Test 09/24/12 Detection and Diagnosis Chapter 5

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RadTherapy
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172873
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Test 09/24/12 Detection and Diagnosis Chapter 5
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2012-09-24 21:02:12
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Radiation therapy oncology radiography imaging
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Detection and Diagnosis:Chapter 5 Principals and Practice of Radiation Therapy by Washington and Leaver
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  1. __________ and ________are the two most important and effective strategies of saving lives from cancer.

    Give examples of each:
    prevention ,screening


    • Examples of prevention:staying out of the sun, not smoking, eating a diet rich in antioxidants
    • Examples of screening: PAP smears, colonoscopy, mammography, PSA
  2. A________is an objective finding as perceived by examiner

    Give examples:
    sign

    • Examples of a sign: a rash, a change in color of the skin, a palpable mass
  3. A ___________ is a subjective indication of a disease or a change condition as perceived by patient.

    Give examples:
    symptom

    Examples of symptoms:headaches, pain, fatigue, difficulty sleeping, dsypnea(shortness of breath)
  4. What is the difference between a sign and a symptom?



    I am betting this question will be on the test...
    • Signs are the physical manifestation of injury, illness or disease that can be seen,felt or measured by the doctor. Symptoms,on the other hand. are what a patient experiences about the injury, illness or disease.
    • While signs are objective, symptoms are subjective
    •  
    • REMEMBER:Remember Ace of
    • Base's song that goes like this: "I Saw the Sign, and it opened up my eyes". The physician
    • sees the signs.
  5. The distinguishing between two or more diseases with similar symptoms by systematically comparing their signs and symptoms is called ___________.
    differential diagnosis
  6. A__________ is a  set of signs or symptoms arising from common cause.

    Give an example
    Syndrome

    Horner's syndrome: ptosis(drooping eyelid), anhidrosis, impaired facial flushing:Seen in lung cancer as well as other diagnoses

    • Tumor lysis syndrome: refers to the constellation of metabolic disturbances that may be seen after initiation of cancer treatment. It usually occurs in patients with bulky, rapidly proliferating, treatment-responsive tumor.s Typically associated with acute leukemias and high-grade non-Hodgkin lymphomas, such as Burkitt's lymphoma.
  7. The identification of a disease or condition is called the
    _________.
    Diagnosis

    • a diagnosis can be subjective(based on patient's medical history and complaints or the physician's preliminary diagnosis that doesn't have any hard evidence) or objective(based on results of current medical procedures and tests such as a biopsy or lab test)
  8. The most powerful diagnostic tool of the physician is the
    ___________.
    interview

    ž
  9. What are the four goals of the interview?
    • 1. Learns the chronological events and symptoms of patient
    • 2. Physician determines patient’s chief complaints and current status
    • 3. Establishes the physician patient relationship
    • 4. Verbal and nonverbal cues are assessed

    • This is how I remember:
    • 1.Get a timeline and symptoms from patient
    • 2. Determine chief complaints/current status
    • 3.Establish  relationship w/ patient relationship
    • 4.Assess patients nonverbal & verbal cues
    • OR:
    • 1. timeline/symptoms
    • 2.chief complaints/current status
    • 3.establish relationship
    • 4. assess verbal & NONVERBALcues

    This one probably doesn't need a pneumonic to remember but here's one just in case

    (Twin Sisters Catch Colds Every Rainy August)


  10. ___________is the most preventable cause of death in our country.
    Smoking
  11. What is the survival rates for cancers that the ACS has specific early detection guidelines and what are those cancers?
    81%  breast, colon, rectum, prostate, skin, cervix
  12. What is demographic data?
    It includes age, race, gender, marital status, national origin and current occupation

    • Remember that there are  SIX
  13. What is the reason for obtaining demographic data?
    some disease condition are found to be more prevalent for groups according to age, race, gender, occupation, and possibly national origin
  14. Examples of cancers that occur more frequently in women:
    breast, thyroid
  15. Examples of cancers occur more frequently in men:
    lung , prostate(obviosly-lol),
  16. Where is the incidence of esophageal cancer extremely high?
    Russia, Scotland, China, Japan, Caspian region of Iran, Bantu of Africa
  17. In the U.S rates of prostate cancer are significantly higher in ____________ men and screening should begin at age ________ which is _______yrs earlier than________ men.
    African-American, 45, 5, Caucasian
  18. Patient's witha long history of indisgestion and gastric reflux caused by a hiatal hernia have may be at risk for ulcers or _____________ of the _________.
    carcinoma, esophagus
  19. A condition is a disease, syndrome, or  finding that, if left untreated, may lead to cancer.
    premalignant
  20. Give some examples of premalignant conditions.
    actinic keratosis, cervical dysplasia, Barrett's esophagus
  21. _____________is a collection of symptoms resulting from substances or hormones produced by a tumor but occurring remotely from the tumor.
    paraneoplastic syndrome
  22. What are the mutated genes responsible for breast cancer is inherited.
    BRCA1, and  BRCA2
  23. What are the four aspects of physical examination?
    • Pnemonic: IPPA
    •        (very simply put....   )
    • 1.Inspection: looking
    • 2. Palpation: feeling
    • 3. Percussion: tapping
    • 4. Ausculation: listening
    • Basically using your senses.  Smelling is not one of the four, but it is still an important tool in the assesment process.
  24. ____________refers to the regularity of breathing.
    rhythm
  25. What is the fifth vital sign according to the Joint Commission on Accreditation of Healthcare Organizations
    (JCAHO)?
    pain


    pain intensity levels should be recorded along with blood pressure, pulse, temp, repirations
  26. ____________is defined as the ability of a test to give a true positive when the disease is present.
    Sensitivity

    • In other words: when a patient is identified as being positive from a high sensiivity test then patient really has the disease
    • (not a false positive--what a horrible thing that would be to be told you have AIDS or cancer and you don't reallt have it.....someone might make all sorts of rash decisions based on a false diagnosis)
  27. _____________ is the probability of a positive test among
    patients with disease.
    sensitive
  28. _________is the probability of negative test among patients without disease
    Specificity
  29. The ability of the test to give a true positive is called
    __________________.
    sensitivity
  30. ___________is defined as the ability of the test to obtain a TRUE NEGATIVE result.
    specificity

    • in other words: if a patient tests negative for a disease on a highly specific test, then he/she can be assured that they really don't have the disease
  31. __________is the probability of a disease in the entire population at any given time.
    prevalence
  32. ________is the probability that a patient without a disease will develop the disease during an interval(approximately 1 in 225, or 1.4 milllion cancers were predicted for 2008.
    Incidence.
  33. The probability of a positive test among patients with the disease
    sensitivity
  34. The probability of a negative result among patients without the disease.
    specificity
  35. ___________ is the most common camcer among American women , except for skin cancers.
    breast cancer
  36. What is the chance of a of an American woman developing breast cancer in her lifetime?
    1 in 8 or 12%
  37. How many breast cancer survivors are there in the US?
    2.5 million
  38. Women living in ___________ _____________ have the ighest breast cancer rate in the world.
    North America
  39. The average risk adult should begin colorectal screening at age ____________.
    50
  40. Beginning at age ________ men and women should one of the following o screen for colorectal cancer:
    • 1. Fecal occult blood test (FBOT) or fecal immunochemical
    • test (FIT) every year
    • 2. Flexible sigmoidoscopy (FSIG) every 5 year
    • 3. Annual FOBT or FIT & FSIG every 5 years
    • 4. Double contrast BE every 5 years
    • 5. Colonoscopy every 10 years
    •  
    • Which option is chosen depends on what is available to the patient(including insurance issues), personal perferences of the patient and/or physician and the patient's risk factors
  41. What are the screening reccommendations for prostate cancer?
    • žStarting at age 50, men should have a PSA test and
    • digital rectal exam (DRE) done by a physician annually

    *African American men or men with strong family history should start at age 45
  42. Screening for cervical cancer should begin ________ but
    no later than age ____  until a woman reaches age______ when testing can be reduced to every 2 to three years if multiple negative results have been performed.
    3 years after after a women begins vaginal intercourse, 21, 30



  43. Wha virus is implicated in cervical cancer?
    • HPV (human papillomavirus ) 
    • most common high risk subtypes that are believed to account for 70% of cervical cancer: HPV 16, HPV

    vaccine: Gardasil
  44.  For endometrial cancer, ________ women should report
    any ___________   ___________ or _____________.
    menopausal, vaginal bleeding, spotting
  45. Three most common nuclear imaging devices are the
    ________, ___________, and the __________.
    gamma camera, rectilinear scanner, and PET scanner
  46. __________ imaging is especially useful in distinguishing between benign and malignant lesions when the CT and MRI cannot.
    PET

    *images are more related to physiology
  47. The __________ ____________  starts at the top or bottom of the area of interest and scans  from side to side until the entire image has been imaged. This method may be used to detect metastatic cancer in the bone.
    rectilinear scanner
  48. The large circular _________ ________ does not move and views the whole area of intrest at one time.
    gamma camera

    (I remember it doesn't move because it's a "camera" and a camera doesn't move when taking a picture.)
  49. _______digitizes complex xray images and stores it in a computer. It cn be recontructed digitally on more than one plane, so that  see structures ican be viewed in 3-D.
    CT or Computed Tomogrsaphy
  50. Screening guidlines for breast cancer include
    1. Yearly_________ starting at age ________.
    2.Clinical breast exams every _____ years starting at age _________, and every year for starting at age _____.
    3. –Self breast exams(SBE) should start age ___.
    4. ___________recommended for women with strong family .history
    • mammograms , 40,  3 , 20,40, Screening
    • MRI
  51. One of the big difference between the CT scanner and the MRI is the ability of the _____ to obtain anatomic images in the ___________ plane.
    MRI, sagittal
  52. An ___________ scan is much better for viewing soft tissues while the __________ is better for________.
    MRI , CT. bone
  53. Which would be used for a scan of the brain and spinal cord-a MRI or a CAT scan?
    MRI
  54. ___________ which uses _______  ________waves s sometimes used to gude the needle in a fine needle aspiration for breast cancer.
    Sonography, high- frequency sound

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