Cancer Flashcards by Linsay AugustinCRNA

▪ 2nd Leading cause of Death in U.S.

Cancer

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65% of people diagnosed survive

> 5 years

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▪ Median age at diagnosis-

65 yrs old

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▪ Risk of acquiring and dying cancer

▪ Gender differences

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Cancer results from

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

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

p53- monitors cellular DNA damage.

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Stimulation of oncogene formation by:

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

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Staging of Cancer

the higher the number the worst you are

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2 diagnostics tst

CT and MRI

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Cancer treatment’s most serious adverse effects:

▪ Bone marrow suppression
▪ Cardiovascular toxicity
▪ Pulmonary toxicity

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Chemotherapy cardiotoxicity

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

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Hematologic Radiation acute and chronic effect

Acute is : Bone marrow suppression

Chronic is : Coagulation necrosis

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Endocrine radiation acute and chronic effect

No acute

Chronic: Endocrine Hypothyroidism, panhypopituitarism

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Hepatic radiation acute and chronic effect

no chronic

ACute: Sinusoidal obstruction syndrome

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Renal Radiation acute and chronic effects

Acute: Glomerulonephritis
Chronic: Glomerulosclerosis

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Respiratory Radiation acute and chronic effects

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

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Cardiac Radiation acute and chronic effects

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

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Skin Radiation acute and chronic

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

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Gastrointestinal Radiation acute and Chronic

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

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▪ Alkylating agents causes

damage cell DNA

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▪ Alkylating agents

Busulfan
Carmustine
Chlorambucil
Cisplatin
Cyclophosphamide
Etoposide
Ifosfamide
Paclitaxel
Vinblastine

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Antitumor antibiotics:

form a complex with DNA or RNA

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Antitumor antibiotics are

Doxorubicin
Bleomycin
Mitomycin
Mitoxantrone

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Vitamin K dep

2,7, 10

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If on steroids and unable to give PO give

Solu medrol 100mg IVP

CA Nervous system autonomic dysfunction

Labile BP

Methotrexate long term

Dementia

Antimetabolites action

block enzymes necessary for protein synthesis

Antimetabolites

Fluorouracil Asparaginase Methotrexate

Doxorubicin adverse effects

Cardiac toxicity | Myelosuppression

Asparaginase adverse effects

Coagulopathy, hemorrhagic pancreatitis, hepatic dysfunction, thromboembolism

Bleomycin adverse effects

Pulmonary hypertension, pulmonary toxicity

Busulfan adverse effects

Cardiac toxicity, myelosuppression, pulmonary toxicity

Carmustine adverse effects

Myelosuppression, pulmonary toxicity

Chlorambucil adverse effects

Myelosuppression, pulmonary toxicity, SIADH

Cisplatin adverse effects

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

Cyclophosphamide adverse effects

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

Etoposide adverse effects

Cardiac toxicity, myelosuppression, pulmonary toxicity

Fluorouracil adverse effects

Acute cerebellar ataxia, cardiac toxicity, gastritis, myelosuppression

Ifosfamide adverse effects

Cardiac toxicity, hemorrhagic cystitis, renal insufficiency, SIADH

Methotrexate adverse effects

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

Mitomycin adverse effects

Myelosuppression, pulmonary toxicity

Mitoxantrone adverse effects

Cardiac toxicity, myelosuppression

Paclitaxel adverse effects

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

Vinblastine adverse effects

Cardiac toxicity, hypertension, myelosuppression, pulmonary toxicity, SIADH

Nephrotic and Nephritics

Spill more protein with nephrotic

Spinal Cord Compression usually Mets in

epidural space

Anesthesia for SPINAL CORD COMPRESSION

No neuraxial anesthesia

Spinal Cord compression S/S-

pain, muscle weakness, sensory loss, autonomic dysfunctionoid neuraxial

Breast Cancer

▪ Women in U.S. 12% lifetime risk

Anesthesia management Prostate and Breast

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

Anesthesia Management for Cardiac Tumors | CO ? PA , arrhythmias

▪ 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

What is atrial myxoma?

noncancerous tumor in upper right or left side of heart

Head & Neck Cancer | ▪ Anesthesia consideration:

possible difficult airway

Thyroid Cancer | ▪ Anesthesia considerations:

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

Thyroid CA and Radiation history =

potential difficult airway

Esophageal Cancer- Mostly caused by

alcohol, smoking & Barrett’s.

Anesthesia Considerations for Esophageal CA

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

Gastric Cancer- S/S-r

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

Gastric Cancer Anesthesia considerations

malnutrition, liver dx

▪ Liver Cancer | ▪ Anesthesia:

medication metabolism

Pancreatic CA Anesthesia:

Malnutrition, hypovolemia, hypoglycemia

Renal Cell Cancer | ▪ Anesthesia-

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

Pancreatic Cancer | ▪ S/S-

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

▪ > in men, associated with smoking

Bladder Cancer

Rare, but most common cancer in young men

▪ Testicular Cancer

Cervical & Uterine Cancer

▪ Most common gynecologic cancer in females | aged 15 to 34 years

Most deadly of the gynecologic cancers

Ovarian Cancer

▪ Bone Cancer

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

Cancer Flashcards

(69 cards)