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CNS 2 > Wk 5: Oncology/ Hematology > Flashcards

Wk 5: Oncology/ Hematology Flashcards

1
Q

Staging

A

how much cancer is in the body. Used in treatment plan. Includes size, location and number of tumors

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2
Q

Grading

A

How abnormal cells look under microscope, usually 1-4, 4 worst. More abnormal cells, worse prognosis

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3
Q

Cell type

A

different cell types have different staging scales even if affecting same organ.

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4
Q

Cancer of Unknown Primary (CUP)

A

Unknown primary site, named for where they start. Harder to treat with unknown primary site. Cancer may make itself known later with time and retesting

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5
Q

Breast Cancer

A

75% begins in ducts of breasts, 15% in lobules. Usually slow growing but if aggressive may grow fast

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6
Q

Breast Cancer types

A

distinguished by where it develops and whether invasive or not.

  1. Ductal Carcinoma In Situ (DCIS)- non invasive in milk duct, not life threatening
  2. Invasive Ductal Carcinoma (IDC)- infiltrating ductal, most common form (80% of all breast cancer). Starts in milk ducts and spreads
  3. Invasive Lobular Carcinoma (ILC)- second most common kind. Originates in milk glands, spreads to healthy tissue
  4. Lobular Carcinoma In Situ (LCIS)- starts in milk lobules and stays there. Has highest risk of developing breast cancer in future.
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7
Q

Breast Cancer Staging

A

0: abn cells have not spread outside ducts/lobules
1: Cancer under 2 cm, not spread to lymph or surround breast
2A: not greater than 2 cm and spread to 3 axillary lymph nodes or is 2-5cm with no spread.
2B: 2-5 cm, spread to 3 axillary lymph nodes or cancer larger than 5cm, no spread
3A: tumore 2-5cm and spread to 9 lymph nodes
3B: cancer spread to other tissue near breast (skin, chest wall, rib, muscle ot lymph nodes in chest wall of above collar bone)
4: Cancer spread to liver, brain, lungs, skeletal system, or lymph nodes next to collar bone

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8
Q

Breast Cancer Symptoms

A 
Often early there may be no symptoms, but found by mammography
May find lump/mass
swelling in or around breast
irritation of skin or dimpling
pain in the breast or nipple area
changes in appearance of nipple or surrounding skin
DC from nipple, not breast milk
changes in breast or surrounding area
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9
Q

Breast Cancer Screening/detection

A

Women in 20- SBE
20-30- every three years examined by doctor
40- every 1-2 years mammogram
50 plus- yearly mammograms

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10
Q

Breast Cancer Causes/ Risk Factors

A 
No cause
RF: 
family history
age
overweight
early/ late menstruation
OCP for more than 10 years
Radiation to chest at early age
HRT
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11
Q

Breast Cancer Treatment

A

surgery, radiation, chemo, hormonal. Dpends on type and stage of CA

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12
Q

Breast Cancer Prognosis

A

non-invasive stage 0-2, better survival rate,

stage 4 poorest survival rate

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13
Q

Colon Cancer/ Colorectal Cancer (CRC)

A

3rd most common cancer in US, in large intestines

Lymphoma. melanoma and sarcoma and other types of cancer can affect colon- but rarely

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14
Q

CRC symptoms

A 
may be asymptomatic
Abd pain, cramps/gas
Blood in stool/ bleeding rectum
Change in bowel habits
feeling like bowels dont empty fully
weakness/fatigue
unexpected weight loss
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15
Q

CRC screening

A

if family history- screening at age 50

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16
Q

CRC causes

A

nonspecific
Can start with polyps, cells can turn cancerous.
Could be genetic mutation

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17
Q

CRC genetic mutations

A

FAP Familial adenomatous polyposis: thousands for polyps in colon/rectum- rare but may lead to CRC before age 40
HNPCC Hereditary nonpolyposis CRC: Lynch syndrome, usually CRC by age 50.
Can do genetic testing

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18
Q

CRC Risk Factors

A 
Over 60y
Crohns/UC
family h/o CRC
colorectal polyps
breast ca
diet high in red meat and fat, low fiber
smoke/ ETOH excessive use
overwieght/ sedentary lifestyle
DM
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19
Q

CRC Diagnosis

A

Colonoscopy or CT scan

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20
Q

CRC staging

A

1: Inner layers on colon
2: CA spread to walls of colon
3: spread to Lymph nodes close by
4: spread to other organs

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21
Q

CRC treatment

A

Depends on stage, easiest way to get rid of CA- surgery if sall and ow stage, could be removed with colonoscopy. In advance stages may need ostomy
other options:
chemo, radiation

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22
Q

CRC prevention

A

screen at 50, maintain healthy life style

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23
Q

CRC trends

A

1 in 20 have CRC. lower in women than men slightly. 50,000 deaths in 2013 expected. Screening ID early and polyps get removed.

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24
Q

Lung Cancer

A

Difficult to diagnos d/t no standard screening

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25
Q

Prostate CA

A

common male cancer. Affects gland producing seminal fluid responsible for nourishing and transporting sperm

26
Q

Prostate CA Causes & Risk Factors

A

Cause unknown- cancer develops, genetic mutation in abnormal cells DNA causes cells to grow and multiply. Usually men notice probs with urination or sexual ability.
Risk Factors:
Age: rare before 40, risk increases after 50
African American ethinicty- more prevalent. More likely to be Dx with advanced stages and die than other ethnicities
Family h/o prostate CA- known to run in families
Geographic- most likely New England vs other locations in the US
Unhealthy diet- high fat/calories increase risk
Inactive- more likely to develop

27
Q

Prostate CA symptoms

A 
may be asymptomatic
difficult urination
decreased urine stream
blood in urine or semen
leg swelling
pelvic discomfort
bone pain

may be nonspecific symptoms physical exam and PSA- routine screening after 50y

28
Q

Prostate CA Treatment

A

surgery, radiation, hormone therapy.

Usually surgery

29
Q

Prostate CA Prognosis

A

if confined to prostate, 5 year survival rate 100%

30
Q

Metastatic CA

A

Indiscriminate, almost any kind of CA spreads to another location. No particular type- can travel locally, through blood or lymph nodes

31
Q

Metastatic CA symptoms

A

HA, dizziness, bones aches/pain, gen wkns, exhaustion, wt loss, localized pain, SOB

32
Q

Metastatic CA causes and risk factors

A

No causes or specific RF. Undiagosis/treated cancer has more opportunity to spread.

33
Q

Metastatic CA Diagnostic Tests

A 
Blood work, tumor markers
CXR
MRI
CT scan
US
PET scan
Bone scan
34
Q

Metastatic CA Treatment

A

varies depending on type of CA

35
Q

Metastatic CA survival

A

not predictable

36
Q

Anemias

A

Microcytic
Macrocytic
Normocytic

37
Q

Microcytic anemia

A

Iron deficiency- #1 of all anemia’s, not enough FeSO4, decr iron in diet, poor absorption, blood loss, low d/t pregnancy, GIB

38
Q

Macrocytic anemia

A

B12 deficiency- #2 type of anemia

Pernicious anemia

39
Q

Normocytic anemia

A

Chronic disease (RA, chronic inflammation, ETOH, liver disease, CKD

40
Q

Anemia symptoms

A

tired, cold, irritable, SOB, headed, pale, fatigued

41
Q

Anemia Treatment

A

Physical exam, blood work
treatment: iron, folic acid, Vit B 12
Not cured, can reoccur

42
Q

Aplastic anemia

A

complete failure of BM- produce nothing, emergency, bleeding, infection, unstable

43
Q

MDS Myelodysplastic Syndrome

A

disorders of stem cell production in BM d/t chronic inflam, CA, CKD, infections- can flip to leukemia

44
Q

Thalassemia/ Cooley’s Anemia

A

inherited autosomal chromosomal recessive defect

45
Q

Sickle Cell Anemia

A

Inherited trait, associated with pain

46
Q

Solid Tumor

A

benign/malignant abnormal mass of tissue

Name for cells that form them (lymphoma, sarcoma, carcinomas)

47
Q

Liquid Tumor

A

Blood born cancer- Leukemia
AML-adult
ALL- child

48
Q

Cancer Treatment

A

Surgery/Biopsy
Radiation- site specific
Chemotherapy- systemic
Targeted Therapy- Biological TX, vaccine, live bacteria antibodies, genetic materials
Complimentary Therapy- art, music, pet therapy

49
Q

Radiation Therapy

A

depends on site treated
fair skinned red heads- more skin irritation
consult to other specialty
schedule and transportation

50
Q

Chemotheraphy symptoms

A

Neutropenia, thrombocytopenia, anemia, mucositis, N/V/D, body image, hair loss

51
Q

Targeted Therapy

A

Monoclonal antibodies- ID and attack specific CA cells, may have fewer side effects than other cancer treatments

52
Q

Symptom Mangement

A 
Psychosocial:
anxiety/distress/depression
adjustments
confusion/agitation/memory loss
spiritual needs
coping and support
financial concersn
support for family
53
Q

Older Oncology

A

Age predisposes: OP, fractures, HF, DM, sensory impairment, mobility, ADLs, skin, cognitive factors.
Pharmocologic issues: patient perspective; fear of dying, dying alone and of the unknown.
Who will be caregiver, pay bills, take care of pet.

54
Q

Types of Cancer

A 
Adeno- gland
chondro- cartilage
erythro- RBC
hemangio- blood vessel
hepato- liver
lipo- fat
lympho- lymphocyte
melano- pigment cell
myelo- BM
myo- muscle
osteo- bone
55
Q

Neutropenia

A

reduced WBC, at risk for infection

56
Q

WBC components

A

Neutrophils (polys/segs)-Phagocytosis, increase with acute infection, first line defensehalf life 7-8 hours in circulation. Bands are immature neutrophils, increase bands = shift to left, occurs with acute infection
Lymphocytes (T and B cell combinations)- combat chronic bacterial and acute viral infections
Monocytes (monos)- Phagocytosis of bacteria, last longer than monocytes in circulation
Eosinophils (eos)- allergic reactions and parasite infections
Basophils (mast/basos)- Inflammatory process and allergic reactions

57
Q

Reduce Chemo induced Neutropenia

A

Granulocyte colony stimulating factor

Granulocyte macrophage colony stim factor

58
Q

When to use colony stimulating factor

A

h/o febrile neutropenia
chemo adm in dense dose manner
high risk of febrile neutropenia exists

59
Q

Febrile Neutropenia

A

One time temp or 101F or higher

Temp 100.4 of higher for more than 1 hr

60
Q

Neutropenic precautions

A 
wash hands
avoid crowds/ anyone sick
avoid cleaning excrement
bathe daily
brush teeth BID
floss daily- if plt count not low
avoid constipation, take stool softener
avoid suppositories/enemas
eat only fruits/vegies washed or cooked
eat only fully cooked meat
avoid unpasteurized milk
61
Q

S&S of infection

A

fever, chills, change in cough or new cough, sore throat, new mouth sore, burning pain with urination, redness/swelling in any area, catheter site painful/sore, diarrhea, pain abd/rectum, hands MS

CNS 2 (5 decks)

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