Cancer Rehab Board Review

1. Cancer Rehab Board Review

2. Question # 1 You are examining a breast cancer patient whose upper extremity lymphedema has a brawny texture . Which of the following statements is true ? • A) The edema is likely to be reversible with retrograde massage. • B) The edema is irreversible • C) The edema will improve or reverse with elevation of the affected extremity and ACE wrapping • D) The edema is pitting to palpation

3. B) Stage 2 lymphedema is irreversible and is described to have a brawny texture. Once edema reaches this stage, it is irreversible, and the tissue does not pit on palpation

4. Question # 2 2) Post mastectomy symptoms of patchy numbness in the medial and posterior upper arm may be secondary to sacrifice of which of the following nerves ?a) Intercostal brachial nerveb) Musculutaneous nervec) Axillary nerved) Long thoracic nerve

5. a) Intercostal brachial nerve

6. Question #3 • Damage to which of the following nerves during cancer surgery can cause the condition shown at the right : a) Intercostal brachial nerveb) Spinal accessory nervec) Axillary nerved) Long thoracic nerve

7. d) Long thoracic nerve palsy, may cause serratous anterior weakness, thus the trapezius will be unopposed and pull the scapula medially

8. Question # 4 • Contraindications for breast cancer conservation surgery includea) multicentric cancerb) inability to receive radiationc) tumor > 5 cmd) all of the above are contraindications.

9. d) All of the above are contraindications

10. The most common cause of lymphedema resulting in elephantiasis worldwide is?a) infestation of lymph nodes by Wuchereria bancroftib) removal of lymph nodes by surgeryc) radiationd) infection

11. Question # 5 • The most common cause of lymphedema resulting in elephantiasis worldwide isa) infestation of lymph nodes by the parasite Wuchereria bancrofti

12. Question # 6 • Which of the following is the first symptom experienced in 95% of patients with spinal cord compression from cancer?a) Weaknessb) Paresthesiasc) Loss of proprioceptiond) Pain

13. d) Pain is the first symptom in 95% of patients

14. Question # 7 • Which of the following is true regarding metastatic spinal cord tumors?a) The majority are intradural and located in the lumbar regionb) The majority are extradural and located in the lumbar regionc) The majority are intradural and located in the thoracic regiond) The majority are extradural and located in the thoracic region

15. d) The majority are extradural (95%) and located in the thoracic region (70%)

16. Question # 8 • Which of the following is not true of radiation plexopathy ? • A) It most commonly involves the lower trunk of the brachial plexus • B) Myokymia is pathognomonic of this disorder • C) Numbness & paresthesias are the typical presenting symptoms • D) It most commonly involves the upper trunk of the plexus

17. Question # 9 • Which of the following is not true regarding childhood cancers ? • A) the most common form of cancer in children is leukemia • B) Cerebellar astrocytoma is the most common posterior fossa tumor in children • C) Medulloblastomas are more common than cerebellar astrocytomas in children • D) Cerebellar astrocytomas have a better prognosis than medulloblastomas

18. C is the answer • Cerebellar astrocytomas are more common and have a better prognosis than medulloblastoma • Leukemias are the most common pediatric cancers

19. Question # 10 • The lesion in the radiograph of a female patient on the right was probably caused by : • A) Thyroid cancer • B) Lung Cancer • C) Breast cancer • D) Colon cancer

20. Answer : this is a humeral metastatic lesion which is lytic • 90% of upper extremity metastatic disease involves the humerus • Usual cancers responsible are : breast, multiple myeloma, renal cell ca.

21. Question # 11 • Which of the following is not true regarding cancer and bone disease ? a) Most lower extremity metastases involve the hip or femur b) Most upper extremity metastases involve the humerus c) Lytic lesions are more prone to fracture than blastic lesions d) Osteosarcomas in children most frequently involve the hip and the proximal humerus

22. Answer D. • Osteosarcomas in children typically involve the KNEE and proximal humerus

23. Question # 12 • A post mastectomy patient is on 2 mg IM Dilaudid q 4 hours for pain, and she is to be discharged today and is still in pain, but unable to give herself injections of Dilaudid. How would you write your discharge prescription for Dilaudid? • A) Dilaudid 2 mg po q 4 h • B) Dilaudid 3 mg PR q 4 h • C) Dilaudid 8 mg po q 4 h • D) Both B and C would be acceptable

24. Answer : D – both B and C are acceptable.

25. Question # 13 • A patient who is receiving chemotherapy while on your service is complaining of nausea and is not improving on standard anti - emetic medications. Which of the following would you prescribe to help this patient ? • A) Atarax • B) Chlorpromazine • C) Ondanestron • D) Reglan

26. Answer : Ondanestron, the serotonin antagonist should be prescribed, as it does not have extrapyramidal side effects or other CNS side effects.

27. Question # 14 • What type of cancer does the patient on the right have ? • A) Renal Cell • B) Prostate • C) Breast • D) Multiple Myeloma

28. Question #15 • Which of the following is not a complication of vincristine chemotherapy for cancer ? • A) Ileus • B) Abdominal Pain • C) Pulmonary Fibrosis • D) Peripheral Neuropathy

29. Answer – C - Pulmonary Fibrosis