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Pathophysiology > cancer notes-- patho > Flashcards

cancer notes-- patho Flashcards

1
Q

malignant growth

A

cancer cells invades adjacent tissues and travels in lymphatic system and bloodstream

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2
Q

benign growth

A

do not invade other tissues, more closely resemble cell of origin

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3
Q

etiology of cancer: genetic basis

A

cancer is a disease caused by a small number of mutations in a single cell

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4
Q

minimum number of mutations is ___ for cancer

A

2

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5
Q

carcinomas

A

tumors of epithelial origin

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6
Q

sarcomas

A

malignant cancers of bones, nerves, muscles

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7
Q

leukemias

A

malignant growths of WBC’s, only in blood

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8
Q

lymphomas

A

cancer of WBC’s and lymph tissue, usually start in lymph

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9
Q

adenocarcinomas

A

cancers of ductal or glandular tissue

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10
Q

tumor suppressor genes

A

inhibit tumor formation and cell proliferation, usually function to switch off cell division

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11
Q

there are ___ genes in each pair of tumor suppressor genes

A

2

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12
Q

one gene in each pair of tumor suppressor genes can be absent or damaged, loss of the second gene leads to ________ division.

A

uncontrollable

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13
Q

BRCA 1

A

chromosome 17; tumor suppressor gene that is autosomal dominant inheritance , 85% of women with mutation will develop breast cancer, also increased risk for ovarian cancer

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14
Q

BRCA 2

A

chromosome 13, accounts for 10-15% of all breast cancer cases

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15
Q

proto-oncogenes

A

normally act to turn on or maintain cell division

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15
Q

oncogenes

A

tumor causing genes that increase rate of cell proliferation

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16
Q

how do oncogenes increase the rate of cell proliferation?

A

they become permanently active or overproduce their products with mutations and disrupt intracellular communication pathways that regulate cell proliferation.

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17
Q

oncogene activation

A

virus or retirovirus, has a mutagenic effect= changes structure and function

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18
Q

cellular effects of oncogene

A

promote cell proliferation, growth factor, second messengers, abnormal gene transcription begins

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19
Q

caretaker genes

A

genes responsible for dna repair, mutation does not directly lead to tumor formation, increases mutation rate of all genes, does not lead directly to formation of cancer

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20
Q

pathogenesis of cancer

A

initiation– genetic mutation, carcinogen applied to cell. If no repair before cell division= cells are damaged

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21
Q

promotion

A

mutant cell induced to proliferate, reversible proliferation of altered initiated cells, promoting factors in proliferation

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22
Q

progression

A

cells acquire properties that allow mallignant behavior

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23
Q

progression properties

A

-increased growth rate and invasiveness of tumor
-tumors produce own growth factor
-lack contact inhibition
-able to metastasize

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24
Q

metastasis

A

ability to spread to distant parts of the body, spread through blood or lymph pathways. Seeding is needed to kill all cells. Characteristics of primary site are retained

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25
Q

grading of cancer

A

microscopic anatomy (what cell looks like), number system is used

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26
Q

staging

A

location and pattern of spread

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27
Q

TNM classification

A

T describes the size of the tumor and any spread of cancer into nearby tissue; N describes spread of cancer to nearby lymph nodes; and M describes metastasis (spread of cancer to other parts of the body).

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28
Q

anatomical site classification–skin and glands

A

carcinomas

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29
Q

anatomical site classification– connective tissue, muscle, bone, fat

A

sarcomas

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30
Q

warning signs of effect of cancer on host

A

change in bowel or bladder habits, a sore throat that does not heal, unusual bleeding or discharge from any body orifice, thickening or lump in breast or elsewhere, indigestion or difficulty swallowing, obvious change in a wart or mole, nagging cough or hoarseness

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31
Q

late signs of effect of cancer on host

A

pain, weight loss and weakness, bone marrow suppression (anemia, thrombocytopenia, leukopenia), loss of function of involved organ, obstruction, deficits in immune system competence

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32
Q

tumor markers are

A

produced by cancer cells, presence may indicate possibility of cancer

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33
Q

Carcinoembryonic antigen

A

CEA, colorectal or breast cancer

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34
Q

alpha-fetoprotein

A

testicular, liver cancer

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35
Q

human chorionic gonadotropin

A

HCG, testicular

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36
Q

prostatic specific antigen

A

PSA, prostate cancer

37
Q

CA125

A

ovarian cancer

38
Q

other tests used to diagnose cancer

A

X-ray, CT, ultrasound, MRI, PET, nuclear medicine studies, endoscopic exams

39
Q

biopsy

A

definitive diagnosis test for cancer, only way to truly diagnose

40
Q

surgery treatment for cancer

A

used to remove solid tumors

41
Q

radiation treatment for cancer

A

kills cells that are not resectable due to location or that have escaped after surgery

42
Q

immunotherapy treatment for cancer

A

boost immune system’s ability to locate and destroy cancer cells

43
Q

gene and molecular therapy

A

enhance tumor suppressor genes

44
Q

risk factors for cancer

A

smoking, sunlight, alcohol, smokeless tobacco, estrogen, radiation, occupational hazards, high fat diet, obesity

45
Q

common neoplastic disorders of bone marrow and lymphoid tissues

A

Lymphoma, plasma cell myeloma, leukemia

46
Q

where is lymphoma located?

A

lymph nodes

47
Q

where is plasma cell myeloma located, what is it?

A

malignant transformation of B-cell plasma cells, likes to form tumors on bony structures

48
Q

where is leukemia located?

A

blood and bone marrow

49
Q

Myeloid Neoplasms properties

A

myoproliferative (bone marrow makes too many RBC’s)

50
Q

Myeloid Neoplasms Cancers

A

Chronic Myeloid Leukemia, Acute Myeloid Leukemia, Polycythemia Vera, Essential Thrombocytopenia

51
Q

Lymphoid Neoplasm properties

A

B cell neoplasm

52
Q

Lymphoid Neoplasm Cancers

A

Chronic Lymphoid Leukemia, Acute Lymphoblastic Leukemia, Plasma Cell Myeloma, Hodgkin’s Disease

53
Q

Non-Hodgkin’s Lymphoma properties

A

lymphomas of B cell, T cell and NK cell origin. Includes a large and diverse group of mallignancies

54
Q

etiology of hematologic (myeloid and lymphoid) neoplasms

A

Exact cause of hematologic neoplasms is unknown.
Basic mechanisms involve cell mutation that disrupts growth control
& differentiation pathways.

55
Q

Malignant Disorders of WBC’s typical signs and symptoms

A

Malaise, weakness, Unexplained fever, night sweats, Recurrent infections, Lymphadenopathy with lymphoma & some leukemias, Very high total WBC count or the presence of abnormal cell
types

56
Q

leukopenia common clinical manifestations

A

lymphadenopathy, joint swelling and pain, weight loss, anorexia, hepatomegaly, splenomegaly

57
Q

anemia common clinical manifestations

A

pallor, fatigue, malaise, shortness of breath, decreased activity tolerance

58
Q

thrombocytopenia common clinical manifestations

A

platelet count below 20,000 cells/microliter, petechiae, easy bruising, bleeding gums, occult hematuria, retinal hemorrhages

59
Q

neutropenia common clinical manifestations

A

absolute neutrophil count less than 500 cells per microliter, evaluation of peripheral blood sample is a key aspect of diagnosis. Definitive diagnosis is made after bone marrow aspiration or lymph node biopsy

60
Q

Prevention and management of mallignant WBC disorders

A

bone marrow transplantation, peripheral stem cell transplantation, autologous transplantation, allogenic transplantation, graft vs. leukemia

61
Q

bone marrow transplantation

A

transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood in order to replicate inside of a patient

62
Q

peripheral stem cell transplantation

A

allows stem cells to be harvested from circulating bloodstream

63
Q

autologous transplantation

A

stem cells from patient’s own blood to be reinfused

64
Q

allogenic transplantation

A

stem cells from closely matched relative

65
Q

graft v. leukemia

A

transplanted cells in allograft that detect & kill
leukemic cells.

66
Q

myeloid neoplasms result from..

A

proliferation of an abnormal cell in bone marrow and overproduction of more than 1 cell type, offspring of abnormal cells build up and are released into bloodstream. Results in myoproliferative disease

67
Q

chronic myeloid leukemia

A

myeloid neoplasm– malignant granulocytes carrying Philadelphia chromosome

68
Q

cml clinical presentation

A

high granulocyte count on CBC, splenomegaly

69
Q

cml symptoms

A

fatigue, weight loss, sweats, bleeding, abdominal discomfort (enlarged spleen)

70
Q

cml prognosis and treatment

A

does not respond well to chemo; poor overall survival time. untreated= median survival is 2 years, blast stage cml prognosis= 4 months

71
Q

Acute Myeloid Leukemia

A

associated with transformation of myeloid stem cell, bone marrow aspirate must have greater than 20% blasts.

72
Q

AML symptoms

A

bone pain, anemia, thrombocytopenia, increased infection succeptibility

73
Q

AML common infection sites

A

skin, GI, GU, respiratory

74
Q

AML prognosis

A

less than 50% and less than 30% of adults survive long term

75
Q

chronic lymphoid leukemia symptoms

A

fatigue, weight loss, anorexia, increased susceptibility to infections

76
Q

cll progression of cells

A

Malignant lymphocytes invade lymph tissues & bone marrow; disrupt
function and cause enlarged, painless lymph nodes (lymphadenopathy) Enlarged spleen

77
Q

cll prognosis and treatment

A

Certain genetic mutations present better/worse diagnosis.
Chemotherapy used to induce remission.
Stem cell transplantation to prolong remission.

78
Q

acute lymphoblastic leukemia/lymphoma

A

Malignant transformation of lymphoblasts, 80% B-cells; 20%-T
cells
Lymphoblastic neoplasms: leukemia
lymphoblastic lymphomas: same disease at a different stage

79
Q

acute lymphoblastic leukemia/lymphoma symptom onset

A

abrupt; bone pain, bruising, fever, infection, loss of appetite, fatigue, abdominal pain, enlarged spleen, enlarged liver, enlarged lymph nodes

80
Q

Plasma Cell Myeloma (multiple myeloma)

A

malignancy of mature, antibody-secreting b lymphocytes

81
Q

plasma cell myeloma progression of cells

A

Malignant plasma cells invade bone & form multiple tumor sites;
Bone destruction releases Ca+ into bloodstream (hypercalcemia).
Pathologic fractures common.Excessive identical monoclonal antibodies made up of Bence Jones
Proteins, accumulate in blood and urine.

82
Q

diagnosis of plasma cell myeloma is based on:

A

Presence of Bence Jones protein
Hypercalcemia
Evidence of bone lesions. Bone marrow biopsy confirms diagnosis.

83
Q

Hodgkin Disease

A

Malignant disorder of the lymph nodes

84
Q

Hodgkin Disease cell progression

A

Malignant transformation of B cells in lymph nodes called Reed-
Sternberg cells
Grow/spread predictable, usually metastasizes along lymphatic
pathways. Sets HD apart from other lymphomas

85
Q

Hodgkin Disease (Hodgkin’s Lymphoma) clinical manifestations

A

Early stages: often asymptomatic
Painless lymphadenopathy; possibly with fever, night sweats,
pruritus, weight loss, malaise.
Lymph node enlargement above diaphragm, cervical nodes most
common site.

86
Q

hodgkin’s disease prognosis and treatment

A

Localized tumors: radiation therapy (most common)
Disseminated disease: chemotherapy

87
Q

Non-Hodgkin’s Lymphomqa (B cell, T cell and NK cell lymphoma)

A

DO NOT HAVE REED STERNBERG CELLS, majority arise in lymph nodes, tumor cells derived from one single mutant precursor cell

88
Q

non-hodgkins lymphoma symptoms

A

Painless lymphadenopathy, fever, night sweats, weight loss,
malaise, pruritus

89
Q

combination therapy type of treatment

A

primary

90
Q

stem cell transplant type of treatment

A

primary

Pathophysiology (6 decks)

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