Christmas Exam bits & pieces Flashcards
Define a tumour
An abnormal growing mass of tissue, growth is uncoordinated with surrounding tissue & continues after the external stimulus is removed
What is the prefix for glandular epithelial tumorus?
Adeno-
What do we call Epithelial malignant tumours?
Carcinomas
What is differentiation like in benign/malignant tumours?
Benign are well differentiated
Malignant tumours are poorly differnetiated
What are the 2 types of neural malignant tumour?
Astrocytoma in the CNS
Schwannoma in the PNS
How does invasion work?
multi-step process
Proteolytic enzymes degrade ECM
Cells lose cell-cell & cell-matrix adhesion
What are the 4 types of Tumour spreaD?
Lymph
Blood
Local
Trans-coleimic
Examples of a diagnostic tumour biomarker:
ALpha-fetoprotein
Marker for hepatocellular carcinoma & Testicular Teratoma.
Common metastasis sites:
- Axial Skeleton
- Adrenal Gland
- Liver
- Lung
- Brain
Example of a predictive biomarker:
OEstrogen receptors are monitored in breast cancer as theyre prescence/type can indicate the specific type of cancer & therefore the best treatment
Common metastasis for breast, prostate & colorectal cancer?
Breast/Prostate -> Bone
Colorectal - > Liver
Whats the abnormal morphology of cancer cells speciically?
Cellular & Nuclear Pleomorphism
MArked difference in cell & nucleus size/shape
Dysplasia?
Uncontrolled growth of abnormal cell type
Characteristics of Dysplasia:
- Graded (high/low)
- Disorganised (Increased nuclear size & mitotic activity + abnormal mitosis)
- No invasion
Example of abnormal hormone secretion by a tumour?
Lung Carcinoma can secrete ADH & ACTH
Systemic effects of malignant tumours:
Weight loss cachexia
PAraneoplasstic syndrome
Abnormal hormones
Treatments effects
Causes of pain in cancer:
Commonly:
= Perineural infiltration
- Pathological fractures
- Ulceration/haemorrhage
External stimuli/inhibitors of cell growth:
- Growth facors
- Hormones
- Cytokines
Define cell cycles?
Time between mitotic division
3 types of enviromental carcinogens?
Radiation
Chemical
Oncogenic viruses
How do enviromental cacinogens cause cancer?
- Radiation mutates bases
- Chemical binds to DNA fomrming adducts which eventually causes oncogenesis
- Oncogenic viruses either isnert oncogenes into cells ( Retrovirals) or viral promoters cause proto-oncogene overexpression
Difference between inherited & sporadic oncogenesis?
Inherited involves being born with atleast one mutated allele
Sporadic involves both hits occuring as sporadic point mutations
Difference between inherited cancer syndromes & familial cancers?
- Inherited is autosomal dominent of a single mutant gene
- Familial has multifactorial inheritence with no clear predisposing gene
Some inherited/ familial cancers:
Inherited - MEN, FAP, Familial retinoblastoma
Familial - Some breast/ovarians
How do proto-oncogenes becomeoncogenes?
Overexpresssion or mutation
Some common oncogenic viruses and their cancers?
HEP B - > LIver
EBV -> Burkitts lymphoma
HPV -> Cervical
What is the henderson-hasselbach equation and what do we use it for/
pH = pKa + log10 (conjugate base/unionised acid)
Determing the relationship between local pH and a drugs ionisation
What 4 thins affect bioavailiabilty & what is it?
Bioavaliability is the amount of drug reachin the systemic circulation acitive and useable.
- GI factors
- Ability to cross physiologicak barriers
- Formulation
- First Pass MEtabolism
How do GI factors affect bioavailability?
Increased gut motility improves time to the site of absorption
Food & diseases can both impair/enhance the amount of drug absorbed
How does fomrulation affect bioavailiabitly?
Some durgs are slow-release formualtions
What effects a dugs ability to cross barriers?
- Ionisation/pH
- Lipid solubility
- Particle Size
What is taken up by Active transport?
- Levidopa in brain (for parkinsonism)
- Iron
- Calcium
- Sodium
- Potassium
What is taken up by facilitated diffusion?
- Monosacchrides
- AMino acids
- Vitamins
What drives filtration/bulk flow?
Hydrostatic and/or osmotic pressure
What is the aparent volume of distributio?
Vd
Volume is which a durg needs ot be distributed to produce observed blood conc.
What does an increased Vd tell us?
The drug is better at crossing membranes
What is drug clearence?
Cl
Volume of fluid cleared of drug every unit time
e.g. ml/min
What is clearnece dependant on?
Renal clearence - Conc. urine flow rate
Hepatic clearence - Metabolism & biliary excretion
Where does most drug excretion occur?
Kidneys
What other places can du excretion occur?
- lung
- milk
- liver
yadda yadda
What are the 3 types of renal excretion emchanisms?
- Active tubular secreiton
- Passive tubular reabsorbtion
- Glomerular filtraion
What occurs in active tubular secretion?
Acid/alkali drugs (often protein bound) are secreted into urine
What occurs in passive tubular reabsorption?
Small unionised drugs are reabsorbed into circulation
What occurs in Glomerular filtration?
All unbound drugs are filtered from the blood and excreted
How does the liver deactivate metabolsied drugs?
by conjugating them
What happends to non-conjugated drugs after theyre secreted into bile?
Theyre reabsorbed (entero-hepatic cirulation)
What happens to conjugated drugs secreted into bilE?
They cant be reabsorbed so they are shat out
What effects bound drug levels?
- Renal failure
- Hypoalbumineia
- Pregnancy
- Other drugs
- Sturability of bindin
What affects tissue distribution of drugs:
- Plasma binding protein
- Membrane characteristics
- Tissue perfusion
- Transport mechanisms
- ELimnation
- Siseas/otherdrugs
What would make a drug unable to be filteerd out at the glomerulus?
LArge particles or large charges
Whats the difference in metabolism at different ages?
Infants have reduced renal funciton & fewer enzymes
Pubescent kids have the highest metbolic rate of all ages
Waht 3 reactions could occur in phase 1 metabolism?
Hydrolysis
Oxidation
or reduction
What is the purpose of phase 1 metabolism?
To increase polrity & provide ana ctive site for phase 2
What family of enzymes act in phase 1 and examples:
Cytochrome P-450s
CYP1A2
CYP3A4
CYP2D6
What CYP1A2 metabolize?
Theophylline
What does CYP2D6 metabolixe?
- Anti-depressents
- Anti-psychotics
- Codeine->morphine