Quiz (Oncology) #2 prep

Question 1

What is the difference between a benign tumor and a malignant tumor?

Answer 1

Bening tumor - differentiated cells, capsulated, allowing expansion but do not spread to other tissues.
Malignant tumor - undifferentiated cells, encapsulated, invades other tissues causing destruction.

Question 2

What is the difference between primary and secondary tumors?

Answer 2

primary - original tumor in the original location.

secondary - tumors or cancer has metastasized or moved from the primary site.

Question 3

What is a neoplasm?

Answer 3

“new growth” pertaining to an abnormal mass of tissue that is excessive, persistent, and unregulated by physiological stimuli.

Question 4

What is a tumor?

Answer 4

common medical language for a neoplasm.

Question 5

What is cancer?

Answer 5

term for disease in which abnormal cells divide without control and can invade nearby tissue.

Question 6

What is dysplasia?

Answer 6

variability of cell size and shape with an increased rate of cell division (mitosis). Can be a pre-cancerous change or a result of chronic infection.

Question 7

What is metaplasia?

Answer 7

replacement of one mature cell type by a different mature cell type, resulting from certain stimuli such as cigarette smoking.

Question 8

What is hyperplasia?

Answer 8

an increased number of cells resulting in an enlarged tissue mass. It may be a mechanism to compensate for increased demands, or pathological when there is hormonal imbalance.

Question 9

What is differentiation?

Answer 9

the extent to which a cell resembles mature morphology and function.
A cell that is well differentiated is physiological and functions as intended.
A poorly differentiated cell does not resemble a mature cell in both morphology and function.

Question 10

Most cancers probably develop from a combination of ______ and ___________ factors.

Answer 10

genetic; environmental

Question 11

What are the 4 things the American Cancer Society says contribute to or cause several types of cancers?

Answer 11

1. cigarette smoking
2. heavy alcohol use
3. physical inactivity
4. being overweight or obese

Question 12

Signs and symptoms of cancer are most often due to the tumor’s ______ and ________ of surrounding tissues.

Answer 12

growth; invasion

Question 13

What are the general signs and symptoms that may be indicative of early or progressive cancer include?

Answer 13

unusual bleeding or discharge
unexplained weight loss of more than 10 lbs
fever
fatigue
pain
persistent cough or hoarseness w/o known cause
skin changes (hyper-pigmentation, jaundice, erythema, pruritus, excessive hair growth)

Question 14

What are the general goals and guidelines for the physical therapist working with patients with cancer?

Answer 14

1. optimize functional mobility
2. minimize or prevent cancer-related fatigue
3. prevent joint contracture and skin breakdown
4. prevent or reduce limb edema
5. prevent post-op pulmonary complications

Question 15

If a patient is cleared for exercise, what does the physical therapist need to do before prescribing a cancer patient exercise?

Answer 15

evaluate fatigue level and determine the need for medical intervention

Question 16

If cleared for exercise when should you begin program with a caner patient?

Answer 16

when patient starts cancer treatment and continue until the end of treatments

Question 17

Before exercise sessions the physical therapist should?

Answer 17

evaluate the patient to rule out instability and/or decline in medical status

Question 18

When should the physical therapist monitor vital signs when exercising a cancer patient?

Answer 18

before, several times during, and after (HR, BP, O2%)

Question 19

What are the exercise prescription guidelines for cancer-related fatigue?

Answer 19

aerobic = >20min, 40-60% HHR, 3-5 day/week
resistive = 1-2 sets of 8-12 reps (all muscle groups) (1x8-15reps for endurance), 60-70% of 1RM (30% more fatigued pt), 2-3 day/week
Flexibility = 4 reps of 10-30 sec holds static stretch, >2 days/week

Question 20

When preforming mobility or exercise treatments with cancer patient with low platelets, take care to avoid?

Answer 20

brusing or bleeding into joint spaces

Question 21

If patient is in isolation precautions what is recommended after using equipment?

Answer 21

clean/disinfect and keep in patients room

Question 22

What are PT considerations when working with a patient with head and neck cancer?

Answer 22

after surgical procedure determine if pt has activity/ROM orders or restrictions
assess for adventitious breath sounds and effectiveness of airway clearance
PT treatments to restore posture and neck, shoulder, scapulothoracic, and TMJ motion
consider potential difficulties with speech, chewing, swallowing, loss of sensation
RR can be impaired due to muscle

Question 23

What are PT considerations when working with a patient with breast cancer?

Answer 23

clarify physicians orders (UE ROM) once clarified examine ROM in shoulder and neck region
possible post-op complications (nerve injury, pain, edema)
possible drains and splinting incisions
teach log-roll technique (opposite side of mastectomy)
minimize muscle contractions
lymphedema management

Question 24

The overall purpose of chemotherapy is to _______ various signaling pathways that control cancer cell proliferations, ________, __________, angiogenesis, and cell death.

Answer 24

inhibit; invasion; metastasis

Question 25

PT considerations for cancer patients?

Answer 25

side-effects of nausea and vomiting
effects on appetite, ability to consume and absorb nutrients
coordinate around patients medication schedule
always be monitoring vital signs
monitor platelet, RBC, WBC
patient can become neutropenic and at risk for infections and sepsis

Question 26

What are the stages of cancer using the TNM system?

Answer 26

T= primary tumor, N= regional lymph nodes, M= metastasis
X= cannot be assessed
0= no evidence 
1,2,3,4= progressive increase/involvement
example = T0 means no evidence of primary tumor

Question 27

Define the grading of neoplasms?

Answer 27

GX= undetermined grade, cannot be assessed
G1= low grade, well-differentiated tumor
G2= intermediate grade, moderately differentiated tumor
G3= high grade, poorly differentiated tumor
G4= high grade, undifferentiated tumor

Question 28

Patient with advanced stages of multiple myeloma may be __________.

Answer 28

dehydrated so ensure proper hydration before interventions

Question 29

What should be done before mobilizing anyone with a bone lesion?

Answer 29

obtain activity clearance from physician

Question 30

What is neurologic sequelae include?

Answer 30

cognitive deficits, skin changes, bowel & bladder control problems, sexual dysfunction, need for assistive devices and positioning devices.

Question 31

Will a patient who is experience deficits due to compression of CNS experience the deficits once the compression is removed?

Answer 31

yes they can