Oncologic Disease

Question 1

5 most common sites for Metastasize

Answer 1

Lung, Lymph Nodes, Liver, Bone, Brain

Question 2

4 subcategories of malignancy- specific aspect

Answer 2

Carcinoma- Skin & visceral/Exoderm
Sarcoma- CT/mesoderm
Lymphoma- lymphoid cells
Leukemia- blood/bone marrow

Question 3

Epidemiology of CA

Answer 3

2nd leading cause of death in US
Lung/bronchus- ♂ & ♀
Colon/rectum- ♂ & ♀
Prostate-♂; Breast-♀

Question 4

Screening RISK factors for CA include

Answer 4

age >50
previous hx (can metastasize 15-20 ys later)
Gender
♀-unknown cause for shld/chest pain; abnormal menses
♂-sciatica

Question 5

General c/o in hx

Answer 5

• unexplained wt gain/loss
• constant pain
• pain worse @ night
• proximal mm/tendon wk
• failure to progress/improve esp back pain

Question 6

C.A.U.T.I.O.N

Answer 6

Changes in Bowl/Bladder
A sore that doesn't heal w/ 6 wk
Unusual bleeding/discharge
Thickening/lump 
Indigestion/ dysphagia
Obvious change in wart/mole
Nagging hoarseness/cough

Question 7

5 Clinical manifestations of Malignancy

Answer 7

1) early warning signs (CAUTION; change in vital signs, prox mm wk, hypo/hyperreflexia)
2) Skeletal- deep/bone pain; hypercalcemia⟶hypertension, wk, headache, N&V
3) Neurologic- nerve/cord compression; brain tumor; paraneoplastic syndromes/remote effects
4) Pulmonary- Dyspnea
5) Hepatic- Bilat CTS, abd pain, ascites

Question 8

What are “Remote Effects”; give examples

Answer 8

tumpr producing S&S at a distance from the site; wt loss, fever, anorexia, progressive mm wk

Question 9

5 Biologic mechanism of CA pain

Answer 9

1) bone destruction
2) skin distention
3) visceral obstruction
4) nerve compression
5) tissue inflammation/infection/necrosis

Question 10

S&S associated w/ Mild-moderate-superficial pain

Answer 10

(sympathetic- acute type pain)

-hypertension, tachycardia, tachypnea

Question 11

S&S associated w/ Severe/visceral pain

Answer 11

(parasympathetic)

-hypotension, bradicardia, N&V

Question 12

Cardinal Symptoms post CA Tx

Answer 12

N&V, headaches, fatigue, dyspnea

Question 13

Contraindications to exercice post CA Tx
WBC, Platelet, Hgb, Absolute granulocytes
??PT??

Answer 13

WBC <2.5x (12-15 sec)

Question 14

16 specific CA

Answer 14

1. Skin
2. Breast
3. Endometrial/Uterine
4. Ovarian
5. Cervical
6. Leukemia
7. Multiple myeloma
8. Hodgkin’s disease
9. non-hodgkin’s Lymphoma
10. AIDS-non-hodgkin’s Lymphoma
11. soft tissue (mm)
12. bone
13. chondrosarcoma
14. brain tumors
15. SC tumors

Question 15

3 types of Skin CA

Answer 15

Basal cell carcinoma
Squamous cell carcinoma
Malignant melanoma

Question 16

S&S of Breast CA; Risk factors

Answer 16

• lump esp an axillary mass, shoulder/arm pain

- Gender, age, race, fam/previous hx, ↑estrogen, abortion

Question 17

S&S of Endometrial CA; Risk factor

Answer 17

• Pelvic pain

- 75% post menopausal

Question 18

40-70y/o, nulliparous, hx CA, pelvic pain, GI problem

Answer 18

Risk factor for Ovarian CA

Question 19

Risk factor for Cervical CA

Answer 19

30-40 (preinvasive)
>40 (invasive)
hx sexual activity
no early symptoms

Question 20

children/young adults, bleeding (petechaie, epistaxis), fatigue, infection, hemarthrosis

Answer 20

S&S of Leukemia

Question 21

♂, AA, 50-70y/o, Insidious, bone type pain, CTS, fatigue, recurrent infections (esp ribs & spine)

Answer 21

S&S of Multiple myeloma

Question 22

adolescent/older, ♂, painless enlarged lymph nodes, wt loss, fevers, night sweats, pruritus

Answer 22

Hodgkins disease or Non Hodgkins Lymphoma- Difference between is the age (NHL is middle aged)

Question 23

One distinctive difference btw non & hodgkins is:

Answer 23

• infection w/ Epstein-Barr virus~MONO?

- Leads to hodgkins up to 40%

Question 24

S&S of AIDS-non-hodgkin’s lymphoma

Answer 24

♂, early 40’s, AIDS

Question 25

Which Specific CA is rare; in extremities; in early adolescence/middle aged

Answer 25

Soft tissue tumors

Question 26

Which Specific CA is rare; bone pain described as "boring"; most common CHILDHOOD sarcoma of the bone

Answer 26

Osteosarcoma | Ewings Sarcoma

Question 27

Located usually where epiphyses/active growth occurs due to osteoblasts being the ones affected

Answer 27

Osteosarcoma

Question 28

Which CA: young, ♂, growth spurt, loss of motion, pain may be intermittent, swelling

Answer 28

Ewings Sarcoma

Question 29

Which CA are typically found in the young

Answer 29

Leukemia, Hodgkin's disease, Soft tissue tumors, Osteosarcoma, Ewing's sarcoma

Question 30

Which CA: older >40, back pain, sciatica, more common in axial

Answer 30

Chondrosarcoma

Question 31

Which CA: headache, seizures, CNS changes, 1〫 malignant, metastic

Answer 31

Brain tumors

Question 32

Which CA: Back pain is worse w/ lying down, wt bearing, ↑thoracic pressures; Rest pain, altered sensation, cauda equine signs

Answer 32

Spinal Cord Tumors

Question 33

Which CA are typical for older people

Answer 33

Skin CA, breast CA, Endometrial CA, Ovarian, Cervical CA, Multiple Myeloma, Non-Hodgkin's Lymphoma, AIDS-Non-Hodgkin's Lymphoma, Chondrosarcoma