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Medical Conditions II > Oncology > Flashcards

Oncology Flashcards

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USMLE® Step 1 flashcards
1
Q

Cancer

A

indicates any of various types of growths that are uncontrolled by normal cellular mechanisms

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2
Q

Malignant Neoplasm Synonyms

A
  • Tumor
  • malignancy
  • carcinoma
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3
Q

Types of Cancer

A
  • Primary
  • Secondary
  • Carcinoma in situ
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4
Q

Primary Cancer

A
  • arising from cells local to the structure

- primary cell usually determines behavior of cancer

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5
Q

Secondary Cancer

A

-arising from cells that have metastasized from other sites

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6
Q

Carcinoma in Situ

A

-malignant cell changes in epithelial tissue that do not extend beyond the basement membrane (pre-invasive)

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7
Q

Metaplasia

A

-Reversible change in cell

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8
Q

Dysplasia

A

-permanent abnormal changes in cells

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9
Q

Classifications of Neoplasms

A
  • Epithelial
  • Connective/Muscle Tissue
  • Lymphoid
  • Hematopoietic
  • Miscellaneous (reproductive glands, placenta, thymus)
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10
Q

Staging of Cancer

A
  • distinct phase or period in development of disease

- what is the EXTENT of the disease?

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11
Q

Grading of Neoplasms

A
  • degree of malignancy and differentiation of malignant cells
  • Grade I-IV
  • less differentiated=worse
  • what is the severity of the tumor?
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12
Q

TNM System

A
  • Classifies cancer based on Tumor size, lymph Node status, Metastases presence
  • Tumor, Node, Metastases
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13
Q

Grade I

A

well-differentiated cells

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14
Q

Grade II

A

moderately-differentiated cells

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15
Q

Grade III

A

poorly-differentiated cells

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16
Q

Grade IV

A

Undifferentiated

worst

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17
Q

Sources of Cancer (2)

A
  • Endogenous

- Exogenous

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18
Q

Endogenous Origin

A
  • factors that are outside the patient’s control

- familial pattern/genetic

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19
Q

Exogenous Origin

A
  • risk factors, within patient’s control
  • chemical agents, physical agents, drugs/EtOH, hormones
  • inflammatory disease
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20
Q

Risk Factor Examples

A
  • Age
  • Lifestyle (tobacco, diet, nutrition, sexual behaviors)
  • Geography
  • Ethnicity
  • Stress
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21
Q

What are oncogenes?

A

-gene that is likely to produce or is a marker of cancer

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22
Q

What are tumor suppressor genes?

A

-genes that are good at minimizing tumor growth

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23
Q

What are the mechanisms of the spread of cancer?

A
  • Metastasis

- Invasion

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24
Q

Invasion

A

-growth by direct or continuous extension of the tumor into neighboring tissue

25
Q

Metastasis

A

-growth of neoplastic cells at a remote or non-contiguous site in the body

26
Q

How do metastasis cells travel to new sites?

A
  • bloodstream

- lymphatic system

27
Q

Angiogenesis

A

-creation of new circulation (for secondary tumor)

28
Q

Most common sites of metastasis

A

(L3B2)

-Lymphnodes, lungs, liver, bone, brain

29
Q

Other sites of metastasis

A

-skin, ovaries and adrenal glands

30
Q

Most metastases occur within ________

A
  • 3-5 years;

- but can occur 15-20 after original appearance of disease

31
Q

Common Manifestations of Cancer

A
  • NVR
  • Anorexia and weight loss
  • Pain
  • Fever
  • Cancer related fatigue
32
Q

Primary Prevention

A
  • decrease number of cases/prevalence of cancer

- risk reduction

33
Q

Secondary Prevention

A
  • prevent morbidity and mortality of cancer

- early detection

34
Q

Tertiary Prevention

A
  • managing symptoms, limiting complications, preventing disability disability
  • palliative treatment
35
Q

CAUTION: clinical manifestations of cancer

A 
C-change in bowel/bladder
A-a sore that doesn't heal in 6 weeks
U-unusual bleeding/discharge
T-thickening or lump in breast or elsewhere
I-indigestion or difficulty swallowing
O-obvious changes in wart or mole
N-nagging cough/hoarsness
36
Q

Diagnostics

A
  • Biopsy, endoscopy (invasive)

- CT, MRI (radiologic/noninvasive)

37
Q

Types of Treatment

A
  • Surgery
  • Radiation
  • Chemotherapy
  • Biotherapy
  • Immunotherapy
  • Hormonal therapy
38
Q

Medical Management of Cancer Tx

A
  • Medications other than chemo
  • Alternative care
  • Hospice
39
Q

PT management of cancer treatment

A
  • positioning
  • relaxation techniques
  • biofeedback
  • manual therapy
40
Q

Goals of Intervention

A
  • cure the cancer
  • control the cancer
  • palliative care
41
Q

Progression of Cancer

A
  • complete remission/response
  • partial response
  • no response
  • survival
42
Q

Complete Remission/Response

A

-disappearance of clinically evident disease

43
Q

Partial Response

A

-more than 50% reduction in tumor size

44
Q

No Response

A

-no response to treatment

45
Q

Survival=

A

time from diagnosis to death

46
Q

Prognosis affected by:

A
  • type, stage, grade of cancer
  • type/effectiveness of therapy
  • pt’s general health status
  • age
47
Q

Winningham Precautions:

Platelets

A

<50,000/ml

48
Q

Winningham Precautions:

Hb

A

<10g/ml

49
Q

Winningham Precautions:

Absolute Granulocytes

A

<500/ml

50
Q

Winningham Precautions

A

-precautions to aerobic exercise in chemotherapy patients

51
Q

Winningham Precautions:

WBC

A

< 3,000/ml ; 10,000 with fever (no exercise)

52
Q

Side effects of Chemo

A 
fatigue, 
GI, 
anxiety/depression, 
hepatotoxicity, hemorrhage,
bone marrow suppression, 
anemia, 
infection,
neutropenia, 
thrombocytopenia, 
muscle weakness, 
decreased bone density, 
rash, 
neuropathies, 
hair loss, 
sterilization, 
sexual dysfunction, 
weight loss/gain
53
Q

Side Effects of Radiation

A 
fatigue, 
radiation sickness, 
immunosuppression,
decreased platelets/WBC, 
infection,
fibrosis, 
burns, 
mucositis, 
diarrhea, 
edema, 
hair loss, 
ulceration, 
CNS/PNS effects, 
Malignancy
54
Q

Symptoms of Metastasis: Lung

A

-cough, pleural pain, SOB

55
Q

Symptoms of Metastasis: Liver

A

-abdominal pain, RUQ pain, malaise, fatigue, anorexia, weight loss, fever

56
Q

Symptoms of Metastasis: Bone

A

-deep pain worsening with activity, pathologic fractures

57
Q

Symptoms of Metastasis: Brain

A

-cognitive impairment, headache, reduced sensory/motor function

58
Q

Symptoms of Metastasis: Lymphnodes

A

-lymphedema

Medical Conditions II (34 decks)

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