NURS 580 Midterm Exam Questions with
100% Verified Correct Answers
cancer staging
the extent of disease that can be determined from H&P, physical exam, and diagnostic testing
prior to the initiation of treatment
*expressed as TNM and stage group
Primary Tumor (T) Classification
TX = cannot be evaluated (more common in later stage)
T0 = no evidence of tumor (mets found first)
Tis = carcinoma in situ (early; no spread)
T1, T2, T3, T4 = size/extent of prim. tumor
Regional Lymph Nodes (N) Classification
NX = cannot be evaluated (nodes may be absent 2/2 surgery, trauma)
N0 = no evidence of cancer in nodes
N1, N2, N3 = involvement of nodes (size/extent of spread)
Distant Metastasis (M) Classification
MX = cannot be evaluated (trauma/surgery)
M0 = no evidence of distant metastasis
M1 = distant metastasis / cancer has spread to other body parts
types of radiation
-local
-gamma knife (pinpoint for brain/spine)
,-proton beam (uses protons over xray for tumors near more sensitive organs)
-brachytherapy (radiation seeds placed directly into tumor, prostate most common)
-mammosite (radiation seeds placed into breast tumor via vessel/balloon pump)
common chemo side effects
*targets areas with rapidly dividing cells
-skin (dryness, rashes, lesions)
-HEENT (oral/esophageal mucosa ulcers, hair loss)
-respiratory: interstitial lung disease
-cardiac: cardiomyopathy
-GI: n/v/d/c
-urinary: incontinence
-musculoskeletal: fatigue
-neuro: confusion, fog
most common sites of metastasis
bone, liver, lung, CNS
*order varies based on primary tumor anatomical location
general blood cancer patho
1. stem cells differentiate into myeloid or lymphoid cells
2. myeloid cells (myoblasts) mature into WBCs, RBCs, platelets
3. lymphoid cells (lymphoblasts) mature into T cells/B cells
leukemia patho
-occurs when myeloid or lymphoid cells lose the ability to mature and/or differentiate,
leading to an uncontrolled proliferation of cancer cells
,-leads to decreased production of WBCs, RBCs, platelets, which leads to impaired immune
function, clotting, bleeding disorders
Acute Lymphocytic Leukemia (ALL)
-patho: lymphoblasts lose ability to regulate/mature
-no clear cause
-most common cancer in children, adults more rare
-can lead to late sequalae of brain tumors, causing learning disability and osteoporotic
fractures later in life
ALL signs/symptoms
-sudden, acute illness with flu-like symptoms for days to weeks
-bone/joint pain and tenderness
-pale skin
-bleeding: sensitive gums, petechiae, purpura
-hepatosplenomegaly
ALL diagnostic findings
**pancytopenia with circulating blasts
-bone marrow is hypercellular, diagnosis >30% blasts
-TdT tumor marker present
ALL treatment
-chemotherapy with bone marrow transplant if relapse occurs
-cures much more likely in children than adults
Acute Myelogenous Leukemia (AML)
, -patho: myoblasts lose ability to regulate/mature
-predominant type of acute leukemia in adults
-increased incidence in those with down syndrome
AML signs/symptoms
-same as ALL but spontaneous bleeding more prevalent
AML diagnostic findings
pancytopenia with circulating blasts and:
-thrombocytopenia
-granules visible in blast cells**
-Presence of Auer's rods
-increased myoblast count
AML treatment
-approach same as ALL
Chronic Lymphocytic Leukemia (CLL)
-patho: B-lymphocyte clonal* malignancy with slow, progressive accumulation of immuno-
incompetent lymphocytes, leading to immunosuppression and bone marrow failure
-most common in elderly
CLL signs/symptoms
-frequently asymptomatic
-fatigue, lethargy, weight loss
-Lymphadenopathy in 80%
-Hepatosplenomegaly in 50%
100% Verified Correct Answers
cancer staging
the extent of disease that can be determined from H&P, physical exam, and diagnostic testing
prior to the initiation of treatment
*expressed as TNM and stage group
Primary Tumor (T) Classification
TX = cannot be evaluated (more common in later stage)
T0 = no evidence of tumor (mets found first)
Tis = carcinoma in situ (early; no spread)
T1, T2, T3, T4 = size/extent of prim. tumor
Regional Lymph Nodes (N) Classification
NX = cannot be evaluated (nodes may be absent 2/2 surgery, trauma)
N0 = no evidence of cancer in nodes
N1, N2, N3 = involvement of nodes (size/extent of spread)
Distant Metastasis (M) Classification
MX = cannot be evaluated (trauma/surgery)
M0 = no evidence of distant metastasis
M1 = distant metastasis / cancer has spread to other body parts
types of radiation
-local
-gamma knife (pinpoint for brain/spine)
,-proton beam (uses protons over xray for tumors near more sensitive organs)
-brachytherapy (radiation seeds placed directly into tumor, prostate most common)
-mammosite (radiation seeds placed into breast tumor via vessel/balloon pump)
common chemo side effects
*targets areas with rapidly dividing cells
-skin (dryness, rashes, lesions)
-HEENT (oral/esophageal mucosa ulcers, hair loss)
-respiratory: interstitial lung disease
-cardiac: cardiomyopathy
-GI: n/v/d/c
-urinary: incontinence
-musculoskeletal: fatigue
-neuro: confusion, fog
most common sites of metastasis
bone, liver, lung, CNS
*order varies based on primary tumor anatomical location
general blood cancer patho
1. stem cells differentiate into myeloid or lymphoid cells
2. myeloid cells (myoblasts) mature into WBCs, RBCs, platelets
3. lymphoid cells (lymphoblasts) mature into T cells/B cells
leukemia patho
-occurs when myeloid or lymphoid cells lose the ability to mature and/or differentiate,
leading to an uncontrolled proliferation of cancer cells
,-leads to decreased production of WBCs, RBCs, platelets, which leads to impaired immune
function, clotting, bleeding disorders
Acute Lymphocytic Leukemia (ALL)
-patho: lymphoblasts lose ability to regulate/mature
-no clear cause
-most common cancer in children, adults more rare
-can lead to late sequalae of brain tumors, causing learning disability and osteoporotic
fractures later in life
ALL signs/symptoms
-sudden, acute illness with flu-like symptoms for days to weeks
-bone/joint pain and tenderness
-pale skin
-bleeding: sensitive gums, petechiae, purpura
-hepatosplenomegaly
ALL diagnostic findings
**pancytopenia with circulating blasts
-bone marrow is hypercellular, diagnosis >30% blasts
-TdT tumor marker present
ALL treatment
-chemotherapy with bone marrow transplant if relapse occurs
-cures much more likely in children than adults
Acute Myelogenous Leukemia (AML)
, -patho: myoblasts lose ability to regulate/mature
-predominant type of acute leukemia in adults
-increased incidence in those with down syndrome
AML signs/symptoms
-same as ALL but spontaneous bleeding more prevalent
AML diagnostic findings
pancytopenia with circulating blasts and:
-thrombocytopenia
-granules visible in blast cells**
-Presence of Auer's rods
-increased myoblast count
AML treatment
-approach same as ALL
Chronic Lymphocytic Leukemia (CLL)
-patho: B-lymphocyte clonal* malignancy with slow, progressive accumulation of immuno-
incompetent lymphocytes, leading to immunosuppression and bone marrow failure
-most common in elderly
CLL signs/symptoms
-frequently asymptomatic
-fatigue, lethargy, weight loss
-Lymphadenopathy in 80%
-Hepatosplenomegaly in 50%
