Oncology Exam Breakdown Quiz

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Questions and Answers

Which system has the highest number of questions in the exam breakdown?

Cardiovascular System

Immune System

Endocrine System (correct)

Hematologic System

What percentage of the exam questions come from Lectures 6 and 7?

80%

50%

70% (correct)

60%

How many questions are dedicated to the Oncology topic in the exam?

10 questions

6 questions

5 questions

8 questions (correct)

Which system contains the fewest questions according to the breakdown?

Hematologic System Signup and view all the answers

What is a suggested focus area while studying for the exam?

Pop Up Physios Signup and view all the answers

What is the primary function of the liver in relation to blood proteins?

Produces albumin and plasma proteins Signup and view all the answers

What triggers the gallbladder to contract and expel bile?

Cholecystokinin release Signup and view all the answers

Which factor is NOT affected by aging in relation to liver function?

Liver function tests like AST and ALT Signup and view all the answers

Which substance is produced by the pancreas?

Insulin Signup and view all the answers

What is the consequence of decreased liver blood flow with aging?

Decreased production of clotting factors Signup and view all the answers

What is a common symptom associated with hepatic disease?

Dark urine Signup and view all the answers

What role does bile play in digestion?

Emulsifies and digests fat Signup and view all the answers

Which of the following changes occurs in the liver due to aging?

Decreased liver volume Signup and view all the answers

Which factor is crucial for maintaining bone strength?

Bone density and bone quality Signup and view all the answers

What is the most common cause of osteoporosis in women?

Estrogen deficiency Signup and view all the answers

Which is a common clinical manifestation of osteoporosis?

Low back and rhomboid pain Signup and view all the answers

What physical change is associated with Paget Disease?

Bone pain and deformities Signup and view all the answers

Which exercise is most beneficial for individuals with Paget Disease?

Multi-dimensional exercise regimen Signup and view all the answers

What is a common neurological manifestation of Paget Disease?

Impaired cognition Signup and view all the answers

What is the impact of mechanical stimuli on mature bone?

Stimulates bone growth Signup and view all the answers

Which deformity is most commonly associated with Paget Disease?

Kyphoscoliosis Signup and view all the answers

What role does physical therapy play for patients with osteoporosis?

Emphasizes neutral and extension postures Signup and view all the answers

Which of the following describes the bone changes in Paget Disease?

Irregularly thickened and pitted Signup and view all the answers

What hormone is primarily associated with stimulating the adrenal glands?

Adrenocorticotropic Hormone (ACTH) Signup and view all the answers

Which condition is characterized by an undersecretion of all six anterior pituitary hormones?

Panhypopituitarism Signup and view all the answers

What condition results from excessive levels of growth hormone before epiphyseal closure?

Gigantism Signup and view all the answers

Which of the following is a common symptom of hyperthyroidism?

Tachycardia Signup and view all the answers

What is a key symptom of Addison's disease?

Bronzed or slate gray skin Signup and view all the answers

What is a primary characteristic of Type 1 Diabetes?

Autoimmune destruction of beta cells Signup and view all the answers

What complication is commonly associated with poorly controlled diabetes?

Sensory neuropathy Signup and view all the answers

Which treatment option is typically used for Cushing's syndrome?

Pituitary irradiation Signup and view all the answers

Which symptom is indicative of hypothyroidism?

Fatigue and cold intolerance Signup and view all the answers

What condition is associated with excessive insulin production in the body?

Type 2 Diabetes Signup and view all the answers

Which of the following is a common risk associated with obesity?

Impaired mobility Signup and view all the answers

Which nutritional requirement should be considered for a patient with Cushing's syndrome?

High protein diet Signup and view all the answers

Which sign is a typical manifestation of hyperglycemia?

Dehydration Signup and view all the answers

What is a common treatment for Hashimoto’s thyroiditis?

Medication to suppress TSH Signup and view all the answers

What is the most common cause of cirrhosis?

Chronic hepatitis Signup and view all the answers

Which symptom is specifically associated with jaundice?

Clay-colored stools Signup and view all the answers

What condition is 85% of ascites cases associated with?

Decompensated liver cirrhosis Signup and view all the answers

Which of the following symptoms indicates neurologic involvement due to liver impairment?

Confusion Signup and view all the answers

What is a significant complication of portal hypertension?

Esophageal varices Signup and view all the answers

What finding is NOT typically associated with liver dysfunction?

Elevated heart rate Signup and view all the answers

What is recommended for patients with cirrhosis regarding exercise?

A combination of aerobic and resistance exercise Signup and view all the answers

Which Hepatitis virus requires prior infection with Hepatitis B for transmission?

Hepatitis D Signup and view all the answers

When is jaundice typically expected to resolve after treating the underlying cause?

4-6 weeks Signup and view all the answers

Which of the following is a symptom of ascites?

Peripheral edema Signup and view all the answers

What is the primary function of hepatic tissue that gets impaired in cirrhosis?

Metabolism of fats and carbohydrates Signup and view all the answers

Which of the following is NOT a typical sign of liver dysfunction?

Constipation Signup and view all the answers

What exercise should be avoided in patients with increased abdominal pressure due to liver issues?

Isometric exercises Signup and view all the answers

Which assessment is crucial for monitoring patients with ascites?

Fluid intake and output Signup and view all the answers

Study Notes

Osteoporosis

Bone strength depends on bone density and bone quality
Bone density is how many bone cells per square millimeter
Bone quality is the health of bone cells
Bone mineral density is the mass of minerals per volume of bone
Peak bone mass is achieved in the third decade of life
If peak bone mass is low, osteoporosis and fractures are likely
Mechanical stimuli are the only stimuli capable of inducing modelling in mature bone
Estrogen deficiency is the most common cause of osteoporosis in women
Clinical manifestations of osteoporosis:
- Loss of height
- Postural changes (kyphosis)
- Back pain (low back and rhomboids)
- Muscular pain
- Trigger points
- Fractures (compression fractures are the most common)
- Functional impairment
- Disability
- Decreased quality of life

Paget Disease

Increased bone resorption by osteoclasts and excessive and disorganized formation of new bone by osteoblasts
Bone marrow gets replaced by vascular and fibrous tissue
Enlarged bones are weak, leading to deformity, fracture, and arthritis/pain
Cause is unknown
Considered an osteoclastic disorder, but also involves osteoblasts
Unrestrained proliferation of osteoclasts kickstarts the process
Osteoblasts cannot keep up
Initial resorption stage followed by abnormal regeneration
New bone is coarse, irregularly thickened, rough, and pitted
Clinical Manifestations:
- Pain - headache, myalgias, arthritis, radiculopathy
- Skeletal - bone pain and deformities (femur is the most commonly affected bone, kyphoscoliosis is the most common deformity)
- Neurologic - nerve compression, impaired cognition
- CV - increased cardiac output, heart failure
- Fatigue, tinnitus, dizziness/vertigo

Hepatobiliary System - Anatomy

Liver
- Produces albumin and plasma proteins
- Produces bile
- Converts and excretes bilirubin
- Produces clotting factors
- Stores vitamins
Gallbladder
- Stores and concentrates bile
- Expels bile into the duodenum when food is present
- Bile alkalinizes intestinal contents and emulsifies, absorbs, and digests fat
- Cholecystokinin causes the gallbladder to contract
Pancreas
- Exocrine secretion of digestive enzymes and pancreatic juices
- Pancreatic juices are transported through the pancreatic duct to the duodenum
- Secretion of glucagon and insulin by the islets of Langerhans

Hepatobiliary System - Aging

Decreased response to drugs depending on liver function, affecting multiple systems
Liver contains many immune cells and produces proteins associated with the acute inflammatory response
Age-related cell changes impact immunity, often requiring drug dosage modification with age
Liver volume decreases 20-40%, and blood flow decreases up to 35%
Liver function tests (AST, ALT, ALP, GTP, and serum bilirubin) remain unchanged with age

Signs and Symptoms of Hepatic Disease

GI symptoms (nausea, vomiting, anorexia, abdominal pain)
Edema/Ascites
Dark urine and light stools
Skin changes
- Jaundice (elevated bilirubin)
- Bruising
- Spider angiomas & palmar erythema (elevated estrogen)
Neurologic involvement (from ammonia buildup)
- Confusion
- Sleep disturbances
- Muscle tremors
- Hyperreactive reflexes
- Asterixis
Musculoskeletal pain - midscapular pain, right shoulder/upper trap/subscap, thoracic
Hepatic osteodystrophy - manifests as osteomalacia/osteoporosis

Jaundice

Overproduction of bilirubin:
- Reabsorption of hematoma
- Blood transfusion
Decreased uptake or conjugation in bilirubin metabolism
Hepatocyte dysfunction
- Hepatitis
- Chronic hepatic disease
Impaired bile flow
- Cholethiasis
- Primary sclerosing cholangitis
- Pancreatic cancer
- Pancreatitis
If the underlying cause of jaundice is treated, it typically resolves in 4-6 weeks

Ascites

Abnormal accumulation of fluid in the peritoneal cavity
85% of cases associated with decompensated liver cirrhosis
Fluid accumulates due to portal hypertension
Signs and Symptoms:
- Clinically detectable once more than 500 mL has accumulated
- Weight gain
- Abdominal distention
- Increased abdominal girth
- Peripheral edema
- Dyspnea when fluid displaces the diaphragm

Cirrhosis

Chronic progressive inflammation of the liver
#1 cause: viral hepatitis
Cycles of inflammation, and healing with formation of fibrous bands of connective tissue
Irreversible
Clinical Manifestations:
- Interference with liver functions (processing amino acids, carbs, lipids, and vitamins; metabolizing cholesterol, hormones, vitamins, meds, and toxins)
- Treatment based on complications
- Transplant is best for long-term survival

Portal Hypertension

Portal: area where blood vessels enter the liver
Venous blood from the stomach, large and small intestine, pancreas, and spleen is transported via portal vein to the liver
Pressure increases when pressure in the portal vein is higher than pressure in the inferior vena cava
Usually related to cirrhosis (structural changes and hyperdynamic vascular responses)
Ultimately, blood backs up in the stomach, esophagus, umbilicus, and rectum
Engorged vessels
Varices
Bleeding
Clinical manifestatons:
- Gastroesophageal varices (very serious and accounts for 1/3 of deaths related to cirrhosis and bleeding; endoscopy is needed for everyone with cirrhosis to screen, usually treated prophylactically with beta blockers)
- Bleeding
PT Implications:
- Portal pressure is highest at night, after eating, and with coughing, sneezing, and exercise
- Interventions should prioritize reducing abdominal pressure

Hepatitis

Acute or chronic inflammation of the liver from a virus, a chemical, a drug reaction, or alcohol abuse
Types:
- Hepatitis A
  - Acute infection only
  - 25% of people do not progress to cirrhosis or cause cirrhosis prematurely
  - Does not progress to chronic disease
  - Transmission: fecal-oral; food and water
  - Symptoms - Malaise, Fatigue, Mild Fever, Nausea, Vomiting, Anorexia, RUQ discomfort, Diarrhea, Jaundice, Dark urine, Clay-colored stools
  - Treatment - Supportive care
  - Vaccine - Yes
- Hepatitis B
  - 75-85% of acute infections become chronic
  - 10-20% progress to cirrhosis
  - Associated with liver cancer
  - Transmission - Parenteral, sexual contact, vertical, contact with blood or open sores
  - Symptoms - Malaise, Fatigue, Mild Fever, Nausea, Vomiting, Anorexia, RUQ discomfort, Diarrhea, Jaundice, Dark urine, Clay-colored stools
  - Treatment - Acute: supportive, Chronic: combination interferon and antivirals
  - Vaccine - Yes
- Hepatitis C
  - Coinfection of HBV and HDV leads to more acute disease
  - 75-85% of acute infections become chronic
  - 10-20% progress to cirrhosis
  - Associated with liver cancer
  - Transmission - Parenteral, hemodialysis, vertical, blood before 1987, organs before 1992
  - Symptoms - Malaise, Fatigue, Mild Fever, Nausea, Vomiting, Anorexia, RUQ discomfort, Diarrhea, Jaundice, Dark urine, Clay-colored stools
  - Treatment - Acute: supportive, Chronic: interferon alfa2a or alfa2b
  - Vaccine - No
- Hepatitis D
  - Can only get Hep D if already infected with Hep B
  - More acute disease
  - Transmission - Parenteral, sexual contact, perinatal
  - Symptoms - Malaise, Fatigue, Mild Fever, Nausea, Vomiting, Anorexia, RUQ discomfort, Diarrhea, Jaundice, Dark urine, Clay-colored stools
  - Treatment - None
  - Vaccine - No, but Hep B vaccine can prevent Hep D
- Hepatitis E
  - Acute, self-limiting infection
  - Does not progress to chronic
  - High mortality in pregnant women
  - Transmission - Same as Hep A
  - Symptoms - Malaise, Fatigue, Mild Fever, Nausea, Vomiting, Anorexia, RUQ discomfort, Diarrhea, Jaundice, Dark urine, Clay-colored stools
  - Treatment - Preventive measures
  - Vaccine - Not in the US; vaccine approved in China in 2012

Oncology

Risk Factors, Pathogenesis, and Clinical Manifestations
- General and specific to lung, breast, and colorectal
PT Implications for treatment
- Impact of pain and metastases

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Description

This quiz assesses your understanding of the Oncology exam breakdown, focusing on various systems and their question distributions. You'll explore the number of questions allocated to different topics, including Lectures 6 and 7, and determine strategic study areas.