
Q

NADIR

A

lowest ANC after chemo or radiation

stop tx until numbers go up

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8
Q

Ovarian cancer Risk factors

A 
nulliparity
infertility
family Hx
early menses and late menopause (Increased exp to estrogen)
high fat diet
mumps before 1st period
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9
Q

Ovarian cancer protective factors

A

use or oral contraceptives
multiparity
breastfeeding

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10
Q

S&S ovarian cancer

A 
vague and nonspecific 
Palpable ovary in postmenopausal woman
Bloating/flatulence
Abd swelling/pain/ascites
Pelvic pressure/mass
Backache/leg pain
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11
Q

Dx of Ovarian cancer

A 
Biopsy
Pelvic exam
Transvaginal ultrasound
Laparotomy
Ca 125 maker/antigen
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12
Q

Dx findings of Ovarian of cancer

A

Benign
Borderline (proliferation, no invasion)
Malignant

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13
Q

Staging of ovarian cancer

A

Stage 1: limited to ovary
Stage 2: limited to pelvis
Stage 3: limited to and cavity (not the liver)
Stage 4: metastasis to liver, lungs, etc

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14
Q

Management of Ovarian cancer

A 
TAHBSO (total abd hysterectomy with bilateral salpingo oophrectomy)
Omentectomy
Liposomal therapy (encapsulated chemo)
Radiation
chemo
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15
Q

NI Ovarian cancer

A

Control pain
drainage tubes, abdominal binders
Diuretics for ascites
Assist with paracentesis

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16
Q

Cervical Cancer Patho

A

Easiest GYN cancer to prevent thru screening (pap smear)

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17
Q

Risks of Cervical cancer

A 
HPV (STI)--cause
had sex > 1 partner
Early sexual activity
Early child bearing (NO ESTROGEN)
smoking
immunocompromised
no yearly pap smear
younger women
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18
Q

S&S of Cervical cancer

A

Abnormal bleeding between periods and intercourse or after (CONTACT BLEEDING)
Unusual vaginal discharge (foul/smelling)
Leg/pack pain
Pelvic pain after intercourse

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19
Q

Dx of Cervical cancer

A 
-Papsmear: 
  Atypia: mild changes
  low grade: dysplasia
  high grade: malignant
-punch biopsy
-D&C 
-CT
-Colcoscopy (vinegar solution)
-Pelvic exam
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20
Q

Stages of cervical cancer

A

Stage 1: in cervix

2: surrounding tissues
3: lymph nodes and pelvic area
4: bowel/bladder/etc

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21
Q

Management of Cervical cancer

A

Cryotherapy (no intercourse 3 weeks)
LEEP procedure
Cone biopsy
hysterectomy
Radical trachelectomy (cervical os removed)
radiation (external, intraoperative, internal)- Radiation enteritis, vaginal stenosis
teach S&S mets: wt loss, pelvic pain and leg edema.

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22
Q

Breast cancer risk factors

A 
(long exposure to estrogen)
> age
Family Hx of cancer
BRCA1 and 2
Early menses. late menopause. nullipara, contraceptives
Benign proliferate breast disease
obesity
Exposure to Ionizing radiation (young adults, kids)
Excessive alcohol
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23
Q

Breast cancer protective factors

A 
Exercise
breastfeeding
not smoking
no excessive alcohol
full preg before 30
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24
Q

Screening and prevention breast cancer

A

BSE age 20
Mammography 35 high risk 40 no risk
Bilateral Prophylactic Mastectomy: if person has BRCA 1 and 2

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25
Q

S&S Breast cancer

A

Upper Outer Quadrant palpable mass (fixed, painles)
Skin dimpling (like orange)
skin irritation (peeling, flaking, eczema)
skin color changes and texture
Nipple retraction (inverted/flat) pain
Skin ulceration
Spontaneous bloody discharge from nipple area

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26
Q

Dx and assessment breast cancer

A 
mammography
biopsies (incisional and excisional)
MRI
CA15-3
staging 1-4
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27
Q

Tx of breast cancer

A 
Sentinel Lymph node biopsy
total mastectomy
Radical mastectomy
Modified radical 
lumpectomy
chemo/radiation
28
Q

Preop/post op breast cancer

A

More prone to hematomas and lymphedema due to lymph nodes removed
-Wall hand climbing, broomstick lifting, rope/doorknob turning, stress balls (helps lymphedema)
-No heavy lifting for 4-6 weeks
Drainage tubes (monitor, empty
Wear gloves when gardening and baking
If get a scrape on arm, Bacitracin ointment
No BP, blood draws, IVs or tourniquet on side

29
Q

lymphedema NI breast ca

A

elevate arms on pillow for 45 minutes

wear special stockinette over arm

30
Q

S/E of hormonal therapy

A 
hot flashes, vaginal dryness
risk for cataracts
N/V
Dizzy, headache
osteoporosis
uterine cancer risk
31
Q

Testicular cancer at risk

A 
ages 15-40
highly treatable and curable
usually germinal
cryptorchidism
Family Hx
Caucasian
Occupational exposure
Exposure to DES
32
Q

S&S of testicular cancer

A 
Mass or lump in testes
Painless enlargement of testes 
Heaviness in scrotum, inguinal area, low abd
Backache-retroperitoneal node extension
Mets (abd pain, wt loss, weakness)
33
Q

Dx and screening testicular ca

A 
Monthly testicular exam
HCG and AFP
Intravenous urography 
Ultrasound 
CT (mets) to lungs
INGUINAL ORCHIECTOMY
34
Q

Management of testicular cancer

A
  • orchiectomy with possible retroperitoneal dissection
  • Discuss prosthetic device implantation
  • counsel about sperm banking (sterility)
  • the other testes must be protected
  • Radiation
  • conventional tx
35
Q

Bladder cancer risk factors

A 
Recurrent UTIs
Bladder and kidney stones
smoking
chronic exposure to dyes, leather, paint, hairdressing.
High diet and fried foods
Prostate, colon or rectal
36
Q

S&S of bladder cancer

A

painless hematuria
UTI S&S
alteration in voiding patterns
Pelvic/lower back pain (Mets: BONES)

37
Q

Dx of bladder cancer

A
  • cystoscopy together with cytologic exam (look, flush wit saline and biopsy) collect fresh urine
  • excretory urography (entire renal system) dye!!
  • CT scan
38
Q

Medical Management bladder ca

A

Transurethral resection (remove area) goal patency
Intravesical therapy (inject BCG thru foley) push fluids
Cystectomy with ileal conduit
Radiation (cystitis)
chemo

39
Q

Prostate cancer risk factors

A

African american
high fat, dairy and red meat diet
>age

40
Q

Prostate Dx

A

DRE and PSA

TRUS with biopsy

41
Q

Tx of prostate cancer

A

watchful waiting
prostatectomy (radical)-sexual impotency and urinary incontinence
-Transurethral, suprapubic and retropubic removal
-Radiation (brachytherapy, tele therapy) no contact with preg women or young children for 2 months, use condoms for 2 weeks
-Hormonal therapy
-Chemotherapy

42
Q

Colorectal Cancer risk factors

A 
genital or breast cancer
high fat and protein, low fiber diet
IBD
polyps
>age
43
Q

Colorectal cancer S&S

A

change in Bowel habits
Blood in stool
unexplained anemia
wt loss
fatigue
Rt sided: dull abd pain, dark blood in stool (melena)
Lt sided: severe abd pain, constipation, cramps, distention, bright red blood, very thin stool (pencil-like)
Sigmoid-rectal area: tenesmus, rectal pain.

44
Q

Dx colorectal cancer

A 
Proctosigmoidoscopy
Abd & rectal exam
Stool for occult blood
Barium enema
CEA (blood test: check to see reoccurrence)
45
Q

Complications of Colorectal Ca

A 
Bowel obstruction
Hemorrhage
Perforation in abdomen
Tumor extension
Peritonitis
46
Q

Classification Colorectal Ca

A

Dukes (A best, D worst)

47
Q

Tx of colorectal cancer

A 
Segmental resection with anastamosis
Temporary or permanent colostomy
Abdominal resection
Permanent colostomy
If intestinal obstruction (NG suction, IV fluids, Blood products)
Chemo, radiation
48
Q

S&S of lung cancer

A

change in cough (hacking, nonproductive)
hemoptysis
chest pain
wt loss

49
Q

tx of lung cancer

A

radiation (esophagitis, pneumonitis, fibrosis)

  • Lobectomy (2 chest tubes)
  • Pneumonectomy (no chest tubes, DONT position on UNAFFECTED side)
  • wedge resection
  • Segmental resection
50
Q

Laryngeal risk factors

A

smoking and drinking
manufacturing plants
forcing voice
laryngitis

51
Q

S&S laryngeal cancer

A 
hoarseness>2 weeks
graspy low pitch voice
persistent cough, pain, burning in throat
lump in neck
dysphagia
foul breath
we loss
dyspnea
ear pain (mets)
52
Q

Dx Laryngeal cancer

A 
Direct laryngoscopy
P53 tumor marker
CT scan
MRI
Laryngography
53
Q

Medical Management laryngeal ca

A 
Radiation (xerostomi, desguesia, dysphagia, loss of smell.
Partial laryngectomy (voice is kept)
Total laryngectomy (no voice ever, permanent tracheal stoma)
54
Q

Total laryngectomy NI

A

How do you want to communicate? can’t whistle
Assess Resp status
Speech therapist
suction PRN
Humidified 02 and oral suction
encourage Fluid intake
-deflate shiley teach every 2h
-change inner canula q8h
-Avoid irritants from stoma (powder)
-Tub bath or hand held shower (cover stoma)
-swallow test (2-3 days postop, stay with them, thick liquids, suctioning equip.)
-avoid sweet foods
-cleanse stoma with NS daily, asses swell and retraction
-pad and pencil (magic slate)
-electric pharynx
COMP: resp distress, hemorrhage, INF, wound breakdown, aspiration.
-no swimming.

55
Q

Endometrial Cancer Risk factors

A 
menopause
obesity
HTN
diabetes
estrogen use
56
Q

Endometrial ca S&S

A

ENDOMETRIAL HYPERPLASIA

Abnormal bleeding

57
Q

Dx of endometrial Ca

A 
Transvaginal ultrasound 
endometrial biopsy (aspiration)
58
Q

Tx endometrial ca

A 
TAHBSO
hysterectomy
vaginal brachytherapy
hormonal therapy/chemo
pelvic radiotherapy
59
Q

Liver cancer risk factors

A 
Chronic liver disease
Hep B&C
Chemical toxin exposure
Cigarette smoking and ALCOHOL
older men
60
Q

S&S liver Ca

A 
Pain in RUQ and throughout abdomen, back and neck
extreme weight loss
anorexia (get full fast)
Ascites
Jaundice
Hepatosplenomegaly
Anemia
61
Q

Dx liver Ca

A 
Liver function tests (increased levels)
CBC (leukocytosis)
AFP and CEA
Angiography
Liver scans, Ct scan, MRI
62
Q

Tx liver Ca

A 
Lobectomy
Cryosurgery (nitrogen liquid over tumor)
Liver transplant
Radiation (doesn't improve survival)
Internal (seeds, beads)
chemo
Percutaneous biliary drainage (relieves jaundice, itching, pain)
COMP: hemorrhage, infections
63
Q

NI Liver Ca

A

Monitor CBC (hemorrhage)
hypothermia (cryosurgery)
clean biliary drainage, it won’t fall out. skin care for pruritus
oat meal based lotions

64
Q

Pancreatic Ca Risk factors

A 
older 
smoking
exposure to chemicals
high meat, fat, nitrates diet
chronic pancreatitis
DM type 2
obesity
65
Q

S&S of Pancreatic Ca

A 
Pain (when laying down is worse)
Jaundice
Severe wt loss
mid abd discomfort
Insulin deficiency (DM)
Ascites
hepatomegaly
66
Q

Dx pancreatic Ca

A

CA 19 & CEA
endoscopic ultrasound
ERCP (endoscopic retrograde cholangiopancreatography)

67
Q

Tx Pancreatic Ca

A 
Excision procedure
Biliary stent placement
whipple procedure 
radiation 
Chemo 
high protein diet high pancreatic enzymes
Pain relief

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