OCN flashcards

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

Secondary prevention in oncology

Detection of cancer at a preclinical, asymptomatic stage through screening tests such as mammography, colonoscopy, or low-dose CT, with the goal of reducing mortality.

Hospice eligibility prognosis

In the US, hospice generally requires a prognosis of six months or less if the terminal illness follows its expected course, plus a decision to forgo curative-intent therapy.

Mosteller body surface area formula

BSA in square meters equals the square root of (height in cm times weight in kg divided by 3600). Used to calculate chemotherapy doses; many protocols cap BSA in obesity.

Pack-year calculation

Number of packs smoked per day multiplied by years smoked. A 20 pack-year history qualifies for lung cancer screening when combined with age and smoking-status criteria.

Survivorship care plan elements

A document summarizing cancer diagnosis and treatment, surveillance schedules, potential late effects, health-promotion recommendations, and clear allocation of follow-up responsibilities among providers.

Palliative care versus hospice

Palliative care addresses symptom burden and goals at any disease stage alongside curative therapy; hospice is a prognosis-limited insurance benefit requiring a shift to comfort-focused care.

Febrile neutropenia definition

A single oral temperature of 38.3 C or a sustained 38.0 C over one hour in a patient with an absolute neutrophil count below 500 cells per microliter or expected to fall below.

Anthracycline extravasation antidote

Dexrazoxane, given intravenously within six hours of extravasation and repeated on days two and three, is the specific antidote for anthracycline vesicant injury.

Vinca alkaloid extravasation management

Hyaluronidase is the antidote for vinca alkaloid extravasation; apply local heat and aspirate residual drug before administering the antidote through the existing cannula.

Neutropenic precautions rationale

Hand hygiene and avoidance of fresh flowers, standing water, and rectal instrumentation reduce exposure to environmental and endogenous organisms in patients with profound neutropenia.

Hazardous drug safe handling

USP <800> requires closed-system transfer devices, two pairs of chemotherapy-tested gloves, a gown, and eye protection when compounding or administering hazardous drugs.

Antimetabolite cell cycle phase

Antimetabolites such as methotrexate and 5-fluorouracil are S-phase specific, killing cells during DNA synthesis; efficacy depends on prolonged exposure rather than bolus delivery.

Immune-related adverse event timing

Checkpoint inhibitor toxicity may occur weeks to months after starting therapy, often affecting skin, colon, lungs, thyroid, and pituitary; management ranges from observation to high-dose corticosteroids.

Cytokine release syndrome management

CRS after CAR-T or bispecific therapy presents with fever, hypotension, and hypoxia; tocilizumab with or without corticosteroids is first-line treatment for grade 2 or higher.

Trastuzumab cardiotoxicity monitoring

Trastuzumab can cause asymptomatic left ventricular ejection fraction decline; baseline and serial LVEF assessment is required, and the drug is held for significant dysfunction.

Nadir after myelosuppressive chemotherapy

White blood cell and platelet counts typically reach their lowest point seven to fourteen days after chemotherapy administration, with recovery by about day 21.

Oral to parenteral morphine conversion

Oral morphine 30 mg is approximately equianalgesic to parenteral morphine 10 mg; when converting, reduce the calculated dose by 25 to 50 percent for incomplete cross-tolerance.

Opioid-induced constipation prophylaxis

Stimulant laxatives such as senna, with or without an osmotic agent, should be started prophylactically when opioids are initiated; methylnaltrexone is used for refractory cases.

Chemotherapy nausea prophylaxis regimen

Guideline regimens combine a 5-HT3 antagonist, dexamethasone, and an NK1 antagonist such as aprepitant for highly emetogenic regimens, with olanzapine as an effective add-on.

Oral cryotherapy for mucositis

Ice chips held in the mouth for 30 minutes during bolus 5-fluorouracil infusion reduce oral mucositis by producing local vasoconstriction and limiting drug delivery to mucosa.

Dyspnea management in palliative care

Low-dose opioids relieve refractory air hunger in palliative patients regardless of oxygen saturation; supplemental oxygen benefits only those who are demonstrably hypoxemic.

Haloperidol for hyperactive delirium

Haloperidol is first-line pharmacologic treatment for hyperactive delirium in cancer patients; nonpharmacologic measures such as orientation and sleep hygiene should be instituted first.

Spinal cord compression dexamethasone

Give dexamethasone 10 mg IV immediately when malignant spinal cord compression is suspected, then obtain urgent MRI of the entire spine; steroids precede imaging and do not delay it.

Superior vena cava syndrome signs

Facial and upper extremity edema, distended neck veins, dyspnea, and cough suggest SVC obstruction; elevate the head of the bed and avoid venipuncture in the affected arm.

Hypercalcemia of malignancy treatment

Intravenous isotonic fluids followed by a bisphosphonate or denosumab; calcitonin is added for rapid control, and loop diuretics only after volume repletion.

Tumor lysis syndrome electrolyte pattern

TLS produces hyperkalemia, hyperphosphatemia, hyperuricemia, and secondary hypocalcemia; rasburicase is preferred over allopurinol when uric acid is already elevated.

Beck triad in tamponade

Hypotension, distended neck veins, and muffled heart sounds indicate cardiac tamponade; pericardiocentesis is urgent and should not be delayed for imaging in unstable patients.

Neutropenic fever antibiotic timing

After blood cultures are drawn, empiric broad-spectrum intravenous antibiotics should be administered within 60 minutes of fever onset in a neutropenic patient.

Distress thermometer cutoff score

A distress thermometer score of 4 or higher on a 0-to-10 scale prompts further assessment and referral; it is a rapid screen for clinically significant distress.

SPIKES protocol purpose

A six-step framework (setting, perception, invitation, knowledge, empathy, strategy) for disclosing bad news such as a new cancer diagnosis or disease progression.

Fertility preservation before gonadotoxic therapy

Sperm banking and oocyte or embryo cryopreservation should be offered before starting gonadotoxic chemotherapy or pelvic radiation; delay of treatment is often minimal.

Anticipatory grief in caregivers

Grief reactions beginning before an expected death are common in patients and families; they do not predict worse bereavement outcome and should be acknowledged rather than pathologized.