LWBK1006-46 LWW-Govindan-Review December 12, 2011 20:52
Chapter 46•Rehabilitation of the Cancer Patient 577ANSWERS
Answer 46.1. The answer is A.
Taxanes and vinca alkaloids cause a predominately length-dependent
motor and sensory axonal polyneuropathy in a distal symmetric distribu-
tion. Resulting in paresthesias, pain, sensory ataxia, and potentially weak-
ness, this condition usually improves when the treatment is stopped. The
platinum analogs damage the cell body of the sensory nerves in the dor-
sal root ganglion, and at higher doses can damage the anterior horn cell
within the spinal cord. As a result, it is more likely for patients treated with
platinum analogs to have sensory neuropathy without motor weakness.
The clinical manifestations include severe sensory ataxia and pain, usu-
ally without weakness. Peripheral neuropathy is not a commonly reported
toxicity of methotrexate.Answer 46.2. The answer is D.
For platelets 30,000 to 50,000/m^3 , the recommended activities are range
of motion (ROM) exercises, aerobic activity, light weights, and ambula-
tion. If hematocrit is less than 25%, ROM exercise and isometric exer-
cises are recommended. However, aerobic exercises should be avoided.
For bone metastasis involving 25% to 50% of the cortex, mild aerobic
and weight-bearing exercises are recommended. In patients with sodium
less than 130 mmol/L and potassium less than 3 mmol/L, no exercises are
recommended until evaluated by a physician.Answer 46.3. The answer is A.
Occupational therapy is directed toward helping patients perform their
activities of daily living. It involves assessing their activity level, liv-
ing environment, and interventions, such as exercises for strengthen-
ing, improvement in dexterity, proper posture, energy conservation, and
instruction in the use of adaptive equipment. Physical therapy involves the
development of strength, promotion of mobility, and pain-control tech-
niques. Recreational therapists provide treatment services and recreation
activities for individuals with disabilities or illnesses. Speech therapists
address people’s speech production, vocal production, swallowing diffi-
culties, and language needs.Answer 46.4. The answer is D.
Anticholinergic drugs are a well-known cause of hyposalivation, and
as a result, they should not be used in patients with radiation-induced
hyposalivation. Pilocarpine is a sialogogue that promotes saliva secretion
by muscarinic stimulation of the salivary glands. Bromhexine promotes
increased salivary secretion and reduces the viscosity.Answer 46.5. The answer is B.
Cancer pain control includes both pharmacologic and nonpharmacologic
treatment modalities. Both opioid medications and topical anesthetics are