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Pathophysiology > Exam 1: Ch 7 > Flashcards

Exam 1: Ch 7 Flashcards

(90 cards)

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1
Q

2nd leading cause of death in US

A

all cancers lumped together

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2
Q

leading cause of death for children 3-15 YOA

A

cancer

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3
Q

what is the 5-year survival rate of cancer

A

64%

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4
Q

prevalence vs incidence

A

prevalence: how many have the disease
incidence: how many new cases (stable overall now)

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5
Q

is cancer a single disease?

A

no

some organs are much more likely to produce cancer

some cancers are much more deadly

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6
Q

cancers that are readily cured

A

Hodgkin’s disease
`
testicular

acute lymphoblastic leukemia

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7
Q

cancers with low 5-year survival rates

A

small cell lung cancer

pancreatic

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8
Q

high incidence, low death rates

A

prostate, breast

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9
Q

lower incidence, high death rates

A

lung and bronchus

pancreatic

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10
Q

neoplasm

A

new growth, synonymous with tumor

benign or malignant

benign have well differentiated cells, malignant less so

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11
Q

tumor name identifies….

A

tissue of origin

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12
Q

benign tumor add ___ to the end

A

oma

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13
Q

fibroma, adenoma, hemagioma, papilloma

A

fibroma: benign fibrous tumor
adenoma: benign glandular
hemagioma: benign blood vessel tumor
papilloma: benign projections from any surface

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14
Q

carcinoma, sarcoma, adenocarcinoma, hemangiosarcoma,

A

carcinoma: malignant epithelial tumor
sarcoma: malignant mesenchymal
adenocarcinoma: malignant glandular
hemangiosarcoma: malignant blood vessel tumor

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15
Q

polyp

A

growth projecting from mucosa

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16
Q

cancer in situ

A

localized malignant tumor that hasn’t broken through the basement membrane

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17
Q

benign tumor characteristics

A

well differentiated cells

slow growth, no mets

well defined edges

unlikely to be lethal

may compress vital structures –brain

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18
Q

malignant tumor characteristsics

A

grow fast

anaplasia – undifferentiated

attract blood vessels

spread widely

lethal

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19
Q

2 major types of malignant tumor

A

solid: start in 1 organ, spread through blood/lymph
hematological: cancers of blood-forming cells, begin disseminated

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20
Q

lack of differentiation makes cancer cells look _____

A

abnormal

cells and nuclei of various shape

nuclei contain extra DNA and stain very dark

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21
Q

cancer cells are graded on the basis of…

A

degree of anaplasia

the more abnormal, the more dangerous

grade 1: fairly well differentiated

grade 4: high degree of anaplasia

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22
Q

genetic instability

A

large scale chromosome abnormalities

important to know genetic makeup of individual and the cancer

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23
Q

cancer cells divide ____, live ____, and ____ together

A

rapidly, long, crowd

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24
Q

how to cancer cells escape apoptosis

A

they have their own telomerase so they’re immortal

proliferate without proper signals

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25
3 things cancer cells have a loss of
density inhibition: cells can pile up cohesion: cells no longer stick together anchorage dependence: can live detached
26
tumor specific antigens (TSAs)
cancer cells express abnormal surface antigens can target mets to particular tissues may be useful as markers in treatment
27
some cancers express...
hormones and clotting factors paraneoplastic syndrome
28
determinants of tissue growth rate
of cells going through cell cycle duration of cell cycle of cells dying
29
why do cancer cells grow fast
avoid apoptosis almost all tumor cells are cycling (no G0)
30
malignant tumors have a high.. and a short...
high growth fraction (fraction of total cells in cell cycle) short doubling time (time for a tumor to double in size)
31
if a tumor has no blood supply..
they don't get very big epithelial tissue is avascular
32
invasion of nearby tissue
bordering tissues or seeding of a body cavity requires secretion of proteases to break through basement membrane seeding can occur during surgery
33
metastasis
development of secondary tumors at distant sites through lymph or blood
34
lymphatic metastasis
sentinel node mapping checks nodes that drain area of the tumor
35
mets through blood
metalloprotease enzymes break down collagen brain receives high blood flow and lots of mets lungs receive entire CO, common site of mets
36
tumors from the abd cavity spread to ___ via blood
liver
37
some tumors bind to sites in specific ___
tissues prostate cancer --> bone
38
how do cancer cells evade the immune system
stop secreting TSAs aggregate as emboli kill immune cells
39
angiogenesis
tumor cells attract blood vessels allows tumors to grow
40
proto oncogene
normal stimulate cell division normally turn into oncogene (cause cancer)
41
examples of tumor suppressor gene inactivation
RB -- retinoblastoma BRCA 1 p53
42
examples of oncogenes
RAS RAF HER-2 (breast)
43
oncogene formation
point mutations, insertions, deletions translocations can create fusion proteins that are always active amplification can lead to over expression of genes
44
loss of tumor suppressor activity
requires either an inherited mutation plus 1 hit OR 2 hits
45
p53 gene product
monitors cells for genetic mutations arrests cell cycle with mutation present so repair or apoptosis can occur abnormal in 50% of all cancers
46
epigenetic mechanisms
methylation of promotor region can silence tumor suppressor genes
47
3 steps of tumor cell transformation
initiation: cell exposed to carcinogen --> irreversible changes (multiple small doses cause damage) promotion: growth becomes unregulated progression: tumor cells become fully malignant
48
cancer cells can be familial
BRCA 1 & 2 are TS genes... mutation increases breast cancer risk 40% of retinoblastoma is autosomal dom. Rb gene mutation familial adenomatous polyposis autosomal dom
49
hormones may drive cancers of the ...
breast, ovary, endometrium, and prostate
50
obesity contribution to cancer
adipose produces androgens and estrogens, which increases breast cancer risk higher insulin and IGF1 stimulates cell division
51
NK cell
general cancer killer
52
macrophages
take up TSA's and activate T helper cells, which activate B cells to release antibodies that attack cancer cells
53
cytotoxic t cells
kill cancer cells directly
54
immune system kills most ___ cells
cancer failure results in cancer to succeed immune suppression leads to cancer, aids and Kaposi's sarcoma
55
chemical carcinogens may cause up to ___% of cancers
30 many associated w/ lifestyle choices
56
direct vs indirect chemical carcinogen
direct: cause cancer without chemical change in the body indirect: require chemical alteration in the body
57
polycyclic hydrocarbons
produced with tobacco burns and meat is charbroiled
58
EtOH causes what kinds of cancer
oral and esophageal
59
radiation causing cancer
impact depends on dose, age, sex long latency period for leukemia, thyroid and skin cancer intense sun exposure in childhood most dangerous therapeutic radiation also a risk
60
oncogene viruses
HPV permanently changes genes of cervix Epstein-Barr virus --> lymphomas and nasopharyn cancer Hep B --> liver cancer
61
cancer disrupts tissues
local/regional or direct effects (extreme pain) erodes or compresses blood vessels, nerves, lymph vessels destroys bone and marrow obstructs lumens causes effusions
62
cancer cachexia and anorexia
many cancers cause anorexia (loss of appetite) and cachexia (wasting away) weight loss could be an early symptom makes prognoses more negative by increasing toxicity and side effects of chemo
63
cytokines may play a role in
TNF, IL-1 & 6 impact satiety center to decrease appetite cause fever to increase calorie use
64
anemia
result from treatment as well as disease poor quality of life and poor outcome from blood loss, hemolysis, or impaired hematogenesis decreases tolerance of treatment
65
paraneoplastic syndrome
cancer cells can produce hormones ADH (hyponatremia) ACTH (Cushing's syndrome) PTH (hypercalcemia) GH (acromegaly)
66
coagulation factors
cancer cells can produce
67
cancer cells can produce ___ that trigger an _____ response
antigens, autoimmune causes muscle weakness
68
eaton-lambert syndrome
small cell lung cancer autoimmune production of antibodies to motor end plate structures type of paraneoplastic syndrome
69
cancer screening
observation palpation (breast, thyroid, prostate, lymph nodes) xrays: mammography
70
observation of epithelial cells
pap smear: examination of epithelial cells of cervix on a microscope slide
71
tumor markers
antigens may be produced/overproduced by tumors, but not in early stages PSA: prostate cancer CA125: ovarian cancer alpha-fetal protein (AFP): liver cancer carinoembryonic antigen (CEA): colorectal/GI cancer
72
biopsy and types
tissue removal for testing needle: palpable tumors and those IDed by xray endoscopy: lumen excisional: remove entire tumor
73
immunohistochemistry
antibodies used to find cancer cells
74
microarray technologies
screen genome for cancer risk alleles allows for tumor testing
75
gleason score
level of anaplasia in prostate biopsy
76
staging
assess spread of tumor TNM system
77
TNM system
T: elements of stage & grade N: are lymph nodes positive? M: presence of metastasis
78
radiation therapy
primary treatment for some cancers palliative, decreases size of cancers pre or post op some cancers more sensitive to radiation than others
79
radiation mechanism and modes of delivery
DNA damage causes apoptosis external beam: linear accelerator brachytherapy: inserted sealed source injected: I-131 for thyroid cancer
80
adverse effects of radiation therapy
injures or kills normal cells GI effects: diarrhea N/V bone marrow suppression skin burns and hair loss
81
chemotherapy
can potentially reach all tumors and mets cancer cells killed exponentially (fixed fraction die with each dose) more effective against high growth factor tumors can be a primary form of treatment
82
chemo drugs can be classified by ____
stage S-phase specific: methotrexate blocks DNA synthesis
83
phase non-specific chemo
alkylating agents damage resting DNA
84
adverse rxns to chemo
bone marrow suppression vomiting and diarrhea fatigue and hair loss drugs themselves are carcinogenic and teratogenic
85
nadir
time point of max toxicity
86
hormonal therapy
useful when tumors express hormone receptors removal of gonads in sex hormone responsive cancers aromatase inhibitors block androgen (estrogen in peripheral tissue -- breast cancer) hormone receptor blocker tamoxifin
87
immune therapy
active: give antigen passive: give monoclonal antibody or other immune activators adoptive: give activated immune cells
88
targeted therapy
monoclonal antibodies against cancer antigens angiogenesis inhibitors specific drugs to block action of chimeric cancer proteins (Gleevec for CML)
89
Downs may inc risk for which cancer
acute lymphoblastic leukemia
90
childhood cancers
many have good prognosis survivors may have chronic health problems from radiation/chemo increased risk for 2nd malignancy

Pathophysiology (24 decks)

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