Breast Ca Flashcards
(21 cards)
Define Mammogram
It’s a procedure whereby the breasts are gently flattened between an x-ray plate and plastic covers so that an image of the inside of the breast can be seen. Monogram is used investigate any lumps or breast tumours that is too small to be found during physical examination
Define chemotherapy
Selective toxicity applied in the treatment of neoplastic diseases. It targets the replication of cancer cells. These agents are applied systematically to enable them to target cancer cells in any part of the body. Attacking both the primary tumours and metastasises
Symptoms of Ca
Swelling or lump in the axillla Discharge from the nipple Dumpling in the skin of the Breast Inverted nipple Rash
Why has Mary got an enlarged lymph gland in left axilla
Ca cells that invade immune cells (t lymphocytes & B lymphocytes) and (plasma cells and macrophages) in the breast nodes will reach axilla nodes They may grow/divide & then move to another distant part of the body
Explain normal Ca cells/ differentiation
Normal body cells are specialised, taking only certain function (epithelial cells/ muscle cells/ bone cells)
They are DIFFERENTIATED
Properties of Ca cells
As they grow/divide they lose the characterisation that defines them as normal cells
Eventually after cell division & changes, they become UNDIFFERENTIATED= ANAPLASTIC
After their structure has completely changed, they are unable to carry out normal functions
Continue to develop abnormalities
Normal cells have a limited lifespan causing them to die (APOPTOSIS = a process controlled by normal genes)
Define Maligenant Neoplasms (cancer)
Cancer is a group of diseases characterised by unregulated growth of cells which invade and spread across from the cells site to origin
Define breast Ca
Occurs when breast tissue cells have undergone several different mutations.
Are cells with uncontrolled grow and spread locally & to distant parts of the body
Normal cells arises in breast ducal epithelial cells
Or breast cancer is tumour of the breast. It is a hereditary disease of the glandular epithelial tissue, resulting from mutation which occurs during development of epithelial cells
Explain ERs (Oestrogen receptors)
Some normal body cells have oestrogen and progesterone (PRs) in their cytoplasm & nucleus eg breast cells
ERs & PRs stimulate cell activity they quicken cells rate & their cell division rate
These receptors binds to cells taken to the nucleus where it causes a part of the DNA to become active ➡️ causing rate of grow/division to ⬆️
If Ca cells are ER+ they will grow/divide quickly
Explain the implications of knowing that Mary’s ER+
Oestrogen appears to bind to cancer cells receptors and stimulate abnormal growth. If the tumours are ER+ hormone therapy with anti-oestrogenic drugs I.e TAMOXIFEN & ATOMATASE INHIBITORS are used.
After menopause the ovaries no longer produce oestrogen therefore the fat cells have to convert ANDROGENS from the ADRENAL CORTEX into oestrogen using the enzyme AROMATASE. Aromatasr inhibitors stop this production of oestrogen by blocking the action of AROMATASE
Why is Mary prescribed Arimidex
It lovers levels of oestrogen in postmenopausal women by inhibiting the hormone converting process
Reduces the risk of Ca coming back
Adverse effects of Arimidex
Hot flashes Vaginal dryness Vomiting and nausea Swelling of gland Mild rash Joint pain or stiffness
Why does Vaginal dryness occur
Mary has limited oestrogen due to menopause, but still produces some.
Most of the remaining oestrogen is now inhibited by Arimidex
Menopause type symptoms are related to less oestrogen effect on the cells
Explain the pathophysiology of Mary’s Ca
Gene mutations that alter DNA
The cell will develop the structured functional characteristics associated with malignancy
Mutations include Proto-oncogene and Tumours suppressor gene mutations
What are Proto-oncogene and oncogenes
Proto-oncogene are accelerators for normal cells so that they can grow/divide
Once cells have mutated they become ONCOGENES with uncontrolled growth/division
What are Tumours suppressor gene mutations
TSGs are brakes to inhibit cells/division
Ca cells make TSG inactive so cells at uncontrolled
Examples of Necessary mutations
Allow cells to detach from its neighbours
Enable them to move through local tissue/ matrix
Enable cells to enter local lymph channels and capillaries
Allows to exit capillaries
Prevent Ca cells from APOPTOSIS
Explain the pharmodynamics of Morphine
An opioid analgesic
It’s an agonist: activating Mu receptors it inhibits the pain pathways
Has Mu, Delta, Kuppa receptors: the receptors are present in all parts of the CNS concerned with integrating pain information
Substantial gelatinosa in the spinal
cord, lambic system, brain stem,
thalamus and brain cortex
The actions end roof opioids such as endorphins are thus enhanced and pin signals are prevented from reaching or being processed by the brain. Morphine also effects smooth muscle of the GI, reproductive organs and urinary system. This causes the constriction of the bladder and ureters which slows intestinal peristalsis, resulting in constipated
Side effects of Morphine
Extreme drowsiness Headache Anxiety Constipation Nausea and vomiting Mild itchiness Chest pain
What is a “controlled drug”
Any drug which includes narcotics with the potential for abuse/addition
Under the the Misuse of Drugs Legislation
Outline the benefits of modifies release medication
Reduced dosage frequency and ⬆️ pt compliance
Reduce side effects
Control site of drug delivery in the gastrointestinal tract
