pancreatic cancer

Question 1

occurs more frequently in men or women?

Answer 1

men

Question 2

survival rate of pancreatic cancer

Answer 2

5%

Question 3

increased risk with

Answer 3

age 
smoking 
chemical or toxin exposure 
certain petroleum 
etoh, high fat and protien, low fiber may increase risk

Question 4

10-20% of those diagnosed with pancreatic cancer also are having

Answer 4

diabetes

Question 5

why is pancreatic cancer called the “silent disease”?

Answer 5

early cancer does not cause symptoms
if tumor blocks the common bile duct then he bile can not pass into the digestive system
they m

Question 6

if tumor blocks the common bile duct then he bile can not pass into the digestive system

Answer 6

pt will become jaundice

Question 7

pain of pancreatic cancer can

Answer 7

develops in upper abdomen then back

be caused when a person lies down or eats

Question 8

s/s of pancreatic cancer

Answer 8

nausea, loss of appetite, weight loss, weakness

Question 9

clinical manifestations of pancreatic cancer

Answer 9

present of pain and jaundice
rapid/progressive wt loss
mid to upper abd pain unrelated to GI function
pain/dysfunction described as boring to mid back pain unrelieved by posture or activity
worse in supine position
pain is relived sitting up and leaning forward
pain is progressive and severe, requires use of opioids for pain relief
disease is progressed (jaundice and pruitis)

Question 10

assessment of pancreatic cancer

Answer 10

appearance of jaundice 
clay colored stools 
dark urine 
dry skin 
fatigue 
dull pain associated w eating 
back pain w nerve plexus
anorexia w early satiety, nausea, flactulance, vomiting, gi bleed  
diabetes

Question 11

what can occur w late state pancreatic cancer?

Answer 11

ascites

Question 12

whats gonna be elevated w pancreatic cancer?

Answer 12

amylase, lipase, alkaline phosphate, bilirubin, CEA, DU-pan 2

Question 13

Du-pan2 test

Answer 13

non specific for carcinomas

Question 14

dx studies

Answer 14

angiogram
ct
mri
ERCP (special xray of bile duct)

Question 15

Percutaneous trans-hepatic biliary drain

Answer 15

aspiration of fluid, also reveals malignant cells and elevated amylase

Question 16

types of tumors

Answer 16

head of pancreas- bile duct blockage

islet tumors- hyperinsulinemia

Question 17

pre op whipple

Answer 17

high protien diet 
hydration 
correct pt w vit k 
tx anemia 
TPN 
biliary shunt may be placed to decrease jaundice

Question 18

hyperinsulinism

Answer 18

caused by over production of insulin islet cells
s/s: decreased bgt
trx: po/iv glucose
needs to have a surgical excision of hyperplasia

Question 19

ulcerogenic tumors

Answer 19

zollinger-ellison syndrome: islets hypersecrete ulcers gastric acid and cause ulcers to form
surgical intervention is needed

Question 20

use of radiation with pancreatic cancer

Answer 20

pallative reasons- decrease tumors and decrease pain

does not improve the survival rates

Question 21

survival rate of a non resectable pancreatic tumoe

Answer 21

6 months

Question 22

surgical interventions for a pancreatic tumor stage I or II

Answer 22

total pancreatectomy

whipple

Question 23

nis for post pancreas surgeries

Answer 23

tpn
monitor BG
nutritional support
enteral feeds/ tpn

Question 24

post op whipple

Answer 24

ng suction 
tpn to rest gut 
pitting edema 
volume needs to be replaced 
monitor bgts 
h/h 
subacute rehab is most likely needed

Question 25

ng drainage post op whipple

Answer 25

should be serosanguinous not colorless or bile tinged or frank blood

Question 26

why is a thrombophlebitis likely after a tumor resection

Answer 26

increased levels of thromboplastic factors in the blood and necrotic properties results in bloods hypercoagulated state
(also due to bed rest)