Study Guide Leftovers 2

Question 1

What are the 5 most common sites of metastasis in order?

Answer 1

1. pulmonary
2. skeletal
3. hepatic
4. neurologic
5. lymphatic

Question 2

These tumors metastasize first to the lung

Answer 2

primary bone tumors

Question 3

Why do primary bone tumors metastasize to the lung first?

Answer 3

• venous drainage passes through superior and inferior venae cavae into the heart
• lungs are the first organ to filter malignant cells

Question 4

What is often the first symptom of a lung met?

Answer 4

dry, persistent cough

Question 5

Bone mets are very common, especially to this bone type

Answer 5

vascular

Question 6

Most common sites of bone mets

Answer 6

• vertebrae
• pelvis
• ribs
• skull
• proximal femur

Question 7

skeletal metastases: What are some of the qualities of pain?

Answer 7

• deep
• intractable
• poorly localized
• episodic “stabbing” pain
• worst at night
• wakes person up

Question 8

What problems can occur from osteolytic lesions?

Answer 8

• pathologic fx
• back pain
• hypercalcemia

Question 9

Why is there an increase in bone resorption with bone mets?

Answer 9

hormonal stimulus of protein that stimulates osteoclastic bone resorption

Question 10

What type of metastasis is among the most ominous signs of advanced cancer?

Answer 10

liver mets

Question 11

Because the liver filters blood from the GI tract, it is the primary metastatic site for tumors originating in these locations

Answer 11

• stomach
• colorectum
• pancreas

Question 12

s/s liver met

Answer 12

• RUQ pain
• malaise
• fatigue
• may refer to R shoulder
• bilateral carpal tunnel syndrome

Question 13

Why would you get carpal tunnel with a liver met?

Answer 13

It’s actually an ammonia abnormality due to liver dysfunction

Question 14

% of individuals with primary sites outside the CNS that develop brain mets

Answer 14

20-25%

Question 15

Most common primary cancers with mets to brain

Answer 15

• lung
• colon
• kidney
• skin (melanoma)
• breast

Question 16

Brain tumors may be asymptomatic, or vary widely, depending on

Answer 16

• location

- size

Question 17

What are the s/s of cauda equina syndrome?

Answer 17

• LBP
• saddle paresthesia
• LE weakness
• sexual dysfunction
• etc

Question 18

What is a major neuro side effect of chemo?

Answer 18

chemotherapy-induced peripheral neuropathy

Question 19

What are two factors with cancer that may result in dysfunction presenting as lymphedema?

Answer 19

• previous cancer-related surgery

- adverse effects involving radiation fibrosis

Question 20

What is paraneoplastic syndrome?

Answer 20

• tumors produce s/s at a distance from the tumor or its metastasized sites
• these “remote effects” are collectively called paraneoplastic syndromes

Question 21

Is paraneoplastic syndrome common?

Answer 21

No, rare

Question 22

What is a likely cause of paraneoplastic syndrome?

Answer 22

• altered immune system

- tumor elsewhere, possibly not diagnosed

Question 23

paraneoplastic syndrome: sx resemble those of these types of disorders

Answer 23

• primary endocrine
• metabolic
• hematologic
• NM

Question 24

What sorts of nonspecific symptoms will be seen with paraneoplastic syndrome?

Answer 24

• skin changes
• anorexia
• malaise
• etc.