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System Screenings I > Neoplasia > Flashcards

Flashcards in Neoplasia Deck (60):
1

Large group of diseases broadly defined by uncontrolled cell proliferation and spread of abnormal cells

Cancer (aka malignant neoplasm, tumor, malignancy, carcinoma)

2

The process by which normal cells undergo physical and structural changes as they develop to form different tissues of the body

Differentiation

3

A general category that indicates a disorganization of cells in which an adult cell varies from its normal size, shape, or organization

Dysplasia

4

First level of dysplasia, adult cell changes from one type to another; reversible and benign

Metaplasia

5

Loss of cellular differentiation; characteristics of malignant cells only

Anaplasia

6

Increase in the number of cells in tissue, resulting in increased tissue mass

Hyperplasia

7

Abnormal growth of new tissue and may be benign or malignant

Tumor (neoplasm)

8

Where cancer or tumor starts

Primary site

9

Where cancer spreads to

Secondary site

10

Pre invasive, premalignant epithelial tumor of glandular squamous cell origin; malignant tumor but hasn't spread outside of primary site yet

Carcinoma in situ

11

How are neoplasms classified?

1. Cell type
2. Tissue origin
3. Degree of differentiation
4. Anatomic site
5. Benign or malignant

12

Malignant and benign tumors have the same name except malignant tumors have a suffix. Name the 2 suffixes and their meaning.

1. Carcinoma - epithelial
2. Sarcoma - mesenchymal (connective tissue

13

Generally harmless tumor because it does not spread or invade other tissue

Benign

14

Tumor of neural cell precursor (benign and malignant)

Benign - ganglioneuroma
Malignant - neuroblastoma

15

Malignant lymph nodes of the spleen

Lymphoma

16

Hematopeoitic malignant tumors of bone marrow and plasma cells

Leukemia, myelodysplasia, multiple myeloma

17

Germ cell tumor (embryonic cells) benign and malignant

Teratoma (benign); Teratocarcinoma, embyonal carcinoma, seminoma/dysgerminoma

18

The extent of the disease at the time of diagnosis; more predictive of prognosis

Staging

19

The degree of malignancy and differentiation

Grading

20

Staging used in lymphomas

Ann Arbor Staging

21

Name the 3 components of TNM classification

1. Primary tumor - T
2. Regional lymph nodes - N
3. Metastasis - M

22

Is cancer incidence on the rise?

No, cancer overall has decreased 20% over the last two decades

23

Cancer due to genetics

Endogenous

24

Cancer due to environmental/external factors

Exogenous

25

Theory that cancer is due to a series of mutations; induced by carcinogenic agents and hereditary susceptibility; process involves many steps

Somatic mutation theory

26

Theory that there are cancer causing genes; transform normal cells into malignant cells (independently or with a virus)

Oncogenesis

27

Tumor supressor genes

Anti-oncogenes

28

What are clinical manifestations of cancer?

Asymptomatic early; destruction, necrosis, ulceration, hemorrhage; pain; nausea, vomiting; weight loss, m. weakness, anorexia, anemia, coagulation disorders; fever; GI, pulmonary, and vascular obstruction; fatigue; wasting

29

Clinical manifestations of: Pulmonary system? Hepatic system? Skeletal system? Central Nervous system?

Pulmonary - cough, hemoptysis, dyspnea
Hepatic - hepatomegaly, nausea, jaundice
Bones - bone pain, fx
CNS - Neurological symptoms such as headaches, seizures, vertigo

30

What are causes of pain with cancer?

1. Depression/anxiety - may make pain worse
2. Locally - pain due to pressure on structure
3. metastasis
4. Spinal cord compression
5. From treatment - surgery, radiation, chemotherapy

31

Disease where tumors produce systemic signs and symptoms at a distance form the tumor or its metastasized sites; typically hormone related; when cancer expresses characteristics different from its cancerous tissues; malignant cells can acquire new cellular fans uncharacteristic of the originating tissue

Paraneoplastic syndrome

32

What are the medical screenings used for breast cancer?

1. Breast Self Exam
2. Clinical Breast exam
3. Mammography

33

What are the medical screenings used for colorectal cancer?

1. Fecal occult blood test (FOBT), or fecal immunochemical test (FIT)
2. Stool DNA test
3. Flexible sigmoidoscopy
4. Double contrast barium enema
5. Colonoscopy
6. CT colonography

34

What are the benefits exercise for cancer, according to the exercise-cancer hypothesis

1. Enhance immune function
2. Prevent or minimize m. wasting (counteracting cancer or chemo)
3. Maintain quality of life

35

What are the early warning signs of cancer?

1. Change in bowel or bladder habits
2. Sore that does not heal in 6 weeks
3. unusual bleeding or discharge
4. Thickening or lump in breast or elsewhere
5. Indigestion or difficulty swallowing
6. obvious change in a wart or mole
7. Nagging cough or hoarseness

36

What early cancer signs should physical therapists look for?

1. Proximal muscle weakness (shoulder girls, hip)
2. Change in deep tendon weakness

37

What are the early melanoma signs?

ABCD's -
Asymmetry
Border
Color
Diameter

38

What are the curative cancer treatments?

1. Surgery
2. Radiation
3. Chemotherapy
4. Biotherapy (immunotherapy)
5. Hormonal therapy

39

Treatment of disease by delivery of radiation to a particular area of the body using high energy ionizing radiation to kill cancer cells; interacts with nuclear DNA preventing the cell's ability to divide

Radiation therapy

40

What are the clinical manifestations of radiation therapy that PTs are to look out for?

Connective tissues -
1. Fibrosis, atrophy and contraction
2. Limb length discrepancies. scoliosis
3. Lymphadema

41

What are the clinical manifestations of radiation therapy?

1. Esophagitis and enterocolities
2. Heart Disease
3. Lung Disease
4. Dermatitis
5. Connective tissue
6. Nervous system

42

What is an absolute contraindication of radiation therapy?

Pregnancy

43

What should you do post radiation therapy?

1. Avoid topical use of alcohol, lotions, gels, oils, salves, creams
2. Avoid positions where pt is lying on radiated area
3. Avoid exposure to direct sunlight, heat lamps, thermal modalities
4. Expect delayed wound healing

44

Used to cure, palliate prior to bone marrow transplant or adjunct other therapies; goal is to destroy malignant cells and maintain normal cells

Chemotherapy

45

What are the 4 primary agents of chemo therapy? Which has clinical importance for PTs?

1. Alkylating
2. Antimetabolites
3. Antibiotics ** - tend to be cardiotoxic; increases risk of cardiac problems
4. plant alkaloids

46

What are adverse effects of chemotherapy?

1. Nausea/vomiting
2. Mucositis
3. Myelosuppression
4. Sterility
5. Toxic to fetus
6. Alopecia
7. GI toxicity
8. Fatigue
9. Cardio, pulm, renal, hepatic toxicity
10. Peripheral neuropathy

47

What should PTs be aware of with chemotherapy?

1. Possibility of myelosuppression
2. Monitor hematology values
3. Signs and symptoms of myelosuppression
4. Symptoms may lay latent (pulmonary fibrosis)
5. Neuropathies

48

What cancer treatments are palliative (attempt to improve quality of life, not cure cancer)?

1. Radiation
2. Chemotherapy
3. Physical therapy
4. Medications
5. Acupuncture
6. Chiropractic care
7. Alternative medicine
8. Hospice care

49

Clues to screening for cancer: Previous personal history of cancer, especially in the presence of carpal tunnel symptom, back pain, shoulder pain, or joint pain of ______ or _______ cause at presentation

Unknown (think systemic); rheumatic

-if not following normal progression during treatment

50

Clues to screening for cancer: Any woman with chest, breast axillary or ________ pain of unknown cause

Shoulder

51

Clues to screening for cancer: Anyone with back, pelvic, groin, or hip pain accompanied by vague _______ complaints, _____ mass

Abdominal; palpable

52

Clues to screening for cancer: When back "injury" is not __________ or if symptoms are _______.

improving as expected; increasing

53

Clues to screening for cancer: Constant pain (unrelieved by ______ or ________); pain present at _______

Rest; change in position; night

54

Clues to screening for cancer Signs of __________ compression must be screened for cancer as a possible cause

Nerve root

55

Clues to screening for cancer: Changes in ____, _____, _____, and ______ of lymph nodes, especially painless, hard rubbery lymph nodes present in more than location and occurring for more than 4 weeks.

Size; Shape; Tenderness; Consistency

56

Document the number, type, and severity of difficulties that an individual may be facing as a result of the cancer diagnosis; looks at impact cancer has on pts life

CARES (cancer rehabilitation evaluation system)

57

What should PTs address in exercise intensity?

1. Don't just use HR
2. Borg RPE (no greater than 12)
3. Anemia
4. Peak capacity 3-5 MET's
5. 40-65% of peak HR, HR reserve, or VO2 max (just below anaerobic threshold)
6. High rep low load weight circuit

58

What are the time restriction guidelines to follow after radiation?

1. Do not exercise within 2 hours of radiation
2. Slow carful stretching skin and connective tissue can tear
3. low to moderate intensity aerobic exercise during the weeks of radiation may be beneficial
4. Assess fatigue leve (cancer related fatigue as well)

59

What are the most common childhood cancers?

1. All acute lymphoblastic leukemia
2. Non-hodgkin's lymphoma
3. Hodgkin's disease
4. Primary CNS tumor

60

What are the physical therapy interventions with cancer?

1. Fall prevention; neuropathy and fatigue
2. Physical agents; decreased sensation, increased blood flow
3. when to refer