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Lecture 5 Flashcards

1
Q

What are characteristics of normal cells?

A

Small, uniformly shaped nuclei
Large cytoplasmic volume
Conformity in cell size, shape, arrangement
Differentiated cell structures, normal cell surface markers
Lower levels of dividing cells
Clear boundaries

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2
Q

What are characteristics of cancer cells?

A

Large, variable shaped nuclei
Small cytoplasmic volume
Variation in size, shape, arrangement
Loss of specialized features
Increased expression of certain cell markers
Large number of dividing cells
Poorly defined tumor boundaries

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3
Q

How many deaths in the US are caused by cancer?

A

1 in 4

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4
Q

What is the second leading cause of death in the US? Whats the first?

A

Cancer

CVD (first leading cause)

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5
Q

What are the 4 most common cancers?

A

Lung
Colon
Breast
Prostate

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6
Q

What are the current treatment techniques for cancer?

A

Surgery
Radiation therapy
Chemotherapy
Biologic therapy

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7
Q

What ethnicity are cancers the most deadly for?

A

African Americans

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8
Q

What is the most significant risk factor for cancer?

A

Age

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9
Q

What are the burdens of cancer? (3)

A

Physical morality
Emotional distress
Reduction in QoL

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10
Q

What are some factors that makes a person susceptible to cancer?

A

Exposure to a certain environmental factor (how long and often)
Genetic makeup
Age and gender

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11
Q

Improved understanding of carcinogenesis has allowed for what?

A

Specific interventions
Effective screening

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12
Q

What do we concern with for cancer prevention?

A

Identification and manipulation of…
Biologic factors
Environmental factors
Social factors
Genetic factors

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13
Q

What is the focus of primary prevention?

A

Prevent a cancer from developing
Delay the development on a malignancy

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14
Q

If an individual has a high risk for cancer, what are the primary prevention methods?

A

Chemopreventative agents
Prophylactic surgery

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15
Q

What is the most preventable cause of cancer death?

A

Tobacco

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16
Q

How many cancer deaths are due to tobacco?

A

30%

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17
Q

What is the most linked cancer with smokers?

A

Lung cancer

> 80% of lung cancer cases

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18
Q

How can smokers harm other people?

A

Secondhand or passive smoke

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19
Q

Smoking 1 or 2 cigars increases what the risk of what cancers? What about 3 or 4 cigars?

A

1/2 cigars have 2x risk of oral and esophageal cancers
3/4 cigars have 8x risk of oral and esophageal cancers

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20
Q

What health problems are smokeless tobacco linked with?

A

Dental caries
Oral Leukoplakia
Gingivitis
Pancreatic cancer
Oral cancer
Esophageal cancer

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21
Q

What are some primary prevention methods?

A

Physical activity
Dietary modifications
Avoid alcohol

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22
Q

Physical activity reduces the risk of what cancers?

A

Colon and breast cancer

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23
Q

The risk of cancers increases with what BMI?

A

> 25

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24
Q

What cancers are linked to obesity?

A

Breast
Endometrium
Gallbladder
Liver
Pancreas
Ovary
Colon
Kidney
Esophagus
Thyroid

BEGLPOCKET

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25
High fat diets have an increased of what cancers?
Breast Colon Prostate Endometrium Weight gain which increase risk of cancers
26
What are the benefits of dietary fiber in relation to cancer?
Reduced risk of colonic polyps Invasive cancer of colon
27
Alcohol consumption increase the risk of what cancers?
Mouth Throat Liver Voice box Esophagus Stomach
28
What is secondary prevention?
Early detection and treatment
29
What are some screenings for secondary prevention?
Physical examinations Self-examinations Radiologic procedures Lab tests
30
What does screening mean?
Early detection in asymptomatic individuals with the goal of decreasing morbidity and mortality
31
What are the components of screening tests?
Sensitivity Specificity Positive predictive value Negative predictive value
32
What is sensitivity?
Proportion of persons with the disease who test positive in the screen
33
What is specificity?
Proportion of persons who do not have the disease that test negative in the screening test
34
What is a positive predictive value?
Proportion of persons who test positive that actually have the disease
35
What is a negative predictive value?
Proportion testing negative that do not have the disease
36
What cancers screenings are more beneficial for certain age groups?
Cervical Prostate Breast
37
When and what screening tools should be used to find breast cancer?
Starting at age of 40 for women CBE every 2 years 20-30s, every year start at 40 Breast self-exam(BSE) option for women in 20s MRI for women with higher risk(genetics, family hx)
38
When and what screening tools should be used to find colorectal cancer and polyps?
Both men and women at 45 Flexible sigmoidoscopy every 5 years Colonoscopy every 10 years Double-contrast barium enema every 5 years CT colonography (virtual colonoscopy) every 5 years Specifically for only cancer Yearly fecal occult blood test (gFOBT) Yearly fecal immunochemical test (FIT) every year Stool DNA test (sDNA)
39
When and what screening tools should be used to find cervical cancer?
Start at age 21 21-29 Pap test every 3 years 39-65 Pap test, HPV test (co-testing) every 5 years 65+ with normal results form regular testing should NOT be tested Hx of cervical pre-cancer continue testing for at least 20 years, no matter the age
40
What is "CAUTION" (warning signs of cancer)?
Change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in the breasts, testicles or elsewhere Indigestion or difficulty swallowing Obvious change in the size, color, shape or thickness of a wart, mole, or mouth sore Nagging cough or hoarseness
41
What other findings would you find to suspect cancer?
Night sweats Unexplained weight loss/loss of appetite Repeat infection Skin changes (hyperpigmentation, jaundice, erythema, itching, hirsutism) Persistent low-grade fever Chronic pain (bones) Persistant fatigue, N/V
42
What test is HEAVILY relied on for diagnosing cancer?
Invasive tissue biopsy
43
What does a tissue biopsy tell us?
Histology of tumor Grade of tumor Invasiveness/characteristics of tumor
44
What is staging? Purpose?
Determining the extent of disease For prognosis and treatment plan
45
What is monitoring?
Detecting reappearance and progression of cancer
46
What is the rate of depression in cancer pts?
25%
47
Depressed cancer patients are usually diagnosed with what?
Depressed mood(dysphoria) Loss of interest in pleasure(anhedonia) For at least two weeks
48
How many more symptoms do depressed pts? What are there?
Appetite change Sleep problems Psychomotor retardation/agitation Fatigue Feelings of guilt or worthlessness Inability to concentrate Suicidal ideation
49
What is the treatment for depression?
SSRI (fluoxetine, sertraline, paroxetine) TCA (amitriptyline, desipramine) Continued at least 6 more months after resolution
50
What non meditational interventions are used to treat depression?
Support groups Psychotherapy
51
What are the types of staging?
Clinical staging Pathologic staging
52
What tests do you run in clinical staging?
Physical exams Radiographs Isotopic scans CT scans Other imaging procedures
53
What information do you obtain to determine pathologic staging?
From surgical procedure... Intraoperative palpation Resection of regional lymph nodes or tissue adjacent to tumor Inspection/biopsy of organ involved
54
What terms are used to define the extend of disease?
Localized Regional Metastic
55
What system of staging is most used?
TNM system (Tumor, node, metastasis)
56
For lung cancer, after determining TNM system?
Overall stage 0, I, II, III, IV This process is called stage grouping.
57
What is a physiological reserve?
Determinant of how likely to cope with the physiologic stresses imposed by cancer and its treatment
58
What are some markers for physiological reserve?
Pt's age Karnofsky performance status Eastern cooperative oncology group (ECOG) performance status
59
What are treatment recommendations based on?
Extent of disease Prognosis Pt wishes
60
What are the types of treatment?
Curative Palliative
61
What is the difference between partial or complete remission?
In complete remission all signs and symptoms of cancer have disappeared
62
What are the treatment of a relapse known as?
"Salvage" therapy
63
What is the goal of palliative care?
Improve QoL NOT to cure
64
What are the tumor markers best used for?
Used to assess response to a treatment

ClinMed_I (15 decks)

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