Module 16 Exam 3 Flashcards Preview

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Flashcards in Module 16 Exam 3 Deck (49):

What is benin

not malignant


what is malignant

tending to become progressively worse, and to result in death, having the properites of anaplasia, invasiveness, and metastasis, said of tumors


what does cancer refer to

-group of neoplastic diseases in which there is transformation of normal cells into malignant ones
-as cancer cells proliferate, the mass of abnormal tissue that is formed enlarges until it takes over the host site then it metastasizes


how are cancers classified

-origin of the tissue involved: carcinoma (epithelial tissue), sarcomas (conn. tissue))
-type of cell from which they arise


what are characteristics of benin neoplasms

-resemble normal cells
-tumor grows by expansion and doesnt infiltrate
-doesnt metastasize
-doesnt recurr
-doesnt usually cause tissue damage
-doesnt usually cause death


what are characteristics of a malignant neoplasm

-bears little resemblance to normal cells
-tumor grows at the periphery and sends out processes that inflitrate
-rapid growth
-gains access to blood and lymph
-recurs when removed
-generalized effects
-extensive tissue damabe
-usually causes death unless controlled


what are risk factors for cancer

tobacco, alcohol, sunlight, environmental/occupational, viruses (epstein barr- burketts lymphoma, Hep C liver cancer, HPV) socioeconomic


what are the most common types of cancer in men

prostate, lung and bronchus, colon and rectum


what are the most common types of cancer in women

-breast, lung and bronchus, colon and rectum


what is chemotherapy

involves the use of drugs that affect the rapidly dividing cancer cell at different points in the cell cycle


what are the objectives of chemotherapy

-destroy cancer cells, prevent metastasizing
-prevent cancer from recurring
-provide and improved quality of life


what are indications of chemotherapy

-eliminate tumor too large for surgery
-treat cancer that has metastasized
-prevent from reoccurence
-make tumor easier to surgically remove
-extend life


what are the types of agents used for chemotherapy

-alkylating agents, antibiotics, antimetabolites, plant alkaloids, steroids/hormones


what are the side effects of chemotherapy

-nausea, vomiting, diarhha
loss of apetite
GI mucositis


what are the oral complications of chemotherapy

-oral mucositis/stomatitis
-infections:bacterial, viral (herpes simplex, vaicella zoster, cytomegalovirus), fungal (candida albicans)
-neurotoxicity (mimics T.A)


what is radiation?

uses ionizing radiation to treat cancer, impacts the cancer cells ability to replicate and survive, cant be used on all tumors,


what are indications for radiation

-treat a small localized tumor
-shrink a large tumor
-assist chemo
-prevent spread of cancer
-prevent recurrence of cancer
-provide symptom/pain relief


what are the two types of radiation

external beam and internal


what is external beam radiation

-applied outside the body


what is internal radiation

-source of the radiation is placed within the body, less radiation is delivered to the surrounding tissues


what does the dose of radiation depend on?

type of tumor, tx goals, ablity to tolerate


what is the approximate dose of radiation given

3,000 to 7,000 centigreys, divided into equal doses per day


what are the systemic effects of radiation

-skin reactions- looks like a bad sunburn
-nausea, vomitting, diarhhea, constipation


what are the oral complications of radiation

-taste loss
-radiation caries


what is a hematopoietic cell transplantation

-used to treat a varitety of blood diseases, including leukemia
-purpose is to substitute blood stem cells or bone marrow from a healthy, compatible donor to replace the dieseased bone marrow of the patient


what are 3 types of transplants

-autolgous- self
-allogenic- matched donor
-syngenic- identical twin


what are the indications for a transplant

-patient not responsive to chemo alone, relapse occurs after one or more remission


what is evaluated for a transplant

medical and dental assessments to ensure patient is free of infection, and pysically able to undergo


where is the bone marrow aspiriated from

iliac crest, ribs, or sternum


how is the patient prepared to recieve a bone marrow graft

-high dose immunosupressive regiment, chemo or total body radiation
-to kill malignant cells


how long does it take for the new marrow to function after a transplant

10 to 20 days


what is the immune recovery from a transplant? long term?

3 to 12 months, 1-3 years


what is acute graft vs host disease

-t lymphocytes see the host cell antigens as foreign and react against the host tissue


what are symptoms of host vs graft disease

-during first 100 days
-painful red skin rash
-severe persistent diarhhea


what are oral complications of acute graft vs host disease

oral mucositis: 10-14 days post transplant
viral and fungal infections


what is chronic graft vs host disease

-affects all organs of the body, can appear up to 2 years post transplant


what are oral complications of chronic graft vs host disease

-oral mucosits
-oral infection, perio infection
poor OH


what are the objectives of oral health and cancer

-asses for any infection
-eliminate sources of infection
-instruct pt in preventive oral care measures


what should you do with a patient who is going to recieve radiaion

-monitor personal daily care
-once daily fl2 gel
-monitor for trismus
-instruct pt to exercise opening and closing mouth 3 times per day


what should you do in tx after radiation therapy

-first 6 mo, non surgical perio therapy
-reinforce personal OH
-after mucositis subsides, talk to MD about when to make dentures
-watch for trismus, demineralization, caries
-advise against oral surgery on irradiatied bone


what does the extent of oral complications of chemotherapy depend on

-degree of infection present
-drugs used and their dosages
-concurrent radiation therapy
-pts personal OH


During chemotherapy before invasive work is completed what does the platelet and neutrophil count need to bw

-platelet more than 50,000 mm3
-neutrophil more than 1,000 mm3


should you premed if completing work during chem



what should you watch for after the hematopoietic cell transplantation

-watch for oral infections
-monitor oral health
-delay elective dental procedures for 1 year
-follow for long term complication
-follow for second malignancies in oral region


how soon should oral surgery procedures be completed in a patient who is going to undergo cancer therapy

at least 2 weeks prior


what should you instruct your pt about daily biofilm removal

-gently brush with an extrasoft tb every meal and at bedtime, floss gently


what should you instruct your pt about mouthrinsing

-every 2 to 3 hours while awake with baking soda and water
-avoid alcohol containing mouthrinses


what should you instruct your patient about xerostomia

-sip on water
-suck on ice chips
-saliva substitute
-avoid lemon glycerine swabs
-avoid hot spicy salty or sharp food
-moisten food


what should you instruct your pt about oral pain managment

-swish gargle and spit a capful of prescribed mouthrinse containing topical anesthetic 30 min before eating