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Advanced Patho UC > Bolded Cancer > Flashcards

Bolded Cancer Flashcards

1
Q

loss of cellular differentiation, irregularities of size and shape of nucleus, loss of normal tissue structure

A

anaplasia

*cells become pleomorphic - meaning they are variable sizes and shapes

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2
Q

tumor =

A

new growth (neoplasm)

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3
Q

preinvasive epithelial MALIGNANT tumors of glandular or epithelial origin that have not broken through the basement membrane or invaded the surrounding stroma

recognized in? 
main type (probably)
A

carcinoma in situ (CIS)

recognized in cervix, skin, oral cavity, esophagus, and bronchus

glandular epithelial in situ lesions - stomach, breast, endometrium, large bowel

DCIS - ductal carcinoma in situ in breast

  • fills mammary ducts, but not progressed to local tissue invasion
  • readily treatable

*abnormal cells grown in normal place

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4
Q

substances produced by cancer cells or that are found on plasma cell membranes, in the blood, CSF, or urine

examples?

A

tumor cell markers

  • produced by benign or malignant cells
  • hormones, enzymes, genes, antigens, antibodies
  • liver tumor - alpha fetoprotein (AFP) blood
  • PSA in blood = prostate tumor
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5
Q

If tumor marker, itself, has biologic activity what occurs? Example of this?

A

symptoms are expressed

  • this phenomenon AKA paraneoplastic syndrome
  • a type of this is pheochromocytoma = usually benign tumor of the adrenal medulla that causes production of epinephrine and adrenaline (epinephrine) in excess (both considered hormones). This leads to SNS activation - sweating, increased BP, increased HR, h/a
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6
Q

The process by which a normal cell becomes a cancer cell

A

TRANSFORMATION - CARCINOGENESIS

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7
Q

Transformation/carcinogenesis involves

*all cancers involve malfunction of genes that regulate cell growth and devision

A
  • autonomy - independent control
  • lack of contact inhibition - not limited by crowding
  • has anchorage independence - normal cells will not grow unless attached to firm surface
  • are immortal
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8
Q

cancer metabolism

cancer cells always perform ______?

A

cancer can grow in hypoxic & acidic environment

glycolysis, even in presence of O2 - allows for more rapid cell growth

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9
Q

cancer stem cells do what? and are what?

A

self-renew, and are multi-potent meaning they can differentiate into many cell types

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10
Q

cancer causing mutations turn on what?

A

telomerase and new blood vessel growth

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11
Q

cancer causing mutations…

A
  • prevent apoptosis
  • turn on telomerase and new blood vessel growth
  • allow tissue invasion and distant metastasis
  • activate growth-promotion pathways
  • block antigrowth signals
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12
Q

normal genes that direct protein synthesis and cellular growth

A

proto-oncogenes (non-mutant genes)

*a normal gene that when it undergoes mutation becomes an oncogene

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13
Q

encode proteins in their normal state that positively regulate proliferation

A

oncogenes (mutant genes)

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14
Q

encode proteins that in their normal state negatively regulate proliferation

A

anti-oncogenes or TUMOR suppressor genes

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15
Q

encode for proteins that are involved in repairing damaged DNA - responsible for the maintenance

*inherited mutations of these genes can lead to?

A

caretaker genes

HNPCC (hereditary non-polyposis colorectal cancer) - small area of insertions and deletions that lead to high rate of colon cancer

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16
Q

chromosomal instability in cancer can result in…

A

a high rate of chromosomal loss, as well as loss of heterozygosity and chromosomal amplification; each of these events can ACCELERATE THE LOSS OF TUMOR-SUPPRESSOR GENES AND THE OVER EXPRESSION OF ONCOGENES

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17
Q

chromosome instability may result in the over expression of

A

oncogenes

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18
Q

protective caps on each chromosome that blocks cell division and prevents immortality

A

TELOMERES

*remember that telomeres become smaller and smaller with each cell division and eventually die

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19
Q

cancer cells can activate ______ which leads to unlimited division and proliferation

A

telomerase - this restores and maintains telomeres

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20
Q

tumor spread by 3 mechanisms

A

1- direct invasion of contiguous organs known as local spread
2- metastases to distant organs through lymph and blood circulation
3- direct transportation - carried on surgical instrument

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21
Q

a prerequisite for metastasis and the FIRST step in the metastatic process

A

INVASION: LOCAL SPREAD

  • cancer often spreads first to regional lymph nodes and then to distant organs through the blood - can do this through angiogenesis
  • invasion then requires that the cancer attach to specific receptors and survive in that environment
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22
Q

what do cancer cells secrete that helps them move through extracellular matrix and basement membranes?

A

protease

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23
Q

what is EMT

A

epithelial-mesenchymal transition - increases migratory capacity (decreased adherence), increases resistance to apoptosis, and causes dedifferentiation to a stem cell-like state to favor growth in new environment

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24
Q

Cancer Stages

A

stage 1- confined to its organ of origin
stage 2- locally invasive (contiguous)
stage 3- advanced to regional structures (nodes)
stage 4- has spread to distant sites

25
Q

TNM

A

tumor, node involvement, metastasis

26
Q

Pain - how much in early stage, later stage? influenced by? Mechanisms?

A
  • little or no pain is associated with early stages of malignancy; usually associated with later stages of cancer
  • influenced by fear, anxiety, sleep loss, fatigue, and overall physical deterioration
  • mechanisms: pressure, obstruction, invasion of sensitive structures, stretching of visceral surfaces, tissue destruction, inflammation
27
Q

Most reported symptom of cancer and cancer tx?

A

fatigue

28
Q

syndrome of cachexia

includes?

A

loss of appetite, progressive weight loss, and malnutrition

  • MOST severe form of malnutrition
  • present in 80% of cancer patients AT DEATH
  • includes anorexia, early satiety, weight loss, anemia, asthenia (weak), taste alterations, and altered protein, lipid, and carb metabolism
29
Q

clinical manifestations of cancer

A

*anemia - associated w/tx, malignancy (blood-forming organs), chronic bleeding, severe malnutrition

  • leukopenia, thrombocytopenia d/t chemo or malignancy in DM
  • infection d/t low wbc count is the most common cause of complication and death

*stomatitis, malabsorption, diarrhea, hair loss

30
Q

change in genetic expression (phenotype) without DNA mutation

influenced by?

usually involve?

A

epigenetics - involve gene silencing or lack of gene silencing (genes are switched on and off)

-influenced by environment/lifestyle including in utero

31
Q

leading in # of cancer dx in men and women

A

men - prostate; women - breast

32
Q

leading cause of cancer death in men & women?

A

lung for both

33
Q

Tobacco increased r/f what types of cancer?

A
  • lung, lower urinary tract, upper aero-digestive tract, liver, kidney, pancreas, cervix, uterus
  • pipe smoker: lung, throat, esophagus, larynx, pancreas, colon
  • myeloid leukemia
34
Q

study of nutrigenomics

A

study of how nutrition on the phenotypic variation of individuals, based on genomic differences

35
Q

foods that cause cancer

A

foods cooked in fat, meat, and alkaloids or mold byproducts (cheese?)

36
Q

dietary factors can alter what and cause cancer?

A

alters micro-ribonucleic acid (miRNA)

37
Q

foods that improve DNA repair and help prevent cancer

A

cooked carrots, kiwi, co-enzyme Q10

38
Q

other foods that decrease cancer risk?

A

fruit/veggie, fiber; vitamins A, B6, C, D, E, and folate; whole grains; lycopene; legumes/nuts

39
Q

foods that increase r/f cancer?

A

fat (omega-6 fatty acids), high-glycemic carbs, preservatives, alcohol, grilled/blackened, fried, HIGH levels of calcium >2000mg, refined grain products

40
Q

Obesity causes insulin-resistance which causes hyper insulinemia - this does what?

A

increases the r/f cancer of the CE KP - colon, endometrium, kidney, pancreas

+ prostate b/c insulin promotes secretion of insulin-like growth factor which increases r/f prostate cancer

*also remember that adipose tissue secretes adipokines which increase inflammation

41
Q

remember that alcohol consumption can increase r/f

A

breast, colon, esophageal, liver, pharynx, oral cavity cancers

42
Q

EBV connected to what type of cancer?

A

cancers of the nasopharynx, Hodgkin disease, and non-Hodgkin lymphoma

43
Q

HIV r/t what type of cancer?

A

lymphoma and Kaposi sarcoma

44
Q

Human t-cell lymphotrophic virus type 1 linked to what types of cancer?

A

leukemia and lymphoma

45
Q

most common STI

A

HPV

46
Q

which HPV types cause the majority of cancers?

A

16, 18 - think ages when you have SEX

47
Q

HPV can cause cancers of…infect epithelial cells

A

cervix, anus, penis, oropharynx (base of tongue, soft palate, tonsils)

48
Q

ionizing radiation sources and what does it cause?

A

x-ray, radiation - causes deposition of energy into tissue and can lead to oncogene activation, DNA damage, etc.

*could also come from background radiation from soil, rocks, radon (come from homes or other buildings)

49
Q

UV radiation cause gene mutations that cause skin cancer

A

UVA UVB in sunlight - promotes inflammation and ROS

50
Q

Occupational carcinogenic agents

A
  • asbestos - mesothelioma and lung cancer
  • dyes, rubber, paint - bladder cancer
  • explosives, rubber, cement, benzol, and dyeing materials - leukemia
  • heavy metals

*can accumulate in body fat and remain there for years

51
Q

indoor pollution

A

considered worse than outdoor

smoking and radon cause lung cancer

inorganic arsenic - bladder, skin and lung cancer

52
Q

cancer in children

A

leading cause of death d/t disease in children, but relatively rare

53
Q

most common types of childhood cancer

MOST COMMON
most common type of solid tumors

A

leukemias and brain tumors

ALL - acute lymphoblastic leukemia
Central nervous system tumors

54
Q

most childhood cancers originate from

A

mesodermal germ layer - this layer gives rise to connective tissue, bone, cartilage, muscle, blood, blood vessels, gonads, kidneys, and lymphatic system (as child grows these things do too)

  • childhood cancers often diagnosed during peak growth periods
  • usually fast growing and metastasize before dx
  • boys>girls
55
Q

trisomy 21 can lead to what type of cancer

A

acute leukemia - down syndrome is the most common genetic abnormality linked to the development of this cancer

56
Q

genetic factors familial risk - cancer of the kidneys

A

Wilms tumor AKA nephroblastoma - usually responsive to tx

57
Q

genetic factors familial risk - genetic defect that causes immature cells of the retina to proliferate and causes cancer

A

retinoblastoma - almost all children survive, but will have loss of vision in that eye

58
Q

diethylstilbestrol (DES)

A

if mother took while pregnant increased r/f cervical and vaginal cancer

Advanced Patho UC (14 decks)

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