Exam (elaborations)
CPHON Exam – Questions With Solutions
CPHON Exam – Questions With Solutions
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CPHON Exam – Questions With SolutionsInfancy ✔️ - object permanence
-trust vs mistrust
- quick exams
-have parents hold
Children 1-3 ✔️ -understand cause and effect
-toilet training
-Autonomy vs shame
-eye level
-use doll
Preschoolers ✔️ -increased socialization
-recognize feelings of those around them
-make believe play
- Initiative vs guilt
- videos and medical play
Children 7-12 ✔️ - master complex skills but feel inadequate if
can't
-concrete and organized thought process
-industry vs inferiority
-extracurriculars
Adolescents 13-18 ✔️ - identity formation
- form own opinions
-acceptance and inclusion
-privacy is key
- Identity vs role confusion
Young Adults 18-25 ✔️ - influenced by own set of ethical
standards
-intimacy vs isolation
Immunizations ✔️ - avoid contact with people who got OPV
-recommend Varivax to all household members
,-vaccine may have limited efficacy r/t inability to mount sufficient immune
response
-flu vaccine early in season
- all vaccines 3-6 months post chemo
Vaccines post HSCT ✔️ -DTap, Hep B, HiB, IPV given 12,14,24
months post transplant
-over 7 --> dT vaccine instead of DTap
-Flu vaccine 6 months post
- pneumovax 12 and 24 month post
-MMR and VZV 24 months post
MMR not with GVHD
Post Radiation ✔️ 1. avoid tight clothing
2. warm not hot showers
3. use fragrance free soap
4. Aloe mild irritation
5. hydrocortisone for severe irritation
6. wear sunblock
Post Chemo Considerations ✔️ - flush twice for 48hr post chemo
-avoid direct contact with bodily fluids
-machine wash clothes 2x in hot water
- avoid crowds
Risk Factors for Secondary Malignancy ✔️ 1. type of original
cancer
2. age at time of treatment
3. younger at dx
4. radiation
5. females
6. alkylating agents
Cancer Screening ✔️ - monthly self breast exams after puberty
- first mammogram age 20-25
- Pap smear age 18
- monthly testicular exams at 14
- colon screening at 45
- stool testing for blood at 50
,- colonoscopy at 50 every 5 yrs
Reproductive Health Women ✔️ alkylating agents, cytarabine,
pelvic RT, TBI --> infertility
Reproductive Health Men ✔️ alkylating agents, temozolomide,
cisplatin, testicular RT --> azoospermia
CFU-E ✔️ RBCs
CFU-Mega ✔️ -platelets
CFU-G ✔️ neutrophils, basophils, eosinophils, mast cells
CFU-M ✔️ monocytes
Initiation ✔️ when cell undergoes change that is passed on to its
daughter cells
Promotion ✔️ increased in cell growth of an altered cell
Progression ✔️ continued proliferation of altered cell
Cancer cells have... ✔️ telomerase enzyme that prevents the
normal destruction of telomeres and allows for indefinite replications
0-14 common cancer ✔️ ALL
15-19 common cancer ✔️ HL and Germ Cell tumors
Childhood disease is most likely.... ✔️ to have mets at time of dx
Acute Lymphoblastic Leukemia ✔️ age 2-5
Risk Factors: male, white, old mom, hx of fetal loss, toxin exposure, Down
syndrome, falcon anemia, ataxia, telangiectasia
-radiation during pregnancy
Symptoms of ALL ✔️ - anemia
-thrombocytopenia
, -neutropenia
-lymphadenopathy
-hepatosplenomegaly
Lab Features of ALL ✔️ >25% blasts on BMA
- high uric acid
-high K
- high Phos
-Low Ca
-high LDH
French American British Classification System ✔️ L1 = small
cells, most favorable
L2 = larger cells with different shapes
L3 = large cells, least favorable
Pre B ALL ✔️ - most common involvement in brain and testes
Pre T ALL ✔️ - thmyic/mediastinal mass
- teenagers
In ALL, the higher the WBC Count ✔️ the poorer the prognosis
Favorable ALL indicators ✔️ hyperdiploidy
-low disease burden
- good tx response
Current tx of ALL ✔️ Vinc, Asparinginase, Prednisone
-potentially Doxo
CNS prophylaxis: IT MTX or Cytarabine
Induction Goal of ALL ✔️ eliminate blasts <5% in marrow
Consolidation ✔️ -IV MTX, or Doxo with CNS prophylaxis
Maintenance ✔️ -6MP PO and MTX for 2-3 yrs
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