Cancer Flashcards

1
Q

▪ 2nd Leading cause of Death in U.S.

A

Cancer

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2
Q

65% of people diagnosed survive

A

> 5 years

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3
Q

▪ Median age at diagnosis-

A

65 yrs old

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4
Q

▪ Risk of acquiring and dying cancer

A

▪ Gender differences

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5
Q

Cancer results from

A

Results from- alteration in cell DNA
structure, Oncogene, Inactivation of tumor suppressor
gene

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6
Q

What is the Critical gene related to cancer: tumor suppressor?

A

p53- monitors cellular DNA damage.

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7
Q

Stimulation of oncogene formation by:

A

Tobacco, alcohol & sunlight is responsible for 80% of cancers in the U.S

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8
Q

Staging of Cancer

A

the higher the number the worst you are

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9
Q

2 diagnostics tst

A

CT and MRI

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10
Q

Cancer treatment’s most serious adverse effects:

A

▪ Bone marrow suppression
▪ Cardiovascular toxicity
▪ Pulmonary toxicity

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11
Q

Chemotherapy cardiotoxicity

A
▪ Dysrhythmias
▪ Prolonged QT
▪ Cardiomyopathy
▪ Severe bradycardia
▪ Pericarditis
▪ Angina
▪ Coronary vasospasm
▪ Ischemia related EKG changes
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12
Q

Hematologic Radiation acute and chronic effect

A

Acute is : Bone marrow suppression

Chronic is : Coagulation necrosis

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13
Q

Endocrine radiation acute and chronic effect

A

No acute

Chronic: Endocrine Hypothyroidism, panhypopituitarism

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14
Q

Hepatic radiation acute and chronic effect

A

no chronic

ACute: Sinusoidal obstruction syndrome

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15
Q

Renal Radiation acute and chronic effects

A

Acute: Glomerulonephritis
Chronic: Glomerulosclerosis

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16
Q

Respiratory Radiation acute and chronic effects

A

Acute: none
Chronic: Airway fibrosis, pulmonary fibrosis, pneumonitis,
tracheal stenosis

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17
Q

Cardiac Radiation acute and chronic effects

A

ACute: none
Chronic: Cardiac Conduction defects, pericardial effusion, pericardial fibrosis, pericarditis

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18
Q

Skin Radiation acute and chronic

A

Acute: Erythema, rash, hair loss
Chronic: Fibrosis, sclerosis, telangiectasias

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19
Q

Gastrointestinal Radiation acute and Chronic

A

Acute: Malnutrition, mucositis, nausea, vomiting
Chronic: Adhesions, fistulas, strictures

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20
Q

▪ Alkylating agents causes

A

damage cell DNA

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21
Q

▪ Alkylating agents

A
Busulfan
Carmustine
Chlorambucil
Cisplatin
Cyclophosphamide
Etoposide
Ifosfamide
Paclitaxel
Vinblastine
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22
Q

Antitumor antibiotics:

A

form a complex with DNA or RNA

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23
Q

Antitumor antibiotics are

A

Doxorubicin
Bleomycin
Mitomycin
Mitoxantrone

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24
Q

Vitamin K dep

A

2,7, 10

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25
Q

If on steroids and unable to give PO give

A

Solu medrol 100mg IVP

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26
Q

CA Nervous system autonomic dysfunction

A

Labile BP

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27
Q

Methotrexate long term

A

Dementia

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28
Q

Antimetabolites action

A

block enzymes necessary for protein synthesis

29
Q

Antimetabolites

A

Fluorouracil
Asparaginase
Methotrexate

30
Q

Doxorubicin adverse effects

A

Cardiac toxicity

Myelosuppression

31
Q

Asparaginase adverse effects

A

Coagulopathy, hemorrhagic pancreatitis, hepatic dysfunction, thromboembolism

32
Q

Bleomycin adverse effects

A

Pulmonary hypertension, pulmonary toxicity

33
Q

Busulfan adverse effects

A

Cardiac toxicity, myelosuppression, pulmonary toxicity

34
Q

Carmustine adverse effects

A

Myelosuppression, pulmonary toxicity

35
Q

Chlorambucil adverse effects

A

Myelosuppression, pulmonary toxicity, SIADH

36
Q

Cisplatin adverse effects

A

Dysrhythmias, magnesium wasting, mucositis, ototoxicity, peripheral neuropathy, SIADH, renal tubular necrosis, thromboembolism

37
Q

Cyclophosphamide adverse effects

A

Encephalopathy/delirium, hemorrhagic cystitis, myelosuppression, pericarditis, pericardial
effusion, SIADH, pulmonary fibrosis

38
Q

Etoposide adverse effects

A

Cardiac toxicity, myelosuppression, pulmonary toxicity

39
Q

Fluorouracil adverse effects

A

Acute cerebellar ataxia, cardiac toxicity, gastritis, myelosuppression

40
Q

Ifosfamide adverse effects

A

Cardiac toxicity, hemorrhagic cystitis, renal insufficiency, SIADH

41
Q

Methotrexate adverse effects

A

Encephalopathy, hepatic dysfunction, mucositis, platelet dysfunction, pulmonary toxicity, renal failure, myelosuppression

42
Q

Mitomycin adverse effects

A

Myelosuppression, pulmonary toxicity

43
Q

Mitoxantrone adverse effects

A

Cardiac toxicity, myelosuppression

44
Q

Paclitaxel adverse effects

A

Ataxia, autonomic dysfunction, myelosuppression, peripheral neuropathy, arthralgias,
bradycardia

45
Q

Vinblastine adverse effects

A

Cardiac toxicity, hypertension, myelosuppression, pulmonary toxicity, SIADH

46
Q

Nephrotic and Nephritics

A

Spill more protein with nephrotic

47
Q

Spinal Cord Compression usually Mets in

A

epidural space

48
Q

Anesthesia for SPINAL CORD COMPRESSION

A

No neuraxial anesthesia

49
Q

Spinal Cord compression S/S-

A

pain, muscle weakness, sensory loss, autonomic dysfunctionoid neuraxial

50
Q

Breast Cancer

A

▪ Women in U.S. 12% lifetime risk

51
Q

Anesthesia management Prostate and Breast

A

Anesthesia Management
▪ Preop eval- chemo adverse effects
▪ Avoid ipsilateral arm for IV & BP cuff compression-lymphedema
▪ Bone pain/pathologic fractures noted when considering regional anesthesia and positioning patient

52
Q

Anesthesia Management for Cardiac Tumors

CO ? PA , arrhythmias

A

▪ Anesthesia consideration: low cardiac output
& arterial hypoxemia from mitral or tricuspid
obstruction
▪ Right atrial myxoma prohibits placement of right atrial or pulmonary artery catheters
▪ Supraventricular dysrhythmias may follow
surgical removal of atrial myxomas

53
Q

What is atrial myxoma?

A

noncancerous tumor in upper right or left side of heart

54
Q

Head & Neck Cancer

▪ Anesthesia consideration:

A

possible difficult airway

55
Q

Thyroid Cancer

▪ Anesthesia considerations:

A

Medullary thyroid cancers may be associated with
pheochromocytomas in an autosomal dominant
disorder known as multiple endocrine neoplasia type II.

56
Q

Thyroid CA and Radiation history =

A

potential difficult airway

57
Q

Esophageal Cancer- Mostly caused by

A

alcohol, smoking & Barrett’s.

58
Q

Anesthesia Considerations for Esophageal CA

A

alcohol=possible liver disease,
smoking= possible COPD, weight loss=
malnutrition & decreased intravascular fluid volume

59
Q

Gastric Cancer- S/S-r

A

weight loss, palpable epigastric mass, jaundice, and ascites appear

60
Q

Gastric Cancer Anesthesia considerations

A

malnutrition, liver dx

61
Q

▪ Liver Cancer

▪ Anesthesia:

A

medication metabolism

62
Q

Pancreatic CA Anesthesia:

A

Malnutrition, hypovolemia, hypoglycemia

63
Q

Renal Cell Cancer

▪ Anesthesia-

A

Medication excretion, hypercalcemia
d/t ectopic parathyroid secretion, erythrocytosis
d/t ectopic erythropoietin production

64
Q

Pancreatic Cancer

▪ S/S-

A

Abdominal pain, anorexia, and weight loss, Jaundice d/t biliary obstruction

65
Q

▪ > in men, associated with smoking

A

Bladder Cancer

66
Q

Rare, but most common cancer in young men

A

▪ Testicular Cancer

67
Q

Cervical & Uterine Cancer

A

▪ Most common gynecologic cancer in females

aged 15 to 34 years

68
Q

Most deadly of the gynecologic cancers

A

Ovarian Cancer

69
Q

▪ Bone Cancer

A

▪ Multiple myeloma, osteosarcoma, Ewing’s
sarcoma, and chondrosarcoma
▪ Anesthesia- Bone pain, anemia, hypercalcemia,
thrombocytopenia, neutropenia, renal failure and recurrent bacterial infection