Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced MNT 1 > Stem Cell Transplantation > Flashcards

Stem Cell Transplantation Flashcards

1
Q

Blood stem cells are produced in the _________ and can become any kind of blood cell the body needs

A

bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stem cells are constantly dividing and maturing into different types of _________, replacing older and worn ones in the body

A

blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

They produce billions of new blood cells _______
If the stem cells cannot make enough new blood cells, many serious health problems can occur

A

every day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

______ are immature blood cells that are removed from the blood or bone marrow of the patient or a donor, then ______ and stored

A

stem cells
frozen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

High doses of chemotherapy and/or radiation therapy are needed to __________ that is producing the cancerous cells, followed by the transplant.

The infused stem cells replace the blood
destroyed by the cancer treatment by growing into and restoring the body’s blood cells

A

kill existing bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Currently, 85% of transplants performed at UPMC Cancer Center use stem cells from _______ blood

A

peripheral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SCT has the potential to cure a variety of benign & hematologic diseases that may be incurable with conventional therapy. This will ______, not necessarily cure

A

add years of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

common diseases treated with SCT

A

leukemia
lymphoma
myelodysplastic syndrome
multiple myeloma
aplastic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SCT allows high doses of chemotherapy and/or radiation therapy to be used on these diseases

________ becomes depressed due to the higher doses used and the transplanted stem cells will eventually restore normal blood cell production

A

Bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

_____ is from self

Stem cells are harvested from the patient prior to other __________, purged of ________ cells, and transplanted into the patient

Auto SCT is commonly used for lymphomas, myeloma and testicular cancer, less commonly used for _______

Predominant type of transplant used in _______

A

Autologous

cancer treatments
abnormal

leukemia

older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

_______ is from another person

Physicians collect and transplant stem cells from a donor who matches the recipients’ cells

either from __________ or __________

A

Allogenic

Sibling (SIB)
Matched unrelated donor (MUD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Identicle twin is ________

A

syngenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Umbilical Cord Blood Transplants

Stem cells are harvested from umbilical cord blood and transplanted

research has shown that umbilical transplants are_________ as transplants from unrelated donors

A

just as effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

_____________

Half-matched bone marrow transplant that has been successful in “curing” patients of some cancers and blood disorders

Physicians administer just enough chemotherapy to suppress the immune system, which keeps patients from rejecting the donated marrow without harming their organs
Milder side effects
Expands the potential donor pool, making more patients eligible for the transplant

A

Haploidentical Transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

in the Haploidentical Transplantation physicians administer ____________ to suppress the immune system, which keeps patients from ___________ without harming their organs
______ side effects
Expands the potential donor pool, making more patients eligible for the transplant

A

just enough chemotherapy
rejecting the donated marrow
Milder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

SCT consists of three major parts:

A

Conditioning phase
Infusion of SCT
Engraftment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Conditioning phase is Designed to ______________ without causing fatal organ toxicity

The choice of conditioning regimen varies based on patient and disease characteristics as well as donor availability

After conditioning is complete, patient receives the stem cell infusion

A

destroy tumor cells resistant to conventional doses of chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Stem cell infusion
cells are infused through patients’ _______ over several _______

Patients are closely monitored for fever, chills, hives, lowblood pressure & shortness of breath

A

central line
hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

________ is when donated stem cells take hold & begin producing normal blood cells

Defined at UPMC SHY, WBC are considered in this stage when the ANC is ______ for ____ consecutive days or ______ on one day

defined as an unsupported count greater than _______

A

engraftment

> 500
two
1000 cells

20,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Advantages of Autologous

A

No HLA matching requirement

No GVHD

No need for immune suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Advantages of Allogenic

A

Stem cells have not been exposed to chemotherapy

Stem cells product is free of tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Disadvantages of autologous

A

Possibility of stem cell damage from prior therapy leading to delay in engraftment

Possibility of contamination with tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Disadvantages of allogenic

A

Donor availability uncertain
GVHD
Higher risk of complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Autologous has _____ Risk of complications, ______ risk of relapse

A

lower
Higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Allogenic has _____ Risk of complications, ______ risk of relapse

A

higher
lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Outcome of SCT depends on many patient factors such as

A

age
disease factors
donor factors
transplantation factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

problems impacting intake

A

appetite
GI symptoms
mucositis, stomatitis, xerostomia
taste alterations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

After transplantation, patients should receive a __________ comprised of food that contains low numbers of potentially harmful microbes

A

low microbial diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

low microbial diet include…

A
  • Avoid raw honey
    – Do not keep leftovers for >3 days
    – Do not share food and drinks with other people
    – Make sure all dairy products are pasteurized
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

UBW/pre-illness weight
IBW
adjusted weight for IBW >______
weight loss history
_________ patients prognosis is less favorable

A

120%
Underweight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

biochemical data that is looked at

Serum Proteins
–
–
Liver function tests (LFT’s) Absolute Neutrophil Count (ANC) Platelets, WBC

A

serum proteins
- albumin
- pre albumin (desired)

BMP

liver function tests

absolute neutrophil count

platelets, WBC

32
Q

Low absolute neutrophil count (ANC) of <______ recommended low microbial diet

A

500

33
Q

Energy/Calorie Needs
Immediate post transplant needs
________ kcal/kg/actual weight, however usually go between _______kcal/kg

Use _________ if pt is overweight/obese

A

25 to 35
30 to 35

adjusted body weight

34
Q

Protein Needs
SCT - _______ gm/kg

metabolic stress, corticosteroids treatment, GVHD - _____ gm/kg

adjusted for renal failure and/or hepatic encephalopathy - ____

A

1.3 to 1.5
1.5-2
0.8

35
Q

for nausea and vomiting
Recommend _________ foods, __________ meals throughout the day, open dishes on _________, eat when not nauseated or after ________ given

A

cold bland
small frequent
other side of room
antiemetic

36
Q

anorexia/loss of appetite

Small frequent meals. Even if not hungry at all, encourage pt to eat at least a little, but not too much. Sometimes it’s ok if they _____________

A

can’t eat much for a couple days

37
Q

diarrhea

May be afraid to eat, encourage adequate hydration & may need __________

A

soft GI diet/low fiber diet

38
Q

_______ Caused by injury to the mouth tissue from conditioning regimens and/or radiation

Severe can lead to severe pain, hemorrhage, infection, upper airway edema & airway compromise

Supportive care includes ______________

Preventive care includes _______ and _______ therapy

A

Mucositis

opioids, good oral hygiene, avoidance of spicy, acidic, hard and hot food/beverages & use of saline rinses

cryotherapy and laser

39
Q

Mucositis is one of the main reasons why _____ is not frequently used.

Feeding tube can______ the mucous membranes, making it difficult to place a tube. ______ may be required

A

EN
irritate

TPN

40
Q

a noninvasive simple and atraumatic therapeutic management corresponding to a local application of a high-density monochromatic narrow-band light source to prevent mucositis

A

Low Level Laser Therapy (LLLT)

41
Q

LLLT is becoming more common in the clinical setting as a treatment option for preventing and treating oral mucositis

Promotes _____
Reduces oral mucositis incidence and its ______

A

pain relief
severity

42
Q

xerostomia recommendations

A

Mouthwashes without alcohol
Sugarless gum or hard candies
Mouth moisturizer, artificial saliva
Moist foods with extra sauces and gravies

43
Q

hypoguesia is _________

dysguesia is ________

A

reduced ability to taste things

distortion of the sense of taste (ex: metallic taste)

44
Q

tips for taste changes include using _______, ________, something _____ before the meal, _______

A

plastic utensils and plates
seasonings
tart (lemon drop)
saline or baking soda mouth rinse

45
Q

one of the reason EN not used is because placing tube may cause _______

A

irritation with bleeding

46
Q

Major complications that can occur after an allogenic SCT in which the newly transplanted material attacks the transplant recipient’s body

A

graft versus host disease (GVHD)

47
Q

Acute GVHD…
onset is _____ s/p SCT

A

≤100

48
Q

organs mostly affected by acute GVHD

A

skin
liver
gut

49
Q

symptoms of acute GVHD

A

maculopapular rash
anorexia
diarrhea
abdominal cramps
ileus or hepatitis

50
Q

how do they diagnose acute GVHD

A

biopsy

51
Q

MNT for acute GVHD general

A

specialized diets in five stages

52
Q

syndrome that has features resembling autoimmune and other immunologic disorders

A

chronic GVHD

53
Q

chronic GVHD symptoms usually appear ____ after all SCT and often proceeded by a history of ______

A

3 years
acute GVHD

54
Q

chronic GVHD manifestation can be ____ or _____

A

one organ or widespread

55
Q

Diagnosis of chronic GVHD requires what

A
  1. distinction from acute GVHD
  2. at least one clinical sign of chronic GVHD or at least one manifestation confirmed by biopsy or other tests
  3. exclusions of other possible diagnoses
56
Q

It is important to alter ____when making
the diagnosis of GVHD of the gut, once
diagnosis is confirmed

The phase of the diet refers to the
patients symptoms and guides the
dietitian/clinician as to which stage diet
should be followed

Progression of diet occurs as ________________ and can vary patient to patient

A

diet

symptoms improve

57
Q

phase one symptoms

A

cramping
voluminous diarrhea
nausea
emesis

58
Q

phase one diet plan

A

NPO for bowel rest

TPN with increased calorie and protein needs
(35 kcal/kg and 1.8 g/kg)

59
Q

phase 2 symptoms

A

diarrhea volume decreasing
forming of stool
less to no cramping
no emesis

60
Q

phase 2 diet

A

TPN if already started

clear, isotonic, low residue, lactose free beverages

61
Q

phase 3 symptoms

A

stool is formed (pudding like)
no emesis
decreasing diarrhea
toleration phase 2 diet

62
Q

phase 3 diet

A

wean TPN as oral intake increases

progress to solid foods

limit fat intake (20g/day), lactose free, low insoluble fiber, no gastric irritants, high soluble fiber

63
Q

phase 4 symptoms

A

formed stool
minimal cramping
tolerating >50% of needs orally

64
Q

phase 4 diet

A

wean TPN

expand diet by adding more starches, protein, and fatty foods. continue lactose free

65
Q

phase 5 symptoms

A

no GI cramping
normal stool
normal transit time

66
Q

phase 5 diet

A

discontinue TPN

advance diet to regular by adding one new food per day and assess tolerance

67
Q

The patient’s nutritional status, ability to eat and degree of oral and GI toxicity determine if TPN is indicated

– For patients with a high degree of ________
including GVHD of the gut, TPN may be initiated. For patients with ________ conditioning regimens, the period of inadequate oral intake may extend longer before TPN is considered

– At Shadyside the ______________
team will determine if patients are deemed appropriate for TPN

A

GI toxicity
less toxic

Nutrition Support Service (NSS)

68
Q

For post transplant Discharge:
– Engraftment
– There is no indication of ________
– Tolerance of ________
– Able to eat and drink to get sufficient fluids
and nourishment
– No severe treatment complications
– The patient is medically stable and physically able to function outside the hospital

A

infection
medications

69
Q

Shorter recovery period after _________ stem cell transplantation than after
__________ stem cell transplantation.

A

autologous
allogeneic

70
Q

Autologous transplant often takes the immune system ________
to recover

Allogenic transplant often takes ___________ to recover nearly normal blood cell levels and immune cell function

Immune recovery can take longer if the patient
has ______

A

3 to 12 months

at least 6 to 12 months
GVHD

71
Q

early recovery post transplant diet

A

well balances for recovery and repair
blood glucose control
electrolytes

72
Q

tips for early recovery dining out…

Eat early to ______
Ask that food be made ______
Avoid ___________ when dining out
Do not eat salsa or other __________ that are not refrigerated
Ask for __________ condiment packages
Avoid salad bars, buffets, etc.
Check the overall condition of the restaurant

A

avoid crowds
fresh
raw fruits and vegetables
fresh condiments
single-serving

73
Q

Long-term complications
– _____ complications
– ______ system
– Risk for bone loss and subsequent _______
– Infertility
– Chronic GVHD
– Mental health
– Relapse
– Secondary cancer

A

Organ
Endocrine
osteoporosis

74
Q

“Alternative” and “Complementary” often used interchangeably, but the two terms refer to different concepts:

– If a non-mainstream approach is used together with conventional medicine, it’s considered “________.”

– If a non-mainstream approach is used in place of conventional medicine, it’s considered “________.”

A

complementary
alternative

75
Q

A substantial amount of scientific evidence suggests that some complementary health approaches may help to manage some symptoms of cancer and side effects of treatment. For other complementary approaches, the evidence is more limited

Disease treatment. At present, there is no convincing evidence that any
complementary health approach is ________ in curing cancer or causing it to go into remission

Cancer prevention. A 2012 study indicated that taking a
_________ supplement may slightly reduce the risk of cancer in older men. No other complementary health approach has been shown to be helpful in preventing cancer

A

effective

multivitamin/mineral

76
Q

CAM approaches for cancer

A

acupuncture
ginger
massage therapy
mindfulness stress reduction
yoga
hypnosis
herbal supplements

Advanced MNT 1 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions