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NUR 239 > Test #5: Oncology > Flashcards

Test #5: Oncology Flashcards

1
Q

What is The most important risk factor for lung cancer?

A

Smoking

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2
Q

What percentage of deaths from lung cancer are caused by smoking?

A

90% of men/80% of women

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3
Q

What is the most effective non-invasive way to evaluate lung cancer?

A

CT scan

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4
Q

What are the 7 warning signs of cancer represented by the acronym “CAUTION”?

A

C-hange in bladder or bowel habits
A-sore that does not heal
U-nusual bleeding or discharge from any body orifice
T-hinkening or a lump in the breast or elsewhere
I-ndigestion or difficulty swallowing
O-bvious change in a wart or mole
N-agging cough or hoarseness

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5
Q

Why is the TNM staging system not used in small-cell lung cancer?

A

Because small cell is very aggressive and is always considered systemic.

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6
Q

In addition to chemotherapy, what treatment would be used in a patient with small-cell lung cancer to prevent cerebral metastases?

A

Prophylactic Cranial Radiation

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7
Q

Most lung cancer arise from which type of cells?

A

Bronchial epithelial cells

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8
Q

An organ/transplant from one’s own body is called?

A

Allogenic

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9
Q

How many men develop prostate cancer

A

1 out of 5

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10
Q

chemotherapeutic drugs can be divided into….

A

Irritants and vesicants

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11
Q

When can a cancerous lesion be detected on an X-ray?

A

At 1cm diameter. Cells grow slowly and take about 8-10years to become 1cm.

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12
Q

What are the two types of lung cancer?

A

NSCLC-80% and SCLC-20%

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13
Q

How does cancer metastasize?

A

By direct extension and via blood and lymph system

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14
Q

What are the s&s of Lung cancer?

A

Cough that is producing sputum, persistent pneumonitis r/t obstruction causing fever chills and cough, blood tinged sputum, dyspnea and wheezes

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15
Q

How is Lung cancer most commonly caught?

A

Chest X-ray

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16
Q

What is the most effective non-invasive evaluator of Lung cancer?

A

CT

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17
Q

What is the only definitive diagnosis of lung cancer?

A

Biopsy

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18
Q

How is NSCLC staged?

A

With TNM. T=tumor size, N=regional lymph node involvement, M=the presence or absence of metastasis

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19
Q

How is SCLC staged?

A

Limited and extensive. (Limited – confined to the chest and regional lymph nodes) (Extensive – extends to chest wall or other parts of the body)

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20
Q

CAUTION - C

A

Change in bowel or bladder habits

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21
Q

CAUTION - A

A

A sore that does not heal

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22
Q

CAUTION - U

A

Unusual bleeding or discharge

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23
Q

CAUTION - T

A

Thickening or lump in the breast, testicles, or elsewhere

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24
Q

CAUTION - I

A

Indigestion or difficulty swallowing

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25
Q

CAUTION - O

A

Obvious change in the size, color, shape, or thickness of a wart, mole, or mouth sore

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26
Q

CAUTION - N

A

Nagging cough or hoarseness

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27
Q

What race has the highest incidence of lung cancer?

A

African-American

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28
Q

after smoking cessation how much does risk of lung cancer decrease

A

30-50%

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29
Q

which gender is at the greatest risk for lung cancer

A

women (greater risk, younger age, and more likely to have SCLC)

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30
Q

what are the common site for metastatic growth of Lung cancer

A

liver, brain, bones, scalene lymph nodes, and adrenal glands

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31
Q

what is a paraneoplastic syndrome

A

consequence of the process of cancer in the body but not due to the local presence of cancer cells or direct invasion of strutcural metastasis

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32
Q

what are examples of paraneoplastic syndrome

A

hypercalcemia, SIADH, anemia,leukocytosis, hypercoagulable disorders, and neurological syndromes

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33
Q

which type of cancer is most associated with paraneoplastic syndrome

A

SCLC

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34
Q

how does a PET scan reveal lung cancer

A

measures metabolic activity in tissue. (Malignant tissue is more metabolicly active than normal tissue so it shows up readily

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35
Q

what type of lung cancer is more common in people who haven’t smoked

A

adenocarcinoma

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36
Q

what is the prognosis of SCLC

A

only 10% of people who receive aggressive treatment survive 2 years or more. on average pt’s only survive 7-10 months

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37
Q

what is treatment of choice for NSCLC of stages 1 and 2

A

surgical resection

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38
Q

what percentage of NSCLC patients are diagnosed too late surgery

A

50%

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39
Q

when is radiation used as a primary therapy

A

in a patient who is unable to tolerate surgical resection due to comorbidities

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40
Q

what symptoms are relieved by radiation

A

dyspnea and hemoptysis from bronchial obstructive tumors. Treats pain by metastatic bone lesions or cerebral metastasis. Also treats superior vena cava syndrome.

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41
Q

why is radiation used before surgery

A

to shrink tumor mass

42
Q

what are common complication of radiation therapy?

A

esophogitis, skin irritation, and radiation pneumonitis

43
Q

what is stereotactic radiotherapy

A

new type of radiation therapy that delivers high doses very accurately

44
Q

which part of population are most benefited by stereotactic therapy

A

geriatric, pt’s with severe lung or heart disease. (anyone who is not a canadate for surgery

45
Q

what is the primary treatment for SCLC

A

chemotherapy (usually a combination of two or more drugs)

46
Q

which chemotherapy drugs are frequently used to treat lung cancer

A

vepesid, paraplatin, platinol, taxol, navelbine, cytoxin, efex, taxotere, gemzar, alimta

47
Q

what is “biologic and targeted” therapy

A

the use of drugs the block the growth of molecules involved in specific aspects of tumor growth (less toxic than chemotherapy)

48
Q

MOA of tarceva (biologic and targeted therapy)

A

treatment of NSCLC by blocking growth stimulating signal

49
Q

MOA of avastein (biologic and targeted therapy)

A

inhibits angiogenisis thereby preventing the growth of cancer cells

50
Q

why is prophylactic cranial radiation important in addition to chemotherapy

A

because most chemotherapy agents do not cross the blood brain barrier

51
Q

what is photodynamic therapy

A

photofrin is injected IV - percolates 48 hrs - laser light turns O2 toxic to destroy tumor - necrotic tissue removed via bronchoscope

52
Q

priority goal in patient with lung cancer

A
  1. effective oxygenation
    2 pain management
    3 realistic attitude
53
Q

Nursing interventions should include

A

recognizing stresors/anxiety and offering support

54
Q

what symptoms should a patient during treatment be taught to report

A

hemoptysis, dysphagia, chest pain and hoarsness

55
Q

nursing goal should include

A

1 - cure
2 - control
3 - palliative

56
Q

How will the nurse teach a quitting-smoker to avoid relapse?

A

Teach pt to recognize and avoid stressors.

57
Q

How will the nurse teach quitting smoker to deal with the urge to smoke?

A

Teach distraction techniques (like shower or exercise)

58
Q

What are risk factors for Breast cancer?

A

Family history, age (50+), history of cancer, early menarche (before 12), late menopause (after 55), first pregnancy after 30

59
Q

What lifestyle increases risk of breast cancer?

A

Weigh gain during adulthood, high fat intake, obesity and alcohol intake

60
Q

At what age should women begin yearly mammograms?

A

Age 40

61
Q

When should the nurse teach women to perform breast self-exam?

A

At the same time each month, after menses

62
Q

What is the goal for range-of-motion after axillary node dissection or modified mastectomy?

A

ROM restored within 4-6 weeks

63
Q

What can a woman do to make a mammogram less painful?

A

Restrict caffeine and salt intake for 1 week prior to exam

64
Q

What risk does a woman with a BRCA1 gene mutation have of breast cancer?

A

A 40-80% lifetime chance of breast cancer

65
Q

In women with BRCA1 or BRCA2 mutations, what treatment can reduce their risk?

A

Prophylactic bilateral oophorectomy

66
Q

For a woman who is high risk for breast cancer (family history or biopsy), what elective treatment will reduce the risk 90%?

A

Bilateral mastectomy

67
Q

What are women with hereditary breast cancer (non-BRCA related) at a high risk for?

A

Secondary breast cancer in the unaffected breast

68
Q

What treatment may women women at risk for secondary breast cancer choose?

A

Prophylactic removal of the unaffected breast at the same time as the removal of the cancerous breast

69
Q

What are risk factors for breast cancer in men?

A

Hyperestrogenism, family history of breast cancer, and radiation exposure

70
Q

What is the most frequent cause of breast lumps in women under 25 years of age?

A

Fibroadenoma

71
Q

What % of breast cancers are related to BRCA gene mutations?

A

5-10%

72
Q

What is a side effect of Herceptin?

A

Heart failure/Ventricular dysfunction

73
Q

What is a side effect of tamoxifen?

A

Changes in visual acuity

74
Q

What are the vaccines for HPV?

A

Cervarix and Gardasil

75
Q

What is the difference between a total hysterectomy and a radical hysterectomy?

A

A “total” = cervix and uterus

A “radical” = cervix, uterus, ovaries and Fallopian tubes

76
Q

What is the early sign of endometrial cancer?

A

Abnormal uterine bleeding (in the post-menopausal woman)

77
Q

What is the late sign of endometrial cancer?

A

Pain

78
Q

What is the major risk factor for ovarian cancer?

A

Family history

79
Q

What factors reduce the risk of ovarian cancer?

A

Breastfeeding, multiple pregnancies, oral contraceptive use (greater than 5 years) and early age at first birth.

80
Q

What screen tests are recommended for ovarian cancer?

A

No official screening test exists–yearly bimanual pelvic exam should be performed. Abdominal or transvaginal US may also be done.

81
Q

For women with high risk for ovarian cancer, screening should include what?

A

CA-125 tumor marker (in combination with US)

82
Q

What age group has the highest incidence of vulvar cancer?

A

Women in their 70’s

83
Q

What percent of men will develop prostate cancer in their lifetime?

A

1/5; 20%

84
Q

What factor does age play in prostate cancer?

A

More than 75% of cases occur in men older than 65

85
Q

What are normal PSA levels?

A

0-4

86
Q

What are the recommendations of for prostate cancer screening?

A

Yearly digital rectal exam and prostate specific antigen starting at age 50

87
Q

When would a patient with prostate cancer be given chemotherapy?

A

It is generally limited to those who don’t respond to hormone therapy in the late stage of the disease.

88
Q

African-Americans and men with a family history of prostate cancer should begin annual PSA and DRE screening at what age?

A

45

89
Q

What age is testicular cancer most common in?

A

15-34

90
Q

What factor does ethnicity play in incidence of testicular cancer?

A

Incidence is 4x higher in Caucasians than African americans

91
Q

When should testicular self-exam begin?

A

At puberty and monthly thereafter

92
Q

What should be discussed and recommended for the man diagnosed with testicular cancer before treatment begins?

A

Cryopreservation of sperm in a sperm back (due to the treatment causing infertility)

93
Q

What would the blood of a patient with AML look like?

A

Drop in RBCs, drop in platelets and normal WBCs

94
Q

What are the 4 stages of chemotherapy?

A
  1. Induction
  2. Intensification
  3. Consolidation
  4. Maintenance
95
Q

What is the normal range for myeloblasts?

A

None in peripheral blood, less than 5% in bone marrow aspirate.

96
Q

What is the normal range for WBC count?

A

5,000-10,000

97
Q

What is “Leukocytosis” and what is it caused by?

A

WBC count >10,000. Caused by infection, tissue necrosis, inflammation, and leukemic neoplasia

98
Q

What is “Leukopenia” and what is it caused by?

A

WBC count <4,000. Caused by bone marrow failure (chemo, radiation, autoimmune disease)

99
Q

How high would a WBC count be for Leukapheresis and Hydroxyurea to be considered?

A

> 100,000

100
Q

If a patient received an “allogenic” stem cell donation–who did the cells come from?

A

Sibling or volunteer donor

101
Q

If a patient received an “autologous” stem cell donation–who did the cells come from?

A

Removed from self before radiation

102
Q

If a patient received an “syngenic” stem cell donation–who did the cells come from?

A

An identical twin

NUR 239 (8 decks)

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