Soft Tissue Sarcoma Navigator Quiz
Soft tissue sarcomas can develop in:
Tendons, fat, and blood vessels
Cartilage and smooth muscle
Connective tissue and skeletal muscle
All of the above
The most common location of soft tissue sarcomas are in the:
Trunk
Arms and legs
Abdominal cavity
Internal organs
Soft tissue sarcomas include all of the following except:
Rhabdomyosarcoma
Colorectal carcinoma
Liposarcoma
Gastrointestinal stromal tumor
When training a new nurse on your team, you explain the difference between carcinomas and sarcomas. Which statement indicates that the new nurse fully understands your teaching?
Carcinoma is a malignancy of tissues that cover internal organs, but sarcoma are a malignancy of cells that line internal organs
Sarcoma is a malignancy of connective tissue, carcinoma is a malignancy of cells that cover or line internal organs
Sarcoma is a malignancy of the connective tissue, but carcinomas are benign tumors of cells that cover internal organs
Carcinoma is a malignancy of cells that line organs, but sarcoma is a malignancy of cells that cover internal organs
Which is the most commonly seen type of soft tissue sarcoma?
Urothelial carcinoma
Osteosarcoma
Undifferentiated pleomorphic sarcoma
Fibroma
Which statement regarding the pathophysiology of soft tissue sarcomas are correct?
Sarcomas are the most common type of benign tumor in adults between 60-70 years of age and develop in the pigment producing cells of the skin
The most commonly seen soft tissue sarcoma in children is Angiosarcoma, which develop in blood vessels or lymph vessels
Sarcomas are rare malignancies of various connective tissues with over 50 different subtypes that affect all ages
Sarcomas are commonly diagnosed in immunosuppressed patients and are known as rhabdomysarcoma
General work-up for a diagnosis of soft tissue sarcoma includes with of the following type(s) of imaging?
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Positron Emission Tomography (PET)
All of the above
The TNM system is utilized for staging soft tissue sarcomas located in the trunk and extremities. TNM stands for:
Time, Neoplasm, Mode of growth
Tumor, Node, Metastasis
Tumor, Neoplasm, Mode of growth
Time, Node, Metastasis
The MOST important objective of soft tissue sarcoma staging is:
To provide information regarding risk factors
To identify individuals at high risk for disease recurrence
To determine performance status and eligibility for research protocols
To provide the necessary information for individual treatment planning
Grade refers to histology of tumor cells. Which statement regarding grading is accurate?
Low grade tumor cells have a more abnormal appearance when compared to normal cells
High grade tumor cells have a more normal appearance than low grade tumor cells
Low grade tumor cells are more likely to spread and grow
High grade tumor cells are more likely to have nests of dead cells, a more abnormal appearance when compared to normal cells, and more dividing cells
You train a new colleague in your department and explain the various types of biopsies. Which statement by the new colleague demonstrates an understanding of the types of biopsies to determine a diagnosis of soft tissue sarcoma?
During an excisional biopsy, the physician uses a small gauge needle to remove a core piece of suspicious tissue
During a core biopsy, the physician uses a needle to remove a tube-like piece of tissue
CT scans or Ultrasound guide biopsies are used when the physician can palpate the tumor
During a core needle biopsy, the physician uses a small gauge needle to obtain small pieces of the tumor
The French (or FNCLCC System) determines the grading of soft tissue sarcomas. Select the three factors on which grading is based.
Tumor necrosis, Mitotic count, Differentiation
Mitotic count, Location, Tumor necrosis
Differentiation, Tumor necrosis, Nodal status
Cytogenetics, Tumor necrosis, Nodal status
Which statement accurately describes the difference between clinical staging and pathologic staging?
Pathologic staging and clinical staging are the same
Medical oncologists use the pathologic stage, and surgical oncologists use the clinical stage to treat patients
Clinical staging may be done first if surgery cannot be done to determine the pathologic stage, while pathologic stage can provide a more accurate prognosis
Clinical staging encompasses information obtained during surgery, while pathologic staging uses information from diagnostic imaging
Additional tissue testing can be performed on biopsy specimens. Which statement reflects the information obtained in these additional tests?
Fluorescence in situ hybridization (FISH) uses created markers to look for various genetic aberrations
Polymerase chain reaction (PCR) looks for multiple copies of genes in cancer cells
Cytogenetics evaluates chromosomes in cancer cells under a microscope to look for changes
All of the above
A 58 year-old man is going to have chemotherapy for lung cancer. He asks how the chemotherapeutic drugs will work. The most accurate explanation is which of the following?
Chemotherapy affects rapidly dividing cells
The molecular structure of DNA is altered
Cancer cells are susceptible to drug toxins
Chemotherapy encourages cancer cells to divide
Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?
Faster growing cells are less susceptible to chemotherapy
Non-dividing cells are more susceptible to chemotherapy
Faster growing cells are more susceptible to chemotherapy
Slower growing cells are more susceptible to chemotherapy
The following are teaching guidelines regarding radiation therapy EXCEPT:
The therapy is painless
To promote safety, the client is assisted in the therapy room by therapy personnel while the machine is in operation
The client may communicate all concerns/needs while the machine is operating
Safety precautions are necessary only during the time of actual irradiation
Neoadjuvant chemotherapy is:
Chemotherapy administered prior to surgery
Chemotherapy administered after surgery
Chemotherapy administered during surgery
Chemotherapy administered directly to the central nervous system
Mrs. Wagner, a 28 year-old woman, undergoes surgical treatment for osteosarcoma. The surgical oncologist tells the patient that he made a wide excision around the tumor and obtained clear margins. Which statement by Mrs. Wagner indicates she understands the outcome of the surgery?
The surgeon removed the tumor along with good tissue, without any cancer cells left behind
The surgeon was unable to remove all of the tumor
The surgeon was able to remove all of the tumor, but some of the cancer cells are still in the tissue surrounding the tumor
The surgeon was unable to remove the tumor
Limb sparing surgery can be defined as:
An amputation of the extremity
Removal of the cancer along with nearby tissue, cartilage, and surrounding bone
Excision of the tumor
Removal of the cancer along with muscle and nerves
Mr. Allen is a 45 year-old male with Gastrointestinal Stromal Tumor (GIST). He asks you how Imatinib will work to treat his cancer. You explain that:
Imatinib is like chemotherapy and kills all fast growing cells
Physicians do not have a good understanding of how exactly Imatinib works in the body
Imatinib blocks all communication between cells telling them to grow
Imatinib is not indicated for GIST, and that you will work with the physician for a new treatment
Mrs. Esser is a 21 year-old woman with stage IV soft tissue sarcoma. Her treatment includes doxorubicin and olaratumab. Which statement indicates she understands how the olaratumab will work to treat the sarcoma?
I may have an allergic-like reaction while olarutumab is given
The medicine will protect my bladder from the harmful effects of chemotherapy
Olaratumab blocks receptors on the cancer cells and works with chemotherapy to stop the cancer from growing
Both are true: I may have an allergic-like reaction to olarutumab and olarutumab blocks receptors on the cancer cells
The use of chemotherapy given in only a limb for unresectable intermediate or high-grade sarcoma is known as:
Systemic Chemotherapy
Regional or isolated limb perfusion
Targeted Therapy
Radiation Therapy
Which type of treatment is used most often for stage II and III soft tissue sarcoma?
Systemic chemotherapy
Radiation Therapy
Targeted Therapy
Surgery
You teach a class at a local high school on the importance of minimizing risk factors and explain that risk factors may include:
Smoking cigarettes
Family history of cancer
Any factor that increases your likelihood of getting a disease
All of the above are true
Gastrointestinal stromal tumors (GIST) are linked to which hereditary genetic syndrome?
Carney-Stratakis Syndrome
Beta Thalassemia
Neurofibromatosis type 1 (NF1)
Both are true: Carney-Stratakis Syndrome and Neurofibromatosis type 1 (NF1)
You are caring for a 25 year-old male with a history of lymphoma from ten years ago. He received radiation to the chest as part of his treatment plan. You know that:
Previous radiation therapy is a risk factor for developing soft tissue sarcoma
Only lifestyle risk factors (extrinsic) lead to soft tissue sarcoma
Previous radiation therapy does not impact the risk for developing soft tissue sarcoma
Exposure to radiation leads to over 75% of all soft tissue sarcomas
Li-Fraumeni Syndrome is a risk factor for the development of soft tissue sarcomas and is associated with a defect in which gene?
BRCA
ALK
TP53
BRAF
In early cases, most individuals report a ____________________ that has increased over ______________.
A nagging cough; 2-3 years
Pain in the chest; 7 months
Lump in the arm or leg; a few weeks to a few months
No specific symptoms
Mrs. Robertson is confused to why her soft tissue sarcoma in her arm didn't cause any pain. You explain that:
Soft tissue sarcomas always cause pain and its off that she didn't report pain at the time of diagnosis
Soft tissue sarcomas may not cause pain unless they impede function of an organ or extremity
Soft tissues sarcomas never cause pain
She must have had a very high pain threshold
Soft tissue sarcomas found in the retroperitoneum can cause which of the following symptoms?
Flatulence
Diarrhea
Mechanical Ileus
Shortness of breath
The most common and lethal side effect of chemotherapy is:
Myelosuppression
Respiratory distress
Increased liver function tests
Electrolyte imbalance from nausea, vomiting, and diarrhea
Ms. Elliott is a 19 year-old female diagnosed with stage III soft tissue sarcoma. She asks you about her ability to have children after treatment with chemotherapy. You respond by telling her:
Chemotherapy will not impact her ability to have children
She can receive chemotherapy and then have oocyte cryopreservation
It is important to discuss fertility-preserving options with the providers prior to undergoing chemotherapy
Fertility-preservation is not an option for her
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