Cancer Fundamentals

Question 1

What is a Proto-oncogene?

Answer 1

A type of gene that causes cancer when mutated: Proto-oncogenes promote (initiate) and regulate cell division and differentiation; when mutated proto-oncogenes become mutated (oncogenes) this enables a cell to divide without regulation. Proto-oncogene often mutated into oncogenes by suffering a single nucleotide point mutation (ie RAS).

EXAMPLES:
EGFR (receptor)
RAS/KRAS (signaling)

Question 2

What is a tumor suppressor gene?

Answer 2

A type of gene that can cause cancer when mutated: A tumor suppressor gene normally controls (interrupts) cell growth and division. When mutated, tumor suppressor genes may no longer retain the ability to control cell growth and division, leading to uncontrolled growth/cancer.

EXAMPLES:
TP53 (prevents replication of damaged DNA and induces apoptosis)
BRCA1, BRCA2 (Repairs damaged DNA), RB (stops DNA replication)

Question 3

What is a “DNA repair gene?

Answer 3

A type of gene that can cause cancer when mutated: A gene involved in DNA repair. When altered, DNA repair genes are unable to repair DNA and cells tend to accumulate DNA damage such as additional mutations and chromosomal changes (duplications or deletions) which may cause the cells to become cancerous.

Question 4

What is cancer?

Answer 4

Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body

Question 5

What are some differences between cancer cells and normal cells?

Answer 5

grow in the absence of signals telling them to grow. Normal cells only grow when they receive such signals.

ignore signals that normally tell cells to stop dividing or to die (a process known as programmed cell death, or apoptosis).

invade into nearby areas and spread to other areas of the body. Normal cells stop growing when they encounter other cells, and most normal cells do not move around the body.

tell blood vessels to grow toward tumors. These blood vessels supply tumors with oxygen and nutrients and remove waste products from tumors.

hide from the immune system. The immune system normally eliminates damaged or abnormal cells.

trick the immune system into helping cancer cells stay alive and grow. For instance, some cancer cells convince immune cells to protect the tumor instead of attacking it.

accumulate multiple changes in their chromosomes, such as duplications and deletions of chromosome parts. Some cancer cells have double the normal number of chromosomes.

rely on different kinds of nutrients than normal cells. In addition, some cancer cells make energy from nutrients in a different way than most normal cells. This lets cancer cells grow more quickly.

Question 6

How does cancer develop:

Is cancer a genetic disease?

What happens to the DNA?

What happens to cell growth/division?

Answer 6

Cancer is a genetic disease—that is, it is caused by changes to the DNA sequence (genes) that control the way our cells function, especially how they grow and divide.

Question 7

What is metastatic cancer?

Answer 7

A cancer that has spread from the place where it first formed to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer.

Question 8

Under a microscope, do metastatic cancer cells generally look the same as cells of the original cancer?

Answer 8

Yes! Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

Question 9

Is Hyperplasia cancer?

Answer 9

No. Hyperplasia occurs when cells within a tissue multiply faster than normal and extra cells build up. However, the cells and the way the tissue is organized still look normal under a microscope. Hyperplasia can be caused by several factors or conditions, including chronic irritation.

Question 10

Is Dysplasia cancer?

Compare to hyperplasia, especially how do the cells/tissue look?

List one example of dysplasia.

Answer 10

No.

Dysplasia is a more advanced condition than hyperplasia. In dysplasia, there is also a buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater the chance that cancer will form. Some types of dysplasia may need to be monitored or treated, but others do not.

An example of dysplasia is an abnormal mole (called a dysplastic nevus) that forms on the skin. A dysplastic nevus can turn into melanoma, although most do not.

Question 11

Is Carcinoma in situ cancer?

Answer 11

No. Carcinoma in situ is an even more advanced condition (compared to Hyperplasia and Dysplasia). Although it is sometimes called stage 0 cancer, it is not cancer because the abnormal cells do not invade nearby tissue the way that cancer cells do. But because some carcinomas in situ may become cancer, they are usually treated.

Question 12

What is a Carcinoma?

What shape are the cells when viewed under a microscope?

True or false:
Carcinomas are the least common type of cancer.

Answer 12

Carcinomas are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body (derived from the embryonic ectoderm). There are many types of epithelial cells/carcinomas.

The cells have a column-like shape when viewed under a microscope.

FALSE
Carcinomas are the MOST common type of cancer.

Question 13

What are 4 different types of Carcinoma?

Answer 13

Carcinomas that begin in different epithelial cell types have specific names:
Adenocarcinoma
Basal cell carcinoma
Squamous cell carcinoma
Transitional cell carcinoma

Question 14

What is Adenocarcinoma?

Answer 14

Carcinomas (the most common type of cancer) that begin in different epithelial cell types have specific names:

Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus. Tissues with this type of epithelial cell are sometimes called glandular tissues. Most cancers of the breast, colon, and prostate are adenocarcinomas

Question 15

What is Basal cell carcinoma?

Answer 15

Carcinomas (the most common type of cancer) that begin in different epithelial cell types have specific names:

Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person’s outer layer of skin.

Question 16

What is Squamous cell carcinoma?

Answer 16

Carcinomas (the most common type of cancer) that begin in different epithelial cell types have specific names:

Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys. Squamous cells look flat, like fish scales, when viewed under a microscope. Squamous cell carcinomas are sometimes called epidermoid carcinomas.

Question 17

What is Transitional cell carcinoma?

Answer 17

Carcinomas (the most common type of cancer) that begin in different epithelial cell types have specific names:

Transitional cell carcinoma is a cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. This tissue, which is made up of many layers of epithelial cells that can get bigger and smaller, is found in the linings of the bladder, ureters, and part of the kidneys (renal pelvis), and a few other organs. Some cancers of the bladder, ureters, and kidneys are transitional cell carcinomas.

Question 18

What is a Sarcoma?

Answer 18

Sarcomas are cancers that originate from the embryonic mesoderm (middle layer). Sarcomas form in bone and soft tissues including: muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments).

Question 19

What are some types of Sarcomas?

What is the most common?

Answer 19

Sarcomas are cancers, originating from the mesoderm, that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments.

Osteosarcoma is the most common - bone cancer.

The most common types of soft tissue sarcoma are:
leiomyosarcoma - smooth muscle
Kaposi sarcoma - skin, mucous membranes that line the GI tract, blood vessels, lymph nodes, and other organs
malignant fibrous histiocytoma
liposarcoma and
dermatofibrosarcoma protuberans.

Question 20

What is an Osteosarcoma?

Answer 20

Sarcomas are cancers, originating from the mesoderm, that form in Bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments.

Osteosarcoma is the most common Sarcoma. Osteosarcoma is cancer of bone.

Question 21

What is an Leiomyosarcoma (LMS)?

Answer 21

Sarcomas are cancers, originating from the mesoderm, that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments.

Leiomyosarcoma is a soft tissue sarcoma, a rare type of cancer that grows in the smooth muscles. A malignant (cancer) tumor of smooth muscle cells that can arise almost anywhere in the body, but is most common in the uterus, abdomen, or pelvis.

Question 22

What is Kaposi sarcoma?

Answer 22

Sarcomas are cancers, originating from the mesoderm, that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments.

Kaposi sarcoma (KS) is a type of cancer that forms in the lining of blood vessels and lymph vessels. The cancer forms growths of cells, called lesions, on the skin. The lesions often form on the face, arms and legs. The lesions may look pink, red, purple or brown.

Lesions also can appear on the genitals or in the mouth. In severe Kaposi sarcoma, lesions can be in the digestive tract and lungs.

Question 23

What is malignant fibrous histiocytoma?

Answer 23

Sarcomas are cancers, originating from the mesoderm, that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments.

Malignant fibrous histiocytoma is a type of cancer that usually forms in the soft tissue, but it may also form in bone. It can occur anywhere in the body, but it usually occurs in the legs (especially the thighs), arms, or back of the abdomen. It may also occur in a part of the body where a patient received radiation therapy in the past. Malignant fibrous histiocytomas often grow quickly and spread to other parts of the body, including the lungs. They usually occur in older adults, and they may sometimes occur as a second cancer in patients who had retinoblastoma. Also called malignant fibrous cytoma and undifferentiated pleomorphic sarcoma.

Question 24

What is a Liposarcoma?

Answer 24

Sarcomas are cancers, originating from the mesoderm, that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments.

Liposarcomas are the most common subtype of soft tissue sarcomas, accounting for at least 20% of all sarcomas in adults. Liposarcomas arise from the precursor lipoblasts of the adipocytes (i.e. fat cells) in adipose (i.e. fat) tissues. A rare type of cancer that begins in fat cells. It usually forms in the layer of fat just under the skin or in the deep soft tissues of the legs (especially in the thigh or back of the knee) or in the abdomen. It may also form in other parts of the body. Most liposarcomas are painless and tend to grow slowly, but some may grow quickly and spread to nearby tissue or to other parts of the body. Liposarcomas usually occur in adults, and are rare in children and adolescents. They are a type of soft tissue sarcoma.

Question 25

What is dermatofibrosarcoma protuberans?

Answer 25

Sarcomas are cancers, originating from the mesoderm, that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments. Dermatofibrosarcoma protuberans is a type of tumor that begins as a hard nodule and grows slowly. These tumors are usually found in the dermis (the inner layer of the two main layers of tissue that make up the skin) of the limbs or trunk of the body. They can grow into surrounding tissue but do not spread to other parts of the body. These tumors are related to giant cell fibroblastomas.

Question 26

What is Leukemia?

Answer 26

Leukemia are cancers that begin in the blood-forming tissue of the bone marrow. These cancers do not form solid tumors. Instead, large numbers of abnormal white blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells. Leukemia occurs most often in adults older than 55, but it is also the most common cancer in children younger than 15.

Question 27

What are 4 common types of Leukemia?

Answer 27

Leukemia is a broad term for cancers of the blood cells that begin in the bone marrow. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. There are four common types of leukemia, which are grouped based on how quickly the disease gets worse (acute or chronic) and on the type of blood cell the cancer starts in (lymphoblastic or myeloid). Acute forms of leukemia grow quickly and chronic forms grow more slowly. Acute lymphocytic leukemia (ALL) is the most common kind of leukemia. It usually occurs in young children but can also occur in adults. It’s sometimes called acute lymphoblastic leukemia. Acute Myelogenous Leukemia (AML) is the most common kind of aggressive leukemia in adults. It can also affect children. This type of leukemia starts in the myeloid cells of the bone marrow and can spread quickly into the blood. Chronic lymphocytic leukemia (CLL) is the most common type of slow-growing leukemia. It usually affects older adults. CLL starts in the lymphoid (white blood) cells of the bone marrow and progresses slowly. A person with CLL may feel fine for several years before experiencing symptoms or seeking treatment. But it can eventually enter the blood and spread to other parts of the body. Chronic myelogenous (CML) leukemia usually affects adults. It’s sometimes called chronic myeloid leukemia. This type of leukemia starts in the myeloid cells of the bone marrow. It grows slowly, so symptoms may not start for months or years. CML can eventually spread to the blood and other parts of the body.

Question 28

What is Acute lymphocytic leukemia (ALL), one of the 4 most common types of Leukemia?

Answer 28

Leukemia is a broad term for cancers of the blood cells that begin in the bone marrow. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Acute lymphocytic leukemia (ALL) is the most common kind of leukemia. It usually occurs in young children but can also occur in adults. It’s sometimes called acute lymphoblastic leukemia.

Question 29

What is Acute Myelogenous Leukemia (AML), one of the 4 most common types of Leukemia?

Answer 29

Leukemia is a broad term for cancers of the blood cells that begin in the bone marrow. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Acute Myelogenous Leukemia (AML) is the most common kind of aggressive leukemia in adults. It can also affect children. This type of leukemia starts in the myeloid cells of the bone marrow and can spread quickly into the blood.

Question 30

What is Chronic lymphocytic leukemia (CLL), one of the 4 most common types of Leukemia?

Answer 30

Leukemia is a broad term for cancers of the blood cells that begin in the bone marrow. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Chronic lymphocytic leukemia (CLL) is the most common type of slow-growing leukemia. It usually affects older adults. CLL starts in the lymphoid (white blood) cells of the bone marrow and progresses slowly. A person with CLL may feel fine for several years before experiencing symptoms or seeking treatment. But it can eventually enter the blood and spread to other parts of the body.

Question 31

What is Chronic myelogenous leukemia (CML), one of the 4 most common types of Leukemia?

Answer 31

Leukemia is a broad term for cancers of the blood cells that begin in the bone marrow. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Chronic myelogenous leukemia (CML) usually affects adults. It’s sometimes called chronic myeloid leukemia. This type of leukemia starts in the myeloid cells of the bone marrow. It grows slowly, so symptoms may not start for months or years. CML can eventually spread to the blood and other parts of the body.

Question 32

What is Lymphoma?

Answer 32

Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting white blood cells that are part of the immune system. In lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body. There are two main types of lymphoma: Hodgkin lymphoma – People with this disease have abnormal lymphocytes that are called Reed-Sternberg cells. These cells usually form from B cells. Non-Hodgkin lymphoma – This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

Question 33

What are some Key Differences Between Leukemia, Lymphoma, and Myeloma?

Answer 33

Leukemia is the most prevalent of “The Big Three”. Leukemia starts in a person’s blood forming tissue (bone marrow) and will cause an overproduction of abnormal white blood cells which will eventually travel into the bloodstream. Leukemia is broken down into two types, chronic and acute. Chronic leukemia tends to be the less severe of the two, progresses at a slower pace, and inhibits the development of healthy blood stem cells. Acute leukemia progresses rapidly and prevents healthy blood stem cells from being able to mature as necessary. Symptoms of acute leukemia appear earlier than chronic leukemia, and are often more severe. ————— Lymphoma is the cancer of the lymphatic system, (the body’s germ fighting system). The lymphatic system includes lymph nodes, spleen, the thymus gland and bone marrow. With lymphoma, Lymphocytes (B and T cells) develop a genetic mutation. This mutation causes the cells to rapidly multiply and survive in the lymphatic system causing the lymph nodes, the spleen, and liver to swell. The two most common forms: Hodgkins- usually form from B-cells, typically begins in the upper portion of the body’s lymph nodes, characterized by the presence of Reed-Sternberg cells. Non-Hodgkin’s (most common form), can form from B or T cells, will arise in lymph nodes anywhere in the body, are characterized by the absence of Reed-Sternberg cells. ————— Myeloma, is the overproduction of abnormal plasma cells in bone marrow, these cells remain in the bone marrow and do not travel to the bloodstream. Plasma cells are responsible for the production of antibodies. The two most common forms of myeloma are multiple myeloma (located at multiple sites in the body at the time of diagnosis) and Plasmacytoma myeloma (located in one area of the body, most often in the bones, skin, muscles or lungs).

Question 34

What are the two main types of Lymphoma?

Answer 34

Hodgkin lymphoma – People with this disease have abnormal lymphocytes that are called Reed-Sternberg cells. These cells usually form from B cells. Non-Hodgkin lymphoma – This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

Question 35

What is Melanoma?

Answer 35

Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but melanomas can also form in other pigmented tissues, such as the eye.

Question 36

What are Brain and Spinal Cord Tumors, how are they named?

Answer 36

There are different types of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system. For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

Question 37

What are the main types of skin cancer?

Answer 37

squamous cell carcinoma, basal cell carcinoma, and melanoma. Melanoma is much less common than the other types but much more likely to invade nearby tissue and spread to other parts of the body. Most deaths from skin cancer are caused by melanoma.

Question 38

What is a germ cell tumor? What are some of the types? Can germ cell tumors be either benign or malignant?

Answer 38

Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant. Central Nervous System, Childhood Extracranial Germ Cell Tumor, Childhood Extragonadal Germ Cell Tumor Ovarian Germ Cell Tumor Testicular Cancer

Question 39

What are Neuroendocrine Tumors? Are these tumors always malignant? Name some examples (7)

Answer 39

Neuroendocrine Tumors form from cells that release hormones into the blood in response to a signal from the nervous system. Neuroendocrine tumors may make higher-than-normal amounts of hormones, which can cause many different symptoms. These tumors may be benign (not cancer) or malignant (cancer). Some examples of neuroendocrine tumors are: 1. carcinoid tumors 2. islet cell tumors 3. medullary thyroid cancer 4. pheochromocytomas 5. neuroendocrine carcinoma of the skin (Merkel cell cancer) 6. small cell lung cancer 7. large cell neuroendocrine carcinoma (a rare type of lung cancer

Question 40

What are Carcinoid tumors? What speed of growth? Where are they typically found (what two tissues most common) What syndrome can they cause, and how?

Answer 40

Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system (most often in the rectum and small intestine). Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

Question 41

What is carcinoid syndrome?

Answer 41

A combination of symptoms caused by the release of serotonin and other substances from carcinoid tumors of the gastrointestinal tract. Symptoms may include flushing of the face, flat angiomas (small collections of dilated blood vessels) of the skin, diarrhea, bronchial spasms, rapid pulse, and sudden drops in blood pressure.

Question 42

Define incidence.

Answer 42

new cases

Question 43

Define prevalence.

Answer 43

All existing cases

Question 44

Define mortality.

Answer 44

Deaths

Question 45

Define survival

Answer 45

How long people survive after diagnosis

Question 46

Define morbidity

Answer 46

Cancer-related health complications

Question 47

Define survivorship

Answer 47

Survival beyond cancer treatment (including quality of life)

Question 48

Define financial toxicity

Answer 48

Financial toxicity describes problems a cancer patient has related to the cost of treatment. KEY POINTS Several studies show that cancer patients and survivors are more likely to have financial toxicity than are people without cancer. The level of financial toxicity you may have will depend on several factors in your household. Cancer treatment can affect your ability to work and pay your bills. Your age, race, income, and whether you have a job can affect your risk of financial toxicity.

Question 49

Cancer disparities (sometimes called cancer health disparities) are differences in cancer measures/outcomes/metrics such as 9 listed):

Answer 49

1. incidence (new cases) 2. prevalence (all existing cases) 3. mortality (deaths) 4. survival (how long people survive after diagnosis) 5. morbidity (cancer-related health complications) 6. survivorship (including quality of life after cancer treatment) 7. financial burden of cancer or related health conditions 8. screening rates 9. stage at diagnosis

Question 50

Define Carcinogenesis

Answer 50

Process by which a normal cell develops into a cancer cell

Question 51

Define somatic mutation theory -> 3 features related to genetics, cellular origins, irreversibility) Is this the predominant model?

Answer 51

The predominant cancer model 1. Cancer is a disease of genetic variants 2. Cancer arises from a single somatic cell 3. Initiation and carcinogenesis are irreversible

Question 52

What are three characteristics of cancer STEM CELLS described by the: Cancer Stem Cell model (how are they different from OTHER CANCER cells):

Answer 52

Tumors are heterogeneous. Cancer stem cells have special characteristics within the tumor: Only Cancer stem cells can: 1. become a new tumor 2. go into resting phase (resistance to treatment thereby surviving treatment) 3. move back into active phase (causing relapse)

Question 53

Define two hit hypothesis

Answer 53

According to a "two-hit" model, dominantly inherited predisposition to cancer entails a germline mutation, while tumorigenesis requires a second, somatic, mutation. Non-hereditary cancer of the same type requires the same two hits, but both are somatic.

Question 54

Define Hanahan and Weinberg’s model of cellular events to produce Malignancy (6 steps related to: (1) cell signaling; (2) growth suppressors; (3) immortality; (4) invasion/metastasis; (5) angiogenesis and (6) cell death)

Answer 54

(1) sustaining proliferative signaling; (2) evading growth suppressors; (3) enabling replicative immortality; (4) activating invasion and metastasis; (5) inducing angiogenesis and (6) resisting cell death.

Question 55

Describe the cell cycle

Answer 55

Cell cycle is the name we give the process through which cells replicate and make two new cells. Cell cycle has different stages called G1, S, G2, and M. G1 is the stage where the cell is preparing to divide. To do this, it then moves into the S phase where the cell copies all the DNA. So, S stands for DNA synthesis. After the DNA is copied and there's a complete extra set of all the genetic material, the cell moves into the G2 stage, where it organizes and condenses the genetic material, or starts to condense the genetic material, and prepares to divide. The next stage is M. M stands for mitosis. This is where the cell actually partitions the two copies of the genetic material into the two daughter cells. After M phase completes, cell division occurs and two cells are left, and the cell cycle can begin again.

Question 56

List the 4 conceptual stages of Carcinogenesis. What step begins malignancy?

Answer 56

Carcinogenesis can be divided conceptually into four steps: 1. tumor initiation - irreversible change (variant) passed to daughter cells (ie UV, tobacco) 2. tumor promotion - accelerated cancer formation (ie obesity, high estrogen levels) 3. tumor progression - malignant conversion occurs 4. Metastasis

Question 57

Name 5 Key tumor characteristics

Answer 57

1. Uncontrolled cell division, 2. loss of contact inhibition 3. Apoptosis avoidance 4. Angiogenesis 5. Ability to invade surrounding tissues and metastasize

Question 58

Name 6 causes of Carcinogenesis?

Answer 58

1. Chronic inflammation 2. Virus exposure 3. Bacterial exposure (Helicobacter pylori) 4. High-fat diet and obesity 5. Additives (food dyes, artificial flavors/preservatives) 6. Pharmaceutical exposure (ie chemotherapy)

Question 59

Name 8 differences between cancer cells and normal cells

Answer 59

1. Grow in absence of signaling 2. Ignore signaling to stop dividing or apoptosis 3. Invade nearby areas and spread 4. Attract angiogenesis 5. Hide from immune system 6. Trick immune system to aid survival 7. Accumulate multiple genetic changes 8. Utilize different kinds of nutrients

Question 60

True or False: Most cancer deaths are caused by Metastasis

Answer 60

True

Question 61

What are the 6 primary types of cancer histological categories?

Answer 61

Carcinoma Sarcoma Myeloma Leukemia Lymphoma Mixed Types

Question 62

What is a Carcinoma? Carcinomas account for what % of all cancer cases?

Answer 62

Carcinoma refers to a malignant neoplasm of epithelial origin or cancer of the internal or external lining of the body. Carcinomas, malignancies of epithelial tissue, account for 80 to 90 percent of all cancer cases.

Question 63

What Percentage of all cancer cases do Carcinomas (epithelial origin) account for?

Answer 63

Carcinomas, malignancies of epithelial tissue, account for 80 to 90 percent of all cancer cases.

Question 64

What are the two major subtypes of adenocarcinoma?

Answer 64

Carcinomas are divided into two major subtypes: Adenocarcinoma, which develops in an organ or gland. Generally occur in mucus membranes and are first seen as a thickened plaque-like white mucosa. They often spread easily through the soft tissue. Squamous cell carcinoma, which originates in the squamous epithelium. Occur in many areas of the body.

Question 65

True or False: Most carcinomas affect organs or glands capable of secretion, such as the breasts, which produce milk, or the lungs, which secrete mucus, or colon or prostate or bladder.

Answer 65

True

Question 66

What is a sarcoma? What do s the most common sarcoma, where does it develop?

Answer 66

Sarcoma refers to cancer that originates in supportive and connective tissues such as bones, tendons, cartilage, muscle, and fat. Generally occurring in young adults, the most common sarcoma often develops as a painful mass on the bone. Sarcoma tumors usually resemble the tissue in which they grow.

Question 67

Name some examples of Sarcomas (11 listed)

Answer 67

Osteosarcoma or osteogenic sarcoma (bone) Chondrosarcoma (cartilage) Leiomyosarcoma (smooth muscle) Rhabdomyosarcoma (skeletal muscle) Mesothelial sarcoma or mesothelioma (membranous lining of body cavities) Fibrosarcoma (fibrous tissue) Angiosarcoma or hemangioendothelioma (blood vessels) Liposarcoma (adipose tissue) Glioma or astrocytoma (neurogenic connective tissue found in the brain) Myxosarcoma (primitive embryonic connective tissue) Mesenchymous or mixed mesodermal tumor (mixed connective tissue types)

Question 68

What tissue does Osteosarcoma (or osteogenic sarcoma) originate from?

Answer 68

Bone

Question 69

What tissue does Chondrosarcoma originate from?

Answer 69

Cartillage

Question 70

What tissue does Leiomyosarcoma originate from?

Answer 70

smooth muscle

Question 71

What tissue does Rhabdomyosarcoma originate from?

Answer 71

skeletal muscle

Question 72

What tissue does mesothelial sarcoma or mesothelioma originate from?

Answer 72

membranous lining of body cavities

Question 73

What tissue does Fibrosarcoma originate from?

Answer 73

fibrous tissue

Question 74

What tissue does angiosarcoma or hemangioendothelioma originate from?

Answer 74

blood vessels

Question 75

What tissue does Liposarcoma originate from?

Answer 75

adipose tissue

Question 76

What tissue does Glioma or astrocytoma originate from?

Answer 76

neurogenic connective tissue found in the brain

Question 77

What tissue does Myxosarcoma originate from?

Answer 77

primitive embryonic CONNECTIVE tissue

Question 78

What tissue does Mesenchymous or mixed mesodermal tumor originate from?

Answer 78

mixed CONNECTIVE tissue types

Question 79

What is Myeloma?

Answer 79

Myeloma is cancer that originates in the plasma cells of bone marrow. The plasma cells produce some of the proteins found in blood. Myeloma can also form a solid tumor called a solitary plasmacytoma rather than infect your entire bone marrow. These tumors are often treated with radiation therapy.

Question 80

What is Leukemia? Name some examples.

Answer 80

Leukemias ("liquid cancers" or "blood cancers") are cancers of the bone marrow (the site of blood cell production). The word leukemia means "white blood" in Greek. The disease is often associated with the overproduction of immature white blood cells. These immature white blood cells do not perform as well as they should, therefore the patient is often prone to infection. Leukemia also affects red blood cells and can cause poor blood clotting and fatigue due to anemia. Examples of leukemia include: Myelogenous or granulocytic leukemia (malignancy of the myeloid and granulocytic white blood cell series) Lymphatic, lymphocytic, or lymphoblastic leukemia (malignancy of the lymphoid and lymphocytic blood cell series) Polycythemia vera or erythremia (malignancy of various blood cell products, but with red cells predominating)

Question 81

What is Myelogenous or granulocytic leukemia Leukemia?

Answer 81

malignancy of the myeloid and granulocytic white blood cell series

Question 82

What is Lymphatic, lymphocytic, or lymphoblastic Leukemia?

Answer 82

malignancy of the lymphoid and lymphocytic blood cell series

Question 83

What is Polycythemia vera or erythremia Leukemia?

Answer 83

malignancy of various blood cell products, but with red cells predominating

Question 84

Where do Lymphomas develop?

Answer 84

Lymphomas develop in the glands or nodes of the lymphatic system, a network of vessels, nodes, and organs (specifically the spleen, tonsils, and thymus) that purify bodily fluids and produce infection-fighting white blood cells, or lymphocytes. Unlike the leukemias which are sometimes called "liquid cancers," lymphomas are "solid cancers." Lymphomas may also occur in specific organs such as the stomach, breast or brain. These lymphomas are referred to as extranodal lymphomas. The lymphomas are subclassified into two categories: Hodgkin lymphoma (presence of Reed-Sternberg cells) Non-Hodgkin lymphoma (absence of Reed-Sternberg cells)

Question 85

What is the Ectoderm?

Answer 85

The outermost of the three cell layers in a developing embryo; the origin of epidermal tissues such as the skin, nails, hair, nervous system, and external sense organs. Epithelial tissue arises from the ectoderm and the endoderm; therefore, carcinomas can arise from either the ectoderm or the endoderm.

Question 86

True or False Epithelial tissue only arises from the ectoderm not the endoderm.

Answer 86

False. Epithelial tissue arises from the ectoderm AND the endoderm; therefore, carcinomas can arise from either the ectoderm or the endoderm.

Question 87

Epithelial tissue derived from ectoderm is generally what type of epithelium?

Answer 87

squamous epithelium

Question 88

Epithelial tissue derived from endoderm is generally what type of epithelium?

Answer 88

glandular epithelium

Question 89

What are some of the body tissues derived from the third or middle primary germ layer known as the Mesoderm.

Answer 89

Muscles Fibrous tissue Bone and cartilage Fat or adipose tissue Blood and lymph vessels Blood cells

Question 90

What is the Endoderm? What are examples of tissue that arise from Endoderm?

Answer 90

The endoderm is the innermost layer of the three primary germ layers of the embryon. The glandular epithelium arises from the innermost layer. Adenocarcinomas arise from tissues derived from the endoderm. Examples of the tissue that arise from the endoderm layer include: epithelium of pharynx, auditory tube, larynx, trachea, bronchi, lungs, the digestive tract, liver, pancreas, bladder, urethra, tonsils, thyroid, parathyroid, thymus, breast, prostate.

Question 91

Adenocarcinomas arise from what embryonic germ layer?

Answer 91

endoderm

Question 92

Epithelial tissues derived from ectoderm is generally what type of epithelium?

Answer 92

squamous epithelium

Question 93

Epithelial tissue derived from endoderm is generally what type of epithelium?

Answer 93

glandular epithelium

Question 94

What are some of the tissues derived from the middle primary germ layer known as the Mesoderm?

Answer 94

Muscles Fibrous tissue Bone and cartilage Fat or adipose tissue Blood and lymph vessels Blood cells

Question 95

What are the two major Carcinoma subtypes?

Answer 95

Adenocarcinoma, which develops in an organ or gland. Generally occur in the mucous membranes. Squamous cell carcinoma, which originates in the squamous epithelium. Generally occur in many areas of the body.

Question 96

Tumor Grading: Gx through G4 Definitions

Answer 96

Gx - undetermined G1 - Well differentiated (low grade) G2 - Moderately differentiated (intermediate grade) G3 - poorly differentiated (high grade) G4 - Undifferentiated (high grade)

Question 97

TNM Staging

Answer 97

Most common staging system T- Tumor size N - Node involvement M - Metastasis

Question 98

What does "prognostic stage groups" mean?

Answer 98

Merger between anatomical stage (Grade + TNM) with genomic profiles and molecular targets. Utilizes a more personalized approach. May explain why an early-stage cancer has a poor prognosis.

Question 99

What is the Innate immune response?

Answer 99

Occurs naturally and uses phagocytic cells that release inflammatory mediators and natural killer (NK) cells. Nonspecific process Natural immunity

Question 100

What is Acquired or adaptive immune response? What are three types?

Answer 100

involves antigen-specific B and T lymphocytes in response to specific antigens or foreign proteins. Has memory, allows improved consecutive response to the same antigen (AKA anamnesis). Three types: 1. Humoral (antibody)-mediated 2. Cell-mediated 3. Regulatory T cells

Question 101

What is Humoral (antibody)-mediated immune response?

Answer 101

Mediated b antibodies, secreted by plasma cells or transformed B lymphocytes following exposure to an antigen. Destroy the antigen/cell upon binding

Question 102

What is Cell-Mediated immune response?

Answer 102

Mediated by the T lymphocytes that can either induce cell death (when cells express antigens) or activate cells used in innate processes.

Question 103

Which cells within the immune system dampen the immune response to prevent attacks of health tissues (autoimmune disease)?

Answer 103

Regulatory T cells (formerly suppressor T cells)

Question 104

Which cells participate in the Innate immune system?

Answer 104

Myeloid Lineage: Myeloid progenitor differentiates into: Neutrophils Mast cell Basophils Eosinophil Monocyte (differentiates into: Macrophage & Dendritic cell)

Question 105

Which cells participate in the Adaptive immune system?

Answer 105

Lymphoid Lineage: Lymphoid progenitor differentiates into Natural killer cell (innate immunity) B cell progenitor (which differentiates into Plasma cell and Memory B cell) T cell progenitory (which differentiates into Memory T cell, Cytotoxic T cell, Helper T Cell)

Question 106

What is hematopoiesis?

Answer 106

The process that a pluripotent stem cell differentiates ito peripherial blood cell lines.

Question 107

Myeloid blood cell line will differentiate into:

Answer 107

Red blood cells Platelets White blood cells (innate immunity)

Question 108

Lymphoid blood cell line will differentiate into:

Answer 108

Lymphocytes (B cell, T cell, Plasma cell, and NK cell)

Question 109

What are some granulocytes?

Answer 109

Basophils Eosinophils Neutrophils

Question 110

What are some Agranulocytes?

Answer 110

B cells T cells Monocytes (macrophage pre-cursor)

Question 111

Describe T cells

Answer 111

Differentiate from Lymphoid progenitor. Mature in the thymus gland. Job: Kill infected cells and communicate to other immune system players Helper T cells communicate with other cells by stimulating production of T cells, B cells, or phagocytes. Killer T cells attack foreign antigens (particularly viruses)

Question 112

Describe B cells

Answer 112

Derived from a lymphoid progenitor. Secrete antibodies in respons to foreign antigens. Each B cell makes ONLY one antibody. B cells can develop into plasma cells which make LOTS of antibodies.

Question 113

Describe Natural Killer (NK cells)

Answer 113

Derived from a Lymphoid progenitor though part of the innate immune system. Can attack any type of foreign antigen through production of strong chemicals that bind to the foreign antigen.

Question 114

What are some goals of the Complement System within Innate immunity?

Answer 114

Trigger an inflammatory response: swelling, redness, pain which will flood the area with immune system cells to further attack/clean up.

Question 115

What are two types of Immune response within Adaptive Immunity?

Answer 115

Humoral response (B-cells) Cell-mediated response (T cell - inkluding killer T cells)

Question 116

What are Immunoglobulins produced by B cells?

Answer 116

Antibodies: Immunoglobulins - 2x heavy chains, 2x light chains of amino acids

Question 117

What are the different types of antibodies: Immunoglobulins and where is each found?

Answer 117

IgA - body fluids (tears/saliva) IgE - lungs, skin, and mucuous membranes (also involved in allergic/hypersensitivity reactions) IgG - blood, lymphactis, CSF (activates complement system & key player in humeral immunity) IgM - blood and lymph fluid (largest and first responders to antigen) IgD - role not well understood, may have some antibody function for penicillin, diptheria, and insulin.

Question 118

What are some important Cell Mediators in the Immune response?

Answer 118

Soluble mediators (receptors) 1. Antibodies (serum glycoproteins (AKA immunoglobulins) specific to an antigen. 2. Cytokines (polypeptides, ie interleukins, interferons, TNF, CSF) mediate a cellular response (anti- or pro- inflammatory) which can cross the BBB 3. Prostaglandins, which mediate inflammation

Question 119

What are TSA and TAA that have been a focus in immunotherapy and targeted therapy?

Answer 119

TSA - Tumor-Specific Antigen (only found on tumor cells) TAA - Tumor-Associated Antigen (found mostly on tumor cells, also found on healthy cells in lower volumes) EXAMPLE= HER2 targeted by Trastuzumab.

Question 120

What is Immunoediting and what are the 3 steps involved?

Answer 120

The evolution of a tumor cell that allows escape from the immune system. 1. Elimination (highly immunogenic tumors are destroyed, though low immunogenic tumors survive/escape. 2. Equilibrium: the immune stystem ignores the cancer cells with low immunogenicity. 3. Escape: ignored cancer cells grow/divide

Question 121

What are 7 types of immunotherapy?

Answer 121

1. Monoclonal antibodies (rituximab or trastuzumab) 2. Cytokines, proteins created by WBC (interlukins, hematopoetic growth factor) 3. Vaccines, cancer antigens that elicit an immune response 4. Checkpoint Inhibitors (protens that allow the T cells to mount a stronger immune response (nivolumab and ipilimumab) 5. Tumor-infiltrating lymphocytes (TILs), patient's own TILs growing in culture, activated, and then reinfused 6. Chimeric antigen receptor-T cell (CAR-T) therapy: Patient's own T cells are genetically modified to express a specific T cell receptor on the surface of the cancer cells. 7. Gene therapy - introduction of DNA/RNA into the body through a vector

Question 122

Definition of Genomics

Answer 122

The study of the complete set of DNA (including all of its genes) within a person or organism

Question 123

Defintion of Genetics

Answer 123

The study of genes and heredity

Question 124

Define Penetrance

Answer 124

The # of individuals with a genetic variant that will present with a specific disease. Further characterized as High or Low.

Question 125

Define Autosomal dominant

Answer 125

Only one copy of the variant gene is needed to display the quality or disease.

Question 126

Define Autosomal recessive

Answer 126

Two copies of a variant gene are inherited and needed to display the quality or disease.

Question 127

What are some features of heritable cancers in the individual?

Answer 127

In the individual patient: Multiple primary tumors in the same organ. Multiple primary tumors in different organs. Bilateral primary tumors in paired organs. Multifocality within a single organ (e.g., multiple tumors in the same breast, all of which have risen from one original tumor). Younger-than-usual age at tumor diagnosis. Tumors with rare histology. Tumors occurring in the sex not usually affected (e.g., breast cancer in men). Tumors associated with other genetic traits. Tumors associated with congenital defects. Tumors associated with an inherited precursor lesion. Tumors associated with another rare disease. Tumors associated with cutaneous lesions known to be related to cancer susceptibility disorders (e.g., the genodermatoses).

Question 128

What are some features of a heritable cancer in the family?

Answer 128

One first-degree relative with the same or a related tumor and one of the individual features listed. Two or more first-degree relatives with tumors of the same site. Two or more first-degree relatives with tumor types belonging to a known familial cancer syndrome. Two or more first-degree relatives with rare tumors. Three or more relatives in two generations with tumors of the same site or etiologically related sites.

Question 129

What is pharmacogenomics?

Answer 129

The study of how genetics and genomics influences treatment options

Question 130

What is GINA and when was it established?

Answer 130

The federal Genetic Information Nondiscrimination Act, established in 2008, provides protection related to: 1. Analysis of DNA and RNA. 2. Cancer screening testing (ie. breast and ovarian cancer, hereditary nonpolyposis colorectal cancer and familial cutaneous malignant melanoma). 3. Genetic testing for other disease (ie. Huntington's, cystic fibrosis) and sicle cell anemia screening.

Question 131

What does GINA do?

Answer 131

This federal law: Genetic Information Nondiscrimination Act (passed in 2008) protects U.S. citizens with an inherited disorder from being treated unjustly because of their genetic makeup.

Question 132

What are some key protections that GINA provides?

Answer 132

Genetic Information Nondiscrimination Act (passed in 2008) protecs U.S. citizens by: 1. Insurers cannot adjust premiums based on a person's genetic information. 2. Insurers cannot mandate genetic testing for individuals. 3. Employers cannot hire, fire, or change job assignments based on a person's genetic information.

Question 133

What are some GINA limitations?

Answer 133

Employer have access to some information that may include individual genetic testing details for special situations including: Certifying requirements for FMLA Monitoring the biologic effects of substances

Question 134

What two items does GINA NOT prohibit?

Answer 134

Medical underwriting for current health status Mandate coverage for testing or treatment

Question 135

What four U.S. populations are NOT protected by GINA

Answer 135

1. US military (health through Tricare) 2. Those receiving care through Veterans Affairs 3. The Indian Health Service 4. Federal employees with the Federal Employee Benefit Plan The above policies have their own policies preventing discriminiation

Question 136

What % of the population may have a personal or family health history indicative of a hereitary cancer syndrome?

Answer 136

As much as 10%

Question 137

In what ways can Cost be an issue with Genetic Testing,?

Answer 137

Genetic testing costs can be significant. Most insurers WILL cover part or all of the testing costs, though there are often strict eligibility criteria established by insurance companies, and these costs will differ between plans. Individuals should be aware of financial costs prior to obtaining Genetic Testing.

Question 138

In what way can Genetic Counseling be an issue with Genetic Testing,?

Answer 138

Genetic counseling may be a time-intensive process to ensure that the individualized, complete education is understood by the person looking for information and/or screening.

Question 139

What is of the utmost importance when with obtaining Genetic Testing?

Answer 139

Obtaining informed consent, with a clear understanding of risks and benefits.

Question 140

In regards to Genetics & Genetics testing, what are four Roles for a General Oncology Nurse?

Answer 140

1. Perform risk assessments (including personal, medical, occupational, environmental, and family history) using established risk assessmetn tools 2. Refer families with a genetic predisposition to a genetic healthcare professional 3. Assist to implement recommendations prescribed by the genetic professional 4. Provide psychosocial support and encouragement for patients and families pursuing genetic testing.

Question 141

In regards to Genetics & Genetics testing, what are six Roles for an Advance Practice Nurse?

Answer 141

1. Perform risk assessments and identify factors that suggest a hereditary predisposition 2. Initiate data collection for a three-generation pedigree 3. Answer general questions about genetics 4. Refer at-risk familites to a genetic healthcare professional 5. Provide psychosocial support 6. Assist with evaluating and monitoring the impact of genetic testing and recommended screening and preventative measures.

Question 142

In regards to Genetics & Genetics testing, what are ten Roles for an Advance Practice Nurse with Subspecialy in Genetics?

Answer 142

1. Conduct in-depth assessment of family history 2. Construct pedigrees with cancers verified thorugh medical records and death certificates 3. Assess patient's risk of having a specific mutation, and evaluate eligible/appropriate genetic testing 4. Provide genetic counseling, including pre-and post-testing counseling PRN 5. Provid info. to ensure informed consent regarding the strengths, risks, and limitations of testing 6. Conduct physical assessments from a genetics perspective 7. Coordinate follow-up care based on genetics testing results 8. Assess and develop strategies to facilitate coping with any adverse psychological consequences of a diagnosis of a hereditary cancer syndrome 9. Identify other family members who might benefit from genetic testing 10. Assist with enrolling families with unusual syndromes in research studies

Question 143

What are eight elements indicating Heriditary Predisposition for developing cancer?

Answer 143

1. Cancer a a young age 2. More than one primary cancer in one person 3. Evidence of autosomal dominant inheritance (2(+) generations affected both M & F) 4. Bilateral cancer in any paired organ 5. Any pattern of cancer associated with a known cancer syndrome 6. Cancer occuring more frequently in a family than expected by chance in the absence of known environmental and lifestyle risk factors 7. Multifocal cancers in an organ 8. A cluster of the same cancer in close relatives

Question 144

What is autosomal dominant inheritance?

Answer 144

Two or more generations

Question 145

What is absolute risk?

Answer 145

the Chance that a person will develop a disease within a preiod of time, often expressed as a percentage. Applies to a population rather than an individual

Question 146

What is Relative risk?

Answer 146

Compares risk between people who have a particular risk factor and another group that does not have the same risk factor. Both types of risks are considered when providing education in terms of screening and/or lifestyle modification

Question 147

What are the three types of Genetic Testing results?

Answer 147

Positive (predisposition, increased risk) Negative (no risk elevation) Indeterminate significance

Question 148

If Genetics Testing reveals Positive findings (predisposition, increased risk), what are additional items discussed

Answer 148

Follow-up screening lifestyle modification prevention strategies -> results may have implications for others in the family

Question 150

List 7 examples of neuroendocrine tumors, tumors that form from cells that secrete hormone based on signals from the nervous system.

Answer 150

Seven examples of neuroendocrine tumors are: 1. carcinoid tumors 2. islet cell tumors 3. medullary thyroid cancer 4. pheochromocytomas 5. neuroendocrine carcinoma of the skin (Merkel cell cancer) 6. small cell lung cancer 7. large cell neuroendocrine carcinoma (a rare type of lung cancer

Question 151

Tumor Marker CA125 Useful to detect which type of cancer

Answer 151

CA125 Useful for ovarian cancer diagnosis and monitoring in conjunction with other testing

Question 152

Tumor Marker Alpha-Fetoprotein or AFP

Answer 152

Alpha-Fetoprotein or AFP Informative for distinguishing between various types of germ cell tumors, especially when used together with measurement of B-Human chorionic gonadotrophin (B-hCG)

Question 153

Tumor Marker Carcinoembryonic antigen (CEA)

Answer 153

Carcinoembryonic antigen (CEA) Can be elevated in - colorectal - breast - lung however, elevated levels are not tumor specific but can still be of prognostic or monitoring value

Question 154

Tumor Marker Tissue estrogen and progesterone receptors

Answer 154

Tissue estrogen and progesterone receptors Have prognostic utility for the treatment of breast cancer, as test-positive individuals are responsive to antiestrogen therapies

Question 155

Tumor Marker Tissue HER-2/neu

Answer 155

Tissue HER-2/neu Useful in assessment of breast cancer patients for possible treatment with Herceptin

Question 156

Name Tumor Markers for Prostate cancer

Answer 156

PSA Prostate acid phosphatase

Question 157

Name Tumor Markers for Breast cancer

Answer 157

CA15-3 CA27.29 HER-2/neu (if taking Herceptin)

Question 158

Name Tumor Markers for Ovarian cancer

Answer 158

CA125

Question 159

Name Tumor Markers for Pancreatic cancer

Answer 159

CA19-9

Question 160

Name Tumor Markers for Colorectal cancer

Answer 160

CEA CEA = also some limited utility for monitoring breast and lung cancers

Question 161

Name Tumor Markers for Nonseminomatous testicular cancer

Answer 161

AFP (Alpha-Fetoprotein)

Question 162

Name Tumor Markers for Thyroid cancer

Answer 162

Thyroglobulin (contraindicated if the individual has autoantibodies)

Question 163

Lung cancer What rank for cancer diagnosis? (ie 1st, 5th, etc) What rank for cancer death? Compare incidence/death rate: M vs F - Caucasian - African American - Hispanic

Answer 163

Lung cancer: * 2nd leading cancer diagnosis * 1st leading cause of cancer death MEN (2016) - African Americans had the highest incidence (68.1 per 100,000) and death rate (55.3 per 100,000) for lung cancer - Caucasians second highest in both categories (58.8 and 47.1 per 100,000, respectively). WOMEN (2016) - Caucasians had the highest incidence rate (49.6 per 100,000) and death rate (33.2 per 100,000) - African Americans second in both categories (42.1 and 29.8 per 100,000, respectively). HISPANIC (2016) Both sexes had the lowest incidence and death rates

Question 164

Nonanalgesic adjuvant drugs may be useful in supplementing pain control. Name 3x Anticonvulsants commonly used to supplement pain control. What TYPE of pain are anticonvulsants best used to aid?

Answer 164

Anticonvulsants: - gabapentin (Neurontin) - phenytoin (Dilantin) - carbamazepine (Tegretol) May have activity in neuropathic pain such as brachial or lumbosacral plexopathies or chemotherapy-induced neuropathies

Question 165

Nonanalgesic adjuvant drugs may be useful in supplementing pain control. Name 2 Antidepressants commonly used adjuvants

Answer 165

Antidepressants: - amitriptyline (Elavil) - nortriptyline (Pamelor) Commonly used nonanalgesic pain adjuvants.

Question 166

Nonanalgesic adjuvant drugs may be useful in supplementing pain control. Name 1x NMDA (N-methyl-d-aspartate) antagonist with use for neuropathic pain

Answer 166

NMDA (N-methyl-d-aspartate) antagonist: - Ketamine Use for neuropathic pain

Question 167

Name a synthetic opiate where its use is discouraged in oncology patients. Why is its use discouraged?s

Answer 167

Meperidine (Demerol) = a synthetic opiate where its use is discouraged in oncology patients. Discouraged because its metabolite normeperidine may accumulate and cause CNS toxicity

Question 168

Name 3x neurotransmitters released by tissue damage (contributing to perception of pain)

Answer 168

Bradykinin Substance P Prostaglandin

Question 169

Opiates: What is drug tolerance? Is tolerance addiction?

Answer 169

Tolerance = a state in which the dose must be increased to achieve a good clinical results. All opiate drugs continuously taken will lead to tolerance. No: tolerance is not addiction.

Question 170

Opiates: What is drug dependence? Name 5x physical symptoms of withdrawal Is dependence addiction?

Answer 170

Drug dependence is common in long-term opioid therapy; it is characterized by physical withdrawal syndrome on immediate cessation of the drug or the administration of an antagonist. Rapid withdrawal may lead to: 1. exacerbation of pain 2. shivering 3. nausea and vomiting 4. muscle spasms 5. host of unpleasant physical effects. No: dependence is not addiction.

Answer 171

True addiction implies the repetitive use of opioids to satisfy a psychic craving, a drug-centered lifestyle, and continued use despite physical and socioeconomic harm