Special Topics Flashcards
What is cancer related fatigue?
Persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning
NOT acute fatigue, which is a physiologic response, recoverable
What are the most common side effects experienced by patients during radiotherapy?
1) Fatigue
2) Drowsiness
3) Pain
What psychological disorder do the mental and emotional effects of CRF resemble?
Depression
What aspects of life does CRF impact?
Occupational, social/behavioral, mental/emotional, including many commonly performed activities and ADLs
What are common PT treatments for lymphedema?
Manual lymph drainage
Exercise
Pressure garments & pneumatic pressure pumps
What is the basic physiologic explanation for swelling (including lymphedema)?
Filtration exceeds absorption, as explained by Starling’s Forces
What is the definition of lymphedema?
An abnormal accumulation of protein-rich fluid due to mechanical insufficiency of the lymphatic system
Lytic bone lesions are common with which forms of CA?
Multiple myeloma
Bone metastasis
What are the common signs and symptoms associated with fracture?
Pain with weight bearing Pain in the groin Pain with hip scour Pain with hip external rotation and abduction Pain with deep inspiration Pain in a band around the chest wall Increased pain with supine Increased pain with valsalva
How can CA result in spinal cord compression?
Can be a primary or secondary phenomenon:
Direct invasion
Disruption of vascular supply
Vertebral collapse
What are the common signs and symptoms associated with spinal cord compression?
Pain that increases when lying supine Pain with valsalva Escalating back pain Motor weakness Sensory deficits Bowel/bladder dysfunction Hyperreactive reflexes
What are the main areas of examination of CA-related pain?
Temporal
Intensity
Topography (location)
Quality
What are the terms to describe elevated and depressed WBC?
Leukocytosis and leukopenia
What are the terms to describe elevated and depressed platelets?
Thrombocytosis and Thrombocytopenia
What are the terms to describe elevated and depressed RBS?
Polycythemia and Anemia
What symptoms might you expect when working with a patient with anemia?
Decreased cardiopulmonary reserve/ limited endurance
Exercise intolerance/ DOE/ tachycardia/ pallor
Is physical therapy contraindicated in pt’s with “severe” anemia (< 8 g/dL)
Perhaps, per some facility’s policies and procedures; in actuality, PT should be fine until lower levels are reached (< 5 g/dL?)
What is the normal physiological response to anemia?
↑ CO ↑ HR & ↑ SV
↑ SV ↓ blood viscosity &↓ vascular resistance = ↓ afterload stresses)
Acute reduction of blood Hb concentration to 50 to 60 g/L (5-6 g/dL) does not result in detectable inadequate systemic O2 delivery
What is the risk of mortality with anemia?
Mortality increases as Hb drops, but does not become significant until 5-6 g/dL
What are the common signs and symptoms associated with an acute transfusion reaction?
Signs: Shock/hypotension Facial flushing Fever, chills Oliguria/ renal failure Bleeding
Symptoms: Abrupt onset Nausea/Vomiting Anxiety Pain in back or flanks Dyspnea
What are the steps of hemostasis?
Vessel injury
Vascular spasm
Platelet plug (primary hemostasis)
Coagulation (secondary hemostasis)
What are the recommended PT interventions for a patient with thrombocytopenia (ordered from mild to severe)?
Low intensity progressive resistive exercise (PRE) and aerobic exercise (none to minimal elevations/ resistance)
AROM exercise, walking ad lib
Risk of spontaneous bleeding, petechia, ecchymosis and prolonged bleeding time.
Therapy may be contraindicated/ minimal AROM
No brushing of teeth
