Neoplasms... Dun Dun Dunnnnn Flashcards Preview

Pathophysiology > Neoplasms... Dun Dun Dunnnnn > Flashcards

Flashcards in Neoplasms... Dun Dun Dunnnnn Deck (111)
1

a growth that usually does not cause cancer or have the capability to cause

Benign

2

a growth that has the capability of causing cancer and

malignant

3

A malignant neoplasm

Cancer

4

any abnormal growth of new cells aka tumor
• Not all form tumor masses (leukemia)
• Can be benign or malignant

Neoplasm

5

a growth that can be benign or malignant
• Named after the cells from which they arise

Tumor

6

the study of neoplasms

Oncology

7

Number one cancer for females

Breast Cancer

8

Number one cancer for males

Prostate Cancer

9

Number one cancer that kills

Lung Cancer

10

7 Hallmarks of Cancer

1. Self-sufficiency of growth (“go”) signals
2. Evasion of growth suppression
3. Cells divide indefinably (unlimited reproduction
4. Avoid apoptosis (programmed cell death)
5. Recruit nutrients via growth of new blood supply (angiogenesis)
6. Invade nearby tissue and spread to distant tissue (malignant neoplasms only)
7. Evade immune surveillance

11

Cause of cancer

• Damage to DNA- root cause of all neoplasms

12

T/F- • Most of the time the link between disease and behavior or environment is not obvious

True

13

Environmental factors that stimulate cancer development

-Chemicals
-Dyes
-UV light
-Viruses
-Chronic Inflammation
-Smoked Food
-Genetically predisposed cancer

14

4 Categories of Mutant Genes

1. Proto-oncogenes
2. Tumor Suppressor Genes
3. Genes that regulate apoptosis
4. DNA repair genes

15

o The “go” genes
o RAS genes-control the transcription of genes that control cell growth and proliferation
o Overexpression and amplification of cell growth

Proto-oncogenes

16

Characteristics of Proto-Oncogenes

 RAS Attaches to a GTP to turn the cell growth on
 Off- destruction of GTP molecule

17

90% of this cancer are caused by RAS genes

Pancreatic Cancer

18

o The “stop” switches that restrain cell growth by producing proteins that inhibit cell dividing – stop to repair or destroy so the bad cell growth doesn’t continue
o If damage occurs here- the cells divide uncontrollably

Tumor Suppressor Genes

19

This is a mutant tumor suppressor gene that causes 50% or more of cancers

P53 gene

20

This gene encourages breast cancer

BRCA gene

21

Characteristics of the BRCA gene

-Can genetic test to see if you have this mutation
-• Not allow for repair of damage DNA
 If you have a mutation in the BRCA gene it doesn’t allow for the P53 gene

22

T/F- * Carcinogenesis is a multistep process- no single mutation is capable of causing a neoplasm- cancers arise from the accumulation of multiple mutations

True

23

Inheritable germ cell defects- increase risk of cancer to a certain degree but they do not guarantee it

• Inheritable cancer syndromes:

24

chaotic cell growth (reversible and so is metaplasia)
o When it becomes serious it is called carcinoma in situ

Dysplasia

25

o Confined to the epithelium- can’t reach blood vessels so it is not invasive

carcinoma in situ

26

What is the slowest process of malignancy?

The initial mutation to occur and develop

27

T/F- • Neoplasms grow by forming a clone

True

28

a tumor composed of multiple sets of cells that differ a little from all of the rest

Tumor Cell Heterogeneity

29

Describe survival of the fittest in neoplasm

o Highly malignant cells tend to survive and the less malignant cells die
o Tumors that find/have a blood supply are the most likely to survive
o Tumor cells have exponential growth

30

the fraction of dividing cells- determines the cell growth rate

Growth Fraction

31

What types of tumor are effected by chemotherapy

o Tumors with a high growth fraction are usually effected by chemotherapy (more sensitive to drugs that inhibit cell division)
-higher amounts of cells are dividing

32

How many generations does it take until the tumor is the size of a grape?

30

33

The degree to which the neoplasm resembles normal tissue in structure and function- degree of specialization

Degree of Differentiation

34

tissue is normal
o Benign cells

Perfectly differentiated

35

tissue shows some resemblance of normal tissue (appearance and function)
o Grow slowly and are slow to invade and late to metastases

Well differentiated

36

tissue show little to no resemblance of normalcy (appearance and function)
o Grow rapidly, invade aggressively, and metastasize early
o Lose function of that organ- and that can manifest to other symptoms
o Malignant cells are usually poor differentiated

Poorly differenced

37

Loss of differentiation

anaplasia

38

Lack of differentiation

Pleomorphism

39

Dark nuclei due to extra genetic information

Hyperchromatism

40

How are neoplasms nourished?

• Must have nourishment from the bloodstream
• Must develop their own network of blood vessels through angiogenesis

41

Characteristics of tumors with blood supplies

o Tumors with rich nourishment are more prone to metastasize because blood vessels are accessible for invasion
o Tumors need O2
o Cancers have a higher metabolic rate (why one of the biggest symptoms is weight loss)
o Any cell divisions increases the metabolic demand

42

the direct extension of a tumor into adjacent tissue
o Need lymphatic tissue and blood supply

Invasion

43

the discontinuous spread of tumor from one site to another and it is the most reliable sign of malignancy

Metastasis

44

What are the 3 types of metastases?

1. seeding
2. lymphatic spread
3. hematogenous spread

45

* Tumor cells float from point to point in body fluid
* Tumor implants to adjacent tissues

Seeding

46

This type of metastasis is seen in ovarian cancer and gastric carcinoma

Seeding

47

* Tumor cells invade lymphatic vessels and go into the lymphatic chain by the flow of lymph fluid
* Enlarged lymph nodes could present
* Increased filtration can result in splenomegaly- because it is trying to filter more

Lymphatic spread

48

* Occur as tumor cells invade blood vessels
* Veins are typically invaded easiest because the walls are thin
* Tumor cells follow natural venous flow

Hematogenous Spread

49

What 2 organs do metastases tend to travel to?

-Liver
-Lungs (both highly vascularized)

50

What are clinical signs of cancer

- Unintentional weight loss
- Fatigue
- Night sweats
- Chills
- Aches
- Anorexia (loss of appetite`)

51

When is it almost guaranteed that your patient has colon cancer?

if there is blood in the stool in a patient over 50 and they lost weight

52

causes headaches, loses peripheral vision, highly vascularized, brain tumors whether they are benign or malignant cause headaches

Pituitary adenoma

53

What are distant effects of cancer?

-Hyponatremia
-Hypercalcemia
-Hypo/Hyperglycemia
-High metabolic rate

54

What are procoagulant proteins?

o Cancers that can amplify procoagulent proteins- can increase your chances of clotting and could be cause of cancer and increases procoagulent proteins

55

What cancers have high procoagulant proteins?

Kidney and stomach cancer have a high rate of these

56

The immune system’s ability to recognize and attack non-self-invaders

Immune Surveillance

57

Clinical Manifestations of Cancer

• Pressure- due to the tumor expanding onto nearby tissue
• Infection of Bleeding- from ulceration or surfaces
• Infarction or Rupture
• Generalized wasting (cachexia)
• Production of hormones- effect different organs

58

What is neoplastic syndrome?

a set of systemic symptoms not due to local or metastatic spread of a tumor

59

What are examples of effects caused by neoplastic syndromes?

o Caused by hormones
o Mental aberration
o Hypercalcemia
o Hypoglycemia
o Thrombophlebitis

60

a progressive loss of weight accompanied by weakness, lethargy, fatigue, and anemia’

Cachexia

61

Characteristics of cachexia

o Causes fat and muscle loss
o Poor appetite and increased basal metabolic rate
o Wasting
o Can be given appetizing pills that make them want to eat

62

the study of individual cells for any abnormalities
o Ex. Pap Smear

Cytology

63

a thin needle is inserted and clusters of cells and fluid are aspirated and put onto a slide for reading
o Seen in thyroid nodules after
o A nodule bigger than an 1 cm

Fine Needle Aspiration

64

physically separating and sorting individual cells according to characteristics
o Leukemias and blood cancers
o Spin them down and separate them

Flow Cytometry

65

a collection of intact pieces of tissue to be examined
o Breast, prostate, lung, pancreatic
o Multiple samples of tissues themselves – looks at staging too

Biopsy

66

Bathing a biopsy specimen with antibody against specific tumor proteins to see if they attach to tumor cells- this indicates that tumor proteins are present

Immunohistochemistry

67

substances produced by normal or neoplastic tissue that may appear in the blood at increased levels in the presence of a neoplasm
o Can be very useful in early detection of cancers
o Useful in confirming the diagnosis

Tumor Markers

68

Carcinoembryonic Antigen (CEA)

Type of tumor marker
• Do not use for early detection but use for reoccurrence
• Specific to the colon- do other testing as well
• Rise in CEA levels could be a sign of reoccurrence

69

Alpha-fetoprotein

Type of tumor marker that is used for Liver cancer- it is elevated

70

CA 19

Type of tumor marker that is used for pancreatic cancer

71

Prostate Specific Antigen

• Used for prostate cancer screening- monitor the trend of the levels, not the actual levels
• Larger prostate = increased levels of PSA
• Look for spikes in trend- do some further testing

72

Pap Smears

• Taking a sample of cervix and look for cell differentiation

73

a mass that protrudes from an epithelial surface

Polyp

74

grows in a fern like pattern with prominent folds

Papilloma

75

hollow center

Cystic

76

Describe grading

the assessment of the degree of differentiation, nuclear atypical, mitotic figures, and gross structures
o Done under a microscope and looking for differentiation
o “How bad does the tumor look?”

77

Describe staging

- An evaluation of tumor behavior
o 1, 2, 3, 4
o 4- Metastasized
o 2 and 3- Lymph node involvement
o “What is the tumor doing”
 TNM system-
• T= size of the primary tumor
• N= extend of lymph node involvement
• M= metastasis beyond lymph nodes

78

Describe surgery

removal of the tumor
 Most common
 Are cancers that are too advanced that surgery is not an option

79

Describe radiofrequency ablation

destroy the tumor without removing it
• Inserting a probe that emits high frequency radio waves that heats the tissue to the point of necrosis

80

Describe cryotherapy

freezing a tumor until necrosis

81

Describe laser therapy

used to treat superficial cancers by burning the tumor away

82

Describe radiation therapy

damage DNA so that cell division stops
 Shrink cells or kill the floating ones

83

What is the most important thing ever in care of neoplasms

Early Detection: Make sure everything is is up to date with care

84

What is the early detection test for cervical cancer?

Pap smear

85

When should you get your first pap?

21 years old or 3 years after you first start having sex

86

How often do you get paps between the years of 21 and 30?

every year

87

How often do you need to get a pap when you are over 30?

Every 2 to 3 years- If you have a history of normal paps

88

If the patient has a hysterectomy (not because of cancer) do they need a pap?

Nopers

89

What is the early detection test for breast cancer?

Mammogram

90

When do you get your first mammogram?

Baseline at 35

91

If your baseline mammogram is normal how often do you go after that?

Annually starting at 40

92

If you have a family history of breast cancer when do you get your first mammogram?

Earlier than 35

93

T/F- Mammograms are compared year to year?

TRUE DUHH

94

What is the preventative test for colorectal cancer?

Colonoscopy

95

What is the point/goal of a colonoscopy

get in there and look for polyps (pre malignant neoplasms)- remove the polyp the pre malignant polyp

96

Is colorectal cancer preventative if it is caught in a colonoscopy?

Yeahhhh mannn

97

When is a colonoscopy first needed?

Age 50

98

If your colonoscopy is normal at age 50, what happens then?

Repeat in 10 years- after 3 years you are done

99

What if you have a family history of colorectal cancer?

They will screen 10 years earlier

100

Is a sigmoidostomy sufficient enough?

NOPEEEERRRSSS

101

What is the preventative screening test for prostate cancer?

PSA levels (prostate specific antigen)

102

When do you start monitoring your PSA levels?

At 50

103

What do you watch with PSA levels?

The trend of the levels

104

If there is blood in a patients stool, what is that indicative of?

Colorectal Cancer

105

Who is at the highest risk for lung cancer

Smokers

106

Is a chest x ray sufficient for lung cancer screening?

No- it can mill a lot and you probably wont be able to see something small

107

What is a better testing alternative for lung cancer?

Low residue CAT scan

108

When should a low residue CAT be ordered?

If the patient is over 50 and they have a 30 pack/year smoking history

109

Describe pack/year measurements

number of years you have smoked*how many packs a day you smoke

110

How does a CAT scan work

It takes small pictures of your lungs to see if there are any nodules

111

T/F- CAT scan screening shows up with enlarged perihylar lymph nodes with a lung lesion- it will be malignant process not to be ignored

True