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Pathophysiology > Cancer study guide- Mini exam 4 (09/15) > Flashcards

Cancer study guide- Mini exam 4 (09/15) Flashcards

1
Q

What factors contribute to risk of cancer? Is it genetic?

A

cancer is multifactorial and hereditary; environmental factors, cell cycle, and genetics

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2
Q

Explain the environmental factors that contribute to risk of cancer

A

Viruses (HPV), Tobacco smoke (causes chronic inflammation), Food (aspertain in drinks, nitrates in processed foods, grilling), Radiation, Chemicals, and Pollution (respiratory cancer)

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3
Q

what are the different genes associated with cancer

A

oncogenes, tumor repressor genes, and DNA repair genes (AKA caretaker genes)

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4
Q

how are oncogenes created and what do they do? What does this mutation cause?

A

promote self-regulated and normal cellular growth; in their normal state, oncogenes are called protocol-oncogenes or anti-oncogenes, when mutated into oncogenes, cellular growth is unregulated, causing tumor growth,

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5
Q

what is the job of tumor suppressor genes? what happens if they are mutated?

A

regulate cell division in the midst of oncogenes (so if the anti-oncogenes are compromised, this is plan B); these are found in two spots in the chromosomal makeup, so the first mutation is usually inherited, but can also be somatic and the other is the major even, usually environmental, if mutated cell division is no longer regulated

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6
Q

DNA repair genes do what normally? What happens when they are mutated

A

detect a mutation and promote the repair of that action in the cell cycle to ensure that future cells will be normal; normally sends protein to the site mutation to repair, mutations will cause a slow reaction or cause genes to become dormant

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7
Q

What is proliferation?

A

the generation of new, daughter cells divided from progenitor cells (parents) - think of parents letting their kid go off to college/start their career

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8
Q

What specific cells play an important role here?

A

stem cells plan an important role because they don’t have a specific function when they are first produced

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9
Q

explain the properties of stem cells

A

highly undifferentiated, have potential to divide into daughter stem cells, can mature into more differentiated units that have a specific function, but must be put in the right enviornment for this

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10
Q

what is cellular differentiation

A

the maturity, specificity, and functionality of cells; an orderly process

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11
Q

list the steps of differentiation

A
  1. cells start out as undifferentiated stem cells (potential to mature/become more specific, but again its all about the environment)
  2. as a need arises, the stem cells turn into progenitor (parent) cells that can produce daughter cells, allowing the progenitors to mature and have a specific function
  3. daughter cells then become highly differentiated and cannot reproduce
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12
Q

what is ideal when looking at cellular differentiation in patients

A

we want tissue cells to like the surrounding tissue, which means they are still well differentiated. When they do not, they have become undifferentiated

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13
Q

what are the three most frequent problems with cell differentiation

A
  1. over proliferation (production of daughter cells/stem cells): proto-oncogenes become oncogenes, tumor repressor cells are mutated and cannot stop/regulate growth and DNA repair genes no longer recognize/fix mutations
  2. lack of differentiation
  3. neoplasia-irreversible deviant development of cells that can result in the formation of neoplasms (tumors)
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14
Q

where can neoplasia occur

A

only in cells that have the ability to proliferate (lots of reproducing/growing); examples of this are skin, GI tract, and respiratory tract

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15
Q

where can neoplasia not occur

A

cannot occur in cell structures that are permeant because they are not proliferation. Examples include cardiac myocytes, mature neurons (neuroblastoma is almost always in children because adults are not producing these anymore), and the lens of the eye

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16
Q

list and explain the characteristics of neoplastic cells (neoplasms)

A

autonomy, anaplasia, lack cell-to-cell inhibitions, cohesions
angiogenesis
adhesiveness, energy dependent

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17
Q

autonomy

A

unregulated cell growth, independent cells

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18
Q

anaplasia

A

describes the neoplasm’s loss of differentiation, the neoplasms no longer look like the tissue of origin because of the lack of differentiation

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19
Q

cell-to-cell inhibitions

A

knowing when to stop growing

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20
Q

cohesion

A

staying together

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21
Q

adhesiveness

A

stickiness

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22
Q

energy dependent

A

suck away nutrients from other places to provide for own growth

23
Q

angiogenesisi

A

develops new blood vessels to promote new growth, deprive unaffected tissues of oxygen and other nutrients (killing surrounding tissues), this can create inflammation, which then causes edema, can also cause secretion of substances that alter the metabolic processes

24
Q

explain cancer at the cellular level

A

at the cellular level, cancer is genetic. All cancer comes from a malfunction of the genes that turn controls protons-oncogenes, tumor suppressor genes, and DNA repair genes/caretaker genes

25
Q

what are the four steps that outline cancer occurrence

A
  1. reproduction
  2. growth
  3. differentiaton
  4. death
26
Q

what are carcinogens and how do they work

A

cancer-causing agent that interferes with the molecular pathways and can initiate or promote tumors to form in the body

27
Q

explain the 4 steps of carcinogenesis

A
  1. initiating event: irreversible change of DNA, can be stopped
  2. promoters (internal and external): cause further changes to DNA; internal is hormones, external is smoking, food, etc
  3. continued exposure and change in the DNA: this results in a malignant tumor
  4. progression of metals: can spread to other parts of the body
28
Q

explain the differences in characteristics between benign and malignant tumors (cell differentiation)

A
  • benign: similar to normal cells, does not have significant loss of differentiation, mitosis fairly normal
  • malignant: vary in shapes and size, large nuclei, many undifferentiated, mitosis is increased and atypical
29
Q

explain the differences in characteristics between benign and malignant tumors (encapsulated)

A
  • benign: encapsulated and expands, but does not spread

- malignant: no capsule

30
Q

explain the differences in characteristics between benign and malignant tumors (growth rate)

A
  • benign: relatively slow, expanding mass

- malignant: rapid growth, cells do not adhesive, infiltrate tissues

31
Q

explain the differences in characteristics between benign and malignant tumors (location)

A
  • benign: remain localized to where it started growth

- malignant: can spread

32
Q

explain the differences in characteristics between benign and malignant tumors (recurrence after removal)

A
  • benign: rare

- malignant: tumors spread, recurrence is more common

33
Q

explain the differences in characteristics between benign and malignant tumors (others)

A
  • benign: can still be life threatening, in the brain it can compress the brain and can cause loss of function, sometimes a precursor to cancer
  • malignant: extremely invasive and aggressive, does not resemble tissue of origin, can cause ischemia (lack of O2 and nutrients) and necrosis of tissue (cell death)
34
Q

name several systemic effects of malignant tumors

A
  • cachexia-general illness and malnutrition (can include weight loss, wasting of muscle, fatigue, loss of appetite, etc.)
  • anemia due to blood loss at the site
  • nutritional defects that reduce hemoglobin synthesis
  • effusions-escape of fluid
  • infection
  • bleeding
  • erosion of blood vessels
  • paraneoplastic syndrome (biochemical disturbances)
  • tumors can release substances that affect neurologic function and may have hormonal effects
  • psychological factors
35
Q

what can proliferation within the tissue of origin cause

A

obstruction, hemorrhage (bleeding), necrosis, better prognosis

36
Q

explain invasion/direct extension and what it does

A

tumor cells move and grow into adjacent tissues/organs as well as nearby structures; this releases enzymes that degrade tissue walls and allow the tumor to grow

37
Q

what is seeding and where does it occur

A

cancer cells growing in the body fluids or along membranes; occurs many times within the peritoneal or pleural cavities surrounding affected organs/tissues; gravity pulls cells downward or cells will follow flow of fluid within the body cavity

38
Q

what is metals

A

malignant neoplasms (cancer cells) use blood vessels to spread to distant sites; easier for the cancer to get to in via lymphatic system; detection and treatment become more complex if this occurs (if metastasis is present, the cancer is stage four)

39
Q

explain the four steps of metastasis

A
  1. Breaks: breaks through the basement membrane and/or extracellular membrane
  2. Gains: gains access to and begins to circulate within the blood vessels or lymph system
  3. Leaves and adheres: leaves the blood vessels/lymph system and adheres to distant tissues
  4. New network: establishes a new nutrient network through the process of angiogenesis
40
Q

define organ tropism

A

desire of a primary tumor to relocate to a specific distant site
Factors include:
-favorable environment
-increased adherence capability
-location in relation to blood/lymphatic flow

41
Q

three examples of organ tropism

A
  • colon cancer to the liver
  • lung to the brain
  • breast or prostate to bone
42
Q

what is the acronym for cancer classifications and what does each stand for

A

TNM
T: size of tumor
N: involvement in the lymph system
M: metastasis 9remember, if this one is yes, it is immediately stage 4)

43
Q

the grades of cancer

A

Grade 1: well differentiated, cancer confined to one organ of origin
Grade 2: moderatley differentiated, cells invading, but locally
Grade 3: poorly differentiated, spread to regional structures
Grade 4: undifferentiated, spread to distant sites

44
Q

-oma

A

means benign tumor

ex: lymphoma (lymphatic tissue) and glioma (nervous system)

45
Q

-carcinoma

A

cancerous

ex: adenocarcinoma (glandular tissue), sarcoma ( connective, always cancerous)

46
Q

carcinoma-in-situ

A

early stage cancer that has not broken through basement membrane of the organ

47
Q

leukemia-hematopoietic

A

blood forming organs

48
Q

what does the acronym CAUTION stand for

A 
Change in bowel/bladder
A lesion that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Obvious change in wart or mole
Nagging cough or persistent hoarseness
49
Q

four examples of risk factors for cancer

A

chronic irritation and inflammation
age
diet
hormones

50
Q

Your patient has a history of various types of cancer in her family history. What are some ways she can reduce her risk

A

limit UV exposure, self-examinations, diet-increase fiber, reduce fat, regular medical exams

51
Q

explain immunity’s role in cancer

A

cell-mediated immunity can recognize some tumor cells and destroy them (natural killers), immunization (artificial) or cervical cancer and HPV

52
Q

Thrombocytopenia

A

Platelets, low platelets means increased risk for bleeding/hemorrhage, always watching for nosebleeds, brush teeth differently, electric razor

53
Q

neoplasia

A

growth of a tumor

54
Q

neoplasm

A

is the tumor/cancerous cells

Pathophysiology (7 decks)

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