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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
Q

6 hallmarks of cancer

A

self-sufficiency in growth signals

insensitivity to antigrowth signals

evading apoptosis

limitless replicative potential

sustained angiogenesis

tissue invasion and metastasis

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26
Q

autocrine secretion

A

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
Q

proto-oncogenes

A

most common is ras – once it mutates into oncogene, its name changes to c-ras

28
Q

Retinoblastoma (Rb) gene

A

first tumor suppressor gene – maintains normal cell growth but inhibited through mutation

29
Q

BRCA1 gene

A

tumor suppressor gene for breast, ovarian cancer

30
Q

BRACA2 gene

A

tumor suppressor gene for breast cancer (M & F) and ovarian

31
Q

APC gene

A

tumor suppressor gene for colon cancer

32
Q

angiogenesis

A

process by which cancer cells stimulate growth of blood vessels to increase nutrient/oxygen delivery to tumor

33
Q

vascular endothelial growth factor (VEGF)

A

angiogenic factor in colon cancer

34
Q

Avastin

A

drug used to treat colon cancer – monoclonial antibody that deactivates VEGF

35
Q

telomeres

A

protective ends of cellular chromosomes – gradually fragment through cell division, then chromosomes disintegrate and cell dies

cancer cells lose telomeres and replicate uncontrollably

36
Q

telomerase

A

enzyme that rebuilds and maintains telomeres in stem cells, allowing unlimited replication

37
Q

local spread of cancer

A

first step in progression of cancer – all mechanisms must be present for metastasis

38
Q

mechanisms that facilitate local spread of cancer

A

cellular proliferation

angiogenesis

release of lytic enzymes

decreased cell-to-cell adhesion

increased motility of tumor cells

39
Q

tissue selectivity

A

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
Q

criteria for genetic testing, BRCA1 & BRCA2 mutations

A

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
Q

oncogenesis

A

process of malignant transformation leading to formation of tumor

42
Q

carcinogen

A

any substance, radionuclide or radiation that is an agent directly involved in promotion of cancer or facilitation of its propagation

43
Q

carcinogens for colon cancer

A

high-fat/low-fiber diet, lack of physical activity

chronic inflammation–immune response & production of COX2 enzyme

44
Q

carcinogens for lung cancer

A

smoking, air pollution

45
Q

carcinogens for leukemia

A

nuclear fallout, high-voltage electromagnetic fields

46
Q

carcinogens for breast cancer

A

hormonal birth control

47
Q

carcinogens for pancreatic cancer

A

alcohol consumption

48
Q

mechanisms of alcohol-related carcinogenesis

A

direct epithelial cell toxicity (increases mucosal permeability)

carcinogens in beverages

increased oxygen radical production

decreased hepatic detox

nutritional deficiencies

decreased immunity

49
Q

viral causes of cancer

A

HBV & HCV – liver

HPV – cervical

EBV – lymphoma, leukemia

50
Q

bacterial causes of cancer

A

H. pylori – stomach/gastric

51
Q

manifestations of cancer

A

pain, fatigue (muscle wasting), cachexia, anemia, infection

52
Q

cachexia

A

excessive loss of adipose tissue, emaciation

catabolism results from increase in basal metabolic rate

53
Q

causes of pain in cancer

A

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
Q

first sign of multiple myeloma

A

bone fracture

55
Q

most commonly reported symptom of cancer

A

fatigue – fast-growing tumor steals nutrients, loss of appetite (especially w/chemo)

56
Q

causes of anemia in cancer patients

A

chemo. drugs toxic to bone marrow

chronic bleeding

severe malnutrition

malignant cells in bone marrow

decreased production erythropoietin

iron deficiency

57
Q

most common cause of death in metastatic cancer cases

A

infection – increased risk from generalized immunosuppression (leukopenia) from chemo, age, chronic stress

surgery w/poor healing can lead to formation of abscesses/fistulae

58
Q

diagnostic tests for cancer

A

CT, mammogram, MRI, pap, cytology studies, biopsy, tumor marker, endoscopies

59
Q

cure

A

disease gone forever

60
Q

control cancer

A

extend life of patient, but disease cannot be cured

61
Q

palliation

A

provide comfort, relief of symptoms, improve QoL

62
Q

prophylaxis

A

no disease but person at high risk – e.g. bilateral mastectomy for people with BRCA mutation

63
Q

1 tx of cancer

A

surgery – chemo may be done first to shrink the tumor

64
Q

cancer treatments

A

chemo, radiation, surgery, hormonal therapy, immunotherapy

pathophysiology (7 decks)

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