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OPP III final exam > Osteopathic Considerations in Oncology > Flashcards

Osteopathic Considerations in Oncology Flashcards

1
Q

What are the adult cancers that cause bone metastases?

A
  • Breast
  • Prostate
  • Lung
  • Kidney
  • Thyroid
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2
Q

What are the pathways that cancer can spread?

A
  • Direct extension
  • Lymphatic of hematogenous dissemination
  • Intraspinal seeding (Batson plexus of veins)
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3
Q

What are the adult cancers that cause spinal cord metastases?

A
  • Lung
  • Breast
  • Colon
  • Sarcoma
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4
Q

Cancers that are of marrow origin

A
  • Multiple myeloma
  • Lymphoma
  • Leukemia
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5
Q

Matrix and fibrous tumors

A
  • Osteosarcoma: age 20 or younger
  • Chondrosarcoma: age 40 or older
  • Ewing sarcoma: age 20 or younger
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6
Q

How can tumors effect muscles?

A

Tumors can metastasize to muscles and cause pain and decreased function due to muscle or nerve compression

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7
Q

Conditions that have proximal muscular weakness and are associated with lung and gastric cancer

A

Dermatomyositis

Polymyositis

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8
Q

What is acanthrosis nigricans associated with?

A

Gastric or abdominal malignancies

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9
Q

What is acanthrosis nigricans?

A

Hyperpigmented, hyperkeratotic skin lesion in the flexor areas of axillary, neck, or anogenital areas.

Associated with gastric and abdominal malignancies

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10
Q

Most common pediatric cancer

A
  • Osteosarcoma- during puberty around the knee
  • Ewing’s sarcoma
  • Rhabdomyosarcoma
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11
Q

Clinical presentation of leukemia

A
  • Bone pain secondary to marrow hyperplasia
  • Fatigue
  • Pallor
  • Ecchymoses
  • Infection
  • Fever
  • Anorexia
  • Weight loss
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12
Q

CNS tumor presentation and what should you look for?

A

Presents with headache, ataxia, and gait abnormalities
- Seizures or cranial nerve palsies

Look for hx of a headache while sleeping and absence of a family hx of migraines

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13
Q

What is the most common extracranial solid tumor of childhood?

A

Neuroblastomas

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14
Q

Pediatric cancers with bone metastases (5)

A
  • Neuroblastoma
  • Wilms tumor
  • Osteosarcoma
  • Ewing sarcoma
  • Rhabdomyosarcoma
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15
Q

What is a main chief complaint of people with bone metastases have?

A

back pain

1/3 of pts with cancer develop metastases to the spine

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16
Q

How does pain present in bone metastases?

A

Often begins as dull and intermittent but worsens steadily over several days or weeks

  • Pain at night and at rest is common
  • Passive motion of the adjacent joint is not painful
17
Q

Common sites of bone metastases

A
  • Vertebral column
  • Skull
  • Humerus
  • Ribs
  • Pelvis
  • Femur
18
Q

Red flags to look for in a patient with bone or joint pain

A
  • Unexplained MSK pain
  • Pain in spine or proximal extremities that doesn’t correlate with a known injury
  • Night or rest pain
19
Q

Posterior headache correlates to?

A

High cervical spine metastasis

20
Q

Interscapular pain correlates with?

A

C7-T1

21
Q

Flank, iliac crest, or sacroiliac joint pain correlates with?

A

T12-L1

22
Q

Sacral destruction correlates with?

A

Saddle distribution

23
Q

What is the most specific imaging study for metastatic disease?

A

Plain film radiography- not sensitive, 50% of bone needs to be eroded
- Obtain radiograph of the entire long bone for all painful sites

24
Q

Labs for multiple myeloma

A

Immunoelectrophoresis

25
Q

Labs for prostate cancer

A

Prostate specific antigen

26
Q

Treatment for cancer

A
  • Pain management
  • Assessment for impending fracture
  • Chemo, radiation, systemic radionucleotides, hormone therapy, bisphosphate therapy
  • Surgery
  • Emotional/spiritual support
  • Nutritional
  • OMT
27
Q

Why treat a cancer pt with OMT?

A
  • Empowers pt to live until they die
  • Emotional support- reduces tension and stress
  • Pain reduction
  • Optimization of function especially visceral
28
Q

Indications for OMT

A
  • SD
  • Pain including post surgical pain
  • Prevention or treatment of immobility-related complications in a bed-ridden pt
  • Treatment of extremity lymphedema
29
Q

Contraindications for OMT

A
  • Treatment in the immediate vicinity of the cancer- risk of hematogenous spread
  • HVLA- risk of pathologic fracture of weakened bones
  • Lymphatic pumps and effleurage due to risk of lymphogenous spread
30
Q

When should a bone scan be done?

A
  • If there is a lesion on xray

- Pt has known primary cancer and negative xray

OPP III final exam (14 decks)

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