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Med Surg > Oncology Part 3 > Flashcards

Oncology Part 3 Flashcards

1
Q

uncontrollable growth of WBC (immature/blasts) in bone marrow

A

leukemia

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2
Q

describe leukemia

A

overcrowding of immature, nonfunctioning cells in bone marrow (decrease in normal production)

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3
Q

what are the types of leukemia

A

acute, chronic, lymphocytic, myelocytic

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4
Q

immature cell

A

blast

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5
Q

describe acute leukemia

A

immature cells

no function

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6
Q

most common acute in adults

A

AML

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7
Q

10% adult onset
common in kids
Philadelphia chromosome

A

ALL

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8
Q

sudden onset, short duration
progress to death without intervention
S/S within weeks

A

ALL

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9
Q

what is the major cause of death in leukemia pts

A

INFECTION- gram bacteria are most common problem

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10
Q

s/s of acute leukemia

A 
*vague overall symptoms
cardiovascular
respiratory
bleeding
wt loss, nausea
organ enlargement
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11
Q

20% of adult onset

insidious onset

A

CML

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12
Q

phases of CML

A

1) slow progressing (10% blast)
2) accelerated (10-30% blast): spleen enlarges, fever, wt loss (6-12 mos)
3) blast (30% blast) spread to other tissue

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13
Q

this type of leukemia RARE
> 50 yo
survival time= <19 mo for advanced
vague symptoms

A

CLL

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14
Q

phases in acute drug treatment

A

induction, consolidation, maintenance

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15
Q

induction stage of acute drug treatment

A
  • aggressive chemo
  • causes severe bone marrow suppression (kill ALL cells)
  • s/s of chemo
  • 2-3 wks then look at ANC levels (how susceptible to infection)
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16
Q

consolidation stage of acute drug treatment

A

course of same or different drug to put in remission

GOAL=decrease in blast cells (CURE)

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17
Q

maintenance stage of acute drug treatment

A

months-years (maintain remission)

low dose chemo as needed

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18
Q

lab tests for leukemia

A
  • bone marrow biopsy to identify an increase blast and immature cells
  • antigens on cells mark type of leukemia
  • Hb and HCT decrease
  • platelet count decrease
  • WBC normal or increase
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19
Q

WBC count in leukemia pt if cells are mature

A

decrease

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20
Q

chronic drug therapy for leukemia

A

don’t need to know

just watch and wait

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21
Q

describe bone marrow transplant

A

pt gets new bone marrow
kill existing marrow, attempt to reset
HSCT
*treatment for leukemia pt

22
Q

where does bone marrow come from in a transplant

A

allogenic-matched donor HLA
autogoes- own stem cells
syngenic-identical sibling

23
Q

what is HSCT

A

hematopoietic stem cell transplant

24
Q

phases of bone marrow transplant

A

1) obtain stem cells
2) conditioning
3) transplantation
4) engraftment

25
Q

describe conditioning phase

A

wipe out additional cells
void of immune system
NEED transplant or die of infection

26
Q

describe transplantation

A

day 0
infused through central line
s/s: fever, HTN

27
Q

describe engraftment

A

successful take
12-28 days for bone marrow to take
**want ANC >500
ONLY donor cells present

28
Q

what does oma mean

A

tumor

29
Q

BMT complications

A

infection, bleeding
failure to engraft
VOD
GVHD

30
Q

what is VOD

A

veno occlusive disease
blocks liver blood vessels by clotting/inflammation
20% of pts develop this

31
Q

what is GVHD

A

graft vs host disease
graft cells attack host cells of skin, GI tract, and liver
visible side effects (NOT DEATH)
*means body is reacting to transplant

32
Q

describe multiple myeloma

A
  • bone disease
  • WBC cancer that involves either B or T cells
  • overproduce antibodies-become ineffective
33
Q

multiple myeloma is cancer of what

A
  • plasma cells that fight infection

- produce cytokines that cause bone destruction

34
Q

elevated paraprotein and plasma cells
uncommon
NOT good prognosis

A

multiple myeloma

35
Q

describe malignant lymphomas

A

cancers of lymphoid tissue
SOLID TUMOR (clumped up lymph cells)
PAINLESS growth/lump

36
Q

types of malignant lymphomas

A

Hodgkins (HL)

Non-Hodgkins (NHL)

37
Q

describe HL

A 
treatable 
external radiation
Reed Sternberg cell
confined to lymph nodes
orderly to progression
38
Q

describe NHL

A 
more difficult to treat chemo, radiation
travels
no Reed S
non orderly progression
classified as B or T cells
39
Q

more common in transplant and HIV patients

nodes are in GI, skin, bone marrow, sinuses, thyroid

A

NHL

40
Q

what do you treat NHL with

A

chemo, radiation, antibodies, stem cell transplants and vaccine therapy

41
Q

clinical symptoms of malignant lymphomas

A

large, painless lymph nodes
begin on neck
fever, night sweats, wt loss

42
Q

diagnosis of malignant lymphomas

A

biopsy of lymph nodes

staging= PET and CT scan

43
Q

what is Hb and normal levels

A

hemoglobin

12.1-17.2 g/dL

44
Q

what is the key to remember for sickle cell disease pts

A

PREVENT crisis

45
Q

describe sickle cell disease

A
  • hereditary disorder (genetic)
  • affects African American pts most
  • leads to chronic anemia
  • pain, disability, organ damage
46
Q

what are you at risk for if sickle cell disease

A

increase risk for infection

47
Q

what is different in sickle cell disease

A

beta cell chains (HbS)

HbS make up about 40% of blood

48
Q

describe HbS in sickle cell pts

A

sensitive to low Oz content of RBC
this causes cells to pile together, become sticky, rigid and clump together
FRAGILE

49
Q

HbS cause what

A

poor blood flow

clumping up ALL over body (not just one area)

50
Q

what is the big sign of sickle cell crisis

A

*diffuse widespread PAIN

crisis or vasocclusive event

51
Q

what can occur if sickle cell crisis or vasocclusive event occur often

A

can cause organ damage, muscle destruction

*long term management is VITAL

52
Q

how long do HbS cells live

A

12-15 days

Med Surg (23 decks)

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