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Semester 4 > Case 4 > Flashcards

Case 4 Flashcards

1
Q

What is the distinction between a benign and malignant tumour?

A

A benign tumour has relatively innocent characteristics and will appear to remain localised. Whereas a malignant tumour will invade and destroy adjacent structures and is more likely to metastasise and cause death

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2
Q

What is an adenoma?

A

A tumor of epithelial tissue with glandular origin

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3
Q

What is a papilloma?

A

A benign epithelial tumor that grows exophytically (outwards beyond surface epithelium) creating a finger/nipple like projection.

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4
Q

What is a polyp?

A

A polyp is an abnormal growth of tissue projecting from a mucous membrane.

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5
Q

What is the differance between a pedunculated and sessile polyp.

A

A pedunculated polyp is attached to the surface it grows from by a long narrow stalk, a sessile polyp is not.

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6
Q

What does the term carcinoma refer to?

A

Any malignant neoplasm of epithelial cell origin derived from any three of the germ layers.

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7
Q

What is a sarcoma?

A

A cancer that is derived from cells of mesenchymal origin

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8
Q

what is the rough length and width of the large intestine?

A

1.5M long and 6.5cm in diameter

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9
Q

What is the term for the valve formed by a fold of mucosa that borders the end of the ileum/ start of the cecum?

A

The ileocecal sphincter

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10
Q

Roughly how long is the cecum?

A

6cm

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11
Q

In what quadrant is the cecum found?

A

The lower right quadrant.

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12
Q

What is attached to the lower end of the cecum?

A

The appendix

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13
Q

The mesoappendix attaches the appendix to what?

A

The inferior part of the mesentery of the ileum

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14
Q

The appendix is densely populated by what type of cell that helps it act as a source of immune cells.

A

lyphocytes

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15
Q

How long is the appendix?

A

7-8cm

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16
Q

What is the colon’s relationship with the peritoneum?

A

The ascending and descending parts are retroperitoneal

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17
Q

What are the other names for the right and left colic flexures respectively?

A

The hepatic and splenic felxures

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18
Q

Where does the sigmoid colon begin what is its course?

A

It begins at the left iliac crest projects medially to the midline then terminates at about S3

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19
Q

How long is the rectum?

A

roughly 15-20 cm

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20
Q

What is possible because of the transverse rectal folds in the colon?

A

The passing of flatus while retain feces

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21
Q

How many transverse folds does the rectum have?

A

3

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22
Q

describe the curvatures of the rectum?

A

It has three transverse folds and a antero-posterior curve

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23
Q

What is the name for the last 2-3cm of the rectum what muscle does it pass through?

A

The anal canal, it passes through the levator ani muscle

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24
Q

Describe the arrangement of the mucous membrane of the anal canal

A

It is arranged in longitudinal folds called anal columns with depressions called anal sinuses between them.

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25
Q

What make hemorrhoidal veins susceptible to distension/pooling?

A

They lack valves

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26
Q

What are the two distinct portions of the anus?

A

internal smooth muscle sphincter and external skeletal muscle sphincter

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27
Q

Unlike in other parts of the GI tract the colon has portions of thickened longitudinal muscle. What are there called?

A

teniae coli

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28
Q

What is the name for the pouches the colon is divided into that give it a “puckered” appearance?

A

Haustra

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29
Q

Stimulation by parasympathetic nerves arising from where increases secretion in the colon?

A

The pelvic region

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30
Q

What are the two types of movement that the colon undergoes in order to aid mechanical digestion?

A

Mixing movements/haustrations and propulsive/mass movements

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31
Q

How long is each typical haustration? when does it reach its peak contractile strength?

A

Each haustration typically lasts 60 seconds reach its peak contractillity halfway through this time

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32
Q

Haustrations/mixing movements in the colon are mediated by what kind of innervation?

A

parasympathetic autonomic motor impulses

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33
Q

How often do propulsive/mass movements happen in the colon in a typical day?

A

1-3 times

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34
Q

What mediates the initiation of mass/propulsive movements in the colon in response to the stomach filling?

A

the gastrocolic reflex

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35
Q

how does the strength of a propulsive/mass movement vary over time?

A

mass movements occur in a series upon initiation it becomes more and more forceful over 30 seconds then relaxes over the course of 2-3 minutes the begins again, this pattern continues for 10-30 minutes

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36
Q

What are the four main substances amino acids are broken down into by bacteria in the colon which two are excreted mostly in feces and contribute to its odor?

A

indole, skatole, hydrogen sulfide and fatty acids. Indole and skatole contribute to odor.

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37
Q

which breakdown product of bilirubin contributes to the color of faeces?

A

stercobilin

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38
Q

What are the main two vitamins that are both produced by colon bacteria and are required for normal metabolism.

A

B and K

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39
Q

What are the main roles of the proximal and distal halves of the large intestines respectively?

A

The proximal half is mostly for absorption whereas the distal half is predominantly for storage.

40
Q

What ion is actively transported out of the large intestine what two effects does this have?

A

Na is actively transported creating and electrical chemical gradient which draws Cl out and an osmotic gradient that draws water out.

41
Q

Faeces is composed of how much water and solid matter proportionally?

A

75% water 25% solids

42
Q

What proportion of the solids in faeces is composed of dead bacteria?

A

30%

43
Q

What proportion of the solids in faeces is composed of fat?

A

10-20%

44
Q

What proportion of the solids in faeces is composed of inorganic matter?

A

10-20%

45
Q

What proportion of the solids in faeces is composed of protein

A

2-3

46
Q

What proportion of the solids in faeces is composed of undigested roughage, dried constituents of digestive juices and sloughed epithelial cells?

A

30%

47
Q

What two compounds are responsible for the color of faeces?

A

stercobilin and urobilin, derivatives of bilirubin

48
Q

The external anal sphincter is controlled by what nerve?

A

pudendal

49
Q

What are the two defecation reflexes?

A

The intrinsic and parasympathetic defection reflexes.

50
Q

What co-ordinates the intrinsic defecation reflex?

A

the myenteric/auerbach’s plexus.

51
Q

How is breathing effected by defecation?

A

a deep breath is taken in before defaction

52
Q

What happens to the glottis during defecation?

A

it closes

53
Q

What happens to the abdominal wall muscles during defecation?

A

it contracts forcing the contents of the colon downwards

54
Q

what happens to the pelvic floor during defecation?

A

It relaxes

55
Q

What happensto the anal ring during defecation?

A

it is pulled outward envaginating the feces

56
Q

What are the two types of carcinogens?

A

mutagenic and non mutagenic

57
Q

How can something that is not mutagenic still be a carcinogen?

A

it can promote cancer through stimulation of mitosis

58
Q

What is atrophy in cells?

A

decrease in size

59
Q

What is hypertrophy

A

increase in cell size

60
Q

what is hyperplasia?

A

abnormal multiplication of cells

61
Q

What is metaplasia?

A

transformation of one tissue type to another

62
Q

What is dysplasia?

A

loss of normal tissue arrangement/structure

63
Q

What is the most extreme disturbance of cell growth?

A

Anaplasia

64
Q

What is neoplasia?

A

an abnormal mass of tissue

65
Q

What is the most common class of cancer?

A

carcinoma

66
Q

What type of cell are carcinomas derived from?

A

epithelial

67
Q

What type of cell are leukaemias derived from?

A

blood forming tissues

68
Q

What are the two main types of sarcomas?

A

bone and soft tissue

69
Q

What type of cell are sarcomas derived from

A

connective tissues

70
Q

What type of cancer is more common in children?

A

blastoma

71
Q

What type of cells are blastomas derived from?

A

precursor cells

72
Q

What is a teratoma?

A

A tumor with tissue or organ components resembling more than one germ layer

73
Q

What is an oncovirus

A

a virus that can cause a cancer

74
Q

In what phase of the cell cycle is DNA replicated?

A

s phase

75
Q

How long does S phase usually take?

A

8 Hours

76
Q

How long does G2 phase usually take?

A

2 hours

77
Q

In what phase of the cell cycle do the chromosomes begin to condense?

A

G2

78
Q

In what phase of the cell cycle does mitosis usually occur? How long does this phase usually last?

A

M phase, it typically lasts an hour

79
Q

In what phase does cell growth and duplication of organelles occur as well as the normal functions of the cell? How long does this phase last?

A

G1, it can last from 6 hours to several days or longer

80
Q

What are the two key classes of regulatory molecules that determine a cell’s progression through the cell cycle?

A

cyclins and cylcin dependant kinases

81
Q

What is the difference in the synthesis of CDK’s and cyclins

A

cyclin dependant kinases are constantly expressed while kinases are only expressed during specific stages of the cells cycle

82
Q

What is the action of CDK’s once activated?

A

they phosphorylate specific target proteins, activating or deactivating them

83
Q

What are the two families of genes that prevent the progression of the cell cycle and act as tumor suppressors.

A

Cip/kip family and INK4 family

84
Q

Members of the cip/kip gene family inhibit the effect of what? what is the effect of this?

A

INK4They inhibit the activity of CDK4 and CDK6 arresting the cell in G1 phase

85
Q

What are the four members of the INK4 family?

A

p15 p16 p18 and p19

86
Q

What part of the cell cycle do the cip/kip family arrest the cell cycle in?

A

G1

87
Q

What is hyperchromatism?

A

the darker staining of cytoplasm and nuclei often observed in cancer cells

88
Q

Tumor cells are constricted to what thickness if angiogenesis does not occur?

A

1-2mm in diameter

89
Q

What is extravasion?

A

The exiting of cells from the lumen of a vessel to the surrunding tissue

90
Q

What family of proteases is most important to the process of apoptosis? How are they stored in cells?

A

caspases are the most important type of protein they are stored in cells as caspases.

91
Q

Bax and Bak are what?

A

pro apotitic proteins

92
Q

Bcl-2 and Bcl-Xl are what?

A

anti apoptitic proteins

93
Q

What is a cell’s response to the presence of Bac and Bax into the cell, what is the effect of this?

A

cytochrome c is released leading to the activation of the caspase cascade.

94
Q

What is the mos common abnormality in the proto-oncogenes in human tumors

A

RAS oncogene

95
Q

What proportion of human tumors contain a mutation of the p53 tumor suppressor gene?

A

over 50%

96
Q

What is the main role of the APC

A

to decrease the amount of growth promoting signals

Semester 4 (10 decks)

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