Oncology and Palliative Care Quiz

Oncology - Warning Signs of Cancer

• Seven warning signs of cancer include changes in bowel/bladder habits, sore throat that won't heal, unusual bleeding/discharge, thickening/lump in the breast/elsewhere, indigestion/difficulty swallowing, obvious change in a wart or mole, and nagging cough/hoarseness.
• Unexplained weight loss can also be a symptom.

Colon Cancer Risk Factors

• Risk factors for colon cancer include red meat, a sedentary lifestyle, alcohol, processed foods, and age 50+.
• Family history, obesity, smoking, and low vitamin D levels are also risk factors.
• Inflammatory diseases are additionally linked to an increased risk.

Differentiating Hospice and Palliative Care

• Palliative care manages symptoms, as well as psychological and spiritual care.
• Hospice care is for people with 6 months or less to live. It focuses on pain/symptom management.
• Unlike palliative care, hospice does not use life-sustaining treatments, including fluids, blood, and lab testing.

Chemotherapy Side Effects

• Chemotherapy side effects can include mucositis/stomatitis (oral sores), anemia/pancytopenia (reduced blood cells), bleeding precautions, no acidic foods, alopecia (hair loss), and infertility/sexual alterations.

Extravasation Treatment

• Extravasation is the leakage of fluid (chemo drug) from a blood vessel into surrounding tissue.
• Stop the infusion, aspirate the remaining drug from the site, and apply a cold/warm compress are the first steps.
• Antidotes may be necessary, depending on the situation.

Tumor Lysis Syndrome

• Tumor lysis syndrome (TLS) occurs when cancer cells rapidly break down and release contents into the bloodstream.
• This can cause hyperkalemia (high potassium) and hyperuricemia (high uric acid).
• TLS is a sign that cancer treatment is effective.
• Management includes significant fluid intake, diuretics (to eliminate excess fluids and electrolytes), and dialysis (for severe cases).

Immunocompromised Patient Interventions

• Interventions for immunocompromised patients include neutropenic precautions (e.g., no raw foods, hand hygiene, etc).
• Limiting visitors, providing prophylactic antibiotics, and using a private room are also recommended.
• Limiting activity, monitoring for infections (especially pneumonia), using caution with warm tubs baths and mild analgesics are further interventions.

Leukemia Care

• Leukemia care includes managing the overproduction of immature/non-functioning white blood cells (WBC) and possible pancytopenia (low WBC, red blood cells, and platelets).
• Bleeding precautions are important.

Infections

• Use an electric razor, soft bristle toothbrush for oral hygiene only when needed, to prevent infection.

Cancer Treatment Therapies

• Induction therapy is a combination chemotherapy used to achieve remission quickly.
• Consolidation therapy often involves stem cell transplants to eliminate any remaining cancer cells.
• Maintenance therapy involves taking oral medications for long term management.

Blood Cell Counts

• Absolute neutrophil count (ANC) is a measure of the effectiveness of an immune system against infection, with normal range 2,500–7,000.
• A level lower than 500 may indicate the need for holding chemo or further procedures.
• Hodgkin's lymphoma involves lymph nodes, while non-Hodgkin's lymphoma shows abnormalities other than reed-Sternberg cells.

BRCA1/2 Positive Patients

• Long-term surveillance is a focus for early detection
• Prophylactic surgery (mastectomy, oophorectomy) may be considered
• Superior vena cava syndrome, occurs when the superior vena cava is compressed/obstructed by a tumor, causing edema and other symptoms.

Radiation Therapy

• Sealed radiation therapy is a brachytherapy type, where radiation is precisely placed in a specific area, inside the body, and or as an implant.

Radiation Therapy Side Effects

• Systemic effects of radiation therapy include fatigue, malaise, anorexia (loss of appetite), bone marrow suppression (low blood cell counts), anemia (low red blood cells), leukopenia (low white blood cells), thrombocytopenia (low platelets), skin integrity problems like dermatitis and alopecia (hair loss).
• Oral mucosa problems (e.g., mucositis/stomatitis, xerostomia) and altered taste can also occur.

Hematological Conditions

• Iron deficiency anemia, often microcytic (small red blood cells), can result from poor diet, blood loss, and alcoholism.
• Vitamin B12 deficiency/folic acid deficiency anemia (macrocytic-large red blood cells) can be caused by poor absorption, diet, and some medications.
• Autoimmune hemolytic anemias are caused by antibodies attacking red blood cells.
• Thrombocytopenia is a condition where platelet counts fall below 150,000.

Renal Function Monitoring

• Specific gravity (1.003-1.050) is measured through urinalysis to assess hydration status.
• Low specific gravity (less than 1.003) suggests overhydration.
• High specific gravity (greater than 1.030) suggests dehydration.

UTI Prevention and Treatment

• Prevention of UTIs should involve proper hygiene, adequate fluid intake, avoidance of irritants (certain foods or drinks), appropriate clothing, and wiping from front to back after urination.
• Treatment options include short-term, high-dose antibiotics for uncomplicated infections.
• Longer courses of antibiotics are typically used for complicated infections or recurrent UTIs.
• If epididymitis (infection of the epididymis) is suspected, it may spread from the urethra.

Genitourinary Conditions

•Heaviness in a testicle, edema, and the need for antibiotics, scrotal elevation, ice, and avoiding strain are common interventions. •A TURP (transurethral resection of the prostate) can resolve urinary retention or frequency from benign prostatic hyperplasia (BPH) or cancer. •Post-operative care includes monitoring for bleeding, maintaining appropriate urine output, and managing complications. •Pyelonephritis (upper UTI) can be caused by recurrent UTIs, immunosuppression, or pregnancy.

Urinary Tract Infections (UTIs)

• Urinary tract infections (UTIs) can manifest with symptoms such as nocturia, incontinence (involuntary urination), suprapubic/pelvic pain, and hematuria (blood in urine).
• Prevention strategies include urination before and after sexual activity, no restrictive clothing, wiping from front to back, and no scented products.
• Treatment involves antibiotics for a specified period depending on infection complexity.

Urologic Conditions, Symptoms and Treatments

• Pain, including flank pain related to groin, dysuria and frequency, are common symptoms. •Appropriate pain management, including medications, is necessary. •Treatment may include antibiotics- for 2 weeks for acute and 4-12 weeks for chronic cases. • Prostatic massage and non-infectious therapies may be utilized depending on the condition.

Diagnostic Testing

• Diagnostic testing might involve imaging evaluations to check for problems, assessment for allergies, pre-procedure preparations, and discontinuation of certain medications before procedures.
• Some tests may include blood tests (BUN, Cr, GFR; CBC, blood glucose).
• Urine tests to assess hydration status, may be important to monitor for renal stones and possible infection.