AOCNP flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Hallmarks of cancer

Sustained proliferation, evasion of growth suppressors, apoptosis resistance, replicative immortality, angiogenesis, invasion and metastasis, and immune evasion are acquired capabilities enabling malignant growth.

Oncogene vs tumor suppressor

Oncogenes are gain-of-function drivers acting dominantly, such as RAS and MYC; tumor suppressors require loss of both alleles, such as TP53 and RB1, to remove growth restraint.

TNM staging meaning

T describes primary tumor size or invasion, N regional lymph node involvement, and M distant metastasis; the combined stage guides prognosis and therapy selection.

Tumor grade

Grade describes how differentiated tumor cells appear; well-differentiated low-grade tumors resemble normal tissue and generally have a better prognosis than poorly differentiated high-grade tumors.

Paraneoplastic hypercalcemia

Squamous cell lung cancer and multiple myeloma can secrete PTHrP or cause bone destruction, producing hypercalcemia with confusion, constipation, polyuria, and dehydration.

SIADH in small cell lung

Small cell lung cancer may cause syndrome of inappropriate ADH with euvolemic hyponatremia, concentrated urine, and low serum osmolality; treatment includes fluid restriction.

Cell cycle checkpoints

G1/S and G2/M checkpoints verify DNA integrity before replication and mitosis; loss of checkpoint control permits mutation accumulation and is targeted by some therapies.

Lung cancer screening criteria

Annual low-dose CT is recommended for adults aged 50 to 80 with at least 20 pack-years who currently smoke or quit within 15 years, after shared decision-making.

Colorectal screening start

Average-risk adults begin colorectal cancer screening at age 45 with colonoscopy every 10 years or annual FIT; hereditary syndromes or family history require earlier screening.

BRCA1/2 inheritance

BRCA1/2 pathogenic variants are autosomal dominant and raise lifetime breast and ovarian cancer risk; genetic counseling guides surveillance and risk-reducing surgery decisions.

Sensitivity and specificity

Sensitivity is true positives divided by all people with disease; specificity is true negatives divided by all people without disease; positive predictive value also depends on prevalence.

Lynch syndrome

Mismatch repair gene mutations cause Lynch syndrome, increasing colorectal and endometrial cancer risk; tumors typically show microsatellite instability or loss of MMR protein expression.

Core needle biopsy

Core needle biopsy removes tissue cores for histology and biomarker testing; it is preferred over fine-needle aspiration when tumor architecture or receptor status is needed.

Neoadjuvant vs adjuvant

Neoadjuvant therapy is given before surgery to shrink tumor and assess response; adjuvant therapy follows surgery to eradicate micrometastases and reduce recurrence risk.

SBRT

Stereotactic body radiation therapy delivers high-dose radiation in few fractions with precise targeting, used for small lung tumors, oligometastases, and some prostate cancers.

Cell-cycle-specific chemotherapy

Antimetabolites act mainly in S phase, while taxanes and vinca alkaloids act in M phase; alkylating agents and platinum compounds are cell-cycle nonspecific DNA-damaging agents.

Checkpoint inhibitor mechanism

PD-1, PD-L1, and CTLA-4 inhibitors release brakes on T cells, restoring antitumor immunity; immune-related adverse events can affect skin, gut, lungs, liver, and endocrine organs.

Trastuzumab target

Trastuzumab is a monoclonal antibody against HER2, used in HER2-amplified breast and gastric cancers; baseline and periodic cardiac function monitoring is required.

Autologous transplant

Autologous stem cell transplant uses the patient's own collected stem cells to rescue bone marrow after high-dose chemotherapy, commonly in multiple myeloma and lymphoma.

Phase III trial

Phase III trials compare a new treatment with standard therapy in large populations to measure efficacy and adverse effects; results support regulatory approval and practice change.

Febrile neutropenia definition

Fever of 38.3 C once or 38.0 C sustained plus absolute neutrophil count below 500 cells/microL; obtain cultures and start empiric broad-spectrum antibiotics promptly.

Opioid conversion

When switching opioids, calculate the equianalgesic dose, reduce for incomplete cross-tolerance, and reassess; oral morphine to intravenous morphine is approximately 3 to 1.

Highly emetogenic prophylaxis

Regimens such as cisplatin require a 5-HT3 antagonist, an NK1 receptor antagonist, and dexamethasone, often with olanzapine, before and after chemotherapy.

Tumor lysis syndrome

Rapid tumor cell death releases potassium, phosphate, and nucleic acids, causing hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia; treat with hydration and urate-lowering therapy.

Hospice eligibility

Hospice is appropriate when prognosis is about 6 months or less and goals focus on comfort; palliative care can be provided alongside curative treatment.

Hypercalcemia management

Intravenous fluids restore volume, bisphosphonates or denosumab inhibit bone resorption, and calcitonin lowers calcium rapidly; monitor renal function and electrolytes.

Survivorship care plan

A survivorship care plan summarizes cancer treatment, surveillance schedule, potential late effects, health promotion, and coordination between oncology and primary care.

Anthracycline cardiotoxicity

Doxorubicin and related drugs cause dose-dependent cardiomyopathy; baseline and periodic ejection fraction monitoring with echocardiography or MUGA is recommended, especially with cardiac risk factors.

Fertility preservation

Before gonadotoxic therapy, discuss sperm banking, oocyte or embryo cryopreservation, and possibly ovarian suppression; referral should occur before treatment starts.

Distress screening

Use a validated tool such as the NCCN Distress Thermometer at diagnosis and intervals; distress affects adherence and quality of life and warrants appropriate referral.

Lymphedema risk reduction

After axillary surgery or radiation, monitor arm circumference, educate about skin care and gradual exercise, and refer for compression or physical therapy if swelling occurs.

Chemotherapy-induced neuropathy

Taxanes, platinum agents, and vinca alkaloids can cause sensory peripheral neuropathy; assess gait, falls, and function, and adjust treatment when symptoms are severe.