Cancer Biology and Health Screening Quiz

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Questions and Answers

What is the recommended frequency for PSA/DRE screening in males over 50 years old?

Every 2 years

Annually (correct)

Every 10 years

Every 5 years

Which of the following is NOT an ACS Warning Signal for cancer?

Nagging cough

Change in bowel habits

Frequent headaches (correct)

Unusual bleeding

What initial management approach is best for stomatitis?

Hard-bristled toothbrush

Spicy mouthwash

Soft-bristled toothbrush (correct)

Alcohol-based mouth rinses

How soon after therapy does alopecia typically begin?

Within 2 weeks Signup and view all the answers

Which of the following is recommended for promoting nutrition in patients?

Providing small, frequent meals Signup and view all the answers

What type of cell remains dormant and does not actively participate in the cell cycle?

Neurons Signup and view all the answers

Which phase of the cell cycle involves the synthesis of DNA?

S Signup and view all the answers

What is the primary molecular cause of cancer as suggested in the content?

Change in DNA structure Signup and view all the answers

Which of the following are classified as physical agents in the etiology of cancer?

Exposure to sunlight and altitude Signup and view all the answers

Which of the following dietary habits is associated with an increased risk of cancer?

Processed foods Signup and view all the answers

Which step of carcinogenesis involves irreversible changes leading to malignancy?

Progression Signup and view all the answers

What kind of viruses are known to be associated with cancer according to the content?

Both DNA and RNA viruses Signup and view all the answers

What is the most common method through which cancer spreads?

Lymphatic system Signup and view all the answers

Which type of tumor is characterized by uncontrolled growth and the ability to metastasize?

Malignant Signup and view all the answers

What suffix is typically used to denote a benign tumor?

OMA Signup and view all the answers

What is the characteristic feature of anaplasia in neoplastic cells?

Lack of normal cellular characteristics Signup and view all the answers

Which term refers to the conversion of one type of mature cell into another type?

Metaplasia Signup and view all the answers

What does the term 'oma' refer to in tumor nomenclature?

Only benign tumors Signup and view all the answers

Which of the following tumors would most likely be classified as malignant?

Fibrosarcoma Signup and view all the answers

What kind of tumor is a teratoma derived from?

Three germ layers Signup and view all the answers

Which of the following cell origins is indicated by the suffix 'sarcoma'?

Connective tissue Signup and view all the answers

Which tumor marker is associated with pancreatic adenocarcinoma?

CA 19-9 Signup and view all the answers

What does the 'T' in the T-N-M staging system stand for?

Tumor size Signup and view all the answers

Which of the following is a characteristic of Grade 1 cancer?

Well-differentiated Signup and view all the answers

What type of surgery involves the removal of a tumor along with a significant margin of surrounding tissue?

Wide or radical excision Signup and view all the answers

What is the purpose of prophylactic surgery?

To prevent cancer in at-risk individuals Signup and view all the answers

Which of the following is NOT a type of general medical management for cancer?

Homeopathy Signup and view all the answers

What is the recommended screening method for breast cancer in women over 40?

Mammogram once a year Signup and view all the answers

Which of the following tumor markers is associated with bladder cancer?

NMP22 Signup and view all the answers

Which intervention is most appropriate for reducing fatigue in patients?

Planning daily activities with alternating rest periods Signup and view all the answers

What is the most important sign of infection in a cancer patient?

Fever above 38.3°C Signup and view all the answers

Which of the following is a common nursing intervention to assist in the grieving process for cancer patients?

Identifying and referring to support groups Signup and view all the answers

Which surgical management involves the complete removal of the breast, chest muscles, and axillary lymph nodes?

Radical mastectomy Signup and view all the answers

What is a primary objective when managing complications of septic shock?

Monitoring vital signs and administering IV antibiotics Signup and view all the answers

What intervention can improve body image in cancer patients?

Offering cosmetic materials like makeup and wigs Signup and view all the answers

Which of the following is NOT a factor that predisposes cancer patients to infection?

Well-nourished with a balanced diet Signup and view all the answers

What is an important preoperative nursing intervention for breast cancer patients?

Explaining breast cancer and treatment options Signup and view all the answers

What is the most common site of gliomas?

Cerebral hemisphere Signup and view all the answers

Which type of astrocytoma is most commonly associated with pediatric clients?

Pilocytic astrocytoma Signup and view all the answers

Which grade of astrocytoma is characterized as poorly differentiated and highly malignant?

Grade IV Signup and view all the answers

What is a common clinical feature of increased intracranial pressure (ICP) resulting from brain tumors?

Triad symptoms including headache, nausea, and papilledema Signup and view all the answers

Which imaging technique is particularly utilized to evaluate the metabolism of a brain tumor?

MRS Signup and view all the answers

What is the median survival time for patients diagnosed with glioblastoma multiforme?

12-18 months Signup and view all the answers

What characterizes oligodendrogliomas compared to other types of gliomas?

Most often low grade and slow growing Signup and view all the answers

Ependymomas commonly develop from which part of the brain?

Lining of the ventricles Signup and view all the answers

Which type of brain tumor is commonly benign and can be cured with surgery?

Meningioma Signup and view all the answers

What is the primary medical treatment for increased intracranial pressure (ICP)?

Dexamethasone Signup and view all the answers

What type of radiation therapy is designed to match the shape of a tumor from multiple directions?

3DCRT Signup and view all the answers

How often is radiation therapy typically administered for primary brain tumors?

Five days a week for six weeks Signup and view all the answers

Which factor primarily determines the treatment approach for mixed gliomas?

Location and degree of malignancy Signup and view all the answers

Signup and view all the answers

Study Notes

Oncology Nursing

Oncology is a branch of medicine focusing on the study, detection, treatment, and management of cancer and neoplasia.
Key "root words" include:
- Neo- new
- Plasia- growth
- Plasm- substance
- Trophy- size
- +Oma- tumor
- Statis- location
- A-none
- Ana- lack
- Hyper- excessive
- Meta- change
- Dys- bad, deranged

Characteristics of Neoplasia

Neoplasia involves uncontrolled growth of abnormal cells.
Benign tumors are characterized by:
- Well-differentiated cells resembling normal cells
- Slow growth
- Encapsulated (well-rounded)
- Non-invasive (do not spread)
- Do not metastasize (spread to other locations)
Malignant tumors are characterized by:
- Undifferentiated cells
- Erratic and uncontrolled growth
- Expansive and invasive (spread into surrounding tissue)
- Secrete abnormal proteins (tumor markers)
- Metastasize (spread to other locations)
Borderline tumors have characteristics between benign and malignant.

Proliferative Patterns

Anaplasia: cells that lack normal cellular characteristics and differ significantly in shape and organization.
Dysplasia: cells display bizarre growth, differences in size, shape, or arrangement from normal cells of the same tissue type.
Metaplasia: conversion of one type of mature cell into another type of cell

Cellular and Tissue Types Affected

Different cancers affect various tissues and cells.
Carcinoma—epithelial cells
Sarcoma—connective tissues (bone, muscle, and blood vessels)
Lymphomas—lymphatic tissue
Leukemia—blood-forming cells

Cancer Spread

Lymphatic spread: tumors travel via lymph vessels to lymph nodes, then potentially to other locations.
Hematogenous spread: tumors enter blood vessels and travel to distant organs.
Direct spread: tumors spread by invading adjacent tissues.

Nomenclature of Neoplasia

Tumors are named based on their:
- Parenchyma, organ, or cell of origin (e.g., Hepatoma—liver tumor)
- Pattern or structure (e.g., cyst—fluid-filled; adeno—glandular; papillo—finger-like; polyp—stalked)
- Embryonic origin (ectoderm, endoderm, mesoderm)
Benign tumors have the suffix "-oma" (e.g., lipoma, osteoma, myoma).
Malignant tumors derived from epithelial tissues (e.g., carcinoma) use the suffix "-carcinoma."
Malignant tumors derived from mesodermal tissues use the suffix "-sarcoma" (e.g. fibrosarcoma)

"PASAWAY" Tumors

Some tumors with the "-oma" ending are malignant. Examples are hepatomas, lymphomas, gliomas, and melanomas.
Teratomas are tumors arising from three germ layers.
Choristomas and hamartomas are non-neoplastic tumors containing tissue not typical for the location.

Cancer Nursing- Normal Cell Cycle

Cell cycle has three phases:
- Permanent cells (neurons, cardiac muscle)
- Stable cells (liver, kidney)
- Labile cells (epithelial cells, blood cells)

Cancer Nursing- Molecular causes of cancer

DNA structure alteration.
Altered DNA function.
Cellular aberration.
Cellular death.
Neoplastic change.
Proto-oncogene and anti-oncogene genes in DNA

Cancer Nursing- Etiology of cancer

Physical agents (radiation, irritants, sunlight, altitude, humidity)
Chemical agents (smoking, dietary ingredients, drugs)
Genetics and family history (colon cancer, premenopausal breast cancer)
Dietary habits (low fiber, high fat, processed foods, alcohol)
Viruses and bacteria (HepaB, herpes, EBV, CMV, papilloma viruses, HIV, HTCLV, H. pylori)
Hormonal agents (DES, OCPs, especially estrogen)
Immune disease (AIDS)

Cancer Nursing - Carcinogenesis

Initiation: Carcinogens alter DNA in cells. Either death or repair may occur. If DNA is altered and not repaired, it leads to apoptosis
Promotion: repeated exposure to carcinogens causing abnormal genes to express.
Progression: irreversible change, cells undergo neoplastic transformation leading to malignancy

Cancer Nursing- Spread of cancer

Lymphatic spread
Hematogenous spread
Direct spread

Cancer Nursing - Cancer Diagnosis

Biopsy (most definitive)
CT scans
MRI scans
Tumor markers

Cancer Nursing- Tumor Markers

General tumor markers (CEA, LDH)
Breast cancer markers (CA 15-3, CA 27.29, HER2, estrogen/progesterone receptors)
Liver and Germ cell tumor markers (AFP)
GI system markers (CA 19-9, CEA)
Prostate markers (PSA)
Ovarian markers (CA 125)

Cancer Nursing- TNM Staging

T-tumor size
N-node involvement
M-metastasis
Stage progression from 1 to 4

Cancer Nursing - General Medical Management

Surgery (cure, control, palliation)
Chemotherapy
Radiation therapy
Immunotherapy
Bone marrow transplant

Cancer Nursing- Surgery

Types of cancer surgery include:
- Local excision
- Wide/Radical excision
- Salvage surgery
- Electrosurgery, Cryosurgery, Laser surgery
Types of surgery include: Prophylactic surgery, Palliative surgery, and Reconstructive surgery

Cancer Nursing- Screening

Male: Occult blood, chest x-ray, DRE (for prostate and Testicular self-exam)
Female: SBE, CBE, mammography, Pap Smear
Combined screening (for males and females)

Cancer Nursing - Nursing Assessment

Utilize the CAUTION warning signals (change in bowel/bladder habits; a sore that doesn't heal; unusual bleeding; thickening/lump in breast; indigestion; obvious change in warts; nagging cough and hoarseness; unexplained anemia; sudden weight loss.)
Assess for additional warning signs, including weight loss, frequent infections, skin problems, pain, hair loss, fatigue, and disturbances in body image/depression.

Cancer Nursing - Nursing Interventions

Maintain tissue integrity: Handle skin gently, do not rub affected areas, apply lotion, clean with soap and water
Manage stomatitis: use soft-bristled toothbrush, oral rinses with saline gargles or tap water; avoid alcohol-based rinses
Manage alopecia: recommend wig, scarves, or hats; give information about temporary hair loss
Promote nutrition: make food appealing, consider patient's preferences, provide small frequent meals, avoid fluids during meals, practice proper oral hygiene before meals. encourage the use of vitamin supplements
Relieve pain: mild-NSAIDS, moderate – weak opioids, severe-morphine; administer analgesics as needed
Decrease fatigue: plan activities with rest periods, encourage light exercise, and promote small frequent meals
Improve body image: use therapeutic communication, encourage self-care and decision making, offer cosmetic material such as makeup and wigs
Assist in the grieving process: recognize that cancer can cause loss of health, income, sexuality, and body image; answer questions and offer information about cancer and treatment options; provide access to resources and support groups; refer to appropriate support groups for patient
Manage infection: assess for infection (fever is the most important sign - 38.3 degrees Celsius/100.9 degrees Fahrenheit); monitor patients closely; administer prescribed antibiotics; maintain aseptic technique; and avoid or limit exposure to crowds or other patients with infections
Identify factors that predispose cancer patients to infection such as impaired skin or mucus membranes, malnutrition, and some medications
Treat potential complications such as septic shock and bleeding

Cancer of the Central Nervous System (CNS)

CNS Tissues:
- Astrocytes – maintain the blood-brain barrier (BBB) and hold neurons in place, also involved in nutrition and waste removal of dead cells in CNS.
- Oligodendrocytes – produce the myelin sheath within CNS
- Ependymal – produce and direct Cerebrospinal fluid (CSF) flow, surrounds the choroid plexus
- Schwann – produce the myelin sheath within the Peripheral nervous system (PNS)
Meninges: dura mater, arachnoid mater, pia mater (protective coverings around brain and spinal cord)
Malignant CNS Tumors:
- Most common primary brain tumors are gliomas, meningiomas, nerve sheath tumors, and pituitary tumors
- Glioma: (astrocytomas, oligodendrogliomas, mixed gliomas, ependymomas) - highly malignant tumors
- Meningiomas: derived from protective arachnoid lining of the brain, often benign but can recur
- Schwannomas and Pituitary tumors: usually benign tumors developing from CN sheath or pituitary tissue, responding to treatment including surgery, radiation or chemotherapy
- Embryonal/Primitive neuroectodermal tumor (PNET): Medulloblastoma—most common malignant tumor in posterior fossa of the brain, occurs in children and young adults, poor prognosis, associated with CSF metastasis.
Clinical Features of CNS Cancer:
- Increased intracranial pressure (ICP): Headaches, nausea, vomiting, papilledema, changes in mental status (confusion, drowsiness), and seizures (especially in 1/3 of patients)
Diagnosis of CNS Cancer:
- Imaging techniques like CT scans and MRIs with contrast and angiography are employed to detect and diagnose.
- MRS (magnetic resonance spectroscopy) assists in evaluating tumor metabolism.
Treatment Modalities for CNS Cancer:
- Radiation Therapy (RT) may be used alone or in conjunction with chemotherapy.
- Common RT techniques include 3DCRT, IMRT, stereotactic radiosurgery and brachytherapy.
- Chemotherapy with drugs such as Nitrosoureas, Carmustine, Lomustine, Procarbazine, and Biodegradable chemotherapy wafers are some treatments.
- Radiosensitizers may be used to enhance the effects of RT on tumors.
- Boron Neutron Capture Therapy is another treatment modality

Colon Cancer

Risk factors: Increased age, family history, previous colon cancer or polyps, history of inflammatory bowel disease (IBD), high fat, high protein, and low-fiber diet, breast cancer, or genital cancer
Pathophysiology: Benign neoplastic - DNA alteration —- malignant transformation —- malignant neoplasm- cancer growth and invasion—metastasis (liver)
Assessment findings: Change in bowel habits (most common), blood in the stool, anemia, anorexia and weight loss, fatigue, rectal lesions (tenesmus), alternating D and C.
Diagnostic findings: Fecal occult blood, sigmoidoscopy/colonoscopy, biopsy, CEA (carcinoembryonic antigen)
Complications: Obstruction, hemorrhage, peritonitis, sepsis
Medical management: Chemotherapy (5-FU), radiation therapy
Surgical management: Resection, anastomosis, colostomy (temporary or permanent based on tumor location and size)
Nursing interventions (Pre-operative): Provide protein, calorie, and residue diet, provide information about post-operative care and stoma care, and administer pre-operative medications one day prior to surgery
Nursing interventions (Post-operative): Monitor for complications (e.g., leakage from the site, prolapse of the stoma, skin irritation, pulmo complications) , assess abdomen for return of peristalsis, assess wound dressings and assist patients with post-operative ambulation, provide nutritional counseling limiting foods that cause gas-formation and odor (cabbage, beans, eggs, fish, peanuts), and use a low-fiber diet for the initial recovery period, splint the incision, and administer pain meds before exercise, and monitor the stoma (pinkish to cherry red, slightly edematous, minimal pinkish drainage).
Colostomy care: Best time for skin care is after a shower; Apply tape to pouch sides; and maintain the patient in a sitting or standing position when changing the pouch

Breast Cancer

Risk factors: Genetics (BRCA1/2), Increasing age, Family history, Early menarche/late menopause, Nulliparity, Late age at pregnancy, Obesity, Hormonal replacement therapy, Alcohol use, and Exposure to radiation
Protective factors: Exercise, Breastfeeding, Pregnancy before age 30
Pathophysiology: Tumor growth from a single cell, Invade neighboring tissue, Spread through lymph and blood vessels
Assessment findings: Mass (upper outer quadrant), non-tender, fixed, hard with irregular borders, skin dimpling, nipple retraction, peau d'orange
Laboratory findings: Biopsy procedures, mammography
Staging: TNM staging (I - < 2cm, II - 2 to 5 cm, (+) LN, III - > 5 cm, (+) LN, IV - metastasis)
Medical management: Chemotherapy, Tamoxifen therapy, radiation therapy
Surgical management: Radical mastectomy, Modified radical mastectomy, Lumpectomy, Quadrantectomy
Nursing interventions (Pre-operative): Provide breast cancer information and treatment options, reduce fear/anxiety, facilitate decision-making, and offer pre-op routines(consent, NPO, meds, breathing exercises)
Nursing interventions (Post-operative): Elevate affected extremity, provide pain management, monitor for and manage skin integrity, monitor for drainage and hematoma, encourage and monitor activity; and teach follow-up care (regular checkups, monthly BSE, annual mammography
Manage lymphedema: Elevate the arm, encourage hand exercises while elevated, refer to physiatrist or physical therapist

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Test your knowledge on cancer biology, screening guidelines, and nutrition management related to cancer care. This quiz covers critical aspects such as warning signals for cancer, management strategies for stomatitis, and factors influencing cancer risk. Perfect for healthcare professionals and students in the medical field.