Chapter 25: Cancer

Question 1

What are some diagnostic procedures for cancer?

4 tests

Answer 1

• imaging – CT, MRI, PET
• bone marrow aspiration/biopsy
• CSF fluid analysis
• labs – CBC, electrolytes, liver function tests

Question 2

What are the 3 types of bone marrow transplants?

Answer 2

1. autologous – self marrow
2. allogenic – donor marrow
3. isogenic – identical twin marrow

Question 3

What is leukemia?

6 aspects

Answer 3

• most common form of childhood cancer
• cancer of the WBCs in which large numbers of abnormal/immature WBCs (blasts) are produced –> crowd bone marrow –> flood bloodstream
• these WBCs have no ability to provide immunity
• 2 forms:
  – acute lymphoblastic leukemia (ALL) – affects lymph tissue of immune system
  – acute nonlymphoid (myelogenous) leukemia (AML) – affects myeloid cells (WBCs)
• peak onset: 2 - 3 y.o.
• more common in males and Hispanic > white > AA

Question 4

What are some s/s of leukemia?

4 s/s

Answer 4

• anemia – d/t decreased RBCs
• infection – d/t neutropenia
• bleeding – d/t decreased platelets
• spleen, liver, lymph glands are infiltrated, enlarged, and fibrotic
  – hepatosplenomegaly
  – splenomegaly
  – fever

Question 5

What are some treatments for leukemia?

4 treatments

Answer 5

• chemo – usually combo treatments
• cranial irradiation
• hematopoietic stem cell transplant (HSCT)
• infection control – reverse isolation, hand hygiene, visitor restriction, nutrition

Question 6

What are lympomas? What are the 2 types?

Answer 6

• neoplastic disease originating in the lymphoid system and then metastasizes to non-nodal sites
• 2 types:
  – Hodgkin disease
  – non-Hodgkin lymphoma (NHL)

Question 7

What is the difference betwen Hodgkin lymphoma and non-Hodgkin lymphoma?

Answer 7

• Hodgkin:
  – usually diagnosed in pts 15 - 19 y.o.
  – primarily involves lymph nodes
  – asymptomatic (painless) lymphadenopathy (firm, non-tender nodules)
  – presence of Hodgkin or Reed-Sternberg cells
• non-Hodgkin:
  – more common in general – 60% of pediatric lymphomas
  – usually diagnosed in pts < 14 y.o.
  – disease is usually diffuse rather than nodular
  – undifferentiated cell types

Question 8

What are some s/s of Hodgkin disease?

4 s/s

Answer 8

• asymptomatic (painless) lymphadenopathy
• cough
• abdominal pain
• anorexia

Question 9

What are some treatments for Hodgkin disease?

2 treatments

Answer 9

• irradiation
• chemo

Question 10

What are some s/s of non-Hodgkin lymphoma (NHL)?

4 s/s

Answer 10

• rarely does a single symptom lead to diagnosis
• diffuse disease
• undifferentiated cell types
• metastasizes to bone marrow or CNS quickly – may appear like leukemia

Question 11

What are some treatments for NHL?

1 treatment

Answer 11

• combo chemo – since widespread disease

Question 12

What are some reactions that can result from transfusion?

8 reactions

Answer 12

• hemolytic reaction – RBCs transfused are destroyed by pt’s immune system; most severe but rarely occurs
• ABO incompatibility – most common
• fever
• chills
• allergic reaction symptoms
• air emboli – d/t excessive pressure
• hypothermia
• electrolyte imbalances – mostly hyperkalemia

Question 13

What is a delayed hemolytic reaction?

Answer 13

destruction of RBCs and fever within 5 - 10 days after transfusion