CHAPTER 5: NEOPLASIA

Question 1

Neoplasia

Answer 1

process of abnormal growth of cells

Question 2

Cell Cycle Checkpoints
- CDK
- Cyclins
- CDK inhibitors

Answer 2

CDK: constitutively expressed, allow cell cycle to proceed when bound to cyclin

Cyclins: bind to and activate CDK

CDK Inhibitors: tumor suppressors, bind to complex and stop cycle progression to repair DNA errors

Question 3

Tissue Renewal and Repair (3)

Answer 3

Cell proliferation: cell division
cell differentiation: specialization, new cells acquire structure/function
apoptosis: programmed cell death of damaged cells

Question 4

Cell Proliferation (3)

Answer 4

Permanent: lose ability to divide/reproduce (neurons, skeletal, cardiac, RBC)

labile: progenitor cels continuously divide rapidly (bone marrow, gut, skin)

stable/quiescent: enter cell cycle from G0 when stim (hepatocyte, WBC)

Question 5

Cell Differentiation

Answer 5

maturation of a normal cell to one with specialized functions

Question 6

Neoplasms: benign v. malignant

Answer 6

benign: well differentiated cells cluster together in single mass (-oma_

malignant: less well differentiated, can break loose and enter circ or lymphatic system to form tumor at other sites

Question 7

Cancer Cells

Answer 7

• abnormal and rapid proliferation
• loss of differentiation (anaplasia)

Question 8

Metastasis Types (3)

Answer 8

• direct invasion and extension of surrounding tissues
• seeding of cancer cells in body cavities (pleural, pericardial, peritoneal)
• lymphatic and hematogenous spread

Question 9

Proto-oncogene vs. Oncogene

Answer 9

Proto: normal genes which encode for proteins that promote cell growth/normal activity

oncogene: mutated proto-oncogenes, GAIN OF FUNCTION MUTATION

Question 10

Tumor Suppressor Genes

Answer 10

responsible for slowing replication or cell growth
- once mutated the genes TURN OFF and lose their function of suppressing tumors

Question 11

Carcinogenesis (3 steps)

Answer 11

process of transforming normal cells into cancer cells
- initiation: exposure to cancer causing agent damages DNA
- promotion: promoter stimulates mutated cells to enter cell cycle
- progression: accum. mutations and continued cellular transformation

Question 12

Clinical Manifestations: Tissue Integrity

Answer 12

ulceration and necrosis with bleeding and hemorrhage

ex) sore that doesn’t heal

Question 13

Clinical Manifestations: Systemic Manifestations

Answer 13

cachexia (assoc w anorexia), anemia, fever, hemostasis abnormalities

Question 14

Clinical Manifestations: Paraneoplastic Syndromes

Answer 14

distant effects of a tumor that are unrelated to metastasis
- hormones, neuro, derm factors

Question 15

Clinical Manifestations acronym: CAUTION

Answer 15

Change in bowel/bladder
A sore that doesn’t heal
Unusual bleeding/discharge
Thickening or lump in breast
Indigestion or difficulty swallowing
Obvious change in a mole
Nagging cough or hoarseness

Question 16

Diagnostic Screening: early detection

Answer 16

• inspect skin, mouth, genitalia
• palpation: breast, thyroid, rectum, prostate, lymph nodes
• lab tests/procedures: pap smear, colonoscopy, mammo

Question 17

Diagnostic Screening: methods

Answer 17

• tumor markers
• tissue biopsy
• endoscopy
• ultrasonography
• x-ray, MRI, CT, PET

Question 18

Grading tumors

Answer 18

microscopic examination of cancer cells to determine level of differentiation
- grades I, II, III, IV

Question 19

Staging Tumors

Answer 19

determine size, extent, and spread of tumor

TNM System & Stage 1-4
- T= tumor size and local spread
- N= lymph node involvement
- M= metastasis to other organ

Question 20

Cancer Treatment

Answer 20

• surgery
• radiation therapy: interrupts cell cycle, kill/damage DNA
• chemotherapy: systemic treatment, drugs reach site of tumor, targets cell growth/replication processes
• hormonal therapy
• biotherapy/immunotherapy
• stem cell transplantation