CSO Exam| 142 questions| with complete
solutions
Ageusia ;~Loss or absence of the sense of taste
Allogenic marrow transplantation ;~Transfer of marrow from donor to another person
who is not genetically identical
Antineoplastic agents ;~Chemical agents (cytotoxics, biotherapies, hormones) or other
agents used to prevent the development, maturation or spread of neoplastic cells
antioxidants ;~molecules (ie. vitamins) that block action of activated oxygen molecules
(free radicals) that can demage cells
autologous marrow transplantation ;~transfer of marrow from the pt's OWN tissue
(from hematopietic stem cells)
cancer cachexia ;~per sample test question:temporal wasting, depleted fat stores,
profound anorexia
Multifactorial syndrome characterized by ongoing loss of skeletal muscle mass,
anorexia, early satiety, wt loss, anemia, edema, fatigue, possible metabolic alterations,
increased inflammatory markers and progressive functional impairment.
Pathophysiology characterized by negative protein energy balance driven by variable
combination of reduced food intake and abnormal metabolism
carcinogen ;~an agent (physical, chemical, or viral) that induces CA
carcinogenesis ;~the origin or development of CA, a multistage, biological process that
proceeds on a continuum but is often described in stages of initiation, promotion and
progression
cytokines ;~protein mediators produced by inflammatory cells in response to
exogenous stimuli, produce metabolic changes & wasting
dysgeusia ;~altered taste
,graft-versus-host disease (GVHD) ;~a disease caused by the immune response of
histoincompatible, immunocompetent donor cells against the tissues of an
immunoincompetent host; an immuniologic reaction of allogeneic donor cells (graft)
reacting against the pt (host) tissues
evidenced by icterus & abnormal liver functions, severe /secretory diarrhea - may need
total bowel rest --> isomotic, low residue, lactose-free diet --> solids with low lactose,
fiber, fat & acideity, gastric irritants --> regular diet
- usually 3 onths after transplant (but may be 7-10 days post)
hypogeusia ;~decreased taste acuity
initiation ;~the initial stage of tumorigenesis, involving transformation of cellular DNA
malignant neoplasm ;~mass of cancer cells that invades surrounding tissues or
spreads to distant areas of body
metastasis ;~growth of malignant tissue THAT SPREADS to surrounding tissue or
organs
myelosuppression ;~suppression of bone marrow cell production
neutropenia ;~a reduction of WBC (neutrophils) that can be caused by chemo or XRT,
results in increased susceptibility to life-threatening infections
pancytopenia ;~a reduction in all cellular elements of the blood (WBC, RBC, platlets)
phytochemicals ;~nonutritive compounds in plants thought to influence the process of
tumorigenesis.
Compounds in plants (apart from vitamins, minerals, and macronutrients) that have a
beneficial effect the body.
progression ;~the phase in which tumor cells aggregate, grow autonomously and form
benign tumors that eventually lead to malignant phenotype with the capacity for tissue
invasion & mets
Promotion ;~The stage of tumorigenesis in which initiated cells are activated by a
promoting agent to multiply and form a discrete tumor
radiation-induced enteritis ;~a condition of inflammation that can occur after XRT to the
GI tract & that leads to diarrhea & malabsorption
staging ;~a classification system known as TNM that is used to identify the "extent" of
the tumor: its size, the degree of growth & spread;
T - size of tumor
N- degree of spread to lymph nodes
,M- presence of mets
Tumor necrosis factor ;~a protein that is produced chiefly by monocytes and
macrophages in response especially to endotoxins and that mediates inflammation and
induces the destruction of some tumor cells and the activation of white blood cells
(cachectin, interleukin-1, interleukin-6, interferon-y); a hormone-like protein that
releases fat from fat stores, reduces the concentration of enzymes required for the
production and storage of fat & induces a stage of anorexia
veno-occlusive disease (VOD) ;~- transplant related complication
- a symptomatic occlusion of the small hepatic venules caused by hepatotoxins & XRT;
may resolve after removal of the offending agent or may progress to portal HTN & liver
failure
- 1-3 wks post transplant
-hepatomegaly, ascites, jaundice, hepatic failure, encephalopathy & multi-organ failure
Xerostomia ;~mouth dryness
cultural-Halal diet ;~Muslim/Islamic law.
Fasting common
Women have decreased sun exposure 2/2 coverings
forbidden: pork, pork products, gelatin, ETOH (including extracts), diet can be low in
heme iron
cultural-Kosher diet ;~Jewish dietary laws/ Parve:
separate utensils for food prep/eating
diet tends to be high in cholesterol, sat fat, sodium, consider DASH
Forbidden: pork, pork products, rabbit, shellfish, eel
ALL meats must be slaughtered according to Jewish Law, blood drained prior to
cooking/eating.
Dairy: milk can be consumed prior to a meal or 3-6 hours after meal
no leavened bread during passover
fasting during yom kippur
cultural-Macrobiotic diet ;~Avoid animal products including dairy, eggs, coffee, sugar,
poultry, and processed foods.
No "nightshade vegetables" including potato, peppers and eggplant
Diet may be deficient in protein, iron, zinc, vitamin B12 and calcium
, 50-60% from whole grains, 25-30% from veg, remaining from beans, seaweed, soups
cultural-Seventh-Day Adventist: ;~Lacto-ovo vegetarian diet
Avoid overeating
snacking discouraged
strong seasonings avoided
Avoid: beef, lamb, pork, chicken, seafood, coffee, tea and alcohol
Diet may be deficient in protein, iron, zinc, vitamin B12 and calcium
cultural-The Church of Jesus Christ of Latter -Day Saints (Mormons) ;~forbidden:
ETOH, hot drinks (coffee-tea), caffeine
church encouraged limited meat consumption and to eat mostly grains
some fast 1 day per month and donate food money to the poor
nausea and vomiting - anticipatory ;~occurs prior to the beginning of a new cycle of
chemotherapy. This occurs after the patient has experienced N&V from an earlier
chemotherapy treatment.
nausea and vomiting-acute ;~occurs during the first 24-hours after chemotherapy.
nausea and vomiting- delayed ;~occurs more than 24 hours after chemotherapy.
Usually 1-6 days immediately.
Patients at highest risk for delayed N&V include those receiving cyclophosphamide,
cisplatin, doxorubicin and ifosfamide.
Chemotherapy agents are categorized according to their potential to induce nausea &
vomiting. ;~High risk >90%
Moderate risk 30-90%
Low risk 10-30%
Minimal risk <10%
chemo - Highly emetogenic: CCCMD ;~Cisplatin
Cyclophosphamide >1500mg/m2
Carmustine
Mechlorethamine
Dacarbazine
chemo - Moderate emetogenic: CCDDEIIIO ;~Oxaliplatin
Cytarabine >1gm/m2
Carboplatin
Ifosfamide
Cyclophosphamide <1500mg/m2
Doxorubicin
Daunorubicin
Epirubicin
Idarubicin
solutions
Ageusia ;~Loss or absence of the sense of taste
Allogenic marrow transplantation ;~Transfer of marrow from donor to another person
who is not genetically identical
Antineoplastic agents ;~Chemical agents (cytotoxics, biotherapies, hormones) or other
agents used to prevent the development, maturation or spread of neoplastic cells
antioxidants ;~molecules (ie. vitamins) that block action of activated oxygen molecules
(free radicals) that can demage cells
autologous marrow transplantation ;~transfer of marrow from the pt's OWN tissue
(from hematopietic stem cells)
cancer cachexia ;~per sample test question:temporal wasting, depleted fat stores,
profound anorexia
Multifactorial syndrome characterized by ongoing loss of skeletal muscle mass,
anorexia, early satiety, wt loss, anemia, edema, fatigue, possible metabolic alterations,
increased inflammatory markers and progressive functional impairment.
Pathophysiology characterized by negative protein energy balance driven by variable
combination of reduced food intake and abnormal metabolism
carcinogen ;~an agent (physical, chemical, or viral) that induces CA
carcinogenesis ;~the origin or development of CA, a multistage, biological process that
proceeds on a continuum but is often described in stages of initiation, promotion and
progression
cytokines ;~protein mediators produced by inflammatory cells in response to
exogenous stimuli, produce metabolic changes & wasting
dysgeusia ;~altered taste
,graft-versus-host disease (GVHD) ;~a disease caused by the immune response of
histoincompatible, immunocompetent donor cells against the tissues of an
immunoincompetent host; an immuniologic reaction of allogeneic donor cells (graft)
reacting against the pt (host) tissues
evidenced by icterus & abnormal liver functions, severe /secretory diarrhea - may need
total bowel rest --> isomotic, low residue, lactose-free diet --> solids with low lactose,
fiber, fat & acideity, gastric irritants --> regular diet
- usually 3 onths after transplant (but may be 7-10 days post)
hypogeusia ;~decreased taste acuity
initiation ;~the initial stage of tumorigenesis, involving transformation of cellular DNA
malignant neoplasm ;~mass of cancer cells that invades surrounding tissues or
spreads to distant areas of body
metastasis ;~growth of malignant tissue THAT SPREADS to surrounding tissue or
organs
myelosuppression ;~suppression of bone marrow cell production
neutropenia ;~a reduction of WBC (neutrophils) that can be caused by chemo or XRT,
results in increased susceptibility to life-threatening infections
pancytopenia ;~a reduction in all cellular elements of the blood (WBC, RBC, platlets)
phytochemicals ;~nonutritive compounds in plants thought to influence the process of
tumorigenesis.
Compounds in plants (apart from vitamins, minerals, and macronutrients) that have a
beneficial effect the body.
progression ;~the phase in which tumor cells aggregate, grow autonomously and form
benign tumors that eventually lead to malignant phenotype with the capacity for tissue
invasion & mets
Promotion ;~The stage of tumorigenesis in which initiated cells are activated by a
promoting agent to multiply and form a discrete tumor
radiation-induced enteritis ;~a condition of inflammation that can occur after XRT to the
GI tract & that leads to diarrhea & malabsorption
staging ;~a classification system known as TNM that is used to identify the "extent" of
the tumor: its size, the degree of growth & spread;
T - size of tumor
N- degree of spread to lymph nodes
,M- presence of mets
Tumor necrosis factor ;~a protein that is produced chiefly by monocytes and
macrophages in response especially to endotoxins and that mediates inflammation and
induces the destruction of some tumor cells and the activation of white blood cells
(cachectin, interleukin-1, interleukin-6, interferon-y); a hormone-like protein that
releases fat from fat stores, reduces the concentration of enzymes required for the
production and storage of fat & induces a stage of anorexia
veno-occlusive disease (VOD) ;~- transplant related complication
- a symptomatic occlusion of the small hepatic venules caused by hepatotoxins & XRT;
may resolve after removal of the offending agent or may progress to portal HTN & liver
failure
- 1-3 wks post transplant
-hepatomegaly, ascites, jaundice, hepatic failure, encephalopathy & multi-organ failure
Xerostomia ;~mouth dryness
cultural-Halal diet ;~Muslim/Islamic law.
Fasting common
Women have decreased sun exposure 2/2 coverings
forbidden: pork, pork products, gelatin, ETOH (including extracts), diet can be low in
heme iron
cultural-Kosher diet ;~Jewish dietary laws/ Parve:
separate utensils for food prep/eating
diet tends to be high in cholesterol, sat fat, sodium, consider DASH
Forbidden: pork, pork products, rabbit, shellfish, eel
ALL meats must be slaughtered according to Jewish Law, blood drained prior to
cooking/eating.
Dairy: milk can be consumed prior to a meal or 3-6 hours after meal
no leavened bread during passover
fasting during yom kippur
cultural-Macrobiotic diet ;~Avoid animal products including dairy, eggs, coffee, sugar,
poultry, and processed foods.
No "nightshade vegetables" including potato, peppers and eggplant
Diet may be deficient in protein, iron, zinc, vitamin B12 and calcium
, 50-60% from whole grains, 25-30% from veg, remaining from beans, seaweed, soups
cultural-Seventh-Day Adventist: ;~Lacto-ovo vegetarian diet
Avoid overeating
snacking discouraged
strong seasonings avoided
Avoid: beef, lamb, pork, chicken, seafood, coffee, tea and alcohol
Diet may be deficient in protein, iron, zinc, vitamin B12 and calcium
cultural-The Church of Jesus Christ of Latter -Day Saints (Mormons) ;~forbidden:
ETOH, hot drinks (coffee-tea), caffeine
church encouraged limited meat consumption and to eat mostly grains
some fast 1 day per month and donate food money to the poor
nausea and vomiting - anticipatory ;~occurs prior to the beginning of a new cycle of
chemotherapy. This occurs after the patient has experienced N&V from an earlier
chemotherapy treatment.
nausea and vomiting-acute ;~occurs during the first 24-hours after chemotherapy.
nausea and vomiting- delayed ;~occurs more than 24 hours after chemotherapy.
Usually 1-6 days immediately.
Patients at highest risk for delayed N&V include those receiving cyclophosphamide,
cisplatin, doxorubicin and ifosfamide.
Chemotherapy agents are categorized according to their potential to induce nausea &
vomiting. ;~High risk >90%
Moderate risk 30-90%
Low risk 10-30%
Minimal risk <10%
chemo - Highly emetogenic: CCCMD ;~Cisplatin
Cyclophosphamide >1500mg/m2
Carmustine
Mechlorethamine
Dacarbazine
chemo - Moderate emetogenic: CCDDEIIIO ;~Oxaliplatin
Cytarabine >1gm/m2
Carboplatin
Ifosfamide
Cyclophosphamide <1500mg/m2
Doxorubicin
Daunorubicin
Epirubicin
Idarubicin
