Deck 23: Neoplastic Disease

Question 1

Which of the following is the primary tumor marker for bladder cancer that is found in urine?

A) CA-125
B) estrogen receptor
C) fibrinogen
D) CA19-9
E) beta-2-microglobulin

Answer 1

C

Question 2

What type of hormone promotes altered gene expression and is linked to prostate cancer?

A) eicosanoids
B) peptides
C) catecholamines
D) androgens
E) estrogens

Answer 2

D

Question 3

What percent of cancer patients are purportedly cured by surgery?

A) 5%
B) 15%
C) 22%
D) 33%
E) 40%

Answer 3

E

Question 4

What are the different stages of cancer according to the Tumor Node Metastases (TNM) Staging System?

A) 0, I, II
B) I, II, III
C) 0, I, II, III
D) 0, I, II, III, IV
E) I, II, III, IV, V

Question 5

How many types of diseases fall under the term "cancer"?

A) 1
B) 10
C) about 25
D) at least 100
E) thousands

Question 6

What class of chemotherapy drugs works by arresting cellular metaphase by inhibiting mitotic tubular formation (spindle)?

A) alkylating agents
B) nitrosureas
C) antimitotics
D) indirect DNA agents
E) topoisomerase inhibitors

Question 7

What term is used to infer the spread of cancer from the primary site to nearby or distant areas through the blood or lymph?

A) metastasis
B) malignant
C) benign
D) neoplasm
E) apheresis

Question 8

In what phase of cell division is the DNA replicated?

A) S phase
B) G1 phase
C) G2 phase
D) G3 phase
E) D phase

Question 9

What does the term apoptosis refer to?

A) genetic mutations
B) stoppage of blood flow
C) severe weight loss
D) programmed cell death
E) uncontrollable cell division

Question 10

What does the term angiogenesis refer to?

A) increase in blood flow
B) development of new blood vessels
C) destruction of arteries
D) synthesis of red blood cells
E) change in blood pressure

Question 11

What ethnicity has the higher incidence of cancer and mortality rates?

A) Caucasians (European ancestry)
B) Asian Americans
C) Native Americans
D) Latinos
E) African Americans

Question 12

Breast cancer accounts for what percentage of cancer-related deaths in American women?

A) 41%
B) 31%
C) 24%
D) 20%
E) 14%

Question 13

Which of the following radionuclides is taken orally to treat thyroid cancer?

A) phosphorus 32
B) carbon 14
C) iodine 131
D) gadolinium 153
E) strontium 90

Question 14

What are the three deadliest cancers in American women (most mortality)?

A) lung, breast, colorectal
B) breast, liver, bone
C) brain, lung, breast
D) bone, blood, brain
E) breast, colorectal, pancreas

Question 15

What does the term cachexia mean?

A) genetic mutations
B) stoppage of blood flow
C) severe weight and appetite loss
D) programmed cell death
E) uncontrollable cell division

Question 16

What are the three deadliest cancers in American men (most mortality)?

A) prostate, liver, lung
B) liver, bone, brain
C) lung, prostate, colorectal
D) bone, lung, skin
E) prostate, skin, pancreas

Question 17

What is the primary tumor marker for ovarian cancer that's found in the blood?

A) CEA
B) HE4
C) PSA
D) AFP
E) CA15-3

Question 18

Where does cancer rank in terms of causes of mortality in the United States?

A) 1st
B) 2nd
C) 3rd
D) 4th
E) 5th

Question 19

In the Tumor Node Metastases (TNM) Staging System, what does "N0" mean?

A) nearby lymph nodes do not contain cancer
B) nearby lymph nodes cannot be evaluated
C) the tumor cannot be measured
D) metastasis cannot be evaluated
E) no distant metastases were found

Question 20

Where does breast cancer typically metastasize to?

A) bone and armpits
B) brain and lung tissue
C) GI tract and lung tissue
D) brain and liver
E) bone and GI tract

Question 21

Pharmacologic doses of which amino acid may benefit patients undergoing hematopoietic cell transplantation?

A) glutamine
B) arginine
C) lysine
D) cysteine
E) tyrosine

Question 22

Which of the following drugs works by preventing RNA synthesis and interfering with DNA synthesis by binding DNA?

A) bleomycin
B) busulfan
C) docetaxel
D) carmustine
E) hydroxyurea

Question 23

What are the two agents that have been recognized as useful for appetite stimulation in cancer patients?

A) methotrexate and antidiarrheal agents
B) sugar-free chewing gum and hard sour candy
C) methotrexate and prokinetics
D) megestrol acetate and corticosteroid agents
E) cisplatin and corticosteroid agents

Question 24

Which of the following chemotherapy agents works by altering DNA structure by misreading DNA code and cross-linking DNA strands?

A) bleomycin
B) carboplatin
C) asparaginase
D) vincristine
E) irinotecan

Question 25

Which of the following are the two types of cytokines used to treat patients with cancer?

A) chemokines and lymphokines
B) interferons and interleukins
C) monokines and interleukins
D) interferons and lymphokines
E) chemokines and monokines

Question 26

Which of the following antineoplastic drugs has the lowest emetogenic potential?

A) cisplatin
B) alemtuzumab
C) dacarbazine
D) idarubicin
E) rituximab

Question 27

Prescription of which analgesic causes vomiting and nausea in cancer patients?

A) ibuprofen
B) acetaminophen
C) naproxen
D) aspirin
E) morphine

Question 28

What is the average protein need per day IBW for cancer patients as per ASPEN critical care guidelines and the 2018 American Society for Enhanced Recovery and Perioperative Quality Joint Consensus Statement?

A) 0.5-1.0 g/kg
B) 1.5-2.5 g/kg
C) 1.1-1.3 g/kg
D) 3.0-3.5 g/kg
E) 3.5-3.8 g/kg

Question 29

Which of the following is the most emetogenic chemotherapeutic drug?

A) vinblastine
B) cisplatin
C) etoposide
D) rituximab
E) mitomycin

Question 30

What is the name of the procedure for harvesting stem cells from the blood?

A) marrow scraping
B) brachytherapy
C) apheresis
D) dysgeusia
E) erythropoiesis

Question 31

Which of the following best describes a nutrition intervention for emesis?

A) consuming fried and greasy meals
B) using high emetogenic chemotherapeutic drugs
C) increasing intake of carbonated beverages
D) adding extra sauces and gravies to foods
E) consuming small, low-fat meals

Question 32

What is the estimated energy requirement for nonambulatory or sedentary cancer patients?

A) 40-45 kcal/kg
B) 11-15 kcal/kg
C) 25-30 kcal/kg
D) 32-37 kcal/kg
E) 15-20 kcal/kg

Question 33

AS is a 54-year-old business man who has a family history of lung cancer. AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain. He then noticed white sores that were getting bigger in his oral cavity near the tongue. He started feeling generally lousy and was unable to eat because of severe pain; he lost 30 lbs in a month. AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the tongue. AS has undergone radiation therapy (RT) and surgery to remove the cancer and a restorative surgery was scheduled. Because of the RT, AS has developed mucositis and xerostomia in his oral cavity. All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed. The surgeons felt confident that they had removed all the cancer.
HT: 5'11" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids and antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
What simple and inexpensive recommendation might help AS with his xerostomia?

A) supplement with vitamin C
B) chew sugar-free gum
C) supplement with omega-6 fatty acids
D) eat high fiber foods
E) supplement with coenzyme Q10

Question 34

AS is a 54-year-old business man who has a family history of lung cancer. AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain. He then noticed white sores that were getting bigger in his oral cavity near the tongue. He started feeling generally lousy and was unable to eat because of severe pain; he lost 30 lbs in a month. AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the tongue. AS has undergone radiation therapy (RT) and surgery to remove the cancer and a restorative surgery was scheduled. Because of the RT, AS has developed mucositis and xerostomia in his oral cavity. All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed. The surgeons felt confident that they had removed all the cancer.
HT: 5'11" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids and antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
Approximately how many grams of protein does AS require according to his current body weight?

A) 75 g
B) 93 g
C) 80 g
D) 53 g
E) 45 g

Question 35

Which of the following beverages is a high-kilocalorie nutritional supplement?

A) Forticare
B) Fortisip
C) Scandishake
D) Replete
E) Boost

Question 36

Which growth factor is used to counteract side effects of certain chemotherapy regimens?

A) exocrine
B) endocrine
C) skeletal
D) hematopoietic
E) metabolic

Question 37

Which type of stem cells are used for hematopoietic stem cell transplantation?

A) peripheral blood stem cells
B) fetal stem cells
C) bone marrow stem cells
D) stem cells from umbilical cords
E) stem cells from pigs/cows

Question 38

AS is a 54-year-old business man who has a family history of lung cancer. AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain. He then noticed white sores that were getting bigger in his oral cavity near the tongue. He started feeling generally lousy and was unable to eat because of severe pain; he lost 30 lbs in a month. AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the tongue. AS has undergone radiation therapy (RT) and surgery to remove the cancer and a restorative surgery was scheduled. Because of the RT, AS has developed mucositis and xerostomia in his oral cavity. All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed. The surgeons felt confident that they had removed all the cancer.
HT: 5'11" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids and antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
Given AS's weight loss, what would his MD likely diagnose him with?

A) failure to thrive
B) anorexia nervosa
C) mildly underweight
D) moderately underweight
E) cancer cachexia

Question 39

AS is a 54-year-old business man who has a family history of lung cancer. AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain. He then noticed white sores that were getting bigger in his oral cavity near the tongue. He started feeling generally lousy and was unable to eat because of severe pain; he lost 30 lbs in a month. AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the tongue. AS has undergone radiation therapy (RT) and surgery to remove the cancer and a restorative surgery was scheduled. Because of the RT, AS has developed mucositis and xerostomia in his oral cavity. All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed. The surgeons felt confident that they had removed all the cancer.
HT: 5'11" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids and antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
To help combat the mucositis, what would the registered dietitian recommend?

A) avoiding acidic food
B) rinsing with commercial mouthwash
C) rinsing with hydrogen peroxide
D) taking oral arginine
E) using a tongue scraper

Question 40

AS is a 54-year-old business man who has a family history of lung cancer. AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain. He then noticed white sores that were getting bigger in his oral cavity near the tongue. He started feeling generally lousy and was unable to eat because of severe pain; he lost 30 lbs in a month. AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the tongue. AS has undergone radiation therapy (RT) and surgery to remove the cancer and a restorative surgery was scheduled. Because of the RT, AS has developed mucositis and xerostomia in his oral cavity. All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed. The surgeons felt confident that they had removed all the cancer.
HT: 5'11" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids and antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
What values should be used to estimate AS's caloric requirements?

A) 20-25 kcal/kg IBW
B) 25-30 kcal/kg current body weight
C) 30-35 kcal/kg current body weight
D) 35-40 kcal/kg IBW
E) 40-45 kcal/kg IBW

Question 41

Cancer is a disorder of cell _______________ and regulation.

Question 42

Cancers are characterized by unregulated cell growth, tissue invasion, and _______________.

Question 43

It is estimated that 60% of patients with head and neck cancers will present with malnutrition at the time of diagnosis.

Question 44

Cancers are named based on their origin: those derived from epithelial tissue are called _______________.

Question 45

Radioimmunotherapy can also deliver radiation to a specific tissue through attachment to a(n) _______________ or other ligands.

Question 46

Biochemical analysis of blood, serum, urine, and other body fluids can detect tumor biomarkers.

Question 47

_______________ involves the placement of radioactive sources either within an existing body cavity in close proximity to the tumor, or directly within a tumor.

Question 48

Chemoprevention treatment is used to reverse, suppress, or prevent carcinogenesis before the development of invasive malignancy.

Question 49

African American women have a 10% _______________ incidence rate than white females for all cancers combined.

Question 50

Epidemiologic studies have found that heavy consumption of _______________ increases cancer risk, especially for colorectal, bladder, prostate, breast, gastric, oral, and pancreatic cancers.

Question 51

_______________ is the study of changes in gene activity that are not caused by changes in the DNA sequence.

Question 52

There are two major types of genes that are thought to influence the development of cancer: oncogenes and _______________ genes.

Question 53

The most common cause of nausea and vomiting in cancer patients is palliative therapy.

Question 54

A neoplasm is malignant when it grows without tissue invasion.

Question 55

Some biological therapies for cancer use live viruses or parasites to stimulate the body's immune system to act against cancer cells.

Question 56

Nausea and vomiting related to radiation are dependent on the field being irradiated.

Question 57

Tumor suppressor genes normally cause apoptosis (cell death), but in a mutated form, they may lose this function.

Question 58

Palliative surgery is used to ameliorate disease and/or treatment-related symptoms and cure cancer.

Question 59

Because hair follicles also contain rapidly dividing cells, _______________ is also a common side effect of chemotherapy.

Question 60

Cancer of the lung and bronchus remains the number one killer in both men and women.

Question 61

Describe the causes and treatment for xerostomia.

Question 62

_______________ is the complex of DNA and proteins-primarily histones-in the nucleus of a cell.

Question 63

Chemotherapy-induced mucositis commonly occurs _______________ days after chemotherapy is initiated.

Question 64

Discuss the etiology of cancer.

Question 65

Outline radiation therapy (RT) for cancer.

Question 66

The most _______________ chemotherapeutic agents include cisplatin, methotrexate, doxorubicin, and cyclophosphamide.

Question 67

Biological therapies that interfere with specific molecules involved in tumor growth and progression are also referred to as _______________ therapies.

Question 68

Describe the GI side effects of chemotherapy and how they can be managed.

Question 69

A _______________ neoplasm will spread from the primary tissue to other body tissues

Question 70

_______________ stimulates red blood cell formation, and IL-11 increases _______________ production.

Question 71

List the primary signs and symptoms of cancer.

Question 72

In the Tumor Node Metastases (TNM) Staging System, _______________ means that distant metastases were found.

Question 73

_______________, or alterations in taste, can have a profound effect on a patient's ability to ingest an adequate amount of nutrition.

Question 74

Immune-enhancing enteral formulas containing mixtures of arginine, glutamine, _______________, and polyribonucleotides have been of interest for surgical patients.

Question 75

Describe the main causes of dysgeusia.

Question 76

Describe the different types of chemotherapy agents.

Question 77

Define cancer.

Question 78

List the tumor imaging techniques available today.

Question 79

_______________ are signaling proteins that are produced by white blood cells and help mediate and regulate immune responses, inflammation, and hematopoiesis (new blood cell formation).

Question 80

Discuss the diagnosis and complications of pancreatic cancer.