CSO Exam 2025 > Questions From Study Guide > Flashcards

Questions From Study Guide Flashcards

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1
Q

Hgb normal lab ranges

A

Men: 13.5-18 g/dL
Women: 12-15 g/dL

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2
Q

Hct normal lab ranges

A

Men: 40-54%
Women: 36-48%

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3
Q

Na normal lab range

A

135-145 mEq/L

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4
Q

K+ normal lab range

A

3.5-5.2 mmol/L

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5
Q

Phos normal lab range

A

2.5-4.5 mg/dL

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6
Q

Mg normal lab range

A

1.7-2.2 mg/dL

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7
Q

ANC normal lab range

A

1500-8000 cells/uL

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8
Q

What are side effects and food/supplements to avoid for afinitor (everolimus)?

A

Mucositis, neutropenia, N/V/D, poor appetite

Grapefruit, St. John’s Wort, etc

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9
Q

What type of drug is alimta (pemetrexed) and what is an important nutrition consideration?

A

Antifolate chemo

Should take folic acid 300-1000 mcg daily 1 week prior to 1st dose until 21 days after last dose, vitamin B12 1000 mcg IM 1 week prior to 1st dose & every 3 cycles after

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10
Q

Nutritional considerations for patients receiving anastrazole and what type of med is it?

A

Aromatase inhibitor

Need extra vitamin D and calcium + weight bearing exercise

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11
Q

Nutritional considerations for patients receiving bortezomib (velcade)?

A

Major interactions with vitamin C, green tea, avoid/limit vitamin K

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12
Q

Notable side effect and interaction for capecitabine (xeloda)

A
  • Heart failure
  • Folic acid -> increased toxicity
    .
    .

Other SEs: N/V/D, mucositis

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13
Q

Side effects and nutritional considerations for carboplatin

A

Taste changes,

Low Mg

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14
Q

Side effects and 4 nutritional considerations for cisplatin

A
  • Taste changes, N/V, CIPN
    .
    .
  • Low Mg
  • Need extra hydration
  • Omega-3 and curcumin can increase clinical efficacy
  • Milk thistle can decrease side effects
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15
Q

Side effects, food/supp to avoid, and other considerations for cyclophosphamide (cytoxan)

A

Taste changes, N/V/D, mucositis, poor appetite, heart failure

Grapefruit

Need extra hydration, causes secondary malignancies

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16
Q

Common side effect and food/supp to avoid for cytarabine (ara-C)

A

Mucositis

Grapefruit

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17
Q

Common side effect and food/supp to avoid for dacarbazine (DTIC)

A

Taste changes

Grapefruit

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18
Q

Common side effect of dactinomycin

A

Taste changes

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19
Q

Food/supp to avoid and other nutritional consideration for dasatinib (sprycel)

A

Grapefruit, St. John’s Wort, etc

Causes fluid retention

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20
Q

Nutritional consideration for deferasirox (exjade)

A

Contains lactose

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21
Q

Nutritional considerations for denosumab (xgeva, prolia)

A

Causes low Ca, osteonecrosis of jaw

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22
Q

Nutritional considerations for dexamethasone

A

Need extra vitamin D & Ca, weight bearing exercise

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23
Q

Side effects and food/supp to avoid for docetaxel (taxotere)

A

Heart failure, fluid retention, taste changes, mucositis

Grapefruit, St. John’s Wort, etc

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24
Q

Side effects, food/supp to avoid, and *other nutritional considerations for doxorubicin (adriamycin, doxil)

A

“Red devil”

Mucositis, taste changes, heart failure

Grapefruit, St. John’s Wort, etc

*Extra info (not verified to be on exam by anyone): Black cohosh & turmeric increase toxicity, omega-3 can increase clinical efficacy, theanine can decrease toxicity

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25
Nutritional consideration for eribitux
Causes low Mg
26
Side effects, food/supp to avoid for erlotinib
N/V/D, poor appetite, mucositis Grapefruit, St. John’s wort etc
27
Notable side effect of etoposide (VePesid, Toposar)
Taste changes . . Other SEs: N/V, mucositis
28
Food/supp to avoid and other nutritional considerations for Exemestane (Aromasin)
Grapefruit, St. John's Wort Need extra vitamin D and calcium + weight bearing exercise
29
Side effects of 5-Fluorouracil (5-FU)
Mucositis*, taste changes, heart failure
30
Side effects and food/supp to avoid for Gleevec (imatinib)
Heart failure, fluid retention, N/V/D Grapefruit, St. John's Wort, etc
31
Food/supp to avoid and other considerations for irinotecan
Grapefruit, St. John’s wort etc “I run to the can”, omega-3s can increase detoxification
32
Side effects of kadcyla
Constipation, low K+
33
Food/supp to avoid and other nutritional considerations for letrazole (femara)
Grapefruit, St. John's Wort Need extra vitamin D and calcium + weight bearing exercise
34
Side effect & nutritional consideration for Mercaptopurine (6-MP)
Taste changes Avoid dairy
35
Side effects & nutritional consideration for Methotrexate (MTX)
Mucositis, taste changes Avoid all folic acid supplementation or dose away from MTX if true deficiency
36
Nutritional consideration for Nilotinib (Tasigna)
Contains lactose
37
Side effects for oxaliplatin
N/V/D, mucositis, taste changes, CIPN, heart failure
38
Side effect and nutritional considerations for paclitaxel (taxol)
Taste changes Omega-3s can increase detoxification
39
Side effect, food/supp to avoid, and other nutritional considerations for Procarbazine
Constipation Green tea, caffeine Need low tyramine diet (no aged/fermented foods), causes secondary malignancies
40
Nutritional considerations for Rapamune (sirolimus)
May increase TGs
41
Side effects and food/supp to avoid with Sorafenib
N/D, mucositis, heart failure Grapefruit, St. John's Wort, etc
42
Nutritional consideration for Stivarga (Regorafenib)
Take whole with water after low-fat meal (< 600 calories & <30% fat)
43
Nutritional considerations for tamoxifen
- Causes fluid retention - Flaxseed can increase efficacy - Black cohosh interacts - Causes secondary malignancies
44
List 5 side effects of Torisel
- Nausea - Diarrhea - Mucositis - Poor appetite - Extremity swelling
45
Side effect of Vecibitux
Low Mg
46
Side effects and nutritional consideration for Vincristine
Jaw pain, taste changes, constipation* Omega-3s can increase efficacy
47
Side effect of Vinblastine
Jaw pain, constipation
48
Side effect of Vinorelbine
Jaw pain, constipation
49
Nutritional considerations for Zolindronic acid (Zometa)
Need extra vit D/ Ca/wt bearing exercise, causes osteonecrosis of jaw
50
Meds for delayed nausea/vomiting (1-7 days after chemo)
NK-1 receptor antagonists: - aprepitant or fosaprepitant (Emend) - rolapitant (Varubi) - netupitant and palonsetron (Akynzeo) Phenothiazines: - prochlorperazine/Compazine - promethazine/Phenergan
51
Meds for acute nausea/vomiting (24 hours after chemo)
Serotonin (5-HT3) antagonists: - ondansetron/Zofran, - granisetron/Kytril, - dolasetron/Anzemet, - palonosetron/Aloxi, - tropisetron/Navoban
52
Meds that cause osmotic diarrhea
Lactulose, magnesium, sorbitol-containing meds
53
Meds that cause secretory diarrhea and how to treat it
- Irinotecan, fluorouracil (5-FU), capecitabine (xeloda), tyrosine kinase inhibitors: erlotinib (Tarceva) and gefitinib (Iressa) - Treat: oral rehydration, avoid lactose, limit fiber, greasy, or spicy foods, take Imodium
54
Major interactions with Bortezomib (Velcade)
Green tea, vitamin C
55
Generic names for Miralax, Gas-X, Prilosec
- Miralax: polyethylene glycol 3350 - Gas-X: simethicone - Prilosec: omeprazole
56
Small molecule drugs associated with GI perforation
- NSAIDs - Corticosteroids - Tyrosine kinase inhibitors: Erlotinib, Pazopanib, Regorafenib, Sorafenib, Sunitinib, Temsirolimus, Vandetanib - JAK inhibitors: Baricitinib, Tofacitinib, Upadacitinib - Methotrexate
57
What does Epoetin alpha do?
Stimulates red blood cell production
58
What do Neupogen & Neulasta do?
Stimulate neutrophil (white blood cell) production
59
Short-term side effects of head & neck XRT
- Fatigue - Hair loss in treatment area - Mouth changes (dysguesia, oral mucositis, xerostomia) - Skin changes - Throat changes (dysphagia, odynophagia, esophagitis) - Thick saliva - Oral infections - Stiffness of jaw - Earaches
60
Long-term side effects of head & neck XRT
- Trismus - Dental decay - Permanent xerostomia - Taste/smell changes - Osteoradionecrosis - Mucosal sensitivity
61
Short-term side effects of breast XRT
- Fatigue - Hair loss in treatment area - Skin changes - Tenderness - Swelling of breast
62
Long-term side effects of breast XRT
- Changes to look, feel, size of breast
63
Short-term side effects of pelvis & rectum XRT
- Diarrhea - Fatigue - Hair loss in treatment area - Sexuality & fertility changes - Skin changes - Urinary & bladder changes - Rectal bleeding
64
Long-term side effects of pelvis & rectum XRT
- Bowel or bladder incontinence
65
Short-term side effects of brain XRT
- Fatigue - Hair loss in treatment area - N/V - Skin changes - Headache - Blurry vision
66
Long-term side effects of brain XRT
- Headache - Leukoencephalopathy - Dementia
67
Short-term side effects of chest XRT
- Fatigue - Hair loss in treatment area - N/V - Skin changes - Throat changes - Cough - Dyspnea
68
Long-term side effects of chest XRT
- Heart complications - Radiation pneumonitis
69
Short-term side effects of stomach & abdomen XRT
- N/V/D - Fatigue - Hair loss in treatment area - Sexuality & fertility changes - Skin changes - Urinary & bladder changes
70
Long-term side effects of stomach & abdomen XRT
- Diarrhea - Malabsorption - Chronic enteritis or colitis - Intestinal changes (stricture, obstruction, etc)
71
What is radiation enteritis?
- Results from radiation to abdomen, pelvis, or rectum - May occur during treatment or months after finished - Causes N/V/D and stomach cramps - Usually temporary but chronic radiation enteritis can cause complications such as anemia, diarrhea or bowel obstruction
72
What is Definitive RT?
Primary treatment to remove the cancer; higher total dose given in daily fractions over several weeks
73
What is Adjuvant RT?
Secondary treatment after primary treatment (such as surgery) given to reduce the risk of cancer reoccurring; lower dose
74
What is trismus, what causes it, and how can it be treated?
- Lock jaw, inability to fully open mouth d/t muscle spasms in jaw - May be caused by head & neck RT - Muscle relaxers, PT exercises, jaw exercises can help treat
75
What is the ECOG scoring (Eastern Cooperative Oncology Group)?
- Describes a patient’s level of functioning in terms of their ability to care for themself, daily activity, and physical ability 0: fully active 1: restricted PA but ambulatory (light house work) 2: ambulatory but unable to carry out work activities, up and about >50% waking hours 3: capable of limited self-care, confined to bed/chair >50% waking hours 4: completed disabled, totally confined to bed/chair 5: dead
76
What is Hemochromatosis and what are diet recs for someone with it?
Iron overload Recs: - Limit red meat - Avoid iron supplements - Avoid vitamin C supplements (increases absorption) - Avoid raw/undercooked shellfish (more susceptible to bloodstream infections) - Avoid cooking in cast iron pans - Avoid excessive sugar consumption (increases absorption) - Include coffee/tea (tannins inhibit absorption)
77
What cancer diagnoses are associated with physical activity?
Breast, endometrial, colorectal
78
What are 8 cancer diagnoses associated with increased body fat?
- Breast (post-menopausal) - Cervical - Endometrial - Esophageal - Colorectal - Gallbladder - Pancreatic - Kidney
79
What cancer diagnoses are associated with most catabolic disease?
Gastric, pancreatic, esophageal, NSCLC
80
What cancer diagnoses are associated with EtOH use?
Breast, pharyngeal, laryngeal, esophageal, prostate, liver
81
Cancer-related side effects for thyroid cancer
- Cough - Swallowing difficulty - Breathing difficulty - Enlargement or lump in thyroid gland - Neck pain - Hoarseness or change in voice
82
Cancer-related side effects for peritoneal carcinoma
- Abdominal pain - Bloating - Nausea - Unexplained weight loss
83
Cancer-related side effects for anal cancer
- Itching or pain - Change in stool diameter - Abnormal anal discharge - Swollen lymph nodes in groin - Bleeding
84
Cancer-related side effects for colon cancer
- Change in bowel habits - Unexplained anemia - Visible blood in stool - Abdominal pain - N/V - Unintended weight loss - Fatigue
85
Cancer-related side effects for esophageal cancer
- Dysphagia - Odynophagia (painful swallowing) - Reflux-like pain - Throat or back pain - Weight loss
86
List 4 supplements that may cause liver toxicity
- Chaparral - Ephedra - Comfrey channel - Black cohosh
87
Considerations regarding omega-3s and chemo
- Can increase detoxification of Taxol (paclitaxel) & Irinotecan - Can increase clinical efficacy of Adriamycin, Vincristine, Cisplatin - Can increase bleeding risk
88
Considerations regarding Silymarin (milk thistle) and chemo
- Antioxidant - May reduce side effects of cisplatin (rat study) - Can regulate cell cycles, induce apoptosis, and reduce angiogenesis - Anti-inflammatory - Generally well-tolerated
89
What supplements are contraindicated in allogenic HCT patients?
- Glutamine; may increase risk for relapse - Iron; risk for iron overload after transfusion - Herbal supplements; infection risk
90
What are some cancer-related issues that acupuncture can help with?
- N/V - Arthralgia’s and hot flashes (AIs) - Xerostomia (XRT) - Neuropathy
91
What are the 4 validated malnutrition screening tools?
Inpatient & Outpatient - Patient Generated Subjective Global Assessment (PG-SGA)- Malnutrition Screening Tool (MST) Inpatient only - Malnutrition Screening Tool for CA Patients (MSTC) - Malnutrition Universal Screening Tool (MUST)
92
Which cancers have the greatest risk for malnutrition at dx?
- Gastrointestinal - Pancreatic - Head & Neck - Colorectal
93
Gastrectomy & terminal ileum resection cause decreases in which two nutrients?
- Iron - Vitamin B12 levels
94
Explain the relationship between B12 deficiency and risk of gastric CA
If B12 deficiency is caused by pernicious anemia (body produces antibodies that attack parietal cells in the stomach, which produce intrinsic factor), chronic inflammation in the stomach can damage the stomach lining and increase the risk of developing gastric cancer
95
Causes and nutrition interventions for SIADH
- May be caused by brain tumors 2/2 increased intracranial pressure - 70% of SIADH is caused by small cell lung carcinoma - Restrict water intake (body retains water) - Provide hypertonic saline when Na is low
96
Nutrition intervention for someone receiving radioactive iodine (RAI)
- Low iodine diet to deplete body of iodine and increase thyroid uptake of RAI (for thyroid cancer treatment)
97
Food sources and what to avoid on low iodine diet
Sources: - Seaweed - Fish/shellfish - Iodized salt - Dairy (milk, cheese, yogurt) - Eggs (specifically the yolk) - Beef liver - Enriched bread (w/ iodate dough conditioners) Avoid: - Foods listed above - Most salted packaged foods - Canned vegetables or fruits - Dried fruits - Juices that have red dye #3 - Maraschino cherries - Any salted meats - Butter/mayo - Commercial salad dressings - Beer - ONS drinks (check label) - Instant drink mixes - Restaurant foods - Foods w/ carrageenan, agar-agar, algin, or alginate
98
What is CA 19-9
Tumor marker used primarily in the management of pancreatic cancer to monitor how well treatment is working Also associated w/ colon, stomach, and bile duct cancers
99
What does TX, NX, and/or MX mean in cancer staging?
Tumor (T), Regional Lymph Nodes (N), and/or Distant Metastasis (M) cannot be evaluated
100
What does T0, N0, and/or M0 mean in cancer staging?
No evidence of tumor (T), no lymph node involvement (N), and/or no distant metastasis (M)
101
What does Tis mean in cancer staging?
Carcinoma in situ (abnormal cells are present but not spread to neighboring tissues; not cancer but may become cancer)
102
What does T1 mean in cancer staging?
Tumor (T) not palpable or visible by imaging
103
What does T2 mean in cancer staging?
Tumor is confined to the primary site
104
What does T3 mean in cancer staging?
Tumor extends to neighboring tissue
105
What does T4 mean in cancer staging?
Metastatic disease
106
What does N1, N2, N3 mean in cancer staging?
Involvement of regional lymph nodes (# of nodes indicates extent of spread)
107
What does M1 mean in cancer staging?
Distant metastasis is present
108
Diet factors that increase risk of prostate cancer
- Dairy (calcium >1,500 mg/day) - Processed meat - Eggs (specifically the yolks; choline) - Poultry w/ skin - Animal fat and other sat fat - Selenium supplementation
109
Describe the basics of the Budwig diet and potential micronutrient deficiencies from following it
- Vegetarian, Budwig muesli: blend of cold-pressed flaxseed oil and quark cheese eaten at breakfast & lunch = 6-7 Tbsp flaxseed oil/day - Essaic tea encouraged (or the modified product Flor-Essence) - Prohibited foods: processed foods, peanuts, meat/seafood, sugar, refined foods, unfermented soy products, dairy (other than quark cheese used to make Budwig muesli) - Vitamin B12, vitamin D, iron, zinc, calcium, iodine - Also low in protein
110
Describe the basics of the Gerson diet and potential micronutrient deficiencies from following it
- Organic, plant-based, includes raw juices and natural supplements - No sodium and no fat except flaxseed oil - Requires eating 15-20 lb of fruits and vegetables daily and up to 13 glasses of juice (raw carrots, apples, green leafy vegetables) daily - Multiple supplements are required including vitamin B12, thyroid hormone, pancreatic enzymes, and potassium - Coffee enemas, vaccines, injections from liver extract recommended - Diet high in potassium and carbs - Vitamin B12, vitamin D, iron, calcium, zinc, iodine - Risk of malnutrition, hyponatremia, dehydration, colitis from enemas
111
Describe the basics of the Gonzalez diet and potential micronutrient deficiencies from following it
- Dietary patterns are individualized (vegan to red meat several times per day) - Supplements, extracts of animal organs (for panc enzymes), and detox practices (coffee enemas 2x/day) are components of the regimen - Followers may take up to 150 pills daily - Side effects & deficiencies vary, but coffee enemas can result in electrolyte imbalances, increased risk for colitis & infection, and death
112
Describe the basics of the Livingston-Wheeler diet and potential micronutrient deficiencies from following it
- Combines vegetarian diet (75% raw fruits & vegetables) w/ megadoses of vitamins & minerals and digestive enzymes - Includes a bacilli Calmette-Guerin (BCG) vaccine made from each patients own blood or urine - Enemas of coffee, lemon juice, or hot water - Vitamin B12, vitamin D, iron, zinc, calcium, iodine, protein - Megadoses of vitamins may exceed TUL and pose health risks
113
Describe the basics of the Macrobiotic diet and potential micronutrient deficiencies from following it
- Adaptation from traditional Japanese diet; variations from mostly vegetarian to vegan - Organic, locally grown foods in the following proportions are recommended: whole grains 40-60%, vegetables 20-30%, beans 5-10%, soup w/ beans, miso, vegetables 5%, nuts/seeds/fruit/fish on occasion - Nightshade vegetables, dairy, eggs, processed foods, refined sugars, meats not allowed - Specific cooking methods & utensils recommended (no microwaves or electricity) - Food chewed until fluid (50 times) - Vitamin B12, vitamin D, iron, zinc, calcium, iodine, possibly protein
114
Nutrients absorbed in the stomach
- Water - Alcohol - Copper - lodide - Fluoride - Molybdenum
115
Nutrients absorbed in the duodenum
- Ca, Phos, Mg, Fe, Cu, Se - All B vitamins except B12 - Vitamins A, D, E, K - Alcohol
116
Nutrients absorbed in the jejunum
- Lipids - Monosaccarides - Amino acids - Small peptides - All B vitamins except B12 (B5 pantothenic acid preference here) - Vitamin A, C, D, E, K - Ca, Phos, Mg, Fe, Zn, Cr, Mn, Mo - Alcohol
117
Nutrients absorbed in the ileum
- Vitamin B12 (only in ileum*) - Bile salts and acids (only in ileum*) - Vitamin C, D, K - Folate - Magnesium - Others, depending on transit time
118
Nutrients absorbed in the colon
- Water - Vitamin K - Biotin (B7) - Na, Cl, K+ - SCFA
119
List 4 common nutrient deficiencies for someone with EPI
Vitamins A, D, E, K
120
What cancer type is associated with pernicious anemia?
Gastric
121
What labs are used to diagnose anemia?
- Hemoglobin - Hematocrit
122
What are the side effects of sinusoidal obstructive syndrome (SOS), which can occur after HCT? How can you manage it?
- Portal hypertension, ascites, hepatomegaly - Can lead to organ failure and death - Diuresis, Na restriction, HD or CRRT, use of defibrotide
123
What are SSAs and why are they used for NETs?
- Somatostatin analogues (octreotide, lanreotide, paireotide) - Similar to hormone somatostatin, which is responsible for the release of other hormones - SSAs can reduce the amount of hormone released from functional NETs - SSAs improve diarrhea and flushing - Side effects: malabsorption, hyperglycemia, hypothyroidism
124
What are some common side effects of PRRT?
- Fatigue - Nausea/vomiting - Risk of kidney damage
125
What foods should be limited to help manage carcinoid syndrome?
Sources of tyramine - Aged cheeses - Alcohol - Smoked & salted animal proteins - Yeast extracts - Fava beans - Soybeans - Fermented foods - Chocolate - Peanuts, Coconut, Brazil nuts - Raspberries, Avocados, Bananas - Caffeine Sources of dopamine - Dairy products - Unprocessed meats - Omega-3 containing fish - Eggs - Nuts - Fruits & Vegetables, especially bananas - Dark chocolate
126
What may need to be supplemented for patients with carcinoid syndrome?
- Daily MVI + niacin (may be given as niacinamide 20-50 mg 2x/day) - High protein (1.5 g/kg BW) also recommended to add more tryptophan
127
Side effects, risks, and nutrition management for peritoneal carcinomatosis
- N/V/C, abdominal pain, ascites, poor appetite - Risk of bowel obstruction - Small frequent meals, increased protein, sodium restriction, low fiber to prevent SBO, may require TPN if SBO present
128
What are Seventh Day Adventist eating practices?
- Mainly plant-based diet, not uncommon for them to follow vegan diet - No tobacco, alcohol, tea, caffeinated beverages - For those who eat meat, it must be "clean" based on bible (no pork, shellfish, sea mammals, insects w/o jointed jumping legs) - Eating to feel full is discouraged (r/t temperance) - "Good diet, exercise, pure water, adequate sunlight, temperance, fresh air, rest, and spirituality"
129
What are Muslim eating practices and appropriate food choices during Ramadan?
May have (halal): - All fruits, vegetables and grains, except those that cause intoxication - All beef, poultry, and lamb products slaughtered according to Islamic dietary laws - All animal-derived products that come from dhabiha (or zabiha) animals - Seafood May not have (haram): - Pork and all its byproducts, including gelatin - Any animal that wasn’t slaughtered according to Islamic guidelines - Blood and its by-products - Birds of prey (those with talons) and any other carnivorous animals, including reptiles and insects - Alcoholic beverages and any other intoxicants Ramadan: - Fast from sunrise to sunset daily for the entire month - Breakfast-like meal (suhur) before sunrise - After sunset, dinner (iftar) - End of month, celebrate w/ festival (Eid al-Fitr) - forbidden to fast
130
What are Kosher eating practices?
- No pork, shellfish - No diary w/ meat - No blood (meat must be salted or roasted first) - No wine or alcoholic beverages not produced by Jews During Passover - No leavened bread (can have matzah instead)
131
Describe the use of IV hydration, EN, and PN during hospice and palliative treatments/role of RD during palliative care.
- May be beneficial during ongoing palliative care if supports improved QOL, but not beneficial near end of life -RD role to educate patients, caregivers, providers and facilitate discussions about nutrition options
132
Why place a prophylactic GT before H&N chemoRT?
- Improved nutritional outcomes have been found in a study (not large enough to demonstrate distinct benefit) - To determine who may benefit, consider: tumor type & stage, RT treatment field, weight loss prior to treatment, dysphagia, comorbidities, risk for aspiration, anorexia, pain interfering w/ PO intake, dehydration
133
What are appropriate food choices post-colectomy?
- Clear liquids -> soft low fiber -> regular - Avoid/limit gas-producing foods, tough meats/hard to digest foods, greasy foods, spicy foods - Stay hydrated, eat SFM, chew thoroughly
134
What are appropriate food choices when experiencing xerostomia?
- Choose soft, moist foods - Avoid dry coarse foods (toast, crackers, etc) - Add sauces, gravy, olive oil to enhance moisture - Chew sugar-free gum or use lozenges to stimulate saliva
135
What are appropriate food choices with dysgeusia?
- Add strong seasonings - Incorporate citrus or sour tastes - Limit use of metallic silverware - Consume fruit/smoothies
136
What are appropriate food choices after tumor lysis syndrome?
Avoid foods high in K+ & Phos
137
What deficiencies are anticipated after ileocecal valve resection?
- Vitamin B12 - Vitamins A, D, E, K d/t decreased bile acid reabsorption - Also note risk of SIBO
138
What treatments are associated with bowel perforation?
- Immunotherapy drugs, especially immune checkpoint inhibitors (ICIs) like nivolumab and ipilimumab - Also PD-1 inhibitor Pembrolizumab, in combo w/ anti-angiogenic drugs such as bevacizumab
139
What are the signs & symptoms of hypovolemia?
Hypovolemia = low volume of fluid in the body - Dizziness when standing - Dry skin and mouth - Fatigue, weakness - Muscle cramps - Unable to urinate
140
What is esophageal stenosis? What are nutrition interventions?
- Narrowing of the esophagus - Choose soft, moist, and easy-to-swallow foods
141
Describe the NCI Common Terminology Criteria for Adverse Events
- Grade 1: Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated - Grade 2: Moderate; minimal, local or noninvasive intervention indicated; limiting instrumental ADL - Grade 3: Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL - Grade 4: Life-threatening consequences; urgent intervention indicated - Grade 5: Death related to AE
142
What is leukocytosis?
- Abnormally high # of WBCs in bloodstream - Often caused by blood cancers
143
What is thrombocytopenia?
- Deficiency of platelets in the blood - Causes bleeding into the tissues, bruising, and slow blood clotting
144
What is pancytopenia?
- Decrease in all three major types of blood cells (RBC, WBC, platelets) - Causes anemia, increased infection risk, and bleeding or bruising
145
Describe anticipatory nausea and how to manage it.
- Nausea prior to chemo - Guided imagery/relaxation, hypnosis, biofeedback, behavior modification and distraction - Antiemetics do not seem to be helpful - Anti-anxiety meds may help manage it
146
What is the Karnofsky performance scale?
100: Normal; no complaints; NED 90: Able to carry on normal activity; minor signs/symptoms of disease 80: Normal activity with effort; some signs or symptoms of disease 70: Cares for self; unable to carry on normal activity or do work 60: Requires occasional assistance, but is able to care for most personal needs 50: Requires considerable assistance and frequent medical care 40: Disabled; requires special care and assistance 30: Severely disabled; hospitalization indicated although death not imminent 20: Very sick; hospitalization necessary; requires active support treatment 10: Moribund; fatal processes progressing rapidly 0: Dead
147
True or false: Higher calcium intake (1000 mg or more/day) is associated with a lower risk of colon cancer
True
148
What is CA-125 used for?
- Predicting resectability: Studies have shown CA 125 to be superior to CA 19-9 in predicting whether a pancreatic tumor can be surgically removed - Indicating Metastasis: High CA 125 levels are strongly linked to metastatic disease - Prognosis: monitoring CA 125 levels can provide insights into disease progression and survival
149
GVHD gut side effects and management
- N/V, anorexia, food intolerance, abdominal pain, voluminous diarrhea & cramping (if in lower GI tract) - Vitamin D supplement may decrease the incidence of Grade 3-4 acute GVHD - Supplement zinc if increased losses d/t diarrhea
150
What are 4 cancer treatment medications that cause hypomagnesemia?
- Carboplatin - Cisplatin - Eribitux - Vecibitux
151
What are 10 chemotherapy drugs commonly associated with taste changes?
- Carboplatin - Cisplatin - Cyclophosphamide - Dacarbazine - Dactinomycin - Doxorubicin - 5-fluorouracil - Methotrexate - Paclitaxel - Vincristine
152
Name 2 medications that contain lactose
- Nilotinib (Tasigna) - Deferasirox (Exjade)
CSO Exam 2025
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