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pathophysiology > cancer > Flashcards

cancer Flashcards

1
Q

cancer

A

uncontrolled cell division resulting in invasion of healthy tissues

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2
Q

characteristics of benign tumors

A

encapsulated, well-differentiated cells, do not metastasize

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3
Q

characteristics of malignant tumors

A

rapid growth, no capsule, will metastasize

undifferentiated cells with large nuclei, frequent mitotic figures, anaplastic

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4
Q

anaplastic cells

A

little to no tissue organization (undifferentiated) – have few characteristics that make them recognizable as mature cells of a certain type

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5
Q

carcinoma

A

epithelial – squamous cell carcinoma, adenocarcinoma (e.g. breast, colon, gastric)

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6
Q

sarcoma

A

connective (e.g. muscle)

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7
Q

lymphoma

A

lymphoid

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8
Q

leukemia

A

blood-forming cells

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9
Q

teratocarcinoma

A

germ cells (e.g. neurological, testicular)

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10
Q

carcinoma in situ (CIS)

A

malignant cells confined to epithelial layer, have not penetrated basement membrane

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11
Q

Papanicolaou (PAP) smear

A

used to screen for CIS

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12
Q

TNM system

A

T=size of primary tumor in cm
N=nodal status (lower–>better survival)
M=distant metastases

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13
Q

Gleason Grading System

A

prostate – two largest areas of cancer in tissue samples are assigned a grade from 1-5 (lower less aggressive)

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14
Q

Gleason score chart

A 
2-4 = low-grade tumor
5-7 = intermediate
8-10 = high
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15
Q

tumor markers

A

substances produced by cancer cells – can be found on surface of cancer cells or released

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16
Q

types of tumor markers

A

mutated tumor cell proteins, overexpression of normal antigens, viral gene expression on surface cell, gene products normally produced only during fetal development

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17
Q

MUC1

A

breast cancer tumor marker (mutated tumor cell protein)

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18
Q

MAGE

A

melanoma tumor marker (overexpression of normal antigens)

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19
Q

HER-2/neu

A

breast cancer tumor marker (overexpression of normal antigens)

increases growth factor receptors on cell, allowing replication in response to very low levels of growth factor

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20
Q

PSA

A

prostate cancer (overexpression of normal antigens)

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21
Q

HPV

A

cervical cancer marker (viral gene expression on surface of cell)

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22
Q

alpha fetoprotein (AFP)

A

testicular and liver cancer marker – normally produced only during fetal development (level should be 0 in adults)

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23
Q

carcinoembryonic antigen (CEA)

A

colon cancer marker – normally produced only during fetal development (level should be 0 in adults)

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24
Q

mutation that causes Burkitts lymphoma

A

chromosome translocation C8 fused to C14

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25
6 hallmarks of cancer
self-sufficiency in growth signals insensitivity to antigrowth signals evading apoptosis limitless replicative potential sustained angiogenesis tissue invasion and metastasis
26
autocrine secretion
ability to secrete growth factors that act on cell itself to stimulate cellular replication -- cell continues to divide even when normal growth factors are removed
27
proto-oncogenes
most common is ras -- once it mutates into oncogene, its name changes to c-ras
28
Retinoblastoma (Rb) gene
first tumor suppressor gene -- maintains normal cell growth but inhibited through mutation
29
BRCA1 gene
tumor suppressor gene for breast, ovarian cancer
30
BRACA2 gene
tumor suppressor gene for breast cancer (M & F) and ovarian
31
APC gene
tumor suppressor gene for colon cancer
32
angiogenesis
process by which cancer cells stimulate growth of blood vessels to increase nutrient/oxygen delivery to tumor
33
vascular endothelial growth factor (VEGF)
angiogenic factor in colon cancer
34
Avastin
drug used to treat colon cancer -- monoclonial antibody that deactivates VEGF
35
telomeres
protective ends of cellular chromosomes -- gradually fragment through cell division, then chromosomes disintegrate and cell dies cancer cells lose telomeres and replicate uncontrollably
36
telomerase
enzyme that rebuilds and maintains telomeres in stem cells, allowing unlimited replication
37
local spread of cancer
first step in progression of cancer -- all mechanisms must be present for metastasis
38
mechanisms that facilitate local spread of cancer
cellular proliferation angiogenesis release of lytic enzymes decreased cell-to-cell adhesion increased motility of tumor cells
39
tissue selectivity
ability of different cancers to spread to different sites, e.g. breast cancer often spreads through bloodstream to bones but rarely to kidney or spleen all cancer can spread to bone
40
criteria for genetic testing, BRCA1 & BRCA2 mutations
Ashkenazi Jewish 1st degree relative w/hx breast cancer before age 50 hx ovarian cancer at any age in 1st or 2nd degree relative 2 or more relatives dx w/breast cancer at any age pt/relative dx bilateral breast cancer hx breast cancer in male relative
41
oncogenesis
process of malignant transformation leading to formation of tumor
42
carcinogen
any substance, radionuclide or radiation that is an agent directly involved in promotion of cancer or facilitation of its propagation
43
carcinogens for colon cancer
high-fat/low-fiber diet, lack of physical activity chronic inflammation--immune response & production of COX2 enzyme
44
carcinogens for lung cancer
smoking, air pollution
45
carcinogens for leukemia
nuclear fallout, high-voltage electromagnetic fields
46
carcinogens for breast cancer
hormonal birth control
47
carcinogens for pancreatic cancer
alcohol consumption
48
mechanisms of alcohol-related carcinogenesis
direct epithelial cell toxicity (increases mucosal permeability) carcinogens in beverages increased oxygen radical production decreased hepatic detox nutritional deficiencies decreased immunity
49
viral causes of cancer
HBV & HCV -- liver HPV -- cervical EBV -- lymphoma, leukemia
50
bacterial causes of cancer
H. pylori -- stomach/gastric
51
manifestations of cancer
pain, fatigue (muscle wasting), cachexia, anemia, infection
52
cachexia
excessive loss of adipose tissue, emaciation catabolism results from increase in basal metabolic rate
53
causes of pain in cancer
pressure on/invasion of tissue/nerve endings release of inflammatory chemicals obstruction of GI/urinary systems bone metastases stretching of viscera infectious complications complications of tx
54
first sign of multiple myeloma
bone fracture
55
most commonly reported symptom of cancer
fatigue -- fast-growing tumor steals nutrients, loss of appetite (especially w/chemo)
56
causes of anemia in cancer patients
chemo. drugs toxic to bone marrow chronic bleeding severe malnutrition malignant cells in bone marrow decreased production erythropoietin iron deficiency
57
most common cause of death in metastatic cancer cases
infection -- increased risk from generalized immunosuppression (leukopenia) from chemo, age, chronic stress surgery w/poor healing can lead to formation of abscesses/fistulae
58
diagnostic tests for cancer
CT, mammogram, MRI, pap, cytology studies, biopsy, tumor marker, endoscopies
59
cure
disease gone forever
60
control cancer
extend life of patient, but disease cannot be cured
61
palliation
provide comfort, relief of symptoms, improve QoL
62
prophylaxis
no disease but person at high risk -- e.g. bilateral mastectomy for people with BRCA mutation
63
#1 tx of cancer
surgery -- chemo may be done first to shrink the tumor
64
cancer treatments
chemo, radiation, surgery, hormonal therapy, immunotherapy

pathophysiology (7 decks)

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