Module 16 Exam 3

Question 1

What is benin

Answer 1

not malignant

Question 2

what is malignant

Answer 2

tending to become progressively worse, and to result in death, having the properites of anaplasia, invasiveness, and metastasis, said of tumors

Question 3

what does cancer refer to

Answer 3

• group of neoplastic diseases in which there is transformation of normal cells into malignant ones
• as cancer cells proliferate, the mass of abnormal tissue that is formed enlarges until it takes over the host site then it metastasizes

Question 4

how are cancers classified

Answer 4

• origin of the tissue involved: carcinoma (epithelial tissue), sarcomas (conn. tissue))
• type of cell from which they arise

Question 5

what are characteristics of benin neoplasms

Answer 5

• resemble normal cells
• tumor grows by expansion and doesnt infiltrate
• slow
• doesnt metastasize
• doesnt recurr
• localized
• doesnt usually cause tissue damage
• doesnt usually cause death

Question 6

what are characteristics of a malignant neoplasm

Answer 6

• bears little resemblance to normal cells
• tumor grows at the periphery and sends out processes that inflitrate
• rapid growth
• gains access to blood and lymph
• recurs when removed
• generalized effects
• extensive tissue damabe
• usually causes death unless controlled

Question 7

what are risk factors for cancer

Answer 7

tobacco, alcohol, sunlight, environmental/occupational, viruses (epstein barr- burketts lymphoma, Hep C liver cancer, HPV) socioeconomic

Question 8

what are the most common types of cancer in men

Answer 8

prostate, lung and bronchus, colon and rectum

Question 9

what are the most common types of cancer in women

Answer 9

-breast, lung and bronchus, colon and rectum

Question 10

what is chemotherapy

Answer 10

involves the use of drugs that affect the rapidly dividing cancer cell at different points in the cell cycle

Question 11

what are the objectives of chemotherapy

Answer 11

• destroy cancer cells, prevent metastasizing
• prevent cancer from recurring
• provide and improved quality of life

Question 12

what are indications of chemotherapy

Answer 12

• eliminate tumor too large for surgery
• treat cancer that has metastasized
• prevent from reoccurence
• make tumor easier to surgically remove
• extend life

Question 13

what are the types of agents used for chemotherapy

Answer 13

-alkylating agents, antibiotics, antimetabolites, plant alkaloids, steroids/hormones

Question 14

what are the side effects of chemotherapy

Answer 14

-alopecia
-mylosupression
-immunosuppression
-nausea, vomiting, diarhha
loss of apetite
GI mucositis

Question 15

what are the oral complications of chemotherapy

Answer 15

• oral mucositis/stomatitis
• xeriostomia
• infections:bacterial, viral (herpes simplex, vaicella zoster, cytomegalovirus), fungal (candida albicans)
• bleeding
• neurotoxicity (mimics T.A)

Question 16

what is radiation?

Answer 16

uses ionizing radiation to treat cancer, impacts the cancer cells ability to replicate and survive, cant be used on all tumors,

Question 17

what are indications for radiation

Answer 17

• treat a small localized tumor
• shrink a large tumor
• assist chemo
• prevent spread of cancer
• prevent recurrence of cancer
• provide symptom/pain relief

Question 18

what are the two types of radiation

Answer 18

external beam and internal

Question 19

what is external beam radiation

Answer 19

-applied outside the body

Question 20

what is internal radiation

Answer 20

-source of the radiation is placed within the body, less radiation is delivered to the surrounding tissues

Question 21

what does the dose of radiation depend on?

Answer 21

type of tumor, tx goals, ablity to tolerate

Question 22

what is the approximate dose of radiation given

Answer 22

3,000 to 7,000 centigreys, divided into equal doses per day

Question 23

what are the systemic effects of radiation

Answer 23

• skin reactions- looks like a bad sunburn
• fatigue
• nausea, vomitting, diarhhea, constipation

Question 24

what are the oral complications of radiation

Answer 24

• mucositis/stomatitis
• xerostomia
• taste loss
• radiation caries
• infection
• trismus
• osteoradionecrosis

Question 25

what is a hematopoietic cell transplantation

Answer 25

- used to treat a varitety of blood diseases, including leukemia - purpose is to substitute blood stem cells or bone marrow from a healthy, compatible donor to replace the dieseased bone marrow of the patient

Question 26

what are 3 types of transplants

Answer 26

- autolgous- self - allogenic- matched donor - syngenic- identical twin

Question 27

what are the indications for a transplant

Answer 27

-patient not responsive to chemo alone, relapse occurs after one or more remission

Question 28

what is evaluated for a transplant

Answer 28

medical and dental assessments to ensure patient is free of infection, and pysically able to undergo

Question 29

where is the bone marrow aspiriated from

Answer 29

iliac crest, ribs, or sternum

Question 30

how is the patient prepared to recieve a bone marrow graft

Answer 30

- high dose immunosupressive regiment, chemo or total body radiation - to kill malignant cells

Question 31

how long does it take for the new marrow to function after a transplant

Answer 31

10 to 20 days

Question 32

what is the immune recovery from a transplant? long term?

Answer 32

3 to 12 months, 1-3 years

Question 33

what is acute graft vs host disease

Answer 33

-t lymphocytes see the host cell antigens as foreign and react against the host tissue

Question 34

what are symptoms of host vs graft disease

Answer 34

- during first 100 days - painful red skin rash - severe persistent diarhhea - jaundice

Question 35

what are oral complications of acute graft vs host disease

Answer 35

oral mucositis: 10-14 days post transplant xerostomia viral and fungal infections

Question 36

what is chronic graft vs host disease

Answer 36

-affects all organs of the body, can appear up to 2 years post transplant

Question 37

what are oral complications of chronic graft vs host disease

Answer 37

-oral mucosits -oral infection, perio infection -xeriostomia poor OH

Question 38

what are the objectives of oral health and cancer

Answer 38

- asses for any infection - eliminate sources of infection - instruct pt in preventive oral care measures

Question 39

what should you do with a patient who is going to recieve radiaion

Answer 39

- monitor personal daily care - once daily fl2 gel - monitor for trismus - instruct pt to exercise opening and closing mouth 3 times per day

Question 40

what should you do in tx after radiation therapy

Answer 40

- first 6 mo, non surgical perio therapy - reinforce personal OH - after mucositis subsides, talk to MD about when to make dentures - watch for trismus, demineralization, caries - advise against oral surgery on irradiatied bone

Question 41

what does the extent of oral complications of chemotherapy depend on

Answer 41

- degree of infection present - drugs used and their dosages - concurrent radiation therapy - pts personal OH

Question 42

During chemotherapy before invasive work is completed what does the platelet and neutrophil count need to bw

Answer 42

- platelet more than 50,000 mm3 | - neutrophil more than 1,000 mm3

Question 43

should you premed if completing work during chem

Answer 43

yes

Question 44

what should you watch for after the hematopoietic cell transplantation

Answer 44

- watch for oral infections - monitor oral health - delay elective dental procedures for 1 year - follow for long term complication - follow for second malignancies in oral region

Question 45

how soon should oral surgery procedures be completed in a patient who is going to undergo cancer therapy

Answer 45

at least 2 weeks prior

Question 46

what should you instruct your pt about daily biofilm removal

Answer 46

-gently brush with an extrasoft tb every meal and at bedtime, floss gently

Question 47

what should you instruct your pt about mouthrinsing

Answer 47

- every 2 to 3 hours while awake with baking soda and water | - avoid alcohol containing mouthrinses

Question 48

what should you instruct your patient about xerostomia

Answer 48

- sip on water - suck on ice chips - saliva substitute - avoid lemon glycerine swabs - avoid hot spicy salty or sharp food - moisten food

Question 49

what should you instruct your pt about oral pain managment

Answer 49

-swish gargle and spit a capful of prescribed mouthrinse containing topical anesthetic 30 min before eating