Oncology

Question 1

Tumor Staging- T

Answer 1

Tx- cannot be assessed
T0- No evidence of primary tumor
TiS Carcinoma in situ
T1-T4- increasing size or local extent of tumor

Question 2

Tumor Staging- Lymph Nodes-N

Answer 2

Nx- Cannot be assessed
N0- No regional metastasis
N1-N3- Increasing involvement regional lymph nodes

Question 3

Tumor Staging- Metastasis

Answer 3

Mx Distant metastasis cannot be assessed
M0- No distant metastasis
M1- Distant metastasis

Question 4

Purpose of staging

Answer 4

Baseline

Determine tx option and prognosis

Question 5

Intraperitoneal chemo

Answer 5

Abdominal/ovarian cancer

Higher doses provided

Question 6

Intraarterial chemo

Answer 6

Liver only (From colon)

Delivered into hepatic artery. Very high doses chemo.

5 FU and FUDR (Combo)

By pump

Question 7

Intrathecal

Answer 7

For mets to CNS. Tube to spinal fluid.

Cross brain blood barrier

Question 8

Portacath benefits

Answer 8

0 dressing
less heparin
under skin
-may move
-may occlude

Question 9

Most common s/e of chemo

Answer 9

N/v

• premedicate
• relaxation
• no spicy food
• avoid favorite foods
• anti-anxiety meds

Question 10

Management of Diarrhea with chemp

Answer 10

^fiber food
^K+ foods
^fluid intake
Immodium
Call if >24 hr or stanky

Question 11

Managing Mucositis

Answer 11

• Soft nylon tooth brush
• Lidocaine
• Bland, soft, cold foods
• Straw
• Dentist prior to chemo
• pain meds
• Maalox

AVOID

• Salty/sugar/acid/booze
• Whitening toothpaste, mouthwash

Question 12

Cancer fatigue

Answer 12

• Not resolved with rest
• interferes with life
• encourage rest
• administer blood
• assess fluid/electrolyte
• assess meds
• assess nutrition

Question 13

Myelosuppression

Answer 13

• decreased WBC, RBC, PLT

Question 14

Neurtopenia Drug therapy

Answer 14

Neupogen, leukine

IV/SQ

Question 15

WBC WNL

Answer 15

(4.5-11)

Question 16

RBC WNL

Answer 16

(4.5-6)

Question 17

Neutrophil count <500

Answer 17

Severe risk- rating 4

Question 18

Neutrophil count 1500-2000

Answer 18

No risk, normal, Rating 0

Question 19

Thromocytopenia measures

Answer 19

• No IM
• Caution with foley
• Monitor LOC- Intracranial bleed
• Report bleeding

Question 20

Anemia

Answer 20

S/s

• low BP
• Orthostatic BP
• Tachycardisa
• Decreased sat

Give fluids/RBC
Oxygen
OOB with assist

Question 21

Alopecia

Answer 21

Temporary with chemo
Permanent with radiation

Avoid hair dryers/straighteners

Question 22

Top 3 cancers in men

Answer 22

Prostate
Lung
Colorectal

DEATHS
Lung
Prostate
Colorectal

Question 23

Top 3 cancer women

Answer 23

Breast
Lung
Colorectal

DEATHS
Lung
Breast
Colorectal

Question 24

S/s Breast ca

Answer 24

• Redness
• veins
• edema/pitting
• Nipple inversion
• discharge

Question 25

Are Lymph nodes usually palpable?

Answer 25

Nope

Question 26

High risk breast CA screening

Answer 26

Annual mammogram with MRI

Question 27

Excisional lumpectomy

Answer 27

Entire mass, plus margin of skin

Question 28

Incisional biopsy

Answer 28

Surgical- portion of mass

Question 29

Ductal Carcinoma in situ

Answer 29

``` Non-invasive Milk ducts No metz no death Removal of CA without breast ```

Question 30

Invasive

Answer 30

``` Infiltrating ductal (Common, ducts=pathway) Medullary Mucinous tubular inflammatory Paget's ```

Question 31

Risk factors: Breast CA

Answer 31

- female - age - History CA - Family history CA - BRACA1 BRCA2 - Early menarche - Late menopause - No full term pregnancy - Old first pregnancy - hormone therapy - radiation - Obesity - alcohol, high fat diet

Question 32

Chemo Prevention

Answer 32

Tamoxifen, Evista Estrogen blocker

Question 33

Breast CA most likely to spread,,,

Answer 33

Bone, lung, liver, pluera, adreanal, skin, brain

Question 34

Sentinel node

Answer 34

-The first node that receives drainage from primary tumor Found by injecting dye or radioactive isotope into breast and watching for first node

Question 35

Prevention of lymphedema

Answer 35

- avoid IV/injections/blood draws - Avoid BP - Only electric razor - Do not lift more than 5lb - insect/sun repellent

Question 36

Sentinel lymph node biopsy management

Answer 36

Blue/green urine and stool

Question 37

Radiation probably needed for how long?

Answer 37

5-6wks Decreases recurrence

Question 38

SE radiation

Answer 38

``` Erythema Edema Skin breakdown Rash Fatigue ```

Question 39

Combo Chemo time

Answer 39

3-6 mo

Question 40

70% of patients with lung ca have what at time of diagnosis?

Answer 40

Spread to regional lymph nodes

Question 41

Small cell lung CA

Answer 41

Aggressive, quick, rapid spread 10-15% Lower the stage, better the prognosis

Question 42

Non-small cell CA

Answer 42

85-90% Lower the stage, better teh prognosis

Question 43

S/S lung CA

Answer 43

* CHRONIC COUGH* - dyspnea - Hemoptysis - Chest/shoulder pain - Anorexia - weight loss -Asymptomatic until late

Question 44

Diagnostics Lung CA

Answer 44

CXR CT Bronchoscopy with biopsy Fine needle aspiration

Question 45

SE lung radiation

Answer 45

``` Esophagitis Pneumonitis Lung fibrosis Pericarditis Fatigue ```

Question 46

Risk factors colorectal CA

Answer 46

- western culture - age - genetics - IBD - Smoke/drink/fattyfat - High fat, high protein

Question 47

Colorectal CA

Answer 47

-90% survival if caught early, but most not caught early Low rate at late stages Asymptomatic early stages

Question 48

Screening colonoscopy

Answer 48

At age 50 - Blood testing every year -Sigmoidoscopy q3yr Colonoscopy q10yr

Question 49

s/s Butt cancer

Answer 49

Most common- Change bowel habits - blood or tarry stoools - abd pain, constipation, distension

Question 50

Tenesmus

Answer 50

-Gotta poop, can't poop. No poop.

Question 51

Post-op colorectal monitors

Answer 51

- abd assess - bowel sounds - distension - Palpitation - s/s infection - Report stat - --Rectal Bleeding - --Abrupt change in abd pain - --s/s shock Atelectasis Pneumonia

Question 52

Stages Colorectal cancer

Answer 52

``` A- Mucosa B1- Into mucosa B2- Penetrating mucosa C1- Into muscle, nodes C2- Into muscle, nodes D- many spreads ```