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Pathophysiology > Week 4 (ch. 20) > Flashcards

Week 4 (ch. 20) Flashcards

1
Q

Describe neoplasm cell growth

A

no longer responds to normal body controls

    • continue to reproduce even though no need for them
    • deprives surrounding cells of nutrients
    • expanding mass create pressure on surrounding structures
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2
Q

neoplasms consist of what kind of cells

A

atypical or immature

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3
Q

characteristics of neoplasms depend on what

A

cell type

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4
Q

tumors are names according to what

A

system its in

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5
Q

benign tumor names vs malignant tumor names

A

benign: have tissue name plus the suffix -oma (adenoma)

malignant tumors (cancers) have the tissue name plus the suffix -carcinoma (adenocarcinoma)

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6
Q

characteristics of benign tumors

A

differentiated cells
reproduce higher than normal rate
encapsulated (expand but does not spread)
freely moveable on palpation

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7
Q

damage of benign tumors is from what

A

compression of adjacent structures

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8
Q

characteristics of malignant tumors

A

Undifferentiated cells, nonfunctional cells
Reproduce rapidly
Infiltrate or spread into surrounding tissues
Metastasize

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9
Q

Maligant tumors are composed of what cells

A

dysplastic cells

  • absent of normal cell function
  • surface antigens altered
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10
Q

malignant tumors compress nearby blood vessels, which causes what

A

necrosis and inflammation, increase pressure on surrounding structures

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11
Q

Do maligant cells adhere to each other

A

no - break lose from the mass, infiltrating into surrounding tissue

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12
Q

malignant tumors secrete enzymes, which do what

A

add to destruction and facilitate spread

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13
Q

Malignant tumors cause inflammation and loss of normal cell, which does what

A

progressively reduce the organ function

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14
Q

What happens as a malignant tumor enlarged

A

inner cells are frequently deprived of blood and nutrients (they die)

which leads to more inflammation

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15
Q

Some malignant tumors secrete growth factors, which does what

A

stimulates angiogenesis (development of new capillaries in the tumor) - promotes tumor development

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16
Q

Malignant tumors “trap” nutrients depriving normal cells, which does what

A

prevents tissue regeneration

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17
Q

Malignant tumors “in situ” =

A

preinvasive stage

  • months or years
  • offers early diagnosis for cervical or oral cancers
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18
Q

Warning signs of cancer

A
  1. bleeding / discharge at site
  2. change in BM or Bladder habits
  3. change in wart or mole
  4. sore that does not heal
  5. weight loss
  6. anemia / low hemoglobin
  7. fatigue
  8. cough or horseness without reason
  9. lump, painless, in breast, testes or anywhere in body
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19
Q

Local effects of cancer: pain

A

May be absent until well advanced

Severity depends on the type and location

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20
Q

Local effects of cancer: obstruction

A

Occurs when tumor compresses a duct or passageway

blood supply or lymphatic flow may be restricted (ulceration, edema)

digestive tract
airflow in bronci

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21
Q

Local effects of cancer: tissue necrosis and ulceration

A

may lead to bleeding or infectoin around the tumor

– increased in areas of normal flora become opportunistic

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22
Q

Systemic effects of cancer: weight loss and cachexia

A

severe tissue waisting

- increased demands placed on body

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23
Q

Systemic effects of cancer: anemia

A

Common problem

  • due to anorexia, chronic bleeding, bone marrow depression
  • causes poor tissue regeneration
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24
Q

Systemic effects of cancer: fatigue

A 
Inflammatory changes
psychological factors (life threatening illness, depression)
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25
Systemic effects of cancer: infections
host resistance declines
26
Systemic effects of cancer: bleeding
Tumor cells may erode blood vessels or cause tissue ulceration bone marrow depression --> poor clotting common site -- GI tract --> mucosa slow to regenerate
27
Systemic effects of cancer: paraneoplastic syndromes
Certain tumor types | -- tumor cells release substances that affect neurological function and may have hormonal effects
28
Cancer diagnostic tests: routine screening
Educate patients - essential for early detection - following treatment to detect any further tumors
29
Cancer diagnostic tests: self examination
Educate patients - early detection, if done consistently - breast, testicular, skin
30
Cancer diagnostic tests: blood tests
RBC and hemoglobin Measure blood cell levels during treatment Tumor markers...may detect tumor markers (PSA test), BRAC-1
31
Cancer diagnostic tests: radiologic, ultrasound, MRI, CT
Methods of visualizing changes in tissues or organs
32
Cancer diagnostic tests: cytological test
Require biopsy or cell sample — determine degree of differentiation and tumor type — may be test for growth promoter sensitivities (e.g. estrogen dependent tumors) — most dependable confirmation of malignancy
33
Cancer diagnostic tests: genomic tumor assessment
ID genomic mutations that are independent of heredity but only occur with the disease itself
34
Spread of Malignant tumors: secondary tumors
Cells identical to primary tumor
35
Spread of Malignant tumors: invasion
Local spread - grows to adjacent tissues | — ex. Uterine carcinoma invaded vagina
36
Spread of Malignant tumors: metastasis
Spread to distant sites by blood or lymphatic channels Cells erode into vein/lymphatic vessel traveling until lodge into hospitable environment (typically lymph nodes near by) Ex. Carcinoma of colon spreads to liver
37
Spread of Malignant tumors: seeding
Spread of cancer cells in the body fluids or along membranes — typically within cavities — ovarian to throughout peritoneal cavity
38
Why is staging of cancer essential
To standardize comparative studies of treatments and outcomes - used to estimate prognosis
39
Staging of cancer: most common system used in TMN system
1. Size of primary tumor (T) 2. Involvement of regional lymph nodes (N) 3. Spread (metastasis) of tumor (M)
40
Staging of cancer: stage 1 and stage 4
Stage 1: small, well localized, easy to treat, good prognosis Stage 4: well advanced at multiple sites, difficult to treat, poorer prognosis
41
Carcinogenesis
Process by which normal cells form into cancer cells Combination of factors or repeat exposure to single risk factor leads to changes - activates or changes gene expression - leading to transformation of normal cell to malignant cell
42
Cancer is thought to be a multi factorial disease because of what
- environmental effects - changes in gene expression (heredity) - infection in some cases
43
Stages of carcinogenesis
1. Initiating factors —> procarcinogens cause the first irriversible change in cellular DNA A. Do not create an active neoplasm 2. Exposure to promoters causes further damage A. Less differentiation and increase mitosis and or lack of apoptosis B. Includes hormones and environmental Cham C. Dysplasia or analysis may be evident D. Process may lead to tumor dev. 3. Continued exposure — malignant tumor capable of growth and invasion 4. Changes in regulation of growth factors - cells capable of detaching and spreading, metastasis 5. Tumors with metastasize readily and reproduce quickly (aggressive)
44
Cancer host defences
Cancer suppressor genes inhibit neoplastic growth Immune system ID foreign neoplastic material Immunodeficiency shown to increase risk of cancer
45
Cancer treatment
Depends on type and location - surgery, chemo, radiation, immunotherapy Can be combination of these
46
Cancer treatment: surgery
Removal of tumor and surrounding tissue | - laparoscope (minimizes tissue damage, improves recovery time)
47
Removal of adequate surrounding tissue may result in what
Changes in function
48
Cancer surgery: radiofrequency ablation (RFA)
Alternative surgery for small single tumors in solid or fluid-filled organs, but not the lungs - heat in form of radio waves
49
Cancer treatment: radiation
Causes mutation in DNA — prevents mitosis or causes immediate death — damages blood vessels which cuts off blood supply to tumor cells and starves them Some types of cancer are radio resistant
50
Radiation: methods of administration
External sources, Internal insertion Instill radio scope in solution into body cavity
51
Radiation precautions
Minimize radiation exposure of support people, shielding material for body regions not affected
52
Radiation adverse effects
Bone marrow depression: decreased leukocytes - increase risk for infection Decrease RBC: fatigue, tissue breakdown, decreased platelets, excessive bleeding Epithelial cell damage: damage to blood vessels and skin, hair loss Infertility - caused by abdominal radiation Nonspecific fatigue and lethargy - leads to depression
53
Chemotherapy
Anti neoplastic drugs Usually combination of two to four drugs - given at periodic intervals
54
Chemotherapy classifications
Antimitotics Antimetabolites Alkyating agents Antibiotics
55
How do chemo drugs work
Interfere with protein synthesis and or DNA replication
56
Chemo adverse effects
1. Bone marrow depression: If cell number low may need transfusions or cessation of therapy until bone marrow recovers 2. Vomiting: Occurs at any point, anti-emetic drugs may help 3. Epithelial cell damage: hair loss, breakdown of skin, mouth sores, diarrhea, candidiasis infection in mouth (thrush) 4. Damage to specific areas within antineoplastic drugs
57
Cancer treatments: hormones
Tamoxifen estrogen blocking agent used in breast cancer treatment
58
Cancer treatment: glucocorticoid
Decrease mitosis and increase erythrocyte counts
59
Cancer treatment: blocking agents
Act to block receptors for the growth promoters on cancer cells
60
Cancer treatment: biological response modifiers (BRM)
Augment the natural immune response
61
Cancer treatment: angiogenesis inhibitors
Inhibit stimulus for growth of blood vessels
62
Cancer treatment: analgesics
Prescribed to alleviate pain | May be used In high doses
63
Cancer treatment: gene therapy
Experimental cancer treatment design to replace mutated jeans with a healthy copy of the gene, and activate a mutated gene, introduce a new gene
64
Cancer treatment: nutrition
Patients with advanced cancer are often malnourished. Many contributing factors for this
65
Cancer treatment: complimentary therapies
Healthcare workers need to be aware of these different types of therapies to advise patients. Massage, meditation, counseling, exercise, therapeutic touch
66
Remission
No clinical signs of cancer | - client may experience several remissions
67
Cancer free states generally defined as _____ survival without reoccurance
5-year
68
Some cancers such as childhood leukemia s can be considered cured after a _____, cancer free period
10 year
69
Most common cancer in men
Prostate Lung Colorectal
70
Most common cancer in females
Breast Lung Colorectal
71
Examples of malignant tumors: skin cancer
Visible, easily diagnosed and treated | Excellent prognosis with exceptions of malignant melanoma
72
Malignant tumors: ovarian cancer
Poor prognosis because of hidden nature of cancer. High mortality rates
73
Malignant tumors: brain tumors
Both benign and malignant tumors Are life-threatening because of compression of brain tissue. Primary tumor usually fatal, no metastases

Pathophysiology (11 decks)

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