1
Q
Cell cycle
1. Longest phase
2. where cells Grow
3. Synthesis ng DNA
4. Prep/ filter for Mitosis
5. 1 way cell division
6. nuKlear division
7. Cytoplasmic division
8. Resting phase/ tambayan
9. mga kinesis under ng?
A
- Interphase
- G1
- S phase
- G2
- Mitosis
- Karyokinesis
- Cytokinesis
- G0
- Mitosis
2
Q
Sponty cell mutation w 3 stage theory of causation
A
Carcinogenesis
3
Q
Irreversible transformed cell
A
Initiation
4
Q
Reversible Neoplastic lesion stimulated to divide further
A
Promotion
5
Q
Malignant tumor, ca cells compete each other para survive (aggressive-malignant)
A
Progression
6
Q
Cell adaptation (NAHHMD)
A
- Normal cells
- Atropy
- Hypertrophy
- Hyperplasia
- Metaplasia
- Dysplasia
7
Q
Cell adaptation
1. One cell CONVERT/REPLACE/TRANSFORMED to another cell
2. BIZARRE complete alteration dt may basement membrane pa
3. Matic malignant w NO basement membrane
A
- Metaplasia
- Dysplasia
- Neoplasia/Anaplasia
8
Q
Warning signs (CAUTION US)
A
Change in bowel/bladder habits
A sore that doesn’t heal
Unusual bleeding/discharges
Thickening lump
Indigestion/diff swallowing
Obvious change in warts/moles
Nagging cough/hoarseness
Unexplained anemia
Sudden wt loss (cachexia)
9
Q
Radiation SE mngt
1. Alopecia
2. Stomatitis
3. Enteritis
4. Anemia
5. Leukopenia
6. Thrombocytopenia
7. Dermatitis
8. ⬇️libido & sterility
A
- Alopecia- wig, self care (shampoo)
- Stomatitis- ✅bland diet, ❌acidic hot spicy asin
- Enteritis- ⬇️fiber bc diarrhea
- Anemia- injury protection
- Leukopenia- infection precaution
- Thrombocytopenia- bleeding precaution
- Dermatitis- ❌chemical irritabts like lotion and extreme temps
- ⬇️libido & sterility- egg bank
10
Q
Mc SE ng Radiation and Chemo
A
Radiation- FATIGUE
Chemo- NV
11
Q
Aka external/ default radiation, mc, can be done sa OPD & in sessions
A
teletherapy
12
Q
TELETHERAPHY radioACTIVE or not
A
Not, so safe lapitan
13
Q
Used implants means localized type of brachytherapy??
A
SEALED brachytherapy
14
Q
SEALED brachytherapy needed materials incase malaglag
A
Long handed forcep
lead lined container
15
Q
systemic chemo thru IV/ORAL type of brachytherapy?
A
UNSEALED BRACHYTHERAPY
16
Q
UNSEALED BRACHYTHERAPY
- ___ cr and flush __ (if di private)
- __ h after adm DI NA radioactive
A
- Private, Twice
- 48
17
Q
BRACHYTHERAPY
1. Distance:___. Time:___
2. private rooms away from ___
3. __shield w ___
4. Is dosimeter single used?
A
- 6 ft, 30 mins per shift
- Nurses station
- Lead, dosimeter badge
- Yes
18
Q
SE mngt
1. Radiation:
2. Chemo:
A
SE mngt
1. Radiation: ⬆️CHON CAL ✅SFF kc fatigue
2. Chemo: before ✅Odansetron IV or Metoclopromide IV
19
Q
Chemo toxicities
1. Methotrexate
2. Bleomycin
3. Doxurubicin
4. Cyclophosphamide
5. Vincristine/Vinblastine
6. Cisplatin
7. Quinine
8. Aminoglycosides
A
- Methotrexate: stomatitis
- Bleomycin: pulmonary fibrosis
- Doxurubicin: cardiac toxicity
- Cyclophosphamide: hemorrhagic cystitis
- Vincristine/Vinblastine: peripheral neuropathy
- Cisplatin: ototoxicity and nephrotoxicity
- Quinine: ototoxicity
- Aminoglycosides: ototoxicity
20
Q
Compare irritants vs vesicants
A
Irritants- localized tissue damage
Vesicants- permanent and necrosis
21
Q
Infiltration, lumabas sa IV pasok sa tissues
A
Extravasation, stop the infusion
22
Q
Types of Biopsy
1. for solid organ
2. for deeper tissue sample
3. for superficial
4. In posterior iliac crest or sternum or breast bone
5. for large tumors where portion lang removed
6. entire tumor removed
A
- Fine needle aspiration
- Punch
- Shave
- Bone Marrow Biopsy
- Incisional
- Excisional
23
Q
Sternum and breast bone bone marrow biopsy bawal kanino and anong site sila pede
A
<12 y.o
Tibia
24
Q
Types of surgery
1. Prophylactic surgery
2. Implants, skin grafting
3. Relief of sx
4. Treatment
A
- Risk reduction surgery
- Reconstructive/ cosmetic
- Palliative
- Primary tx
25
Cell cycle specific anong phase target
3 class ng drugs under nito
S phase (synthesis ng DNA)
1. Topoisomerase I inhibitor “-tecan”
2. Topoisomerase II inhibitor “-poside”
3. Antimetabolites CHF M —cytarabine, hydroxyurea, fluorouracil, methotrexate
26
Class of chemo drugs na inhibit daughter cells and ano under nyang drugs
Mitotic spindle inhibitors
Plant alkaloids “-vin”
Taxanes “-taxel”
27
Cell cycle NON SPECIFIC (destructs ALL cell cycles) (NAHA)
NitrosUreas “-mUstine”
Anti tumor-antibiotic: Doxurubicin, Bleomycin, Epirubucin, Dactinomycin
Hormonal Agents (Tafugo): tamoxifen for breast Cancer, Fubestrant, Goserelin
AlkyLATINg “-platin” + Cyclophosphamide + Thiotepa
28
Cyclophosphamide antidote and instruction
Mesna
OFI
29
A Cancer caused by bronchogenic Carcinoma dt smoking and occupational pollutants
Lung Cancer
30
LUNG CA Dx
Lobectomy and Pneumonectomy post op position
Bronchoscopic Biopsy
LUPA
31
Lung Ca surgeries
1. Incision sa thoracic cavity
2. To re expand ung natirang lobe
3. Kurot lang for biopsy purpose
4. Entire lung removed
1. Thoracotomy
2. Lobectomy
3. Wedge Resection
4. Pneumonectomy
32
Dalawang di pede gawin after pneumonectomy
1. Lung transplant or else Tracheal Deviation —Mediastinal shift (compli)
2. CTT bc need air
33
Post op device to prevent atelectasis and strengthen intercoastal muscles
How this is done
Incentive spirometer
Inhale sa mouthpiece
34
Blast vs cyte cells sino mature and fxnal
Cyte
35
Tumor grading
1. Poorly differentiated
2. Undifferentiated
3. Benign
4. Moderately differentiated
1. Grade 3
2. Grade 4
3. Grade 1
4. Grade 2
36
Tumor marking (TNM)
1. Alin jan ung start agad sa 1 hindi sa 0
2. 2-5 cm what T
3. extends to skin/chest what T
4. Distant metastasis what M
5. Metastasis to infra/supraclavicular + LN
6. FIXED Metastasis + internal mammary what N
7. Movable
1. T
2. T2
3. T4
4. M1
5. N3
6. N2
7. N1
37
Stages of Ca
1. In situ/incidental findings
2. Large Extensive
3. Large Local spread only
4. Small and only in 1 area
5. Metastasis
1. Stage 0
2. Stage 3
3. Stage 2
4. Stage 1
5. Stage 4
38
Most common metastasis site (3L 2B)
- Lungs
- Lymph
- Liver
- Bone
- Brain
39
MULTIPLE MYELOMA hallmark
Bence-Jones Protein (puro plasma laman ng bone marrow)
40
MULTIPLE MYELOMA sx (CRAB)
Ca ⬆️
Renal failure
Anemia
Bone pain
41
MULTIPLE MYELOMA mngt
IV fluids
Meds
- Bortezomib (kill Ca cells)
- Dexamethasone (steroid & immunosuppressant)
- Thalidomide (blocks Ca sa bv & ⬆️ immune)
- Zoledronic acid (biphosphonate for bone)
42
Most common Ca worldwide
Breast Ca
43
Breast Cancer rx
- History of__
- post menopause age__
- genetic mutations__
- lahi__
- Male syndrome__
- Lifestyle risks like____
- Specific sa babae__
- Ovarian/uterine Cancer
- Over 50 yo
- BRCA 1 & 2
- Caucasians
- Klinefelter
- Oral contraceptive, obesity
- Nulliparity, early menarche <12 yo
44
Breast Ca type of carcinoma na most severe kasi sa terminal duct/lobular unit
Dx
Ductal Carcinoma
Mammograms
45
Breast Ca sx
Peau D’ Orange and HARD PAINLESS IMMOBILE
Abn nipple discharge, retraction, inversion, skin dimpling & ulceration, thick rough skin
46
Kabaliktaran ng HARD PAINLESS IMMOBILE anong type ng cells (benigns)
“Fibro”
47
Xray of breast and done every?
Mammogram q yr
48
Mammogram
1. ❌ maglagay ng ___
2. ❌bata kasi__
3. Bat mas prone larger breast sa Ca
4. Implant?
5. Transwoman?
6. Boys?
7. Mastectomy?
8. ano edad High rx?
9. Edad ng required magpa mammo?
10. Edad na optional sila magpa mammo?
11. >55 yo tuwing kelan papa mammo at bakit
1. Powder lotion/perfumes
2. False result kc changing pa dede nila
3. Subq fat
4. ✅
5. ✅ kc naga pills
6. ✅ kc may gynecomastia
7. ❌ wala na breast tissue
8. 30
9. 45-54
10. 40-44
11. q 2 yrs kasi saggy na
49
1. Detects BRCA 1 & 2
2. Detects CA 125
3. kita Ca proteins
4. 2 dx na if positive maga chemo if negative immunosuppressant or radiation
1. Genetic testing
2. Tumor Markers test
3. HER gene 2 proteins
4. Estrogen Receptor Positive (ERP) & Progesterone Receptor Positive (PRP)
50
Breast self exam
1. Kelan gina gawa pag regular mens
2. post menopause
3. Irreg
4. 3 motions
5. Procedure ng may examiner
1. 5-7 days ater mens
2. Same day each month tapat sa bday
3. Same day each month
4. Circular, up down, spiral (outer to inner kc from node)
* Tayo inspect c arms sa head then hips
* Nakahiga c folded towel/unan under shoulder taas braso
51
MRI
1. Braces pede?
2. Pacemaker?
3. Leg implants
1. ✅
2. ✅
3. ❌
52
Dx that test not only structural-fxnal abnormalities but metabolic abnormalities as well
PET SCAN
53
Mastectomy
1. Remove ALL breast
2. Remove all except pectoralis
3. Prophylactic
4. Breast and nipple lang tanggal
5. Tumor lang tanggal everything intact
1. RadicALL Mastectomy
2. Modified
3. Total Mastectomy
4. Non invasive/benign total mastectomy
5. LUMPectomy
54
Post op mastectomy
1. What kind of drainage bulb
2. Normal ml ng drainage
3. Report ___
4. Mga ❌ post op
5. Expected feeling
6. Ilalagay sa arm
1. Jackson Pratt Bulb
2. <60
3. >100 ml Bright red
4. IV, Blood draw, Vax, Bp
5. Numb and lympn node swelling mawala mobths after
6. Compression sleeve, elevated arm above ♥️, ✅arm exercises
55
Mastectomy 3 compli and mngt
1. Lymphedema - SEMI Fowler c affected arm above ♥️
2. Bleeding— 12h Compression sleeve/bandage
3. Infxn—antibiotic 1-2 wks
56
Most lethal gynecological Ca
Most common gynecological Ca
Ovarian Ca
Endometrial Ca aka Uterine Ca
57
Ovarian Ca
1. Rx factor
2. Tumor marker?
3. Surgery
1. Same c breast cancer
2. BRCA 125
3. Total Abdominal Hysterectomy c Bilateral Salpino-oophorectomy
58
Ovarian Ca early sx & classic sx
1. IRREGULAR VAGINAL BLEEDING (early sx)
2. URINARY URGENCY/FREQUENCY
3. BLOATING & PELVIC PRESSURE
4. URINARY URGENCY/FREQUENCY
59
CerVical Ca rx factors? Screening?
- HPV & HIV (multiple sex partners, first intercourse before 17 yo)
- oral contraceptives >5 mos
- >52 yo
- Smoking
Pap Smear
60
anong type ang STI? Cervical Ca?
STI: type 6 & 11
Cervical Ca: type 16 & 18
61
HPV
1. MOT
2. even c condom use kakahawa?
3. __before sex both gender
1. direct skin to skin contact
2. Yes
3. Vax
62
PAP SMEAR
1. For women ages ___
2. Done q __ yrs
3. together c HPV test: q __ yrs
4. detects what?
5. Avoid ___24h before mamaga repro
6. 2 things bawal 2-3 days before
7. 18 y.o sex active pede?
8. 25 y.o ni sex expi?
9. >65 y.o?
10. Undergo hysterectomy?
1. 25-65 yo
2. 3
3. 5
4. Cervical lesions/inflammations
5. Sex
6. Douching and cervical smear
7. No sabing 25-65 tsaka pedia’s lesions heals on its own
8. Yesss!
9. No! Fragile na yan beh
10. No gagawin e wala na nga
63
PAP SMEAR
1. For women ages ___
2. Done q __ yrs
3. together c HPV test: q __ yrs
4. detects what?
5. Avoid ___24h before mamaga repro
6. 2 things bawal 2-3 days before
7. 18 y.o sex active pede?
8. 25 y.o ni sex expi?
9. >65 y.o?
10. Undergo hysterectomy?
1. 25-65 yo
2. 3
3. 5
4. Cervical lesions/inflammations
5. Sex
6. Douching and cervical smear
7. No sabing 25-65 tsaka pedia’s lesions heals on its own
8. Yesss!
9. No! Fragile na yan beh
10. No gagawin e wala na nga
64
HPV vax
1. indicated for ages?
2. Dose?
3. Brand names ng vax and targets what types
4. if 15-45 y.o ilang dose na?
1. 9-14
2. 2 (0 & 6-12 mos)
3. CERVARIX (type 16 & 18); GARDASIL (types 16 & 18 + 6 & 11 (STI)
4. 3 (0, 1-2, 6 mos)
65
HPV vax
1. indicated for ages?
2. Dose?
3. Brand names ng vax and targets what types
4. if 15-45 y.o ilang dose na?
1. 9-14
2. 2 (0 & 6-12 mos)
3. CERVARIX (type 16 & 18); GARDASIL (types 16 & 18 + 6 & 11 (STI)
4. 3 (0, 1-2, 6 mos)
66
Procedure where acetic acid dissolves mucus in cervix (acetowhite lesions)
Colposcopy
67
Procedure where acetic acid dissolves mucus in cervix (acetowhite lesions)
Colposcopy
68
2 compli of Cervical Ca
1. Vesiculovaginal fistula (ihi lumabas sa vagina)
2. Rectovaginal fistula (poop naman)
69
CERVICAL CA tx
1. Removal of uterus kc lapit sa cervix
2. Cone shaped area sa cervix removal (pede manganak dito)
3. Freezing of Ca tissues
1. Hysterectomy
2. Conization
3. Cryosurgery
70
Prostate vs Testicular Cancer
1. Mc old man >50 yo
2. Mc young man 15-35 yo
3. Best prognosis
4. Impaired seminal fluid production
5. Impaired Sperm production
6. Rx factor is cryptorchordism
7. Anemia as sx & painful urination
8. Hydrocele (feeling of heaviness, painless) c dull ache
9. Bone metastasis
1. P
2. T
3. T
4. P
5. T
6. T
7. P
8. T
9. T
71
Rx factor of Prostate Cancer
1. Lahi
2. Diet
3. History of __
4. __exposure
1. African american
2. ⬆️RED MEATS
3. STI
4. heavy metal
72
Dx ng prostate and testicular ca
prostate: transrectal utz, prostate exam, blood sample, Prostate Specific Antigen (PSA)
testicular ca: testicular self exam
73
testicular ca surgery
1. Orchiectomy
2. BILATERAL orchiectomy: STERILITY
3. Testosterone Replacement therapy
74
Prostate ca surgery and kinds nito
1. TURP or prostatectomy
Prostatectomy kinds:
- Suprapubic (abdominal c bladder incision)
- Retropubic (abdominal ONLY)
- Perineal
75
Prostatectomy
Post op: What type of bladder irrigation and considerations
Cont bladder irrigation (triple lumen cath) to ⬇️bleeding. ✅Outflow>inflow kc ihi + dugo
1. Balloon
2. Outflow
3. NSS inflow
76
Prostatectomy 2 risks
Sterility
Urinary incontinence
77
Kanino maga Androgen Suppression Therapy kc ⬆️ testosterone need ipa ⬇️
Prostate Ca
78
Kanino maga Testosterone Replacement Therapy kc ⬇️testosterone need ipa ⬆️
Testicular Ca
79
Prostate Ca cause, DOC, classic sx
Androgen
Diethylstilbestrol
Dribbling urine
80
Normal PSA level
Ano unahin sa DRE and PSA sa Prostate Cancer
<4 ng/ml
PSA muna kasi tataas ket wala ca
81
Types of biopsy
1. Fastest and least expensive type of biopsy but not the most reliable
2. For larger tumors kuha lang wedge or part/portion
3. ALL/entire tumor + surrounding tissues to prevent recurrence and the most reliable
Fine needle biopsy
Incisional
Excisional
82
Aside sa methotrexate ano pang nakaka stomatitis
5 FU (Fluorouracil)
83
Teletherapy markings considerations
1. When washing markings use ___
2. Use only __when washing
3. How to dry
4. expose to __
5. ❌expose__
6. Type of clothing
7. Avoid applying__
8. Shower and swimming?
9. Dagat?
10. Desquamation (namamalat) mngt
11. Earliest sx of skin reaction
1. Hands
2. Water or water c mild soap
3. Pat dry
4. Air
5. Heat or cold
6. Loose and cotton (❌zipper and garterized)
7. Anything on the skin (lotions, etc.)
8. Pede basta not chlorinated
9. NO dat plain TAP WATER only
10. Warm water
11. Redness called erythema
84
Extravasation mngt
Peripherally central catheter prevents
Stop aspirate antidote
Extravasation kasi may bukasan diretso na sa vena cava
85
Doxorubicin and Vincristine extravasation type of compress?
Doxorubicin- stop aspirate cOlD compress
Vincristine- Warm compress
86
Infiltration vs extravasation
Infil- NSS lang nag lusot sa tissues
Extravasation- chemo drugs
87
Type of brachytherapy radioactive but excreta not
Do both brachytherapy have bathroom privileges?
Sealed
No
88
Tamoxifen is an anti__, SE and gamot
Anti estrogen
Osteoporosis—Raloxifen
89
Diethylstilbestrol is an__, SE?
Estrogen counteract ung androgen
⭐️Gynecomastia & impotence
90
Methotrexate y adjunct c LEUCOVORIN
When to use wig in alopecia
bc hepatotoxic si Methotrexate
BEFORE chemo or before alopecia
91
Chemo pt may consti give
Di mahanap radiation gagawin
Stool softener ❌laxative
Leave report to radiation safety officer sila hahanap kasi may machine then notify md
92
Hodgkin Dse age and caused by 2 virus?
Young adults
Epstein and Helicobacter
