...Ovarian Cancer Michelle Blevins Sullivan University HIM110X Pathophysiology with Pharmacology I March 3, 2014 Abstract Ovarian cancer is a growth of abnormal malignant cells that begins in the ovaries (women’s reproductive glands that produce ova). Cancer that spreads to the ovaries but originates at another site is not considered ovarian cancer. Ovarian tumors can be benign (noncancerous) or malignant (cancerous). Although abnormal, cells of benign tumors do not metastasize (spread to other parts of the body). Malignant cancer cells in the ovaries can metastasize in two ways: directly to other organs in the pelvis and abdomen (the more common way), through the bloodstream or lymph nodes to other parts of the body. While the causes of ovarian cancer are unknown, some theories exist: Genetic errors may occur because of damage from the normal monthly release of an egg. Increased hormone levels before and during ovulation may stimulate the growth of abnormal cells. Keywords: ovarian cancer, malignant, cells, metastasize Ovarian Cancer Ovarian Cancer is the most common cause of cancer death from gynecologic tumors in the United States. Malignant ovarian lesions include primary lesions arising from normal structures within the ovary and secondary lesions from cancers arising elsewhere in the body. Primary lesions include epithelial ovarian carcinoma, germ-cell tumors, sex-cord stromal tumors, and other more rare types. Metastases to the ovaries are relatively...
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...2015. For personal use only. How I treat How I treat enteropathy-associated T-cell lymphoma Antonio Di Sabatino,1 Federico Biagi,1 Paolo G. Gobbi,1 and Gino R. Corazza1 1First Department of Medicine, Centro per lo Studio e la Cura della Malattia Celiaca, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, University of Pavia, Pavia, Italy Enteropathy-associated T-cell lymphoma (EATL) is a complication of celiac disease (CD). This tumor derives from the neoplastic transformation of aberrant intraepithelial T lymphocytes emerging in celiac patients unresponsive to a gluten-free diet. Poor adherence to a gluten-free diet, HLA-DQ2 homozygosity, and late diagnosis of CD are recognized as risk factors for malignant evolution of CD. Recurrence of diarrhea, unexplained weight loss, abdominal pain, fever, and night sweating should alert physicians to this complication. The suspicion of EATL should lead to an extensive diagnostic workup in which magnetic resonance enteroclysis, positron emission tomography scan, and histologic identification of lesions represent the best options. Treatment includes high-dose chemotherapy preceded by surgical resection and followed by autologous stem cell transplantation, although biologic therapies seem to be promising. Strict adherence to a gluten-free diet remains the only way to prevent EATL. (Blood. 2012;119(11): 2458-2468) Introduction Celiac disease (CD) is a chronic gluten-sensitive enteropathy characterized by...
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...dehydrationMod dehydrationSevere dehydrationReplacing ongoing losses | MAJOR TEACHING POINTS | NURSING CONSIDERATIONS | Teach parents at well childcare visits in first yearKeep 24 hour supply of ORT in homeBegin with first sign of diarrheaReplace with ½ cup ORT for each diarrheal stoolSeek medical attention prn signs or dehydrationAfter re-hydration resume breast/formula feeding or normal diet in the older childAdvise them never to try to formulate an OR solution themselves.Teach personal hygiene/ hand washingProper preparation and storage of breast milk or formulaCareful food preparationImmunization for RotavirusAvoid unnecessary antibiotic usage | Acute diarrhea is leading cause of illness in children <5 years (10’s of millions cases in US)65% of hospitalizations and 85% of...
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...rare. In this article, colon cancer refers to colon carcinoma only. Causes Colorectal cancer is one of the leading causes of cancer-related deaths in the United States. Early diagnosis, though, can often lead to a complete cure. Almost all colon cancers start in glands in the lining of the colon and rectum. When doctors talk about colorectal cancer, this is usually what they are talking about. There is no single cause of colon cancer. Nearly all colon cancers begin as noncancerous (benign) polyps, which slowly develop into cancer. You have a high risk of colon cancer if you: Are older than 60 Are African American of eastern European descent Eat a a lot of red or processed meats Have colorectal polyps Have inflammatory bowel disease (Crohn's disease or ulcerative colitis) Have a family history of colon cancer Have a personal...
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...Caucasion | # of days since admission: 7d | Allergies: Latex PCN | Code Status: FULL CODE | Diet: TPN | Rationale: Small bowel obstruction and resection benefit TPN over tube feedings is that all the nutrition is delivered at a cellular level making it immediately available for the body to utilize rather than making the body breakdown and absorb nutrients in the GI tract. It makes it easier on the digestive tract by giving the GI a chance to rest and heal without causing more harm. The patient also has to expend energy to breakdown foods/nutrition through the GI tract. Getting it TPN conserves the much needed energy the patient needs to heal their tissues and gain strength. | Activity: bedridden w/slight mobility with a walker | Rationale: Post surgical abdominal surgery, pt age, weakness, and recent foot surgery limiting her mobility. | Behavior/Affect: My pt was anxious when I first arrived due to her elevated B/P, N&V, and pain intolerance. By the end of shift my patient was very calm and communicative. | Isolation: | Yes | No | Culture: ⦵ | Source: ⦵ | Type of Isolation: ⦰ ⦵ | Height: 5’ 7.5” | Weight: 133 | BMI: 20.5 (BSA 1.71) | General Survey | Age: 85 | Sex: F | Ethnicity: Caucasion | # of days since admission: 7d | Allergies: Latex PCN | Code Status: FULL CODE | Diet: TPN | Rationale: Small bowel obstruction and resection benefit TPN over tube feedings is that all the nutrition is delivered at a cellular level making it immediately...
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...Of all gynecologic malignancies, ovarian cancer continues to have the highest mortality and is the most difficult to diagnose. In the United States female population, ovarian cancer ranks fifth in absolute mortality among cancer related deaths (13,000/yr). In most reported cases, ovarian cancer, when first diagnosed is in stages III or IV in about 60 to 70% of patients which further complicates treatment of the disease (Barber, 3). Early detection in ovarian cancer is hampered by the lack of appropriate tumor markers and clinically, most patients fail to develop significant symptoms until they reach advanced stage disease. The characteristics of ovarian cancer have been studied in primary tumors and in established ovarian tumor cell lines which provide a reproducible source of tumor material. Among the major clinical problems of ovarian cancer, malignant progression, rapid emergence of drug resistance, and associated cross-resistance remain unresolved. Ovarian cancer has a high frequency of metastasis yet generally remains localized within the peritoneal cavity. Tumor development has been associated with aberrant, dysfunctional expression and/or mutation of various genes. This can include oncogene overexpression, amplification or mutation, aberrant tumor suppressor expression or mutation. Also, subversion of host antitumor immune responses may play a role in the pathogenesis of cancer (Sharp, 77). Ovarian clear cell adenocarcinoma...
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...Final Exam Study Guide Important to Know the function of anterior and posterior pituitary gland. Anterior Pituitary Gland: (Adenohypophysis) The anterior pituitary gland regulates several physiological processes including stress, growth, reproduction and lactation (Adrenal, liver, bone, thryroid and gonads). -It is regulated by negative feedback and the hypothalamus. Major hormones: ACTH: Stimulates the adrenal cortex. TSH: Thyroid stimulating hormone, promotes secretion of thyroid hormone. FSH: Follicle-stimulating hormone, promotes growth of reproductive system. LH: Luteinizing hormone. Promotes sex hormone production GH: Growth hormone, promotes growth, lipid and carbohydrate metabolism. PRL: Prolactin, Milk production and progesterone/estrogen. -Hormones are secreted from the hypothalamus to the A. Pituitary so these hormones can be released. Posterior Pituitary Gland: Mainly axons extended from the hypothalamus. These axons contain and release neurohypophysial hormones oxytocin and vasopressin. Oxytocin: Targets the uterus, and mammary glands causing contractions and lactation. Vasopressin (ADH): Antidiuretic hormone, arginine vasopressin, argipressin. Stimulates water retention absorbs it back into blood causing raises blood pressure by contracting arterioles, and inducing male aggression. Very Important to know and understand Diabetic Ketoacidosis Pathophysiology: -In DKA, the lack of insulin prevents glucose from being utilized by the tissues...
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...Hypercalcemia is the most common life-threatening metabolic disorder associated with neoplastic diseases, occurring in an estimated 10% to 20% of all adults with cancer. It also occurs in children with cancer, but with much less frequency (approximately 0.5%–1%).[1-3] Solid tumors (such as lung or breast cancer tumors) as well as certain hematologic malignancies (particularly multiple myeloma) are most frequently associated with hypercalcemia.[4] Although early diagnosis followed by hydration and treatment with agents that decrease serum calcium concentrations (hypocalcemic drugs) can produce symptomatic improvements within a few days, diagnosis may be complicated because symptoms may be insidious at onset and can be confused with those of many malignant and nonmalignant diseases. However, diagnosis and timely interventions not only are lifesaving in the short term but also may enhance the patient’s compliance with primary and supportive treatments and may improve quality of life.[5] When a patient has a refractory, widely disseminated malignancy for which specific therapy is no longer being pursued, the patient may want to consider withholding therapy for hypercalcemia. For patients or families who have expressed their wishes regarding end-of-life issues, this may represent a preferred timing and/or mode of death (as compared with a more prolonged death from advancing metastatic disease). This option is best considered long before the onset of severe hypercalcemia or other metabolic abnormalities...
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...Case Study for Final Exam Myasthenia gravis is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal (voluntary) muscles of the body. The name myasthenia gravis, which is Latin and Greek in origin, literally means "grave muscle weakness." With current therapies, however, most cases of myasthenia gravis are not as "grave" as the name implies. In fact, for the majority of individuals with myasthenia gravis, life expectancy is not lessened by the disorder. The hallmark of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest. Certain muscles such as those that control eye and eyelid movement, facial expression, chewing, talking, and swallowing are often, but not always, involved in the disorder. The muscles that control breathing and neck and limb movements may also be affected. Myasthenia gravis is caused by a defect in the transmission of nerve impulses to muscles. It occurs when normal communication between the nerve and muscle is interrupted at the neuromuscular junction - the place where nerve cells connect with the muscles they control. Normally when impulses travel down the nerve, the nerve endings release a neurotransmitter substance called acetylcholine. Acetylcholine travels through the neuromuscular junction and binds to acetylcholine receptors which are activated and generate a muscle contraction. ...
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...Initiation | * Decreased tissue oxygenation * Decreased intravascular volume * Decreased Myocardial contractility (cardiogenic ) * Obstruction of blood flow (obstructive) * Decreased vascular tone (distributive) * Septic (mediator release) * Neurogenic (suppression of SNS) | No observable clinical indications Decreased CO may be noted with hemodynamic monitoring | Compensatory | * Neural compensation by SNS * Increased HR and Contractiliy * Vasoconstriction * Redistribution of blood flow from nonessential to essential organs * Bronchodilation * Endocrine Compensation (RAAS, ADH, glucocorticoid release) * Renal reabsorption of sodium, chloride, and water * Vasoconstriction * Glycogenolysis | * Increased HR (EXCEPT NEUROGENIC) * Narrowed pulse pressure * Rapid, deep respirations causing respiratory alkalosis * Thirst * Cool,moist skin * Oliguria * Diminished bowel sounds * Restlessness progressing to confsion * Hyperglycemia * Increased specific gravity and decreased creatinine clearance. | Progressive | * Progressive tissue hypoperfusion * Anaerobic metabolism wih lactic acidosis * Failure of sodium potassium pump * Cellular edema | * Dysrhythmias * Decreased BP with narrowed pulse pressure * Tachypnea * Cold, clammy skin * Anuria * Absent bowel sounds * Lethargy progressing to coma * Hyperglycemia * Increase BUN, CREATININE, AND POTASSIUM * Respiratory and metabolic acidosis...
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...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
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...SITUATION : Arthur, A registered nurse, witnessed an old woman hit by a motorcycle while crossing a train railway. The old woman fell at the railway. Arthur rushed at the scene. 1. As a registered nurse, Arthur knew that the first thing that he will do at the scene is A. Stay with the person, Encourage her to remain still and Immobilize the leg while While waiting for the ambulance. B. Leave the person for a few moments to call for help. C. Reduce the fracture manually. D. Move the person to a safer place. 2. Arthur suspects a hip fracture when he noticed that the old woman’s leg is A. Lengthened, Abducted and Internally Rotated. B. Shortened, Abducted and Externally Rotated. C. Shortened, Adducted and Internally Rotated. D. Shortened, Adducted and Externally Rotated. 3. The old woman complains of pain. John noticed that the knee is reddened, warm to touch and swollen. John interprets that this signs and symptoms are likely related to A. Infection B. Thrombophlebitis C. Inflammation D. Degenerative disease 4. The old woman told John that she has osteoporosis; Arthur knew that all of the following factors would contribute to osteoporosis except A. Hypothyroidism B. End stage renal disease C. Cushing’s Disease D. Taking Furosemide and Phenytoin. 5. Martha, The old woman was now Immobilized and brought to the emergency room. The X-ray shows a fractured femur and pelvis. The ER Nurse would carefully monitor Martha for which of the following...
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...Practice Examination One Part One You will have two hours and 30 minutes to complete Part One. 1. The nurse is instructing an unlicensed assistant on how to collect a urine specimen from an indwelling catheter. Which of the following statements indicates that the assistant understands the instructions? A. "I will empty the catheter drainage bag, have the client drink some water, and an hour later collect the urine that drains into the bag. " B. "I will get a sterile syringe and remove urine from the catheter through the collection port to place in the specimen container. " C. "I should collect urine from the catheter drainage bag at the end of the shift and place it in the specimen container. " D. "I will disconnect the drainage tube from the catheter and let urine run from the catheter into the specimen container. " 2. Linda is a 19-year-old primipara who delivered a viable male neonate 2 hours ago. She has decided to breast-feed. Her 22-year-old husband supports her decision. She tells the nurse, "My mother breast-fed all of her children, but I'm going to need lots of help with breastfeeding. I'm worried that I won't be able to do this. " Which of the following should the nurse include when assessing the client? A. Determine the client's level of motivation to breast-feed. B. Perform a complete physical examination to determine her need for help. C. Assess her body-to-fat ratio and nutritional status before beginning...
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...PATHO Exam 3 Study Guide * Define KEY WORDS (terminology) listed in the syllabus * Answer the OUTCOMES in the syllabus as if they are questions * Review all Activities, Games, extra videos, journal articles, etc. posted in course contents * Review the handouts from class: case studies, matching, charts, etc. Normal Values | Intracranial pressure | 5-10 mm Hg | Blood glucose | 70-130 | Hgb A1c | <5.7% | Thyroid levels | | Parathyroid levels | | Types of bone cells | Osteoblasts | Bone forming cellsThey are responsible for bone growth and repair | Osteocytes | Osteoblasts that have become trapped, imprisoned within mineralized bone matrix (MATURE BONE CELLS) | Osteoclasts | Reabsorb or remove bone during growth and repair (also assist in the release of calcium and phosphate)**bone reabsorption; bone destroying cells | *So, if one is immobilized then the osteoclastic activity is greater than the osteoblastic activity in bone marrow decreases. This is why we have debone mineralization during immobilization. Maintenance of bone integrity | This occurs through remodeling and it is a 3 phase process where existing bone is resorbed and new bone is laid down [repairs bone, does not heal bones] | Phase 1 | Activation phaseThis is where a stimulus occurs, such as a weight baring exercise, causing the formation of osteoclasts | Phase 2 | Resorption This is where osteoclasts form a cutting zone and resorb or remove bone | Phase 3 | Formation...
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...NCSBN ON-LINE REVIEW 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. reason for the nurse to elevate the casted leg is to A) Promote the client's comfort B) Reduce the drying time C) Decrease irritation to the skin D) Improve venous return The most important D: Improve venous return. Elevating the leg both improves venous return and reduces swelling. Client comfort will be improved as well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client? A) B) C) D) Clean the meatus, begin voiding, then catch urine stream Void a little, clean the meatus, then collect specimen Clean the meatus, then urinate into container Void continuously and catch some of the urine A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it’s best to just slip the container into the stream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should the nurse see first? A) B) C) D) 16 year-old who had an open reduction of a fractured wrist 10 hours ago 20 year-old...
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