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Onc test 2
Tuberculosis Skin Mantoux Test (PPD)
Delayed Hypersensitivity (Cell Mediated Response)
Intradermal Injection
Read 48-72 hours
Positive Results
≥ 5 mm Induration
Immunosuppressed
≥ 10 mm Induration
High Risk Patients
≥ 15 mm Induration
Considerations
Chest X-Ray
3 mins
Tuberculosis Assessment
Etiology
Airborne Droplet
Assessment
3 Week Productive Cough
Night Sweats
Chest Pain
Fever
Weight Loss
Fatigue
Diagnosis
Chest X-Ray
Blood Tests
Mantoux Skin Test
3 Positive Sputum Tests
1 min
Tuberculosis Intervention
Hospital Care
Airborne Isolation
Drug Therapy
Combination Drug Therapy (RIPE)
6-12 Months
Considerations
DOT
BCG Vaccination
Medication Education
3 Negative Sputum Specimens
Infection Control
2 mins
Isoniazid (INH)
Mechanism
Interferes with DNA Metabolism
Indications
Tuberculosis (TB)
Side Effects
Optic Neuritis
Nausea and Vomiting
Hepatotoxicity
Peripheral Neuropathy
Considerations
Vitamin B6 Prophylaxis
Monitor AST/ALT
2 mins
Lung Cancer Assessment
2nd Most Common Cancer
Assessment
Chronic Cough
Hoarseness
Abnormal Breath Sounds
Hemoptysis
Chest Pain
Anorexia or Weight Loss
Considerations
Symptoms Appear Late in Disease
2 mins
Tamoxifen
Mechanism of Action
Selective Estrogen Receptor Modulator (SERM)
Antagonist on Breast Tissue
Indications
ER-positive Breast Cancer
Side Effects
Decreased Risk of Osteoporosis
Increased Risk of Endometrial Cancer
Increased Risk of Venous Thromboembolism (VTE)
1 min
Breast Cancer Assessment (Self-Exam)
Self Assessment
Fixed, Immovable Mass
Painless
Peau D'Orange
Nipple Retraction
Discharge
Change In Color
Considerations
Upper Lateral Quadrant
2 mins
Cancer Warning Signs (CAUTION)
CAUTION
Change in Bowel or Bladder Habits
A Sore That Does Not Heal
Unusual Bleeding or Discharge
Thickening or Lump in the Breast or Elsewhere
Dyspepsia (Indigestion)
Obvious Change to Warts or Moles
Nagging Cough
1 min
Breast Cancer Diagnosis
Mammography
Ultrasound
MRI for High Risk Patients
Confirmed with Biopsy
Considerations
Lymph Node Involvement
Receptor Positivity
Estrogen and Progesterone Receptors
HER-2
2 mins
Breast Cancer Interventions
Radiation or Chemotherapy
Hormonal Therapy
Tamoxifen
Lumpectomy
Mastectomy
Avoid BP and Injections Affected Arm
Hand Exercises
Considerations
Grief Related to Body Image
Prosthetics
Reconstruction
Lymphedema
3 mins
Prostate Cancer Assessment
Most Common Cancer in Men
Assessment
Mimics BPH
Metastasis to Back
Low Back Pain
Fatigue
Considerations
Prostate Specific Antigen (PSA)
Digital Rectal Examination (DRE)
Transrectal Ultrasound (TRUS)
Biopsy
2 mins
Hodgkin's Lymphoma Assessment
Cause
Lymph Node Cancer
Contiguous Spread
Assessment
Painless Lymphadenopathy
Constitutional B Signs
Night Sweats
Fever
Weight Loss
Considerations
Bimodal Age Distribution
Reed-Sternberg Cells
2 mins
Hodgkin's Lymphoma Interventions
Diagnosis
Biopsy
Staging
Interventions
Radiation
Chemotherapy
Treat Side Effects of Therapy
Considerations
Secondary Cancer Screening
2 mins
Non-Hodgkin's Lymphoma Assessment
Cause
Lymphatic Cancer
Non-Contiguous Spread
B or T Cells
Assessment
Painless Lymphadenopathy
Constitutional B Signs
Night Sweats
Fever
Weight Loss
Mediastinal or Abdominal Mass
Considerations
Older Adults
> 60 Subtypes
2 mins
Pneumothorax
Mechanism
Air Enters Pleural Space
Assessment
Sudden Dyspnea
Absent or Restricted Movement on Affected Side
Decreased or Absent Breath Sounds on Affected Side
Chest Pain
Tracheal Deviation
Vital Sign Changes
Crepitus
Considerations
High Fowler's Position With Oxygen
Prepare For Chest Tube Placement
Educate High Risk Patients
2 mins
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Pathophysiology
Hypersecretion of ADH
Increased Sensitivity to ADH
Signs & Symptoms
Serum Hypoosmolality
Coma and Seizure
Dilutional Hyponatremia
Cramps and Tremors
Euvolemia
Change in LOC
2 mins
Cervical Cancer Screening
Women Aged 21-65 Years
Pap Smear Every 3 Years
Women Aged 30-65 Years
Can Opt for Co-testing (Pap Smear + HPV Testing) Every 5 Years
Identify Lesions
High grade lesions
Cryotherapy
Loop Excision
Cold Knife Conization
2 mins
Cardiac Tamponade
Mechanism
Fluid in the Pericardial Sac
Pericarditis
Decreased Cardiac Output
Signs/Symptoms
Beck's Triad
Hypotension
Jugular Venous Distention (JVD)
Distant Heart Sounds
Pulsus Paradoxus
Electrical Alternans
Treatment
Pericardiocentesis
1 min
Transfusion Reactions
Acute Hemolytic
Febrile, Non-Hemolytic
Mild Allergic
Anaphylactic
Circulatory Overload
Sepsis Reaction
Transfusion-Related Acute Lung Injury (TRALI)
Massive Blood Transfusion
2 mins
Cervical Cancer Assessment
Cause/Mechanism
Human Papillomavirus (HPV)
Assessment
Metrorrhagia
Leukorrhea
Pain
Abnormal Pap Test
May Be Asymptomatic
Considerations
HPV Vaccine
2 mins
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