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Internal Medicine > Week 5- Oncology (pt 2) > Flashcards

Week 5- Oncology (pt 2) Flashcards

1
Q

Most cancers are ___________ but treatable if found early

A

asymptomatic

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2
Q

True or false: As cancer progresses, there may be cases of nausea/vomiting/retching and anorexia/subsequent weight loss

A

True

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3
Q

Contributors of anorexia/cachexia

A

-Metabolic abnormalities
-Pro inflammatory cytokines
-Circulating tumor derived catabolic factors
-Decreased food intake
-Other unknown factors

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4
Q

When does the rapid growth of the tumor encroach on healthy tissue?

A

Later stage

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5
Q

What can rapid growth of a tumor cause?

A

-Destruction
-Necrosis
-Ulceration
-Hemmorrhage

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6
Q

Stage in which the host presents systemically with muscular weakness, anemia, and coagulation disorders, such as granulocyte and platelet abnormalities

A

Advanced or stage IV cancer

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7
Q

This clinical manifestation may be seen without infection and is produced either by WBCs inducing a pyrogen or by direct tumor production of a pyrogen

A

Pyrexia/fever

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8
Q

True or false: Continuation spread of a cancer does not lead to GI, pulmonary, or vascular obstruction

A

False

(it does… lol)

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9
Q

True or false: Continuation spread of cancer decreases the host’s immunity

A

True

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10
Q

True or false: Clinical manifestations may produce systemic signs and symptoms that are not direct effects of either the tumor or its metastases

A

True

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11
Q

Cancer pain occurs in about _____ of adults with newly diagnosed malignancies

A

1/4

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12
Q

Cancer pain occurs in about _____ of individuals undergoing treatment

A

1/3

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13
Q

Cancer pain occurs in about _____ of all people with advanced disease

A

3/4

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14
Q

True or false: Depression and anxiety does not increase the person’s perception of pain or may be the result of the cancer pain

A

False

(can increase)

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15
Q

Some pain is caused by pressure on _________ or by the displacement of _________.

A

Nerves
Nerves

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16
Q

Microscopic infiltration of nerves by tumor cells can result in _______________ generally following the pattern of nerve distribution

A

Continuous, sharp, stabbing pain

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17
Q

Ischemic pain (throbbing) may result from interference with _____________ or from blockage within hollow organs

A

Blood supply

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18
Q

A common cause of cancer pain is metastasis of cancer to __________.

A

Bone

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19
Q

Signs and symptoms accompanying mild-to-moderate superficial pain

A

-Hypertension
-Tachycardia
-Tachypnea

(result of a sympathetic nervous system response)

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20
Q

True or false: Sympathetic nervous system responses is more characteristic in severe or visceral pain

A

False

(Parasympathetic)

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21
Q

True or false: Cancer pain can manifest as spinal cord compression from metastases

A

True

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22
Q

Types of pain regarding spinal cord compression from metastases

A

-Radicular back pain
-Leg weakness
-Change/loss of bowel or bladder control

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23
Q

True or false: Immobility and inflammation can also lead to pain

A

True

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24
Q

Pain should be screened, assessed, and managed according to ________.

A

Clinical practice guidelines (CPGs)

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25
Q

What does pain management depend on?

A

-The underlying etiology
-Whether the individual is experiencing acute or chronic pain

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26
Q

Methods of pain control

A

-Steroids
-Opioids
-Radiation
-Chemotherapy
-Surgical intervention
-Neurosurgery nerve blocks
-Intraspinal
-Rhizotomy
-Cordotomy

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27
Q

True or false: Integrative, psychologic, or rehabilitative strategies do not help pain control

A

False

(they do help)

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28
Q

Most common drugs used for pain control

A

-Morphine
-Hydromorphone
-Fentanyl
-Oxycodone

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29
Q

A balance between analgesia and side effects might be achieved by changing to an equivalent dose of an alternative opioid

A

Opioid rotation

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30
Q

Methods of continuous infusion

A

-Around the clock
-As needed
-Patient controlled analgesia (PCA)

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31
Q

Examples of complementary therapies

A

-Massage
-Simple touch
-Acupuncture
-Imagery/hypnosis
-Reflexology
-Relaxation training

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32
Q

Technique that reduces stress and anxiety but is debatable about its safety in individuals with lymphedema or who are at risk for developing lymphedema

A

Massage

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33
Q

True or false: There is no evidence that shows massage can spread cancer, although direct pressure over a tumor is usually discouraged

A

True

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34
Q

True or false: Biophysical agents do not relieve symptoms associated with cancer

A

False

(They have the potential to relieve some symptoms but not intended to treat the cancer)

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35
Q

How do biophysical agents work?

A

They alter cell membrane permeability and alter transmembrane potentials, potentially triggering tissue growth and development increase circulation, promote cell function, growth, and replication

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36
Q

The use in individuals with cancer or a history of cancer is controversial with the exception of ____________.

A

Hospice or palliative care

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37
Q

PTs need to conduct _________ and have an open dialogue with patients

A

Risk-benefit assessment

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38
Q

Cancer neuropathic pain is directly caused by _______ or indirectly as a side effect of _________

A

Tumor invasion
Cytotoxic drug therapy

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39
Q

Recommended treatment for this pain includes infrared light therapy, anti-depressant drugs, anti-epileptics, and steroids

A

Cancer neuropathic pain

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40
Q

A distressing, persistent, and subjective sense of tiredness or exhaustion related to cancer or cancer treatment (unknown mechanisms)

A

CRF (cancer-related fatigue)

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41
Q

True or false: CRF is not a universal symptom for cancer survivors

A

False

(it is)

42
Q

True or false: It is important to reassure the patient that CRF is not necessarily an indicator of disease progression

A

True

43
Q

CRF may be the result of…

A

-Pain
-Anemia
-Sleep disturbance
-Nutritional deficits
-Deconditioning
-Comorbidities
-Presence of certain cytokines
-Psychological factors (ex: emotional distress, anxiety, depression)

44
Q

Condition when tumors produce signs and symptoms (not direct effects of either the tumor or its metastases) at a site distant from the tumor or its metastasized sites

A

Paraneoplastic syndrome

45
Q

Many of the paraneoplastic syndrome involve…

A

-Ectopic hormone production by tumor cells
-The secretion of biochemically active substances that cause metabolic abnormalities

46
Q

Paraneoplastic syndrome may accompany relatively limited ___________ and provide an early clue to the presence of certain types of cancers

A

Neoplastic growth

47
Q

Examples of primary prevention

A

-Epigenetics
-Nutrigenomics
-Chemoprevention
-Cancer vaccine

48
Q

Prevent cancer through the impact of nutrition on gene structure and stability

A

Nutrigenomics

49
Q

The use of agents to inhibit and reverse cancer, has focused on diet-derived agents

A

Chemoprevention

50
Q

Applies screening to identify high-risk people and subsequent reduction or elimination of modifiable risk factors

A

Epigenetics

51
Q

Aimed at preventing morbidity and mortality uses screening, early detection, and prompt treatment

A

Secondary prevention

52
Q

Focuses on managing symptoms, limiting complications, and preventing disability associated with cancer or its treatment

A

Tertiary prevention

53
Q

Substances that may be found in the blood serum and are produced/secreted by tumor cells. This is not a diagnostic itself but can signal malignancies.

A

Biologic tumor markers

54
Q

By using specific cancer biomarkers, it provides additional information for the oncologist in determining aggressiveness of the tumor; potential response to treatment and prediction of risk for cancer diagnosis with a family

A

Molecular profiling

55
Q

The medical management of cancer may be _______ or ________

A

Curative (intent to cure)
Palliative (provides symptomatic relief but does not cure)

56
Q

Treatment that uses this order:

Surgery to remove primary tumor –> therapies (chemotherapy/radiation therapy) to obtain local regional/systemic control –> possibly finding long term hormonal treatment

A

Anti-neoplastic treatment

57
Q

Adjuvant therapies

A

Chemotherapy/radiation therapy

58
Q

This means before definitive surgical intervention

A

Neoadjuvant

59
Q

The decision to initiate neoadjuvant vs adjuvant therapies is based on the _________, _________, and often the __________

A

Size
Extent of involved tissue
Stage/grade of the tumor

60
Q

True or false: Major therapies may be used alone or in combination, depending on the type, stage, localization, and responsiveness of the tumor and on limitations imposed by the person’s clinical status

A

True

61
Q

Major therapies of curative cancer (list them)

A

-Surgery
-Irradiation Therapy
-Chemotherapy
-Immunotherapy
-Antiangiogenic Therapy
-Hormonal Therapy
-Complementary and Alternative (Integrative) Medicine

62
Q

This is used most often in combination with other therapies. May be used curatively for localized cancer; tumor biopsy and tumor removal or palliatively to relieve pain, correct obstruction, or alleviate pressure

A

Surgery

63
Q

____ phase represents the resting phase of cell proliferation

A

G0

64
Q

_____ phase is the growth and preparation of the chromosomes for replication

A

G1

65
Q

_____ phase is the synthesis of DNA

A

S1

66
Q

____ phase is the preparation of the cell for division

A

G2

67
Q

____ phase represents cell division

A

M

68
Q

The final result of the cell cycle is the production of two ____________.

A

Identical daughter cells

69
Q

When stimulated by growth factors and/or hormones, ____ cells move into the ____

A

G0
G1

70
Q

____ is a checkpoint to stop the cell cycle if DNA is damaged

A

G1

71
Q

____ is another checkpoint when the cell cycle can be stopped if DNA is damaged or unreplicated, in which case repair or apoptosis occurs

A

G2

72
Q

Chemotherapy is most effective during the ____ and ____ phases

A

S
M

73
Q

Cells are more sensitive to radiation therapy in the ____ phase

A

G2

74
Q

Stem cells in the ____ phase are resistant to chemotherapy and radiation therapy

A

G0

75
Q

The repeated or cyclic chemo or radio therapy is designed to capture cells at _______.

A

Each stage of the cell cycle

76
Q

May be used preoperatively to shrink a tumor, making it operable, while preventing further spread of the disease during surgery

A

Radiotherapy

77
Q

True or false: After the surgical wound heals, postoperative doses of radiotherapy do not prevent residual cancer cells from multiplying or metastasizing

A

False

(they do prevent lol)

78
Q

Radiotherapy destroys the dividing cancer cells by destroying _______ between DNA strands within the cancer cells

A

Hydrogen bonds

79
Q

Two types of radiotherapy

A

Ionizing radiation
Particle radiation

80
Q

Depending on the type and extent of the tumor, radiotherapy may be delivered externally or internally by…

A

External beam (teletherapy)
Sealed source (x rays/gamma rays)
Unsealed source (systemic therapy)

81
Q

Radiotherapy is used in approximately ____ of all cases of cancer in the local control phase of treatment, but it has both direct and indirect toxicities associated with its use

A

50%

82
Q

True or false: Radiation reactions and injuries are the harmful effects (acute, delayed, or chronic) to body tissues through exposure to ionizing radiation

A

True

83
Q

Method to treat cancer with systemic drugs traveling throughout the body rather than remain confined to a specific area

A

Chemotherapy

84
Q

True or false: Chemotherapy affects or interferes with the synthesis or function of nucleic acid (DNA) targeting cells in the growth plates and kills all cells

A

False

(it does not kill all cells)

85
Q

True or false: Combination therapies are often used because some drugs work better during different cell cycles

A

True

86
Q

The process of chemotherapy is usually intermittent to allow for ________ recovery between doses

A

Bone marrow

87
Q

Chemotherapy limits cell proliferation by __________.

A

Killing/attenuating the growth of the cancerous cells

88
Q

True or false: Chemotherapy inhibits DNA/RNA synthesis and function or directly inhibit cell division

A

True

89
Q

True or false: Chemotherapy affects cancerous cells to a lesser extent than normal cells

A

False

(greater extent)

90
Q

__________________ have a greater need to replicate their genetic material and thus undergo mitosis at a much higher rate than most _____________ cells

A

Cancerous cells
Noncancerous cells

91
Q

True or false: The growth fraction typically decreases as a tumor gets larger

A

True

92
Q

The % of proliferating cells relative to neoplastic cell population

A

Growth fraction

93
Q

True or false: Blood flow and nutrient supply to the tumor can sustain extremely rapid tumor growth

A

False

(cannot sustain)

94
Q

Each round of chemo will kill a certain _____ of cancerous cells

A

%

95
Q

True or false: The chemo can never completely eliminate the tumor

A

True

96
Q

True or false: If chemo can reduce the tumor to a certain size (typically < 10,000 cells), the body’s endogenous defense mechanisms (i.e., cytotoxic immune responses) can deal with the remaining cancerous tissues, and the disease is considered to be in remission

A

True

97
Q

Chemo works the best when the tumor is ______, and a ______ proportion of the cells are actively dividing

A

Small
Large

98
Q

True or false: Early detection and aggressive chemotherapy are not essential in successfully treating cancer

A

False

(they are essential)

99
Q

If a patient has a tumor in the pancreas, what would be the most common site of pain referral for this tumor?

-Inguinal region, anterior thigh, and genitalia
-Shoulder, midthoracic, or low back
-Sacroiliac joint and hip
-Anywhere in corresponding dermatome

A

Shoulder, midthoracic, or low back

100
Q

Cells are most sensitive to radiation therapy in the ____ phase

-S
-M
-G1
-G2

A

G2

101
Q

What is the last step in the mitotic cycle before cell division?

-G0
-G1
-G2
-G3

A

G2

102
Q

Which of the following concepts describe the theory that each round of chemotherapy will affect a certain percentage of cancerous cells and the chemotherapeutic regimen can never completely eliminate the tumor?

-Growth fraction
-Cell kill hypothesis
-Cytotoxic strategy
-Molecular profiling

A

Cell kill hypothesis

Internal Medicine (25 decks)

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