Oncology and haematology

Question 1

Describe the difference between a benign tumour and a malignant tumour

Answer 1

Benign:
-grow slowly
-encapsulated, not invasive
-tissue resembles parent tissue
-remains localised, doesn’t metastasise

Malignant:
-grows rapidly
-irregular in shape and invades local structures and tissues
-tissue is poorly differentiated and does not resemble parent tissue
-if left untreated the malignant tumour is likely to spread to distant areas of the body (via the blood and lymph systems)

Question 2

What is a ‘well differentiated’ tumour equivalent to in grades

Answer 2

Grade 1
resembles parent cell, low grade

Question 3

What is a ‘moderately differentiated’ tumour equivalent to in grades

Answer 3

Grade 2
some similarities to parent cell

Question 4

What is a ‘poorly differentiated’ tumour equivalent to in grades

Answer 4

Grade 3
very immature, little resemblance to parent cell

Question 5

What is a ‘undifferentiated’ tumour equivalent to in grades

Answer 5

Grade 4
no resemblance to original tissue, high grade

Question 6

What does the T in the TNM classification system represent?

Answer 6

T= size of tumour
-1 being small
-4 being large

Question 7

What does the N in the TNM classification system represent?

Answer 7

N= whether the cancer has spread to the lymph nodes
-0 being no lymph nodes infected
-3 being lots of lymph nodes infected

Question 8

What does the M in the TNM classification system represent?

Answer 8

M= whether the cancer has spread to a different part of the body (metastatic)
-0 meaning cancer hasn’t spread
-1 meaning cancer has spread

Question 8

What does each stage of the cell cycle do?

Answer 8

-growth phase 1= growth, produces double organelles
-synthesis= DNA replication
-growth phase 2= protein synthesis
G0= resting

Question 9

How does a benign tumour develop into a malignant tumour?

Answer 9

-in normal tissues, the rate of new cell growth and old cell death are kept in balance
-in cancer, this balance is disrupted, resulting from uncontrolled cell growth or loss of cell’s ability to undergo apoptosis (programmed cell death)
-the tumour becomes malignant when the cells are no longer encapsulated and cell growth becomes rapid

Question 10

List some carcinogenetic agents that can cause DNA to mutate, but that can be prevented.

Answer 10

-tobacco
-diet
-obesity
-ultra violet radiation
-viruses
-bacteria

Question 11

List some carcinogenetic agents that can cause DNA to mutate, but are not so easy to change

Answer 11

-ionising radiation
-asbestos exposure
-inflammation
-birth weight
-parasites
-pollution
-industrial processes and chemicals
-cytotoxic agents
-sex hormones

Question 12

What is carcinogenesis?

Answer 12

the initiation of cancer formation

Question 13

What is angiogenesis?

Answer 13

The development of new blood vessels

Question 14

What is autonomy?

Answer 14

A cell that works independently from other cells (such as a cancer cell)

Question 15

What is a carcinogen?

Answer 15

A substance, organism, or agent capable of causing cancer

Question 16

What is carcinoma?

Answer 16

A type of cancer that starts in the skin or in tissues that line internal organs

Question 17

What is chemotherapy?

Answer 17

A treatment that kills cancer by stopping the DNA, RNA and protein synthesis, which prevents the uncontrolled cell division occurring
-this includes a mix of medications: alkylating agent, antimetabolite, cytotoxic agent, steroids, and anti-emetics

Question 18

What is differentiation?

Answer 18

When cells become specialised to carry out a specific function

Question 19

What is lymphoma?

Answer 19

A type of cancer that develops in the white blood cells of the lymphatic system which is part of the immune system

Question 20

What is metastases?

Answer 20

-Cancer cells spread from the primary site to distant cites
-common sites for the cancer to spread to are the liver, lungs, brain, adrenal, bone marrow

Question 21

What is neoplasm?

Answer 21

A new and abnormal growth of tissue in a part of the body especially as a characteristic of cancer

Question 22

What is proliferation?

Answer 22

An increase in the number of cells as a result of cell growth and cell division.

Question 23

What is sarcoma?

Answer 23

A tumour that arises in connective tissue

Question 24

What is a stem cell?

Answer 24

The basic cells that can reproduce and then develop into different types of specialist cells

Question 25

What is transformation?

Answer 25

-a process that involves inserting genes into an organism to alter its traits. -this is also known as genetic engineering

Question 26

What is a tumour marker?

Answer 26

Substances that might be raised if there is a cancer, usually proteins.

Question 27

What is a mutation?

Answer 27

a specific change in the gene, which can be random and cumulatively may contribute to the development of a cancer. A cancer needs 5-7 mutations in genes before it can develop

Question 28

What is a wilm’s tumour?

Answer 28

-a type of kidney tumour -composed of three cellular types: stromal, epithelial and blastemic -can either be sporadic or inherited

Question 28

What is leukaemia?

Answer 28

A type of blood cancer that affects blood cells in your bone marrow

Question 28

What are the 5 stages of a wilms tumour?

Answer 28

-stage 1=tumour limited to the kidney, removable via surgery -stage 2= tumour extends beyond kidney into the vessels in the renal sinus, removable via surgery -stage 3= residual tumour is only in abdomen -stage 4= metastases to lung, liver, brain, bone -stage 5= bilateral disease, each kidney needs to be staged

Question 29

How can leukaemia diagnosed?

Answer 29

by analysis of peripheral blood smears and bone marrow aspirations

Question 29

What are the 4 main types of leukaemia?

Answer 29

(ALL) Acute Lymphoblastic Leukaemia (AML) Acute Myelogenous Leukaemia (CLL) Chronic Lymphoblastic Leukaemia (CML) Chronic Myelogenous Leukaemia

Question 30

What are the major differences between acute and chronic leukaemia?

Answer 30

-acute are typically found more in children (ALL most common) -acute has an abrupt onset and more rapid progression -acute consists of less mature blast cells in the blood and bone -chronic more often in adults (CLL most common) -chronic has a subtle onset and progresses more slowly -chronic consist of more differentiated cancer cells

Question 31

What is sickle cell anaemia?

Answer 31

an autosomal recessive genetic condition caused by a mutation of mRNA

Question 32

How does sickle cell anaemia affect haemoglobin and the blood?

Answer 32

sickle haemoglobin doesn’t absorb as much oxygen therefore changes its shape, which can stick together and block blood vessels

Question 33

What is a sickle cell crisis?

Answer 33

-where parts of the body don’t receive enough blood supply, therefore they become painful -a sickle cell crisis can last longer then a few days depending on where it is, usually in joints and bones, but this can be very dangerous if in the chest

Question 34

What are the common triggers for a sickle cell crisis?

Answer 34

-dehydration -infection -stress -over exhaustion

Question 34

How is a sickle cell crisis managed?

Answer 34

-antibiotics and painkillers are used to manage sickle cell e.g penicillin and folic acid to prevent infection (spleen overworked and doesn’t fight infections well) -blood transfusions may also be conducted however there is risk of iron overload and antibodies against future blood transfusions

Question 35

What is intravascular haemolysis?

Answer 35

red blood cells are broken down much faster then normal due to a weakened cell membrane

Question 36

What is the composition of blood?

Answer 36

55% plasma -water -proteins -other solutes 45% formed elements -erythrocytes -haemogolobin -leucocytes

Question 37

What are the symptoms of anaemia?

Answer 37

-yellow eyes -pale, cold skin -shortness of breath -weak muscles -changed stool colour -fatigue, dizziness, fainting -low blood pressure -rapid heart rate

Question 38

What problems can people with sickle cell disease have that require immediate care?

Answer 38

1. Acute chest syndrome- caused by inflammation of small blood vessels in lung=chest pain, trouble breathing 2. aplastic crisis- body temporarily doesn't make enough RBC= severe anaemia, and infection 3. priapism- males with sickle cell disease can have painful long erections, if not treated quickly it can cause problems later on 4. stroke- sickle shaped cells can block small blood vessels in the brain causing a stroke

Question 39

What are the 3 types of sickle cell crisis?

Answer 39

-vaso-occlusive -acute sequestration -aplastic