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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
Prostate CA
common male cancer. Affects gland producing seminal fluid responsible for nourishing and transporting sperm
26
Prostate CA Causes & Risk Factors
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
Prostate CA symptoms
``` 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
Prostate CA Treatment
surgery, radiation, hormone therapy. | Usually surgery
29
Prostate CA Prognosis
if confined to prostate, 5 year survival rate 100%
30
Metastatic CA
Indiscriminate, almost any kind of CA spreads to another location. No particular type- can travel locally, through blood or lymph nodes
31
Metastatic CA symptoms
HA, dizziness, bones aches/pain, gen wkns, exhaustion, wt loss, localized pain, SOB
32
Metastatic CA causes and risk factors
No causes or specific RF. Undiagosis/treated cancer has more opportunity to spread.
33
Metastatic CA Diagnostic Tests
``` Blood work, tumor markers CXR MRI CT scan US PET scan Bone scan ```
34
Metastatic CA Treatment
varies depending on type of CA
35
Metastatic CA survival
not predictable
36
Anemias
Microcytic Macrocytic Normocytic
37
Microcytic anemia
Iron deficiency- #1 of all anemia's, not enough FeSO4, decr iron in diet, poor absorption, blood loss, low d/t pregnancy, GIB
38
Macrocytic anemia
B12 deficiency- #2 type of anemia | Pernicious anemia
39
Normocytic anemia
Chronic disease (RA, chronic inflammation, ETOH, liver disease, CKD
40
Anemia symptoms
tired, cold, irritable, SOB, headed, pale, fatigued
41
Anemia Treatment
Physical exam, blood work treatment: iron, folic acid, Vit B 12 Not cured, can reoccur
42
Aplastic anemia
complete failure of BM- produce nothing, emergency, bleeding, infection, unstable
43
MDS Myelodysplastic Syndrome
disorders of stem cell production in BM d/t chronic inflam, CA, CKD, infections- can flip to leukemia
44
Thalassemia/ Cooley's Anemia
inherited autosomal chromosomal recessive defect
45
Sickle Cell Anemia
Inherited trait, associated with pain
46
Solid Tumor
benign/malignant abnormal mass of tissue | Name for cells that form them (lymphoma, sarcoma, carcinomas)
47
Liquid Tumor
Blood born cancer- Leukemia AML-adult ALL- child
48
Cancer Treatment
Surgery/Biopsy Radiation- site specific Chemotherapy- systemic Targeted Therapy- Biological TX, vaccine, live bacteria antibodies, genetic materials Complimentary Therapy- art, music, pet therapy
49
Radiation Therapy
depends on site treated fair skinned red heads- more skin irritation consult to other specialty schedule and transportation
50
Chemotheraphy symptoms
Neutropenia, thrombocytopenia, anemia, mucositis, N/V/D, body image, hair loss
51
Targeted Therapy
Monoclonal antibodies- ID and attack specific CA cells, may have fewer side effects than other cancer treatments
52
Symptom Mangement
``` Psychosocial: anxiety/distress/depression adjustments confusion/agitation/memory loss spiritual needs coping and support financial concersn support for family ```
53
Older Oncology
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
Types of Cancer
``` 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
Neutropenia
reduced WBC, at risk for infection
56
WBC components
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
Reduce Chemo induced Neutropenia
Granulocyte colony stimulating factor | Granulocyte macrophage colony stim factor
58
When to use colony stimulating factor
h/o febrile neutropenia chemo adm in dense dose manner high risk of febrile neutropenia exists
59
Febrile Neutropenia
One time temp or 101F or higher | Temp 100.4 of higher for more than 1 hr
60
Neutropenic precautions
``` 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
S&S of infection
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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