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PATHOPHYSIOLOGY > U1B > Flashcards

U1B Flashcards

1
Q

ABRASION

A

Abrasion An injury caused by rubbing or scraping that results in the loss of the superficial layer of skin or epidermis and or dermis

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2
Q

ANGIOGENESIS

A

Angiogenesis The process of forming new blood vessels. Occurs in the granulation phase of healing in wound repair.

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3
Q

AVULSION

A

Avulsion a wound that results from tissue being torn away in a large piece; requires healing by secondary intention.

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4
Q

CELLULITIS

A

Cellulitis Inflammation or infection of the cells in tissues characterized by redness, pain, heat and edema.

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5
Q

DEBRIDEMENT

A

Debridement The removal of devitalized or dead tissue and foreign material from the wound bed. A wound should be clear of dead or devitalized tissue to support healing and reduce the risk of infection. There are many ways to debride a wound.

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6
Q

DEHISCENCE

A

Dehiscence The splitting open of a surgical wound (a wound that had been sutured closed).

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7
Q

ERYTHEMA

A

Erythema redness of the skin. Caused by vasodilatation related to inflammation, infection or injury.

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8
Q

EXUDATE

A

Exudate Fluid that comes from wounds. Can be clear (serous), sanguineous (bloody) or purulent (pus).

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9
Q

GRANULATION TISSUE

A

Granulation Tissue forms in the wound base which fills in wounds with scar tissue as healing with secondary intention. The tissue is red or pink and has a lumpy appearance like small grapes. This tissue is necessary to fill in wounds so that they can heal.

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10
Q

ISCHEMIA

A

Ischemia a deficiency of blood supply to an area.

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11
Q

LACERATION

A

Laceration a wound that is produced by the tearing or cutting of the skin.

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12
Q

MASCERATION

A

Maceration A softening and whitish look to the intact skin. around wounds caused by excessive moisture. Often occurs when exudate is not well managed by dressings.

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13
Q

NECROTIC TISSUE

A

Necrotic Tissue dead tissue that usually presents as black or brown and is hard or leathery in texture.

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14
Q

PURULENT

A

Purulent Containing or forming pus.

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15
Q

3 FORMS OF HEALING BY INTENTION

A

Primary: Wound margins are brought together by any means (sutures, steri-strips, glue, Band-Aid, etc.) and heals with minimal scaring.
Secondary: Missing tissue requires margins to contract, and then fills-in, resulting in a large scar. Cannot be sutured closed because too much tissue is missing.
Tertiary: Wound Margins are intentionally left open (to allow infection to drain out of the wound), then brought together (and closed with stitches) after granulation tissue appears.

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16
Q

ANGIOGENESIS

A

the development of new blood vessels

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17
Q

SLOUGH

A

pus, snot like substance on a wound. It is bad.

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18
Q

ESCHAR

A

black, leathery necrotic cells that impede blood flow on a wound.

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19
Q

DIFFERENTIATION

A

Tumors lose differentiation features over time as they multiply and become more “malignant”. The more these fast growing cells multiply, the less differentiated they become. Poor cellular differentiation increases the growth rate. A tumor neoplasm that is well differentiated (retains most of the cellular characteristics of the tissue it is from) is more likely to be benign. Whereas, a poorly differentiated tumor is more likely to be malignant. As a cell becomes malignant it loses the characteristics that made it a unique type of cell, and it no longer functions as normal tissue.

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20
Q

CONTACT INHIBITION

A

Contact inhibition: (density-dependent inhibition) the cessation of growth after a cell comes in contact with another cell—blocking the synthesis of DNA, RNA and protein. As the cell membranes come in contact with each other, they stop reproducing. Not so with cancer cells; they tend to grow rampantly despite coming into contact with other tissue.

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21
Q

COHESIVENESS

A

Cohesiveness: Normal cell walls help support each other by sticking together when they come in contact with each other. Malignant cells lack this cohesiveness. That is why they spread easily to other parts of the body – Cancer cells are fragile since they lack cohesiveness and do not have cellular support from the other cells. Least little bump or contact can cause the cancer cells to shed and spread.

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22
Q

ANCHORAGE INDEPENDENCE

A

Anchorage Independence: Normal cells must be “anchored” to a membrane or matrix of some kind to grow (except blood cells). Cancer cells can move freely (and therefore metastasize).

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23
Q

FACULTY CELL-TO-CELL COMMUNICATION

A

Faulty Cell-to-Cell communication: The chemical messengers bind to specific cell surface receptors and serve to control cell growth and modify cell behavior. The impaired communication may interfere with the formation of intercellular connections and responsiveness of membrane derived signals; so the cancer cell does not get the message to stop growing.

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24
Q

ANTIGENS

A

Antigens: Cancer cells express a number of cell surface molecules or antigens that are immunologically identified as foreign. These tissue antigens are coded by the genes of a cell. Tumor antigens may be used clinically as markers to indicate the presence or progressive growth of a cancer.

25
Q

ENZYMES

A

Enzymes: most cancers synthesize and secrete enzymes (Proteases and glycosidase) that break down proteins involved in insuring intracellular organization and cell to cell cohesion. These enzymes may contribute to the breakdown of intercellular matrix.

26
Q

METHODS OF METASTASIS

DIRECT EXTENSION

A

tumor cells spreads to tissues adjacent to the primary tumor.

27
Q

METHODS OF METASTASIS

SEEDING

A

tumor cells are shed from primary tumor and develop into more tumors (example – during surgery to remove a tumor, some tumor cells remain in the tissue after the main tumor is removed and provide the “seed” for more tumor cells to grow).

28
Q

METHODS MESTASIS

CIRCULATION

A

a secondary tumor develops in a site distant from the primary tumor.

29
Q

PROCESS OF TUMOR METASTASIS

ATTACHMENT

A

tumor cell attaches to basement membrane of tissue affected

30
Q

PROCESS OF TUMOR METASTASIS

DISSOLUTION

A

tumor cell secretes substances to break down cell membrane

31
Q

PROCESS OF TUMOR METASTASIS

LOCOMOTION

A

tumor cell moves (using “pseudopods”) into tissue

32
Q

ANEMIA

BLOOD DYSCRASIA

A

(Low red blood cell count) caused by bleeding, malnutrition, cancer treatments (especially radiation therapy). Tumor may ulcerate or erode blood vessels → bleeding. Causes a decreased delivery of oxygen to tissues and leads to patient fatigue and s/s of low oxygen (short of breath, “sighing”, etc).

33
Q

LEUKOPENIA

BLOOD DYSCRASIA

A

(Low white blood cell count) caused by bone cancers or cancer treatments. Low WBC’s means cancer patients are prone to infections.

34
Q

THROMBOCYTOPENIA

BLOOD DYSCRASIA

A

(Low platelet count) from bone cancers or cancer treatments. Thrombocytopenia causes bleeding disorders which in turn leads to anemia.

35
Q

CACHEXIA

A

“Wasting” syndrome related to malnutrition and increased BMR (basal metabolic rate) caused by growing tumors. An ongoing loss of skeletal muscle mass that cannot be fully reversed by nutrition. Loss of skeletal muscle leads ultimately to loss of body function. Multifactorial causes including fatigue, stress, anorexia, and rapidly growing tumor “stealing nutrition” from the body. Causes and Contributing factors are:

Tumors: Increase the patient’s basal metabolic rate (more calories are needed to maintain muscle mass).

Chemotherapy: Taste buds are destroyed by chemo so patients are not motivated to eat sufficient amounts of food. ALSO, Chemo causes severe nausea and vomiting (CINV = “Chemotherapy Induced Nausea and Vomiting) → so patients do not feel like eating anything because it makes them vomit more.

Immunosuppressed: Allows overgrowth of opportunistic pathogens such as oral yeast that causes mouth sores (Mucositis or stomatitis). Patients will not eat because it is too painful.

36
Q

CANCER SIGNS AND SYMPTOMS

A 
FATIGUE
PAIN
BLOOD DYSCRASIAS
INFECTION
CACHEXIA
37
Q

CANCER TREAMTENT GOALS

CURATIVE

A

Cancer will be eliminated from the individual. Treatment is intended to bring about a complete cure of the cancer. Example: Surgery to remove a localized breast lesion (lump)

38
Q

CANCER TREAMTENT GOALS

ADJUVANT OR CONTROL

A

Treatment that is given in addition to the primary treatment to make sure the cancer is eradicated. Example - radiation or chemotherapy is commonly given as an “adjuvant“ treatment after surgery to kill any cancer cells that may have been missed.

39
Q

CANCER TREAMTENT GOALS

PALLATIVE

A

Treatment given ONLY to relieve cancer symptoms and reduce the suffering caused by cancer – not curative. Treatment is designed to provide comfort to the individual with terminal cancer (life expectancy

40
Q

CHEMOTHERAPY TX

A

Chemotherapy Tx: is not selective in the cells it kills. Chemo drugs kill ALL FAST GROWING cells whether they are cancerous or not. This targets tumors because they are composed of fast growing cells. Unfortunately, other normal fast growing cells in the body are also damaged. This includes the GI tract, Bone Marrow, and hair follicles. There are many different classifications of chemotherapy drugs based on the drugs’ mechanism of action. Commonly, more than one chemo drug is used in adjuvant therapy. Once one drug reaches toxic levels, another chemo drug is given in its place.

41
Q

ADVERSE RX OF CHEMOTHERAPY

A

GI Tract: The lining of the GI tract consists of fast growing cells; therefore, the entire GI tract is damaged by chemotherapy. Severe nausea/vomiting (CINV); Mucositis/stomatitis; diarrhea or constipation (obstructions can cause death)
BONE MARROW SUPPRESSION – Since the bone marrow contains fast-growing blood cells, Chemo can result in reduction of ALL blood components – RBC, WBC, and platelets.
Secondary malignancies can be caused by the caustic chemotherapy agents used to treat the primary tumor.
Alopecia: Hair loss because hair follicles are fast growing cells. Interestingly, both men and women report hair loss as one of the side effects they fear most after being diagnosed with cancer.
Mucositis

42
Q

Mucositis

A

Chemotherapy-induced mucositis is a common complication of chemotherapy.
It begins 5-10 days after the initiation of chemotherapy and lasts 7-14 days.
Causes the mucosal lining of the mouth to atrophy and break down forming ulcers.
Ulcers may act as a site for local infection and a portal of entry for oral flora that may increase the risk of developing septicemia.
Contributes to: Pain, Malnutrition, Cachexia, and Infection. (As well as fatigue due to not eating).

43
Q

RADIOTHERAPY TX

AKA RADIATION

A

Radiotherapy (Radiation) Tx: Ionizing radiation may be used externally or internally (implants). Most effective for rapidly growing, poorly differentiated tumor cells. Radiation is often used in conjunction with chemotherapy and/or surgery as an adjuvant therapy. Can be used palliatively to reduce the size of a tumor and provide comfort even if the cancer is terminal.

44
Q

ADVERSE RX OF RADIOTHERAPY

A

Skin burns where radiation is directed into the body.
GI Tract: Mucous membrane damage in particular.
Bone marrow suppression: so look for s/s of ANEMIA, INFECTION, and BLEEDING as with chemotherapy).
Alopecia: this has an enormous impact on the patient’s body image and self-esteem.

45
Q

Immunotherapy

A

Medications stimulate the Immune system to identify and destroy cancer cells without damaging surrounding normal cells. Biologic Response Modifiers (BRMs) are a class of drugs that are used to treat cancer by altering or augmenting naturally occurring processes within the body. Immunotherapy makes use of BRMs to enhance the activity of the immune system to increase the body’s natural defense mechanisms against cancer.

46
Q

ADVANTAGES OF IMMUNOTHERAPY

A

Advantages of Immunotherapy:
High specificity for antigens (which means less damage to healthy tissue).
Immune memory cells give long protection

47
Q

DISADVANTAGES OF IMMUNOTHERAPY

A

Disadvantages of Immunotherapy:
Negative side effects are similar to chemotherapy and radiotherapy
Side effects include: Nausea and vomiting, diarrhea, loss of appetite, fever and chills, muscle aches, weakness, skin rash, an increased tendency to bleed, or swelling.
Patients need to be instructed to avoid crowds or places where exposure to pathogens is more likely because they are immunosuppressed when taking these drugs.

48
Q

TYPES OF BRM’S

A

Types of BRMs
Monoclonal Antibodies (-Mab drugs)
Interleukin-2 (a Cytokine)
Alpha Interferon (IFN)

Drugs ending in -mab (must avoid bugs)–immunosuppresent

49
Q

TERATOGEN

A

Anything that can cross the placental barrier and cause a birth defect. i.e. chemical, virus, etc

3 generations affected

50
Q

MONOCLONAL ANTIBODY

A

Make the cancer cell more visible to the immune system. The immune system attacks foreign invaders in your body, but it doesn’t always recognize cancer cells as enemies. A monoclonal antibody can be directed to attach to certain parts of a cancer cell. In this way, the antibody marks the cancer cell and makes it easier for the immune system to find.

Block growth signals. Chemicals called growth factors attach to receptors on the surface of normal cells and cancer cells, signaling the cells to grow. Certain cancer cells make extra copies of the growth factor receptor. Monoclonal antibodies can block these receptors and prevent the growth signal from getting through.

Stop new blood vessels from forming (blocks Angiogenesis). Cancer cells rely on blood vessels to bring them the oxygen and nutrients they need to grow. To attract blood vessels, cancer cells send out growth signals. Monoclonal antibodies that block these growth signals may help prevent a tumor from developing a blood supply so that it remains small. Or in the case of a tumor with an already-established network of blood vessels, blocking the growth signals could cause the blood vessels to die and the tumor to shrink.
Deliver radiation to cancer cells. By combining a radioactive particle with a monoclonal antibody, doctors can deliver radiation directly to the cancer cells. This way, most of the surrounding healthy cells aren’t damaged. Radiation-linked monoclonal antibodies deliver a low level of radiation over a longer period of time, which researchers believe is as effective as the more conventional high-dose external beam radiation.

Deliver chemotherapy to cancer cells. By combining chemotherapy drugs with a monoclonal antibody, doctors can deliver chemotherapy directly to the cancer cells. The chemotherapy only damages the cancer cells, leaving the surrounding healthy cells undamaged.

51
Q

TORCH

A

Toxoplasmosis (avoid undercooked meat and kitty litter)
Other (syphilis, varicella-zoster, parvovirus B19)
Rubella
Cytomegalovirus (CMV)
Herpes

52
Q

Oncogenesis

A

Oncogenesis refers to the genetic mechanism whereby normal cells are transformed into cancer cells. Cancer-causing genes are part of everyone’s makeup; some genes turn on while others do not. Genetic predisposition combined with environmental risk factors may promote the development of some cancers. Heredity, hormonal factors and immunologic mechanisms have also been linked to cancer. Lifestyle and environmental influences affect if and/or how these genes will be manifested in a person.

53
Q

Oncogene

A

A gene that has potential to cause cancer.

54
Q

PROTO-ONCOGENE

A

Proto-oncogene: A normal gene that can become an oncogene due to mutations

55
Q

ANTI-ONCOGENE

A

Anti- oncogene is a tumor suppressing gene that inhibits mitosis and turns off growth.

56
Q

CELLULAR ONCOGENES

A

Cellular oncogenes: Cancer characteristics that are coded on inherited genes

57
Q

VIRAL ONCOGENES

A

Viral oncogenes: Cancer characteristic integrated in the host. Transmitted by DNA or RNA.
EBV, HPV, HIV, HEPATITIS can all cause cancer

58
Q

SUMMARY STAGING SYSTEM

A

Stage 1
In situ:
Abnormal cells are present only in the layer of cells in which they developed
Stage 2
Localized:
Cancer is limited to the organ in which it began – no evidence of spread
Stage 3
Regional:
Cancer has spread beyond the primary site to nearby lymph nodes or tissues and organs
Stage 4
Distant/ Metastatic:
Cancer has spread from the primary site to distant tissues or organs or to distant lymph nodes

59
Q

TNM

A

TUMOR X-CANNOT 0-NONE 1,2,3,4 DEGREE OF BAD
REGIONAL NODES
METASTASIS

PATHOPHYSIOLOGY (10 decks)

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