Episodic Diseases - oncology, anemia, neutropenia, thrombocytopenia, Lymphedema

Question 1

___/___ canadians will get cancer, __/___ will die from cancer

Answer 1

2/5, 1/4

Question 2

Which forms of cancer are most common in men

Answer 2

Prostate
Lung
Colon

Question 3

Which types of cancer are most common in women

Answer 3

Breast
Lung
Colon

Question 4

What TMN system used for the staging cancer

Answer 4

tumour, nodes, mets

Question 5

What are the stages of tumours (extent/spread)

Answer 5

TX - cannot be evaluated
T0 - tumor in situ
T1-4

Question 6

What are the stages of nodes (lymph)

Answer 6

• Nx
• N0 (no lymph nodes involvement)
• N1-3 (extend of spread or # involved)

Question 7

What are the stages of mets (distant ones)

Answer 7

• Mx
• M0 (no)
• M1 (distant metastasis present)

Question 8

What are the stages of cancer

Answer 8

• Stage 0 = carcinoma in situ
• Stage 1-3 (cancer has extended beyond organ in which it first developed)*?
• Stage 4 (cancer has spread to different organs)

Question 9

5 Medical treatment options for cancer

Answer 9

• Surgery
• Chemotherapy
• Radiation
• Hormone replacement surgery
• Biological or genetic treatment to destroy cancer cells

Question 10

Side effects of chemotherapy

Answer 10

• alopecia
• mucositis
• pulmonary fibrosis
• cardiotoxicity
• renal failure
• sterility
• myalgia
• neuropathy

Question 11

Side effects of radiation

Answer 11

• skin irritation
• scar tissue
• hair loss (permanent or transient
• temp change in skin colour
• FATIGUE
• swallowing discomfort

Question 12

What is oncology

Answer 12

The study and treatment of tumours

Question 13

What is the clinical presentation of oncology (tumour treatment)

Answer 13

• ROM limitations (need shoulder range for radiation in breast cancer)
• fatigue
• myalgia
• arthralgia
• chemotherapy induced peripheral neuropathy
• deconditioning
• look for any recurring signs of cancer

Question 14

Oncology PT Rx

Answer 14

• fatigue management
• function and mobility management
• physical symptom management
• psychological symptom management

REHAB
- preventive, supportive, or restorative

ACUTE SETTING
- mobility (including eqp), general strength and mobility, and bed positioning

Question 15

Oncology exercise precautions

Answer 15

• Swollen ankle
• fatigue
• vomiting and diarrhea
• unexplained weight loss/gain
• SOB with low level of exertion

Question 16

Oncology exercise precautions

Answer 16

• racing pulse, fever, pain in back or neck or bone, calf pain, chest pain
• nauseated while exercising, confused or disorientated, dizzy or faint
• blurred vision, sudden SOB, very weak or tired

Question 17

Safety guidelines for metastatic disease

Answer 17

• follow protocols from MD (need weight bearing order not just AAT)
• ask about any new neurological symptoms (B/B, unrelenting pain)

Question 18

What is anemia

Answer 18

Condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues.

Question 19

What are safety guidelines for exercise with people with anemia

Answer 19

Exercise needs to be scaled back if below 8G/DL

Question 20

What is Neutopenia?

Answer 20

Decreased WBC

• relates to body’s ability to fight infection

Question 21

What should WBC levels be

Answer 21

> 1000 mcL

Question 22

The rate of infection increases if absolute neutrophils falls below ___

Answer 22

500MCL

Question 23

Safety guidelines for exercise with neutropenia

Answer 23

• avoid public fitness or areas, facilities and activities with inc exposure to viral and/or bac infection
• avoid exercise if have fever (temp greater than 37.5 degree F)

Question 24

What is thrombocytopenia ? what does it increase your risk of?

Answer 24

low platelet count (normal = 150-400, 000/mcL)

-Increased risk of bruising or bleeding (report any unusual bruising or symptoms to MD)

Question 25

Safety guidelines for exercise with thrombocytopenia if <50,000 MCL

Answer 25

avoid activities with contact or risk of falling

Question 26

What is appropriate exercises prescription if 40,000-60,000 MCL in Thrombocytopenia

Answer 26

low weights (1-2 lbs.), stationary bike low resistance, walking or ADLs

Question 27

What is appropriate exercises prescription if 20,000-40,000 MCL in Thrombocytopenia

Answer 27

low intensity exercise, low weights (0-2 lbs.), stationary bike no resistance or minimal, walking, and ADLS

Question 28

Safety precautions for exercise with thrombocytopenia if <20,000 MCL

Answer 28

Increased risk of spontaneous bleed unrelated to trauma

Question 29

What is appropriate exercises prescription if <20,000 MCL in Thrombocytopenia

Answer 29

doctor approval, active ROM exercises, walking, ADLS (may need supervision)

Question 30

Safety precautions for exercise with thrombocytopenia if <10,000 MCL

Answer 30

spontaneous CNS, GI, or respiratory tract bleeding may also occur

Question 31

What is appropriate exercises prescription if <10,000 MCL in Thrombocytopenia

Answer 31

no exercise, only essential ADLs, prevent falls and injury

Question 32

What is the function of the lymph system? via what mechanism does it accomplish this function

Answer 32

- removal of fluid, proteins, bacteria, viruses | - smooth mm in walls contract to move lymph

Question 33

What are the two types of lymphedema

Answer 33

Primary | Seconday

Question 34

What is primary lymphedema

Answer 34

rare, inherited condition that development problems occur in lymph vessels

Question 35

What is secondary lymphedema

Answer 35

D/T damage to or obstruction to normally functioning lymph vessels and nodes

Question 36

Lymphedema risk factors

Answer 36

- Radiation - axillary node dissection - Arm infection/virus (primary thought cause) - weight gain since operation - obesity (BMI >25) - older age

Question 37

Lymphedema prevention

Answer 37

- skin care - activity/lifestyle (body weight gradual buildup of activity) - avoid limb constriction (jewelry, clothes, BP cuffs on that side) - avoid extreme temp

Question 38

Lyphedema outcome measures

Answer 38

- circumferential (greater than 2 cm difference side to side) - water displacement - perometer and bioelectrical impedance

Question 39

PT role is treating lymphedema

Answer 39

- Prevention à weight loss through exercise | - Education: what to avoid, S/S to watch for

Question 40

Is physical activity safe for those with lymphedema

Answer 40

Yes, o prior, during, and post treatment is safe, however may have other variable to consider & check on change daily