Oncology Flashcards

Question

OsteogesarcomaMedical Management

Answer 1

``` Amputation Limb salvage procedure with bone graft and/or hardware Rotationplasty – primarily for femur Chemo 75% survival without mets 30% survival with mets ```

Answer 2

``` Originates in neural crest cells Tumor in vertebral column, rib, sternum, clavicle, pelvis, sacrum, coccyx 2nd most common malignant bone tumor in kids Birth-14 yo 58% survival rate S & S Pain or tenderness at site of tumor Swelling ``` ``` Metastasizes to lungs or other bones Significantly decreases survival rate Medical management Surgical resection XRT Chemo ```

Answer 3

Tumor of soft tissue of muscle cells of head, neck, pelvis, or extremities 0-14 yo urinary tract and reproductive tract also common ``` 45-79% survival rate – the younger the child, the better Signs & symptoms: mass Medical management Surgical resection XRT Chemo ```

Answer 4

Blood counts – check regularly and modify intensity of ex accordingly Bone marrow aspiration/aspiration – painful Lumbar puncture – often on bed rest for 6-24 hours post procedure

Answer 5

``` PLATELETS >50,000 resistive ex OK 20,000-50,000 light aerobic ex only <20,000 no aer. ex WBC >5000 resistive ex OK <5000 no aerobic ex ``` HEMOGLOBIN >10 resistive ex OK 8-10 light aer. ex only <8 no aer. ex **remember, MMT is considered resistance**

Answer 6

Requires 6-8 week hospitalization in laminar flow room with strict compromised host precautions Must bleach any object brought into room Types Autologous: uses patient’s own bone marrow Allogenic: uses bone marrow from compatible donor; much higher risk of rejection Syngenic: uses identical twin’s marrow

Answer 7

One week Total body irradiation and chemo to eradicate disease and immunosuppression to prevent rejection of transplant. This is called the “conditioning phase” and is not done in younger children due to SEs on rapidly growing body Donor marrow harvested surgically via ASIS and PSIS Marrow is filtered, treated, replaced

Answer 8

Time period until engraftment occurs and cell counts rise (WBC, platelets) 10-17 days Complications: graft-versus-host-disease (GVHD) mild to life threatening Rash, itchy skin and/or discoloration, dry mouth and mouth ulcers, GI irritation, wt loss, joint contractures and liver involvement

Answer 9

Routinely ordered on admission for prevention and aerobic care May include bedside program for strengthening, stretching, endurance (bike in room), and balance Educate parent and patient re: role of PT and exercise guidelines when platelets low

Answer 10

May be used before or after surgery Must be aware of side effects of chemo drugs Often delivered via surgically placed catheter such as Broviac or Hickman (inserted into artery or vein for blood draws and chemo) **see Table 16.3 p 388 for drugs/dzs/SEs

Answer 11

May be used before or after surgery Total body irradiation before BMT See Table 16.2 p. 386 for effects of radiation therapy Patient often marked with permanent marker to indicate location of radiation Never put lotion etc. on this area – very prone to burn from XRT

Answer 12

``` Body Function/Structure Range of motion exercises Strengthening exercises Balance/coordination exercises Pain control Activities and Participation Motor learning Aerobic activity (walking, biking, swimming) Participation in sports and age appropriate recreational groups (dance classes, taekwondo) Physical education classes ```