Unit 1 Module 3: Hematopoetic Function and Neoplasms Flashcards
A patient has tested positive for having the BRCA-1 gene. What implications does this finding have?
The patient has an increased risk for developing breast and/or ovarian cancer.
Each child of a patient with the mutation as a 1 in 2 chance of inheriting the mutation.
Is this a risk factor for cancer? Individual who cleans fireplace chimneys for a living
Yes, constant exposure to environmental toxins like chimney soot increases the risk for cancer.
What type of cells is this statement describing?
Cells are stopped by contact inhibition, which means that the cell stops growing when it touches another cell.
Normal cells
Normal cells stop growing when they touch other cells. Benign tumor cells grow by expansion without invading other tissues (usually encapsulated). Malignant tumor cells grow by invasion, sending out processes that infiltrate surrounding tissues.
This type of anemia is caused by deficiencies that lead to RNA/DNA synthesis problems.
macrocytic anemia (folic acid and b12)
t/f risk factor for cancer: h. pylori
true
Oncogenes take one mutation to become activated, where it takes _______ mutation(s) in tumor suppressor cells for these “brakes” to no longer function.
2
Patients who have had a gastrectromy are at risk for this type of anemia.
b12 deficiency (due to lack of intrinsic factor which is found in the stomach)
[normal/benign/cancer] cells go through programmed apoptosis by shortening of telomeres and cessation of cell growth.
normal
What type of cells is this statement describing?
These cells metastasize by infiltrating either the hematologic (blood) or the lymphatic channels.
Only malignant tumor cells metastasize and they do so either by the blood or the lymph channels.
A 35-year old woman is having a preventive exam with her OB-GYN. Which test will used as a screening for cervical cancer?
Pap smear
*It is a common misconception that a pelvic exam or even HPV testing with screen for cervical cancer and that is not true. An individual can have HPV, but not have cervical cancer. The pap smear is a specific cytology examination under the microscope looking for dysplastic cells.
t/f risk factor for cancer: hep C
true
Match the following screening tools with type of cancer: PSA blood test
prostate
Anemia occurs in patients with chronic renal disease due to an inability to make ____________by the kidneys,
erythropoeiten
Is this a risk factor for cancer? Person who weighs 250 lbs. and is 5 feet 2 inches tall.
Yes, obesity increases the risk of cancer. Adipose tissues influence the activity of sex hormones as well as increases hyperinsulinemia.
If a patient has blood loss anemia, what element does the nurse know has been lost in the blood?
Iron
A normal cell repairs errors in DNA made during the cell replication process through the use of:
cyclins are the care-taker proteins that make repairs
A person who carries the BRCA-1 or BRCA-2 gene mutations has an increased risk of cancer.
true
BRCA-1 and BRCA-2 gene mutations that put a person at higher risk for breast, ovarian, prostate, pancreatic and colon cancer. Breast and ovarian cancer is most prevalent.
Is this a risk factor for cancer? A patient who takes immunosuppressive drugs
Yes. The immune system does surveillance and eradicates cancer cells, so anything that decreases the function of the immune system puts the person at risk for cancer.
A patient with cancer had genetic testing done and found out that he has a P53 mutation. The nurse recognizes this as:
Tumor suppressor gene *P53 is a tumor suppressor gene mutation. The presence of a tumor suppressor gene is normal as it makes cells stop replicating when needed. It is the mutation in this “brake pedal” that leads to uncontrolled growth. Remember that two mutations are needed in order for tumor suppressor genes to malfunction.
bleeding disorder that is genetically passed on through the generations (X-linked)
hemophilia A
Is this a risk factor for cancer? Patient with a 20-year history of hepatitis C disease.
Yes, viruses like hepatitis B &C increase the risk of cancer. Hepatitis C is the leading cause of liver cancer.
A sentinel event has occurred in the hospital and a patient has received the wrong type of blood during a blood transfusion. What response does the nurse expect?
hemolytic anemia
An ICU patient has developed a bleeding disorder whereby all of their clotting factors have been used up and the patient keeps bleeding. What is this called?
Disseminated intravascular coagulation
A patient has a fatty growth on the back of her knee that hurts when she bends her knee. The patient is concerned it is cancerous. The pathology report shows it is an encapsulated collection of fatty tissue. What treatment does the nurse anticipate for this patient?
Removal of the fatty mass. *encapsulated-think benign. Also, the report says the cells are “fatty tissue”. Benign growths the cells are the same as normal cells, just growing in the wrong place or at the wrong time.
What differentiates cancer cells from normal cells?
cancer cells do not perform normal functions
How are tumor markers commonly used?
If cancer is suspected, it will be done as one of many tests to diagnose cancer.
There is a usual ratio between the hemoglobin and the hematocrit. If the patient’s hemoglobin is 10 g/dL, then what should the hematocrit be?
30 (usually a 1:3 ratio between hgb and hct)
How much time does it take for a RBC to get into circulation from the bone marrow?
1 week
Match the following screening tools with type of cancer: Cologuard
colon cancer
Patients with this type of anemia are jaundiced.
hemolytic: Patients with hemolytic anemia have jaundice because of the huge release of unconjugated bilirubin that is released into the bloodstream from the broken down red blood cells.
Why do frequent sunburns put individuals at risk for skin cancer?
Constant repair of injured skin leads to increased cell replication and the risk for errors in DNA. UV radiation is carcinogenic.
A newly diagnosed patient has a tumor that measures 1 cm in size.
What stage is this?
Typically, a 1 cm tumor is equivalent to 1 billion cells. *Most tumors are detected at minimum when it is 1 cm in size. This starts the progression stage.
What’s the most advanced grade/stage of cancer
4 (staged 1-4)
What are mutant genes that allow for autonomous cell growth? This allows for cancer cells to grow in the absence of growth promoting signals.
oncogenes
A patient is admitted to the hospital with an infection. What does the nurse expect the patient would have on their lab report?
leukocytosis
A patient who is jaundiced because of anemia has what type of anemia?
hemolytic: too many RBC breaking down and the liver can’t conjugate the bilirubin fast enough leading to jaundice.
Which pregnant woman are we most concerned about having folic acid deficiency?
Woman who is malnourished
benign or malignant: fibrosarcoma
malignant
What is the most common type of cancer in men? (occurrence, not mortality)
Men: prostate, lung, colon and urinary
Women: breast, lung, colon and uterine
The patient is hypoxic. What is a compensatory response?
elevated respiratory rate
benign or malignant: rhabdomyoma
benign
This type of anemia is most commonly caused by ongoing blood loss like a gastrointestinal bleed or heavy menstrual bleeding?
don’t get tricked by the bleed here – blood loss anemia is more like post-hemorrhagic anemia
Typically, when we discuss a patient’s anemia status, the blood tests that nurses use the most often are
hemoglobin and hematocrit
A patient is suspected of having pica. The nurse recognizes this means the patient may be having craving for
ice, red clay, laundry detergent
t/f risk factor for cancer: having HIV
true
Tobacco is associated with _______(insert whole number) percent of all cancers.
30%
t/f: A patient has hepatocarcinoma. The nurse recognizes this is a benign tumor because of the name.
FALSE—“carcinoma” in the name= malignant
How does the body normally control cell replication and proliferation?
contact inhibition, apoptosis, cyclins
cancer of the white blood cells
leukemia
t/f risk factor for cancer: being obese
true
this cancer can be classified as either acute or chronic
leukemia
______ in addition to environmental factors has an influence on the occurrence of oncogenesis.
genetics
Match the following screening tools with type of cancer.
mammography
breast
The nurse is working with a family newly diagnosed with Sickle cell anemia. The nurse advises the parents to take what action to prevent a sickle cell crisis?
Keep them Hydrated.
> Dehydration, infection, illness, physical stressors can all cause a crisis.
bleeding disorder that results in a deficiency in clotting factor VIII
hemophilia A
A patient who has anemia as a result of a blood transfusion reaction would have which type of anemia?
hemolytic
(Sickle cell anemia is a type of hemolytic anemia, but is not the correct response to the question related to blood transfusion reaction.)
t/f: Iron deficiency anemia is microcytic and hypochromic because lack of hemoglobin affects the red blood cell’s size and color.
true
Sickle cell anemia is a type of anemia that is inherited and includes presence of Hg S.
true
What is this statement describing?
Cells are highly undifferentiated and give little resemblance to cells in tissue of origin.
malignant tumor cells
Normal cells are well differentiated and resemble tissue of origin. Benign cells are well-differentiated and resemble tissue of origin. Malignant cells loose differentiation and become undifferentiated with anaplastic atypical structure. Malignant cells eventually can look completely different than the cells in the tissue of origin.
Patients who are vegetarians are at risk for this type of anemia.
iron deficiency
A patient with breast cancer has been complaining of more frequent headaches lately. What is the nurse’s concern?
The breast cancer has metastasized to the brain. *Metastasis is a big concern in every patient with cancer. Patients are routinely screened for metastasis of cancer to other parts of the body.
benign or malignant: hepatoma
benign
A patient with anemia who also has neurological symptoms is most likely to have what type of anemia?
vitamin b12
Is this a risk factor for cancer? Person who had a motor vehicle accident and broke 6 bones in his body including his pelvis.
No this doesn’t increase risk.
What is it called when there is the development of other diseases/disorders that is being caused by cancer?
Examples of paraneoplastic syndrome include SIADH (syndrome of inappropriate anti-diuretic hormone), hypercalcemia, deep vein thrombosis, acanthosis nigricans.
How long do sickle cells live compared to regular red blood cells?
12 instead of 120
If a patient has neutropenia, what is the nurse most concerned about?
infection
Is this a risk factor for cancer? Patient with peptic ulcer disease and is positive for H.Pylori bacterial infection.
Yes, H.Pylori infections increase the risk of gastric cancer.
Substance use disorder (alcohol) are at risk for this type of anemia.
folic acid deficiency
Match the following screening tools with type of cancer: pap smear
cervical
If a patient has low levels of hemoglobin. What will their red blood cells look like?
small and pale
A symptom of this type of anemia is eating pica (non-food items as food).
iron deficiency
Cells have a way to repair themselves. Once a mutation is made, ______ are caretaker genes that make repairs at checkpoints during cell division.
cyclins
t/f risk factor for cancer: being born prematurely
false
most common bleeding disorder
Von Willebrand’s Disease
Which cancer is most advanced?
T4N1M4: A quick and easy way to figure this out is to look at the M, which is for metastasis. This is the most advanced and then look for the highest number.
Metastasis can occur through blood vessels (hematogenic) or _________ and can spread to an area of the body that is exposed to cancer cells.
lymphatic system
A patient with cancer is admitted with neutropenia. How does the nurse know what the ANC level comes from?
It is a formula that includes WBC, neutrophils, and bands
ANC=Absolute Neutrophil Count
This type of anemia is caused by surgery when a large amount of blood is lost
blood loss
and iron deficiency due to blood loss, but primarily blood loss
Angiogenesis is the ____ of blood vessels that feed cancer cells. This is an effective mechanism to promote cancerous growth and metastasis.
growth
benign or malignant: glioblastoma
malignant
t/f All cancer has a genetic basis, as all cancer growth occurs as a result of a mutation.
True. All cancer is caused by a mutation in genes during replication of cells. Not all cancer is genetic in the sense that is not all hereditary and passed on through families. Only about 10% of all cancers are found to have a hereditary basis.
Hodgkins and non-Hodgkins are two types of this cancer
lymphoma
When a patient has a low white blood cell count, a low hemoglobin/hematocrit and low platelets, what is the condition called?
pancytopenia
- -
anemia: RBC or hemoglobin/hematocrit are low
thrombocytopenia: low platelets
leukopenia: low white blood cells
cancer of the lymph system
lymphoma
Bleeding disorder that results because of the many small clots formed throughout the body
Disseminated intravascular coagulation
Is this a risk factor for cancer? Bed-bound patient who has heart failure and lung disease.
No increased risk.
Which patient is going to be more symptomatic of anemia?
- motor vehicle patient with large blood loss
- woman with heavy monthly menstrual bleeding
- man with blood loss from hemorrhoids
- child with blood loss from cut on leg from running through bushes
motor vehicle patient with large blood loss
Patients with this type of anemia often present with neurological symptoms like numbness/tingling in the legs.
b12 deficiency
