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z Su15 HEHI 3 > oncology > Flashcards

oncology Flashcards

1
Q

oncogenes are…?

A

regulate cell growth

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2
Q

cancer cell characteristics

A
  • anaplasia
  • complete/partial loss of specific cell function
  • abnormal proliferation/growth leads to tumor
  • metastasis to distant sites
  • evasion of apoptosis
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3
Q

anaplasia

A

loss of resemblance to parent cell

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4
Q

neuroblastoma

A

common pediatric cancer; starts in embryonic nerve cells

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5
Q

wilms tumor

A

common pediatric cancer; kidney

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6
Q

rhabdomyosarcoma

A

common pediatric cancer; skeletal muscle

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7
Q

adeno: tissue of origin

A

epithelial glands

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8
Q

chrondo: tissue of origin

A

cartilage

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9
Q

fibro: tissue of origin

A

fibrous connective

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10
Q

glio: tissue of origin

A

glial cells (brain)

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11
Q

hemangio: tissue of origin

A

blood vessel

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12
Q

leiomyo: tissue of origin

A

smooth muscle

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13
Q

meningioma: tissue of origin

A

meninges

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14
Q

squamous: tissue of origin

A

epithelial layer of skin, mucous membranes, and organ linings

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15
Q

adjuvant therapy

A

chemotherapy that is used along with surgery or radiation

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16
Q

combination therapy

A

use of more than one specific chemotherapeutic drug, different parts of cells targeted

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17
Q

neoadjuvant therapy

A

treatment of cancerous tumor with chemotherapy to shrink tumor before it is surgically removed; done before primary therapy

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18
Q

alkylating agents

A

break DNA helix strand interfering with DNA replication

ex: carboplatin, cyclophosphamide, cisplatin

chemotherapeutic drug class

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19
Q

antimetabolites

A

replace normal metabolites needed for cellular reactions, cell division impaired

ex: azacitidine, fluorouracil (5-FU)

chemotherapeutic drug class

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20
Q

antitumor antibiotics

A

bind with DNA inhibiting DNA and RNA synthesis

ex: doxorubicin, bleomycin

chemotherapeutic drug class

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21
Q

antimitotic agents

A

interfere with formation and actions of microtubules inhibiting cell division

ex: paclitaxel, etoposide (VP-16)

chemotherapeutic drug class

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22
Q

topoisomerase inhibitors

A

inhibit topoisomerase, enzye needed for DNA synthesis and cell division, causes double-strand DNA changes and result is DNA breakage and cell death

  • can cause severe diarrhea!
    ex: irinotecan, topotecan

chemotherapeutic drug class

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23
Q

chemotherapy patient labs: absolute neutrophil counts

A

gt/eq 1.5 preferred

1.0 - 1.4: might administer chemo, provider dependent

lt 1.0: hold treatment

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24
Q

chemotherapy patient labs: hgb

A

gt 11g/dL preferred

if anemia present, may need to consider supportive therapy (ie, blood transfusion)

may or may not impact decision to proceed

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25
Q

chemotherapy patient labs: platelets

A

gt/eq 100k preferred

lt 100k: may or may not proceed with treatment, provider dependent

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26
Q

solid tumors develop from…

A

specific tissues

ex: breast, colon

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27
Q

hematologic cancers develop from

A

blood cell-forming tissues

ex: leukemia, lymphoma

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28
Q

cancer grading

A

classification of cellular aspects of a cancer tumor; cellular differentiation: how closely cancer cells resemble normal cells

  • higher the grade = more aggressive
  • evaluating patient for prognosis, appropriate therapy
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29
Q

GX

A

grade cannot be assessed

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30
Q

G1

A

well differentiated (resembles parent cell)

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31
Q

G2

A

moderately well differentiated

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32
Q

G3

A

poorly differentiated (bears little resemblance to parent cell)

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33
Q

G4

A

undifferentiated (impossible to tell which cell is the parent)

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34
Q

cancer staging

A

classification of CLINICAL aspects (progression) - verify: extent of disease
- assists: determining prognosis, treatment planning, identification of suitable clinical trials, treatment response

criteria unique for each type of cancer!

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35
Q

clinical staging of cancer

A

based on physical exam, imaging, biopsy

36
Q

pathologic staging of cancer

A

based on pathologic examination of surgical tissue samples

37
Q

restaging of cancer

A

completed upon disease recurrence

38
Q

TNM staging system

A

t umor (local involvement, invasion): primary tumor measured for size, depth of invasion

n ode (nodal involvement): lymph nodes in area of primary tumor examined for evidence of tumor cells. Size, number, location documented.

m etastasis

39
Q

prophylactic surgery for cancer

A

removes at risk tissue

40
Q

diagnostic surgery for cancer

A

biopsy

41
Q

curative surgery for cancer

A

removes all cancerous tissue

42
Q

cytoreductive surgery for cancer

A

partial tumor removal or tumor debulking

43
Q

palliative surgery for cancer

A

improve patient status/minimize effect - not a cure

44
Q

teletherapy

A

external radiation source for cancer treatment

patients are not radioactive or hazardous to others

45
Q

intensity modulated radiation therapy (imrt)

A

single beam broken into smaller beams allowing better tumor focus

46
Q

stereotactic body radiation therapy (sbrt)

A

utilizes three dimensional tumor imaging for exact tumor location

47
Q

teletherapy key patient education point

A

avoid sun and heat exposure!

48
Q

brachytherapy

A

direct, continuous contact of radiation source with tumor tissues

patients emits radiation and are a hazard to others

49
Q

solid source brachytherapy

A

implanted near or within the tumor

50
Q

unsealed radiotherapy

A

isotopes suspended in fluid, given IV or PO, may also be instilled into body cavity

form of brachytherapy

51
Q

low dose rate brachytherapy

A

radiation sources are implanted near or within tumor, low dose radiation continuously emitted

52
Q

high dose rate brachytherapy

A

placed for a short duration of time, then removed

53
Q

visitor considerations for brachytherapy

A
  • visitors limited to 30 minutes/day

- no pregnant women or visitors under 16

54
Q

oral chemotherapy considerations x3

A

more convenient for patient

comprehensive patient education necessary (admin, adherence: diarrhea, skin peeling, may affect adherence; safe handling, side effects, disposal)

very expensive!

55
Q

extravasation of DNA binding vesicant patho

A

binds to nucleic acids in DNA of healthy cells → cell death → uptake of released cell complexes by adjacent healthy cells → continued cycle of tissue damage as DNA-binding vesicant retained and recirculated

56
Q

extravasation of non- DNA binding vesicant patho

A

does not bind to cellular DNA → eventually metabolized, more easily neutralized than DNA-binding vesicants

57
Q

neutropenia nadir in chemo patient

A

time when WBC counts are at their lowest after chemo

58
Q

neutropenia

A

abnormally low count of a type of white blood cell (neutrophils)

59
Q

thrombocytopenia

A

deficiency of platelets, causes bleeding into the tissues, bruising, slow clotting

60
Q

growth factor (colony stimulating factors) - what and types x3

A

growth factors promote recovery from bone marrow suppression induced by chemo

  • neutrophils
  • erythrocytes - outdated
  • platelets
61
Q

give for anticipated n/v (chemo patient)

A

benzo

62
Q

mucositis

A

sores in mucous membranes; may involve entire GI tract or just mouth (stomatitis)

63
Q

stomatitis

A

inflammation of mucus membrane in mouth

64
Q

chemo brain manifests as

A

difficulty with concentration, memory loss, inability to readily learn new info

65
Q

chemotherapy-induced peripheral neuropathy

A

caused by nerve-damaging cytotoxic drugs, may be permanent

66
Q

hormonal manipulation for cancer patients

A

decrease amount of specific hormones available to hormone-sensitive tumors thereby slowing cancer growth

67
Q

immunotherapy for cancer patients

A

modify biologic responses to tumor cells, enhance immune function, or stimulate faster bone marrow recovery

68
Q

cancer immunotherapy: interleukins

A

boost immune system to recognize, destroy cancer cells

se: peripheral neuropathy

69
Q

cancer immunotherapy: interferon

A

inhibits tumor cell growth, enhance natural killer cell anti-tumor activity

se: flu-like syndrome - chills, fever, fatigue, myalgias, malaise. some are cumulative with fatigue as the dose-limiting toxicity, possible depression due to exhaustion

70
Q

targeted therapies in general…

A

interfere with cancer cell growth, division

71
Q

epidermal growth factor/receptor inhibitors: se

A

rash, decrease LVEF

72
Q

vascular endothelial growth factor/receptor inhibitors: se

A

impaired wound healing, hypertension, GI perforation

73
Q

multikinase inhibitors: se

A

hypertension, adverse skin reactions (exfoliative dermatitis acne, hand-foot syndrome), n/v/d/c

74
Q

proteasome inhibitors: se

A

gi disturbance, bowel changes, peripheral neuropathy (may be significant), rash, bone/muscle pain, moderate to severe thrombocytopenia, anemia, neutropenia

PPPPPP!!!!

75
Q

hand-foot syndrome

A

redness, pain, swelling on hands or feet, specific to chemotherapy

76
Q

bone marrow suppression targeted therapies x3

A

proteasome, angiogensis, tyrosine kinase

77
Q

angiogensis inhibitors: se

A

hypersensitivity reactions (significant), hyperglycemia, mucositis

moderate to severe anemia, neutropenia, thrombocytopenia, headache, n/v/d, back/muscle/joint pain, skin issues

78
Q

monoclonal antibodies: se

A

r/t activation of immune system, allergic and infusion reactions can be an issue, flu-like

79
Q

tyrosine kinase

A

bone marrow suppression, fluid retention, electrolyte imbalance

80
Q

disseminated intravascular coagulation

A

proteins that control blood clotting become over active

oncologic emergency

81
Q

oncological emergency: spinal cord compression

A

pressure exerted on spinal cord by tumor bulk or vertebrae collapse
- paralysis results, usually permanent

82
Q

oncological emergency: spinal cord compression - s/s & tx

A

pain, muscle weakness, tingling, impaired gait, incontinence; can be sudden onset

high dose corticosteroids (edema reduction), high dose radiation, surgery

83
Q

oncological emergency: hypercalcemia

A

occurs in patients with bone metastasis which causes release of calcium into bloodstream

84
Q

oncological emergency: hypercalcemia - s/s & tx

A

s/s: fatigue, n/v, appetite changes –> severe muscle weakness, ecg changes

85
Q

oncological emergency: tumor lysis syndrome

A

rapid destruction of tumor burden, intracellular contents released faster than body can eliminate

  • hyperkalemia
  • hyperuricemia
  • hypocalcemia
    s/t hyperphosphatemia - thought to lower plasma Ca2+ by precipitation and deposition of calcium phosphate in bone and soft tissues
  • hyperphosphatemia
86
Q

oncological emergency: tumor lysis syndrome tx

A

hydration (3-5 L/day), diuretics, purine excretion (kidney) promoting drugs, sodium polystyrene, dialysis if severe

87
Q

phosphorus

A

intracellular constituent required for synthesis of cell membranes, protein synthesis/reproduction, ATP

z Su15 HEHI 3 (4 decks)

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