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Thompson- spring > Day 1 part 1- Cancer > Flashcards

Day 1 part 1- Cancer Flashcards

1
Q

Epidemiology: 2 reasons for different occurrence rate

A

~different forms of cancer

~gender

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2
Q

What is the top 3 new cases of cancer for females? *for your info

A

~Breast
~lung and bronchus
~colon and rectum

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3
Q

What is the top 3 new cases of cancer for males? *for your info

A

~prostate
~lung and bronchus
~colon and rectum

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4
Q

Does occurrence rate and mortality rate stay the same for different cancers?

A

No!

*also is difference between countries

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5
Q

What is the top 3 mortality rates of cancer for females? *for your info

A

~lung and bronchus
~breast
~colon and rectum

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6
Q

What is the top 3 mortality rates of cancer for males? *for your info

A

~lung and bronchus
~prostate
~colon and rectum

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7
Q

What are some of the most common risk factors for cancer?

A

~Age over 50
~ethnicity
~family history (first generation)
~env and lifestyle

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8
Q

Some extra info on risk factors:

A

~More than half of all cancer deaths in the US could be prevented through healthier lifestyle and better use of screening
~Some is just “the plain dumb bad luck of the universe”

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9
Q

What is the most important risk factor for cancer?

A

AGE!!

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10
Q

Name some of the nonmodifiable risk factors:

A 
~Age
~Previous history of cancer
~Ethnicity
~Skin color
~Gender
~Heredity (identified oncogenes)
~Age of menarche, menopause
~Adenamotous polyps
~Inflammatory bowel disease
~Fat distribution patterns
~Congenital immunodeficiencies
~Congenital diseases
~Long-term helicobacter infection
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11
Q

Name some of the modifiable risk factors:

A 
~Smoking/ use of smokeless tobacco
~Chemical or other exposure (eg paint, cadmium, dye, rubber, arsenic, asbestos, radon, benzene, ionizing radiation, Agent Orange, pesticides, herbicides, organic amines)
~Urban dwelling
~Alcohol consumption (more than 1-2 drinks per day)
~Sedentary lifestyle
~Obesity; high diet in animal fat
~Insulin resistance (elevated serum insulin)
~Radiation/ chemotherapy treatment
~Estrogen replacement therapy
~STDs
~Ionized radiation
~HTLV-1 (virus)
~Previous lung scarring
~Organ transplant (immunosuppression)
~HIV infection
~Chronic exposure to UV rays
~Geographic location
~Smoked foods, salted fish and meats (nitrates and nitrites)
~Tamoxifen use
~Vitamin B12 deficiency
~Lack of access to or use of health care and screening tests
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12
Q

More details on cancer and age

A

~cancer risk increase with age
~greater increase in men with age but also seen in women
~varies by cancer type
(testicular cancer is more common in men ages 20-40)
(breast cancer increases rapidly after age 45)
(childhood cancers- acute leukemia, etc)

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13
Q

More details on race and ethnicity and cancer

A

~Racial disparities in incidence & mortality
(increase risk African-American populations- 40% higher mortality rate)
(increased risk some Native American & Hispanic populations)
~Related to access to medical care
~Related to different environmental factors
~Related to preventable risk factors

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14
Q

More details on family history

A

~important factor only for first generation family members
~some basic hallmarks of families with a history of caner:
*diagnosis of caner in two or more relatives in the family
*diagnosis of caner in a family member under the age of 50
*occurrence of the same type of cancer in several family members
*occurrence of more than one type of cancer in one person
*occurrence of a rare type of cancer in one or more members of a family

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15
Q

More details on genetics

A

~BRCA 1 & 2 for breast cancer
~Li-Fraumeni Syndrome – inherited chromosomal mutations of the p53 or CHK2 tumor suppressor genes – very rare (400 people from 64 families)
*Variety of cancers in this group, but common denominator is the genetic mutation
~FAP (familial adenomatosis polyposis) – colon cancer

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16
Q

Which does she classify as a lifestyle risk factor?

A

~Smoking
~Excessive alcohol ~consumption
~Diet/Nutrition
*Low fiber-high fat diet
*High fiber vegetables & fruits
*Red meat
~Sedentary lifestyle
~Obesity & type 2 diabetes
~Sexual activity & reproductive behaviors
*Both high and low related to different cancers
*Pregnancy, child-bearing & lactation decrease cancer risk

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17
Q

What is HPV?

A

Human papilloma virus
~It has a strong link to cervical cancer
~Gardasil gives ~65% protection

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18
Q

Which does she classify as environmental risk factors?

A

~Smoke
~Chemicals (herbicides, insecticides, dyes)
~Asbestos & other particulate matter
~Ionizing radiation – healthcare workers, power plants, construction, geological work
~Agent Orange – chronic lymphocytic leukemia, soft tissue sarcoma, non-Hodgkin’s lymphoma

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19
Q

Carcinomas are

A

a malignant tumor that comprises epithelial tissue
~it accounts for 85% of cancers
~can arise form breast, colon, pancreas, skin, large intestines, lungs, stomach
~metastasizes through lymphatic

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20
Q

Sarcomas are

A

a fleshy over growth
~refers to a large variety of tumors arising in the connective tissues
~can develop from fat, muscle, bone, cartilage, synovium, fibrous tissues
~metastasizes hematogenously

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21
Q

Lymphomas are

A

originates in the lymphoid tissues

~lymph nodes, spleen, intestinal lining

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22
Q

Leukemias are

A

cancers of the hematologic system

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23
Q

S/S of cancer (basic)

A

**Symptoms often only occur when the disease has progressed
~Lumps & abnormal growths
~Persistent cough
~Fatigue
~Change in bowel & bladder habits
~Unusual bleeding or discharge
~Pain, which may be specific or not (myalgia, fibromyalgia, arthralgias, headaches)

24
Q

S/S of integumentary (table 13-5)

A

~any skin lesion or observable/ palpable skin changes
~any observable or palpable changes to the nail beds
~unusual mole (ABCDE)
~cluster mole formation
~bleeding or discharge from mole, skin lesion, scar, or nipple
~ tenderness and soreness around mole; sore than does not heal

25
Q

S/S of musculoskeletal (table 13-5)

A 
~may present as an asymptomatic soft tissue mass
~bone pain
**deep or localized 
**increased with activity
**decreased tolerance to WB; antalgic gait
**does not respond to physical agents  
~soft tissue swelling
~pathologic fracture
~hypercalcemia 
~back or rib pain
26
Q

S/S of Neurologic (table 13-5)

A 
~drowsiness, lethargy
~HA
~N/V
~Depression
~increased sleeping
~irritability, personality change
~confusion
~change in mental state, memory loss, difficulty concentrating 
~vision changes (blurring, blind spots, double vision)
~N/T
~balance and coordination issues
~change in deep tendon reflexes
~change in muscle tone for ind with previously diagnosed neurologic conditions
~+ Babinski reflex
~changes in B/B
~myotomal weakness pattern
~paraneoplastic syndrome
27
Q

S/S of pulmonary (table 13-5)

A

~pleural pain
~dyspnea
~new onset of wheezing
~productive cough with rust, green, or yellow-tinged sputum

28
Q

S/S of hepatic (table 13-5)

A 
~Abdominal pain and tenderness
~jaundice
~ascites
~distended abdomen
~dilated upper abdominal veins
~peripheral edema
~general malaise and fatigue
~bilateral carpal/ tarsal tunnel syndrome
~asterixis (liver flap)
~palmar erythema (liver palm)
~spider angiomas (over the abdomen
~Nail beds of Terry
~right shoulder pain
29
Q

What are the 3 screening approaches (categories)?

A

~Inspection & Palpation
~Blood tests & Cytology
~Imaging

30
Q

What are the 4 inspection/ palpation mentioned in the slides?

A

~Regular physical exam
~Skin inspection
~Buccal cavity & throat inspection
~Palpation of thyroid, testicles, breast (self/clinical), prostate (DRE, digital rectal exam) & lymph nodes

31
Q

What does ABCDE stand for?

A 
A = asymmetrical
B = "borders" (irregular = "Coast of Maine sign"), 
C = "color" (variegated)
D = "diameter" (larger than 6 mm—the size of a pencil eraser)
E = evolving over time
32
Q

Other notes on skin inspections:

A

~But often not as obvious – just darkening area – but most commonly on exposed body parts, including hair
~High risk in areas & individuals with high unprotected sun exposures

33
Q

What are you looking for on a buccal and throat inspection?

A

looking for abnormal coloration or growths, sores, or lumps

34
Q

Details on Breast Exams

A

~Monthly breast self-exams (BSE)
~Women 20-39 should have a physical examination including a clinical breast exam (CBE) every three years
~Older than 39- every year
~Women 20 years of age and older should perform breast self-examination (BSE) monthly
~Buddy-check 3 – collaboration of St. Joseph’s Candler & WSAV

35
Q

How is a prostate exam preformed and when should males start getting one?

A

~DRE- digital rectal exam

~males should have it yearly after the age of 40

36
Q

Where are the 3 main areas to screen lymph nodes?

A

~axillary
~cervical
~inguinal

37
Q

What are 5 ways that cytology can be collected/ done to screen for cancer?

A 
~Complete blood cell counts (CBC)
~PSA levels
~PAP test
~Fecal occult blood test
~Urine cytology
38
Q

What is looked at during the CBC (complete blood cell count)?

A

~if there are too few or too many of the different blood types

39
Q

What are the 3 types of abnormal cell types called?

A

Metaplasia
Dysplasia
Hyperplasia

40
Q

What are metaplasic cells?

A

replacement of one differentiated cell type with another mature differentiated cell type

41
Q

What are dysplasic cells?

A

expansion of immature cells with decrease in the number and location of mature cells

42
Q

What are hyperplasic cells?

A

increased number of cells, which may signal a pre-cancerous or cancerous process

43
Q

What does PSA stand for?

A

Prostate specific antigen

44
Q

What does PSA relate to?

A

~Elevated levels related to prostate hyperplasia and prostate cancers

~Not just total but ratio bound to total also important
~High risk for prostate cancer if > 65 years old and/or African-American male

45
Q

What is a PAP test?

A

It is a test where cervical tissue sample taken with regular pelvic exam

46
Q

Why should you have a PAP test?

A

~Looking for abnormal cells – dysplasia or metaplasia

~High sensitivity and specificity

47
Q

What causes an increased risk for cervical cancer?

A 
~Frequent intercourse
~Multiple partners
~STDs – particularly HPV & chlamydia
~Smoking
~Stress
~Oral contraceptives
48
Q

How many stages are there for Pap Staging?

A

7
*I will list the stages in cards, but she said we don’t have to know them by heart. It’s more so you can get a better idea of the staging.

49
Q

Stage 1 for Pap Staging

A

Negative for intraepithelial lesion or malignancy.

50
Q

Stage 2 for Pap Staging

A

Atypical squamous cells of undetermined signficance (ASC-US).

51
Q

Stage 3 for Pap Staging

A

Low grade squamous intraepithelial lesion (LSIL). This includes HPV and mild dysplasia.

52
Q

Stage 4 for Pap Staging

A

Atypical squamous cells— cannot exclude high grade SIL (ASC-H).

53
Q

Stage 5 for Pap Staging

A

High grade squamous intraepithelial lesion (HSIL) encompassing moderate dysplasia (CIN2), as well as CIN 3, which includes severe dysplasia carcinoma in situ (CIS).

54
Q

Stage 6 for Pap Staging

A

Squamous cell carcinoma

55
Q

Stage 7 for Pap Staging

A

Abnormal glandular cells including atypical glandular cells of undetermined significance (AGUS): endocervical adenocarcinoma; endocervical adenocarcinoma in situ; endometrial adenocarcinoma; extrauterine adenocarcinoma; adenocarcinoma, NOS

Thompson- spring (13 decks)

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