Question 1

Which diagnostic mechanism is used to determine tumor size?&#10;A) Staging&#10;B) Tumor biopsy&#10;C) Tumor markers&#10;D) Cytokines

Accepted Answer

A staging classification, such as TNM, identifies attributes of tumor growth, including size, node involvement, and metastases. Tumor biopsy is used to examine the cytology of the tumor. Tumor markers, which may include cytokines, are chemicals in the blood that are used to identify the presence and type of cancer.

Question 2

Which of the following may be avoided after cancer therapy as the result of alteration in taste sensation?&#10;A) Sweets&#10;B) Salty foods&#10;C) Meats&#10;D) Dairy products

Accepted Answer

Meat aversions can result from chemotherapy or radiation therapy that affects oral or mouth cancers. Meat aversions may be acquired because of changes in taste acuity. Taste thresholds for sweet and salty sensations may alter, and the effect on intake varies depending on whether taste acuity increases or decreases. Although the fats in dairy products have been associated with the development of several cancers, alterations in taste sensation after treatment have not been reported.

Question 3

Which of the following presents with the symptoms of progressive weight loss, anorexia, generalized wasting and weakness, and immunosuppression?&#10;A) Radiation-induced enteritis&#10;B) Xerostomia&#10;C) Veno-occlusive disease&#10;D) Cancer cachexia

Accepted Answer

Cancer cachexia is a secondary diagnosis in patients with advanced cancer that is similar to protein-energy malnutrition. The patient exhibits progressive weight loss, anorexia, wasting, immunosuppression, altered basal metabolism, and electrolyte and fluid abnormalities. Radiation-induced enteritis is an inflammation of the intestinal tract that can lead to malabsorption. Xerostomia is the sensation of dry mouth, and it can result from chemotherapy, radiation therapy, or surgery involving the mouth. Veno-occlusive disease, or sinusoidal obstructive syndrome, is a potential consequence of bone marrow transplant surgery, chemotherapy, or radiation treatment, which could lead to liver failure.

Question 4

Which type of cancer treatment is systemic therapy?&#10;A) Chemotherapy&#10;B) Surgery&#10;C) Radiation therapy&#10;D) Syngeneic hematopoietic stem cell transplant

Accepted Answer

Chemotherapy involves the provision of medications to treat cancer. These medications, however, do not only affect cancer cells because when they are administered, they become distributed throughout the body and are therefore capable of affecting other body cells and systems. Surgery and radiation therapy are generally localized in the treatment of tumors. Although chemotherapy and radiation therapy may be used in conjunction with a syngeneic HSCT, the transplant itself does not involve systems throughout the body.

Question 5

Epidemiologic studies have demonstrated most often an association between body weight or BMI and which site-specific cancers?&#10;A) Bladder and lung&#10;B) Breast and prostate&#10;C) Colon, pancreas, and thyroid&#10;D) Esophagus, endometrium, gallbladder, and kidney

Accepted Answer

The most common site-specific cancers that have been positively associated with increased body weight and BMI include the esophagus, endometrium, kidney, and gallbladder. Obesity is associated with increased death rates in 11 types of cancer in men and 12 types in women.

Question 6

Graft-versus-host disease (GVHD)&#10;A) should never be treated with parenteral nutrition.&#10;B) always occurs immediately after transplant.&#10;C) is a minor complication of chemotherapy.&#10;D) is a major complication seen primarily after allogenic transplants.

Accepted Answer

GVHD is a major complication seen after allogenic transplants, in which the donated stem cells react against the tissues of the transplant recipient. It can occur within the first 100 days after transplantation. Symptoms can be severe and include gastroenteritis, abdominal pain, nausea, and vomiting. Parenteral nutrition is often used as Phase I treatment to rest the bowel.

Question 7

What cautions should be made to a cancer patient considering use of a macrobiotic diet for treatment? A) It may not provide enough energy and is deficient in calcium and vitamin B₁₂. B) It may be high in energy, fat, and protein and low in vitamin B₁₂. C) It may be low in protein and high in energy and fat. D) It may be high in protein and low in energy and fat.

Accepted Answer

The macrobiotic diet is a quasi-religious vegetarian diet that is nutritionally incomplete. Whole grains provide 50% to 60% of its calories; vegetables provide 25% to 30%; and the remainder of calories comes from beans, seaweed, and soups. Because of a lack of animal protein, calories, calcium, and vitamin B₁₂ are also deficient.

Question 8

The goal of nutrition therapy during palliative care is to&#10;A) replenish nutrient stores.&#10;B) promote weight gain.&#10;C) improve albumin status.&#10;D) alleviate symptoms.

Accepted Answer

Palliative care focuses on promoting optimal quality of life and does not continue to address curative measures. Nutrition therapy during palliative care should alleviate symptoms that affect quality of life. Examples of these include pain, weakness, loss of appetite, early satiety, constipation, weakness, dry mouth, and dyspnea. Curative measures associated with nutrition therapy focus on goals such as replenishing nutrient stores, promoting weight gain, and alleviating symptoms.

Question 9

Common side effects of radiation-induced enteritis combined with small bowel resection include&#10;A) sore throat, mucositis, and severe dental and gum destruction.&#10;B) nausea, vomiting, and diarrhea.&#10;C) maldigestion, malabsorption, dehydration, and malnutrition.&#10;D) edema, ascites, and weight gain.

Accepted Answer

Short bowel syndrome is a result of radiation-induced enteritis and small bowel resection. Because of the decreased length of the bowel, maldigestion, malabsorption, dehydration, and malnutrition are common side effects. When radiation therapy is used to treat head and neck cancer, sore throat, mucositis, and dental and gum destruction can occur. Nausea, vomiting, and diarrhea are common consequences of a variety of cancer treatments. Chemotherapy treatments that affect fluid retention and excretion can promote edema, ascites, and weight gain.

Question 10

Which of the following is a protein that affects fat stores during cancer and induces a state of anorexia?&#10;A) Insulin&#10;B) Growth hormone&#10;C) Tumor necrosis factor (cachectin)&#10;D) Glucagon

Accepted Answer

Tumor necrosis factor is a cytokine protein that promotes breakdown of both protein and fat stores to provide adequate energy for tumor cells. At the same time, an insulin resistance occurs because of the excessive fatty acid oxidation. Glucose levels increase, but the glucose and amino acids made available from protein breakdown are preferentially used by the cancer cells. Growth hormone has been investigated as a potential treatment to promote weight gain in cancer patients who have lost weight. High levels of glucose suppress the secretion of glucagon.

Question 11

Parenteral nutrition support should be routinely considered&#10;A) for all cancer patients.&#10;B) after hematopoietic cell transplantation (HCT).&#10;C) for well-nourished cancer patients in whom oral intake is about 50% of the desired goal.&#10;D) for patients with advanced cancer whose disease is unresponsive to chemotherapy or radiation.

Accepted Answer

The answer of Parenteral nutrition support should be routinely considered&#10;A)...

Question 12

Chemoprevention is the&#10;A) pharmacologic use of nutrients to suppress or reverse carcinogenesis.&#10;B) pharmacologic use of medications to treat cancer.&#10;C) use of CAM therapy to prevent or treat cancer.&#10;D) reduction of carcinogenic growth factors in the blood.

Accepted Answer

The answer of Chemoprevention is the&#10;A) pharmacologic use of nutrients...

Question 13

Which dietary modification would be used when a patient has neutropenia?&#10;A) Provide bland liquids and soft solids.&#10;B) Avoid strong flavors and acidic or spicy foods.&#10;C) Provide special handling of raw meats.&#10;D) Provide sauces and gravies with foods.

Accepted Answer

The answer of Which dietary modification would be used when...

Question 14

For _____ cancer, epidemiologic studies indicated that alcohol consumption increases the risk of development.&#10;A) ovarian&#10;B) prostate&#10;C) mouth&#10;D) pancreatic

Accepted Answer

The answer of For _____ cancer, epidemiologic studies indicated that...

Question 15

In carcinogenesis, which step does NOT necessarily occur in tumor development?&#10;A) Initiation&#10;B) Promotion&#10;C) Progression&#10;D) Metastasis

Accepted Answer

The answer of In carcinogenesis, which step does NOT necessarily...

Question 16

An autologous hematopoietic stem cell transplant is one involving&#10;A) stem cells donated by a sibling or parent.&#10;B) stem cells donated by a twin.&#10;C) stem cells previously taken from the patient.&#10;D) stem cells from an unrelated donor or cadaver.

Accepted Answer

The answer of An autologous hematopoietic stem cell transplant is...

Question 17

Which of the following is recommended in the medical nutrition therapy for a patient undergoing surgical treatment of esophageal tumors?&#10;A) Placement of a feeding tube at the time of surgery&#10;B) Oral liquid diet with supplements&#10;C) Regular diet with multivitamin supplementation&#10;D) Total parenteral nutrition

Accepted Answer

The answer of Which of the following is recommended in...

Question 18

For which of the following problems associated with cancer treatment should a high-calorie diet supplemented with calorically dense foods be provided?&#10;A) Constipation&#10;B) Xerostomia&#10;C) Anorexia&#10;D) Neutropenia

Accepted Answer

The answer of For which of the following problems associated...

Question 19

According to the evidence from current research, what role does drinking regular amounts of coffee or tea have on cancer development?&#10;A) There is a strong causal relationship between coffee intake and cancer.&#10;B) There is a suggested causal relationship between coffee intake and cancer.&#10;C) Coffee may have an anticancer effect.&#10;D) There is a strong causal relationship for tea but not for coffee.

Accepted Answer

The answer of According to the evidence from current research,...

Deck 36: Medical Nutrition Therapy for Cancer Prevention, Treatment, and Survivorship