Exam 3: Cellular Function (Cancer) Flashcards Preview

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Flashcards in Exam 3: Cellular Function (Cancer) Deck (93):
1

Incidence and death rates of cancer higher in what population? (2)

Higher in males than females
Higher in black people

2

Cancer with the highest incidence for women

Cancer with the highest death rate for women

Highest incidence = breast cancer

Highest death rate = lung cancer

3

Cancer with the highest incidence for men

Cancer with the highest death rate for men

Highest incidence = prostate cancer

Highest death rate = lung cancer

4

Another term for cancer

"Malignant neoplasms"

5

Metastasis definition

Cancer cells infiltrate lymph and blood vessels, which carry the mutant cells to other parts of the body.

6

Surface epithelial tumor:
Benign
Malignant

Benign: Papiloma
Malignant: Squamous Cell Cancer

7

Glandular epithelial cell tumor:
Benign
Malignant

Benign: Adenoma
Malignant Adenocarcinoma

8

Fibrous tumor:
Benign
Malignant

Benign: Fibroma
Malignant: Fibrosarcoma

9

Adipose tumor:
Benign
Malignant

Benign:Lipoma
Malignant: Liposarcoma

10

Cartilage tumor:
Benign
Malignant

Benign: Chondroma
Malignant Chondrosarcoma

11

Bone tumor:
Benign
Malignant

Benign: Osteoma
Malignant Ostemosarcoma

12

Blood vessel tumor:
Benign
Malignant

Benign: Hemagioma
Malignant: Hemagiosarcoma

13

Lymph Vessel tumor:
Benign
Malignant

Benign: Lymphangioma
Malignant Lymphangiosarcoma

14

Lymph tissue tumor
Benign
Malignant

Benign -----
Malignant: Lymphosarcoma

15

Nerve cell tumor:
Benign
Malignant

Benign: Neuroma
Malignant: Neuroblastoma

16

Glial tissue tumor:
Benign
Malignant

Benign: Glioma
Malignant: Glioblastoma

17

Tumor shape:
Benign
Malignant

Benign: Regular shape, cells are well-differentiated
Malignant: Irregular shape

18

Tumor spread to adjacent tissues:
Benign
Malignant

Benign: Non-invasive: Does not invade surrounding tissue
Malignant: Invasive: Invades surrounding tissue.

19

Tumor metastasis:
Benign
Malignant

Benign: Localized
Malignant: Metastasizes to distant sites

20

Tumor encapsulation:
Benign
Malignant

Benign: Encapsulated (usually by fibrous capsule)
Malignant: Not encapsulated

21

Tumor potential for growth:
Benign
Malignant

Benign: Decreased potential for growth
Malignant: Increased potential for growth

22

Tumor recurrence after surgical excision:
Benign
Malignant

Benign: Decreased recurrence
Malignant: Increased recurrence

23

Tumor as the cause of death:
Benign
Malignant

Benign: Doesn't usually cause death unless location interferes with vital function
Malignant: Usually causes death unless growth can be controlled

24

Three mechanisms of cancer spread:

1) Metastasis
2) Invasion
3) Seed

25

4 Risk categories for cancer

1) Environmental
2) Genetic / familial
3) Hormonal agents
4) Age

26

___% of cancer cases are idiopathic

40%

27

25% of all cancer deaths...

are associated with ONE chemical in cigarettes!

28

Two genes that increase the risk of ovarian cancer

Broncho1
Broncho2

29

What family history should you take when looking at cancer

Immediate relatives (parents, siblings)

30

Three factors that correlate with a higher incidence of breast cancer

• Early onset menses
• Late menopause
• Have never given birth

31

Recommended fruit and vegetable intake

5-9 per day

32

Standard guidelines to detect/screen BREAST CANCER (2)

- Mammogram q 2 years
- Clinical breast exam:
q 4 years 20-39
q 1 year age 40+

33

Standard guidelines to detect/screen COLON AND RECTAL CANCER (2)

If 50 years or older:
Yearly fecal occult blood test and one of the following:
- Sigmoidoscopy every 5 years OR
- Colonoscopy every 10 years

34

Standard guidelines to detect/screen PROSTATE CANCER (2)

- Yearly digital rectal exam
- PSA as needed

35

Standard guidelines to detect/screen CERVICAL CANCER

- Yearly GYN exam
- PAP test yearly 21+ (earlier if sexually active) -- q 3 years after 3 or more negative PAPs

36

Five general cancer symptoms (Greenfield)

- Unexplained weight loss
- Unexplained fever
- Fatigue
- Pain
- Skin clues

37

Seven common cancer symptoms (American Cancer Society)

1) Change in bowel / bladder function
2) Sores that do not heal
3) Unusual bleeding or discharge
4) Thickening, lump
5) Indigestion or difficulty swallowing
6) Recent change or difficulty swallowing
7) Nagging cough or hoarseness

38

How do tumor markers work?

The higher the number, the greater the likelihood of cancer -- not definitive. Often used to determine treatment efficacy

39

Tumor markers:
- Prostate

PSA

40

Tumor markers:
- Ca 125

Ovarian cancer

41

Tumor markers:
- Ca 15-3

Breast cancer

42

Tumor markers:
- Ca 19-9

Pancreas, liver

43

Tumor markers:
- Alpha-fetoprotein

Hepatic, testicular

44

Computed Tomography: Mechanism

Very narrow beam of x-ray in successive layers

45

What test would be given before an MRI? Why?

CT Scan, shorter duration

46

What does nuclear medicine imaging look at? (3)

Looks at oxygen uptake, glucose transport, blood flow

47

What color would a Nuclear Medicine Imaging be?
- If cancerous:
- If non-cancerous

• Cancerous: Areas of high metabolic rates → GLOW RED
• Non-cancerous: Non-malignant will glow blue, green

48

What test helps observe if a tumor is shrinking?

PET scan

49

Two cytology tests

- PAP smear
- Sputum sample

50

What is a biopsy?

Physically removing a piece of tissue

51

What is the most definitive way to diagnose cancer?

Biopsy

52

What should you do before treating a tumor?

Diagnostic surgery ie biopsy

53

Purpose of staging a tumor

Determines the size of tumor and metastasis

54

Three classifications when staging

T: Primary tumor
N: Lymph node involvement
M: Metastasis is present

55

Purpose of grading a tumor

Classification that predicts the prognosis

56

Four classifications of grading

o I: Small, no metastasis
o II: Large, without lymph spread
o III: Larger cancer with lymph node involvement
o IV: Aggressive and less responsive to treatment

57

What type of surgery is the gold standard?

LOCAL EXCISION

58

What type of surgery is not really done anymore?

Wide or radical treatment, where large portions of the muscle or other tissue are removed.

59

Another term for palliative surgery

Debulking

60

Patients who have _____ prior to surgery are at greater risk for complications post-op

Chemotherapy and/or
Radiation

61

Three cancer surgery complications

• Infection, wound healing
• Pulmonary or renal issues
• DVT

62

What are the benefits of intra-op radiation? (4)

o Lower dose
o Less toxicity
o Precisely target radiation
o No localized tissue problems

63

What is pancytopenia?

Decreased WBC, RBC and platelets.

64

Radiation toxicity: Digestive ADEs (7)

- NVD
- Stomatitis
- Loss of taste
- Dry mouth
- Decreased salivation
- Trouble swallowing
- Reflux

65

Where are needles / seeds / beads used?

Interstitial compartments, such as breast, prostate

66

Benefit of needles / seeds / beads

Less likely to become dislodged

67

First two weeks of needles / seeds / beads

Can't be around children or pregnant women

68

What is chemotherapy?

Antineoplastic agents

69

Mechanism of chemotherapy
(6 categories)

- Can be cell-cycle specific
- Can be phase specific
- Alkalating agents
- Antimetabolites
- Antitumor
- ABX
- Hormonal agents

70

What do cell-cycle specific cancer drugs do?

Destroy cells that are actively reproducing

71

What portion of the cell cycle does phase specific chemotherapy target?

S-PHASE: DNA synthesis

72

Three common side-effects of chemo

- Alopecia
- Stomatitis
- Bone marrow suppression

73

What does "Dose-limiting" mean

More doses increases effects

74

Six dose-limiting side-effects of chemo

o Hepatotoxicity
o Pneumonitis
o Hemorrhagic cystitis: Affects bladder
o Tubular necrosis: Renal failure
o Cardiotoxicity, pericarditis
o Cumulative: Neurotoxicity, numbness, tingling, “chemo-brain” – Can last about a year after treatment

75

What is a "vesicant"?

Blister agent

76

Name an estrogen receptor blocker

Tamoxafin

77

When is Herceptin given?

If tumor is positive for HER2/nue receptors

78

Another term for Bone Marrow Transplatn

HEmatopoitic Stem cell transplant

79

Bone marrow transplant is indicated for ______

Bone cancers

80

Three sources of bone marrow transplant -- which is the most common?

1) Allogenic ** Most common
2) Autologous
3) Synergic

81

What does allogenic mean?

Transplant from a selected donor

82

What does autologous mean?

Transplant from self

83

What does synergic mean?

Transplant from identical twin

84

Before receiving an allogenic transplant, a patient will receive (2):

1) Ablative chemo
2) Possibly a total body radiation

85

After receiving ablative chemo / radiation before a bone marrow transplant, patient is at higher risk for (3)

• Infection
• Respiratory issues
• Bleeding

86

What is happening with graft-versus-host disease?

The donor t-lymphocytes can recognize the recipient as "foreign and attack the recipient

87

What is the most critical time for Graft-versus-Host disease?

First 100 days

88

Is Graft-versus-host disease acute or chronic?

Can be either

89

Prophylactic immunosuppressant drugs for graft-versus-host disease (2)

- Immuran
- High dose steroids

90

How is a patient prepared for an autologous bone marrow transplant? (3)

1) Patient's marrow is harvested, preserved and treated for chemo
2) After harvest, patient is treated with chemo and possibly full-body radiation
3) Patient's own marrow is infused, must undergo engraftment

91

Benefit of stem cell transplatn

Engraftment occurs faster

92

What type of nursing care is used in a stem cell transplant?

REVERSE ISOLATION -- isolation to protect the patient from the healthcare team's germs, not the other way around

93

What does a patient receive before receiving a stem cell transplant?

Chemo
Hematopoitic growth factors