AOCNP TEST QUESTIONS AND
CORRECT ANSWERS LATEST
EDITION.
Most common surgical approach to SCC - ANS -Anterior decompression with mechanical
stabilization followed by RT
Preferred imaging technique to evaluate for suspected hemorrhage or hydrocephalus - ANS -CT
head
Most common site of mets in the brain - ANS -Cerebrum, then cerebellum, then brainstem
Who is at greatest risk for increased ICP? Which cancer types? - ANS -Patient with brain tumors
Lung cancer and melanoma
What is cushing's triad a late sign of? What is it? - ANS -Increased ICP
Cushing's Triad: HTN with widening pulse pressure (rising systolic, declining diastolic),
bradycardia, abnormal respirations
Late sign of ICP that occurs in 70% of patients with brain tumors - ANS -papilledema (1-5 days
unless related to subarachnoid hemorrhage in which case it develops within 2-8 hours)
When is headache worse with increased ICP? - ANS -in the morning
with bending, coughing, valsalva
,Early symptom of increased ICP - ANS -headache accompanied by nausea, vomiting
Causes of increased ICP in cancer - ANS -Tumor, hemorrhage, ischemic stroke, abscess,
autoimmune inflammatory process
Classic signs of autonomic dysfunction - ANS -HTN, bradycardia, punding headache, flushing,
profuse sweating above level of spinal involvement
What are patients at risk for with spinal lesions at T6 or higher? - ANS -autonomic dysreflexia
Minimally invasive surgeries for SCC - ANS -Kyphoplasty: balloon inflation followed by PMMA
injection
Vertebroplasty: PMMA injection only
Indications for surgical intervention of SCC - ANS -1) Rapidly progressing paraplegia
2) worsening neuro dysfunction while undergoing RT
3) pathologic fracture with bone dislocation
4) need biopsy
5) radioresistant tumors
6) recurrence after previous RT
7) prognosis of 3 months or greater
Where would you suspect a cord compression to be if patient was experiencing bilateral sensory
loss following dermatome path involving the buttocks, perineal area, posterior thigh, and lateral
leg - ANS -Cauda equina
How to treat SVC caused by thrombus? - ANS -thrombolytic therapy (tPA) followed by heparin
gtt, remove CVC
, Most common etiology for SVC / cancer - ANS -mediastinal malignancy (right sided lung
cancers), SCLC (followed by SCC of lung then adenocarcinoma of lung)
Beck's Triad - ANS -hypotension, distant heart sounds, JVD
Emergent management of pericardial effusion - ANS -Pericardiocentesis
Late symptoms of SVC - ANS -Stridor, vocal cord paralysis, hemoptysis, cyanosis, periorbital
edema, CHF, Cerebral Edema (seizure, headache, confusion)
Which oncologic emergency is Horner Syndrome associated with? - ANS -SVC syndrome
Conditions that often develop because of SVC? - ANS -Pleural and pericardial effusions
Most common s/s of SVC - ANS -Facial or neck swelling
upper extremity swelling
Dyspnea
Cough
Dilated chest vein collaterals
Extrinsic causes of SVC syndrome - ANS -compressive tumor, mediastinal lymph node
Intrinsic causes of SVC syndrome - ANS -Thrombosis or tumor, intraluminal
More permanent management of pericardial effusion - ANS -Pericardial sclerosis
PC balloon pericardiostomy
CORRECT ANSWERS LATEST
EDITION.
Most common surgical approach to SCC - ANS -Anterior decompression with mechanical
stabilization followed by RT
Preferred imaging technique to evaluate for suspected hemorrhage or hydrocephalus - ANS -CT
head
Most common site of mets in the brain - ANS -Cerebrum, then cerebellum, then brainstem
Who is at greatest risk for increased ICP? Which cancer types? - ANS -Patient with brain tumors
Lung cancer and melanoma
What is cushing's triad a late sign of? What is it? - ANS -Increased ICP
Cushing's Triad: HTN with widening pulse pressure (rising systolic, declining diastolic),
bradycardia, abnormal respirations
Late sign of ICP that occurs in 70% of patients with brain tumors - ANS -papilledema (1-5 days
unless related to subarachnoid hemorrhage in which case it develops within 2-8 hours)
When is headache worse with increased ICP? - ANS -in the morning
with bending, coughing, valsalva
,Early symptom of increased ICP - ANS -headache accompanied by nausea, vomiting
Causes of increased ICP in cancer - ANS -Tumor, hemorrhage, ischemic stroke, abscess,
autoimmune inflammatory process
Classic signs of autonomic dysfunction - ANS -HTN, bradycardia, punding headache, flushing,
profuse sweating above level of spinal involvement
What are patients at risk for with spinal lesions at T6 or higher? - ANS -autonomic dysreflexia
Minimally invasive surgeries for SCC - ANS -Kyphoplasty: balloon inflation followed by PMMA
injection
Vertebroplasty: PMMA injection only
Indications for surgical intervention of SCC - ANS -1) Rapidly progressing paraplegia
2) worsening neuro dysfunction while undergoing RT
3) pathologic fracture with bone dislocation
4) need biopsy
5) radioresistant tumors
6) recurrence after previous RT
7) prognosis of 3 months or greater
Where would you suspect a cord compression to be if patient was experiencing bilateral sensory
loss following dermatome path involving the buttocks, perineal area, posterior thigh, and lateral
leg - ANS -Cauda equina
How to treat SVC caused by thrombus? - ANS -thrombolytic therapy (tPA) followed by heparin
gtt, remove CVC
, Most common etiology for SVC / cancer - ANS -mediastinal malignancy (right sided lung
cancers), SCLC (followed by SCC of lung then adenocarcinoma of lung)
Beck's Triad - ANS -hypotension, distant heart sounds, JVD
Emergent management of pericardial effusion - ANS -Pericardiocentesis
Late symptoms of SVC - ANS -Stridor, vocal cord paralysis, hemoptysis, cyanosis, periorbital
edema, CHF, Cerebral Edema (seizure, headache, confusion)
Which oncologic emergency is Horner Syndrome associated with? - ANS -SVC syndrome
Conditions that often develop because of SVC? - ANS -Pleural and pericardial effusions
Most common s/s of SVC - ANS -Facial or neck swelling
upper extremity swelling
Dyspnea
Cough
Dilated chest vein collaterals
Extrinsic causes of SVC syndrome - ANS -compressive tumor, mediastinal lymph node
Intrinsic causes of SVC syndrome - ANS -Thrombosis or tumor, intraluminal
More permanent management of pericardial effusion - ANS -Pericardial sclerosis
PC balloon pericardiostomy
