Free CSO Exam Flashcards

T describes the primary tumour, N regional lymph-node involvement, and M distant metastasis. Definitions and stage groupings depend on the cancer site. Stage is not the same as histological grade or a nutrition diagnosis.

The person has limited self-care and is confined to bed or a chair for more than half of waking hours. ECOG 4 means complete disability. A score alone does not decide whether nutrition support is beneficial; consider reversible causes, prognosis and goals.

Damage to rapidly dividing normal tissues can produce mucositis, nausea, vomiting or diarrhoea, while the regimen and supportive medicines influence severity. Identify the actual symptoms and treatment schedule rather than assuming every drug causes the same toxicity.

Early diarrhoea occurs during or shortly after infusion and may accompany cholinergic symptoms; the oncology team may use atropine. Late diarrhoea usually starts more than 24 hours later and can cause dangerous dehydration or sepsis. Follow the prescribed treatment plan and urgently report fever, severe pain or dehydration.

It can indicate neutropenic enterocolitis or another serious infection. Escalate promptly for medical assessment. Bowel rest, fluids, antibiotics and the nutrition route depend on severity and bowel function; a low neutrophil count alone does not automatically mandate parenteral nutrition.

Report new or worsening diarrhoea, blood, pain or dehydration to the oncology team for prompt grading and treatment. Assess hydration, intake and gastrointestinal function. Steroid treatment and temporary feeding changes are medical decisions; colitis does not automatically require PN.

Confusion, reduced alertness or impaired swallowing may make oral intake unsafe. Seek urgent team assessment and a swallowing evaluation when indicated; choose a safe nutrition route based on function. CAR-T treatment alone is not an automatic indication for a feeding tube or PN.

Mucositis, dry mouth, taste changes, pain and dysphagia can impair intake. Monitor weight and swallowing, coordinate symptom treatment and offer suitable foods or nutrition support. Effects depend on treatment field and dose; there is no single dose that makes xerostomia permanently inevitable.

Evaluate timing, stool losses, hydration, medications and alternative causes before changing the diet. Tailor food and fluid choices to tolerance and investigate persistent malabsorption. Do not impose permanent low-fibre, dairy-free or other restrictions on every patient.

Donor-cell transplantation adds the risk of graft-versus-host disease to treatment toxicity and infection. Oral intake and bowel function determine support: enteral feeding is generally preferred when feasible; severe gastrointestinal complications may require PN. Assess the individual rather than using transplant type alone.

Screening quickly identifies risk and triggers follow-up. Assessment evaluates intake, symptoms, weight and muscle changes, function, disease burden and social barriers to establish the nutrition problem and care plan. A positive screen is not itself a malnutrition diagnosis.

No. The numerical score guides intervention urgency; a score of 9 or more indicates critical need for symptom management and nutrition intervention. Global categories A, B and C describe nutritional status using a separate clinical assessment. Do not convert score ranges into A/B/C categories.

Following risk screening, assess the criteria and establish at least one phenotypic criterion—weight loss, low BMI or reduced muscle mass—and one etiologic criterion—reduced intake/assimilation or inflammation/disease burden. Severity is graded using phenotypic criteria; cancer diagnosis alone should not replace the assessment.

Weight loss greater than 5% over six months, or loss greater than 2% with BMI below 20 kg/m², or loss greater than 2% with sarcopenia. Assess the wider clinical syndrome and exclude simple starvation as the explanation; weight loss alone does not establish refractory cachexia.

Refractory cachexia occurs with advanced, catabolic cancer that is not responding to treatment and a limited prognosis. Symptoms and goals still need assessment. Poor performance caused largely by inadequate intake may be partly reversible; do not withhold support solely because an ECOG score is high.

Cachexia combines reduced intake with metabolic disturbance and loss of muscle. Nutrition is important but may need symptom control, appropriate activity and cancer treatment to address the drivers. This differs from uncomplicated food deprivation and does not mean feeding is always futile.

(80 − 74) ÷ 80 × 100 = 7.5%. Interpret the time interval, intentionality, fluid changes, muscle and intake. Exactly 7.5% is not greater than 7.5%; a diagnostic or severity threshold must be applied with its stated comparison and clinical framework.

No. Sarcopenic obesity can conceal clinically important muscle depletion. Combine history, nutrition-focused examination, function and appropriate body-composition measures. CT-derived muscle cutoffs vary by method and population; one sex-specific pair is not a universal oncology threshold.

Fluid accumulation can mask tissue loss. Review pre-fluid weights, clinical examination, fluid balance and changes with treatment to estimate an appropriate reference weight. Do not subtract a universal fixed number of kilograms for mild, moderate or severe oedema.

Inflammation, fluid distribution, liver function and losses affect albumin. It can contribute to prognostic assessment but does not directly measure muscle or dietary adequacy. Diagnose malnutrition using intake, weight, body composition and clinical criteria rather than albumin alone.

A fall in phosphorus, potassium or magnesium after calories are restarted or increased, with possible thiamine-related or organ dysfunction. ASPEN defines severity using proportional electrolyte falls within five days; a single absolute phosphorus cutoff is not a complete diagnosis.

Rapid cell breakdown may cause hyperkalaemia, hyperphosphataemia, hyperuricaemia and secondary hypocalcaemia, with kidney injury. This requires urgent medical treatment. Adjust nutrition and electrolytes to actual laboratory results, kidney function and the treatment plan; do not automatically eliminate all potassium and phosphorus.

Ferritin rises with inflammation. Interpret it alongside transferrin saturation, blood counts, inflammatory context and clinical history. A ferritin value above 100 alone does not establish anaemia of chronic disease or exclude concurrent iron deficiency.

If not individually measured, energy needs are generally estimated at 25–30 kcal/kg/day. Protein should exceed 1 g/kg/day and, if possible, reach up to 1.5 g/kg/day. Select an appropriate weight and adjust for organ function, tolerance and response; these are starting estimates, not universal prescriptions.

Reduced meal capacity, dumping, weight loss and micronutrient deficiencies, particularly vitamin B12 and iron. Loss of intrinsic-factor production necessitates a reliable B12 replacement and monitoring plan; the route and regimen should be individualised rather than assuming every patient needs the same injection schedule.

Different formulations can have different food effects. For example, YONSA abiraterone may be taken with or without food, while other abiraterone products have fasting instructions. Verify the current label and oncology-pharmacy plan rather than applying a single rule to the generic drug name.

Ask respectfully about food access, affordability, facilities, preferred foods, beliefs and language needs. Agree on feasible substitutions and connect patients with support. Use qualified interpretation when needed; an idealised meal plan is ineffective if the patient cannot obtain or understand it.

Early symptoms typically occur within about 30 minutes of eating; late symptoms occur one to three hours later and involve reactive hypoglycaemia. Small frequent meals, fewer rapidly absorbed sugars and an individual fluid/meal plan may help; assess symptoms rather than prescribing a universal restriction.

Test a semi-solid or solid stool: below 100 μg/g supports EPI, while 100–200 μg/g is indeterminate. A watery sample can mislead. In adults with confirmed EPI, AGA advises starting PERT with at least 40,000 USP lipase units per meal and half that with snacks, during food intake, then adjusting clinically.

Medium-chain fat is absorbed mainly through the portal route and can reduce reliance on intestinal lymphatic fat transport compared with long-chain fat. The plan depends on leak site, output and nutritional status; retain adequate essential fatty acids and energy. High output is not an automatic indication for one fixed diet or PN.

Measure output trends, intake, urine, symptoms, weight, renal function and electrolytes, and escalate dehydration or acute changes. A specialist may prescribe an oral rehydration solution and modify fluids. Do not give a universal free-water restriction to everyone with an ileostomy.

Assess symptom severity, absorption, tolerance and whether the bowel can safely be used. Enteral feeding is generally preferable when feasible; severe symptomatic GI GVHD or other major intolerance may require PN. A stool-volume number alone is not a universal instruction to stop all oral or enteral intake.

If oral intake remains inadequate, use enteral nutrition when feasible and PN if enteral support is insufficient or impossible. Examples warranting medical nutrition include intake below 50% of requirements for over one week or 50–75% for over two weeks. Assess earlier when clinical risk demands it.

No. Discuss expected treatment toxicity, swallowing, baseline nutrition, aspiration risk, likely duration of support and patient preferences. High-risk patients may benefit, but tube selection is individual. Continue swallowing rehabilitation and safe oral practice only as advised by the swallowing team.

Give thiamine 100 mg before feeding or dextrose and check potassium, magnesium and phosphorus. Start about 10–20 kcal/kg for the first 24 hours, accounting for IV dextrose, and advance cautiously with monitoring. Delay initiation or increases when electrolytes are severely low; adjust for the individual clinical setting.

Glucose, fluid balance, potassium, magnesium, phosphorus, triglycerides, liver tests, line complications and adequacy of delivery. Choose monitoring frequency and formulation for metabolic stability, organ function and the lipid product. There is no universal lipid-dose ceiling appropriate to every adult oncology patient.

The 2023 rapid update permits offering low-dose olanzapine to adults with advanced cancer to improve appetite and weight. Much of the evidence involves lung or gastrointestinal cancers receiving chemotherapy. Prescribing requires assessment of adverse effects and suitability; it is not mandatory for all patients with low appetite.

No. Its specific surgical recommendation concerns upper gastrointestinal cancer resection in traditional perioperative care and an oral/enteral formula containing arginine, omega-3 fatty acids and nucleotides. Do not extrapolate that recommendation to routine supplements for every cancer or treatment setting.

Coughing or choking with intake, a wet voice, difficulty managing food or saliva, recurrent chest infections or suspected aspiration. Coordinate assessment and an appropriate texture or nutrition route. Thickened liquids or oral exercises should not be imposed without evaluating the person’s swallowing needs.

No. CMS policy describes an impairment expected to be of long and indefinite duration, documented by the treating practitioner, plus the other coverage requirements. Coordinate medical necessity, payer documentation, supplies, training and follow-up; reimbursement criteria do not replace clinical route selection.

Specify measurable outcomes, a review interval matched to risk and a response threshold. Track intake achieved, symptoms, hydration, weight or muscle trends, function and treatment tolerance. Reassess the plan when goals are not met instead of treating an initial calorie prescription as the final result.

Offer soft, moist foods at comfortable temperatures and avoid foods that aggravate pain, such as sharp, acidic or spicy choices. Coordinate pain control and oral care with the team. Do not replace medical treatment with an unverified rinse recipe or apply cryotherapy to every chemotherapy regimen.

Use moist foods, sauces and small sips when swallowing is safe; consider the prescribed saliva-management plan and protect oral health. Dry or rough foods may be difficult. Acidic sweets are not a universal remedy, especially when mucositis or dental risk is present.

Clean, separate, cook and chill. Avoid raw or undercooked animal foods and unpasteurised products; wash produce and reheat deli meats until steaming hot or 165°F. Broad low-bacterial diets have not shown consistent infection-prevention benefit; follow the transplant team’s specific precautions and safe-food guidance.

EGCG antagonised bortezomib in laboratory and animal experiments; that is not proof that ordinary tea abolishes treatment in humans. Ask about concentrated extracts and obtain oncology-pharmacy review before supplement use. Explain the evidence level rather than overstating a clinical outcome.

No. Safety and efficacy depend on the treatment and supplement, and there are signals of harm in some settings. Aim to meet nutrient requirements and correct documented deficiencies through the clinical plan; neither a blanket megadose recommendation nor a claim that all food antioxidants are harmful is justified.

Ask what the patient hopes to achieve, acknowledge concerns, examine the evidence and discuss nutritional risks. Offer a practical plan aligned with treatment and preferences. Use teach-back and agree on a measurable next step rather than dismissing the patient or promising a dietary cure.

WCRF recommends limiting red meat to about 350–500 g cooked weight per week and eating very little, if any, processed meat. Explain portions and alternatives in individual or group education. During active weight loss or treatment, maintaining adequate nutrition may take priority over prevention-style restrictions.

Assess treatment-related risk, dietary calcium, vitamin D status when indicated, activity, falls and relevant medical conditions. Coordinate supplementation and bone monitoring with the care team. A single calcium dose or vitamin D blood target should not be imposed on every oncology patient.

Clarify the patient’s goals, expected benefit, burden and prognosis with the team and family. In the dying phase, comfort, mouth care and desired food or drink are usually central; artificial nutrition often offers little benefit. Avoid fixed survival cutoffs that automatically prescribe or prohibit nutrition support.