Exam 2 Flashcards
Malignant
capable of metastasis
tumor
a non-specific term meaning lump or swelling
metastasis
discontinuous spread of malignant neoplasm
neoplasm
uncontrolled growth of cells
cancer
any malignant tumor/neoplasm
carcinoma in situ (CIS)
- cancer in place
- has not through basement membrane yet
- if caught in this stage it can be cut out to cure it
TNM system
- describes staging
- T: describes tumor (0-3)
- N: lymph nodes (0-2)
- M: metastasis (0-2)
staging
describes extent of spreed
Dysplasia
- premalignant state
- if it stays there it will become cancer
- doesn’t necessarily progress to malignancy
- usually occurs in the epithelium
carcinogenesis
the creation of cancer
cachexia
generalized wasting that occurs in terminal cancer
grading of tumor
- shows how differentiated or undifferentiated cells are
- degree of differentiation roughly estimates tumors malignant potential
CAUTION
- Changes in bowel/bladder habits or functions
- A sore that doesn’t heal
- Unusual bleeding or discharge
- Thickening or lump in breast or elsewhere
- Indigestion or difficulty swallowing
- Obvious changes in a wart or mole
- Nagging cough or horseness
lifestyle choices that reduce risk of cancer
- don’t use tobacco
- sun safely
- diet (processed foods are carcinogens)
- drink alcohol moderately
- exercise regularly
- vaccinations (HPV)
- safe sex practices
- maintain a healthy weight
- self-examinations
what is the most deadly cancer in adults?
lung cancer
which cancer is the most common in women?
breast cancer
which cancer is the most common in men?
prostate cancer
proto-oncogene
a normal gene
oncogene
- mutated proto-oncogene
- “green light”
KRAS oncogene
- mutation of the RAS proto-oncogene
- mutated RAS leads to activation of protein which stimulates transcription
- mutation in RAS causes it to always be “on” making cells grow really fast
tumor suppressor genes
- they detect and repair DNA damage before they can go through mitosis
- “red light”
mutation of Tumor Suppressor p53
- mutation causes the levels of p53 to increase in a cell
- results in:
1. ) recruit in DNA repair
2. ) senescence
3. ) death by apoptosis
what is the most mutated tumor suppressor gene?
p53
what is the function of tumor suppressor gene p53
stops the cell cycle and usually found in low amount in cells
senescence
the cell is still alive but it will never divide again
how is cancer a multi-hit development?
in order for cancer to acquire a malignant phenotype it needs to have multiple mutations (hits) to genome
etiology of cancer
-cancer occurs due to mutations in DNA
what cells does cancer occur in
somatic or germ cells
why is cancer hard to treat?
each cancer is genetically unique, not everyone’s is the same
manifestations of cancer
- ) mass
- ) hormone production
- ) systemic manifestation
- ) cachexia
paraneoplastic syndrome
manifestation of aberrant and uncontrolled hormone production by a malignant neoplasm
EX: lung cancer produces unregulated cortisol, so it can be misdiagnosed as Cushings syndrome
Surgery for treating cancer
- prevent cancer
- cure depending on localization
- biopsy for diagnosis
- debulking surgery
- palliative surgery: surgery to manage symptoms
hormone therapy for cancer treatment
- activation or blockage of a receptor
- interferes with cellular growth and signaling
ionizing radiation for cancer treatment
-targets cells in S phase so mutated DNA can’t divide
goals:
-eradicate cancer without excessive toxicity
-avoid damage to normal structure
chemotherapy for cancer treatment
- given via IV
- chemicals target ALL rapidly dividing cells (can’t target only cancer dividing cells)
- puts a base analogue in DNA that won’t work
symptoms of chemotherapy
- hair loss
- low white blood cell count, can get sick more often
- low red blood cell count, anemia
- loss of appetite
immunotherapy
- immune system sees mutant cell as foreign
- it then stimulates own immune system to better recognize cancer cells
- tumor antibodies
targeted therapy
- “precession medicine”: acts on specific molecular targets
- EX: HER2
mammography
screening for breast cancer recommenced at age 40
pap smear
screening for cervical cancer
colonoscopcy/fecal occulta test
screening for colon cancer recommened at age 50
what cancers are the most deadly?
cancers that don’t have screening tests
congenital disease
a disease that you are born with
allele
variation form of a gene (EX: eye color)
Non-disjuction
DNA doesnt pull apart correctly in meiosis
Genetic disease
disease caused by abnormal DNA
Karyotype
illustration of chromosomes that is used to visualize them and look for abnormailites and alterations
Aneuploidy
when there is one or more extra or missing chromosomes which results in abnormal number
what are the main causes of developmental diseases?
1.) birth defects/congenital anomalies
how does a genetic disease develop?
- inherited by parents
- can occur in gamete development
fetal alcohol syndrome causes and effects
- Cause: when mom consumes alcohol during pregnancy
- effects: fetal growth restriction, CNS abnormalities, and distinctive facial features
what is Amniocentesis
- a sample of amniotic fluid is taken via needle to check for disease
- has risk for miscarriage
what is chorionic villi testing
- sample of projections (chorionic villi) of placenta are taken to test for disease
- greater risk for pregnancy loss
is Amniocentesis or CVT more accurate and why?
amniocentesis is more accurate because in CVT it takes samples of the placenta not direct samples of fetus
who is recommended to have amniocentesis or CVT done?
- mother 35 or older
- parents who have a child with genetic disease
- family history
Trisomy 21
- Down syndrome
- 3 21 chromosomes (extra)
- cause due to non-disjunction in mieosis 1
what are manifestations of down syndrome
- intellectual impairment that varie
- round face and slanted eyes
- small stature
- congenital heart defects
- intestinal defects
- increased risk for alzheimers
Turners syndrome
- sex chromosome abnormalities
- females only has 1 x (x)chromosome instead of 1
- causes: non disjunction
- features: short in stature, webbing at neck, secondary sex organ don’t develop, infertile/don’t through puberty
Kleinfelter syndrome
- sex chromosome abnormalitie
- male has extra x chromosome (xxy)
- causes: non disjunction
features: tall, long limbs, breast development, secondary sex organs don’t develop, infertile
Autosomal dominant inheritance
- disease is expressed if only one copy is present
- affected person has 50% of passing disease to off spring
Martan syndrome
- autosomal dominant disease
- effects: tall w long limbs and fingers/toes, heart valves don’t close correctly, eyes can detach from retinas, blood vessels more likely yo stretch, increase in cardiac death
autosomal recessive inheritance
- need two copies of genes
- both parents must be carriers
cystic fibrosis
- autosomal recessive disease
- most common ARD affecting white mothers
- causes mutation in chloride channels which regulates chloride and sodium movement
- effects: thick, sticky mucus that doesn’t move
Sickle cell disease
- mutation in hemoglobin that alters RBC’ shape
- leads to microinfarct due to ischemia
- RBC’s will be removed by body but can result in anemia
Sex-linked inheritance
- mutation on the X or Y chromosome
- more likely to occur on the X chromosome because it is bigger
Duchenne Muscular Dystrophy
- mutation on X chromosome causing neuromuscular disease
- diagnosis: around 2-3 years
- wheelchair bound at 12 years
teratogen
- harmful drug/chemical that affects the development of a fetus
- EX: cigarettes, alcohol, radiation, and infections
when is the embryonic period
first 8 weeks after fertilization
when is the fetal period
9-38th weeks of pregnancy
when is the perinatal period
- “around birth”
- 2 weeks before birth to 1 month after birth
when is infancy
after birth to one year
when is childhood
- after infancy to before adolescene
- 1 to puberty
when does adolescence begin
once child hits puberty
what is the most common embryonic and fetal disease?
congenital heart defects
Sudden Infant Death Syndrome (SIDS)
- unexpected, sudden death of child under age of 1
- risk factors: co-sleeping, sleeping on stomach, premature birth, cigarettes, sibling who had SIDS, teen mom, no prenatal care, live in poverty
what is the most common cause of death in children?
drowning
what is a common disease pf a premature baby?
cerebral palsy
edema
increase in fluid for the interstitial space
effusion
accumulation of fluid in a body cavity
Thrombus
an abnormal intravascular clot which can occur in any vessel within the heart (stationary)
embolus
“traveling blood clot”
-detaches from thrombus and is carried into the pulmonary or systemic circulation
Arterioscelorsis
hardening of the arteries
Atherosclerosis
- type of arterioscelrosis
- inflammation/degenerative disease
Ascites
fluid in abdonmial cavity (effusion)
Aneurysm
ballooning/weakening of an artery
Common causes of edema
- ) increase in hydrostatic pressure
- ) decrease in osmotic pressure due to loss of albumin
- ) kidney/liver disease
- ) lack of protein in diet
hydrostatic pressure
blood pressure pushes fluid out of vessels
osmotic pressure
- water move into vessels due to concentration gradient
- determined by amount of albumin in blood
lymph
fluid that comes out of blood composed of water, proteins, and white blood cells, that the lymphatic system will return back to blood
hemangioma
capillaries that divide locally and form a red spot on the skin (painless, benign, won’t grow
lymphangioma
dilated pass of lymphatics (lump on skin, not red)
how does atherosclerosis develop?
injury to endothelial cells in arteries which eventually lead to endothelial cell dysfunction
what occurs in atherosclerosis?
- increase in permeability causing accumulation of macrophages and smooth cells
- ) lipid accumulation (fatty streaks) and possibly plaque
how does atheroscelorsis harm?
- ) narrows lumen causing ischemia
- ) weakens vessels wall causing aneuryam
- ) rupturing plaque causing exposure to collagen forming a thrombus
what are the complications of atherscelrosis
- ) coronary arteries can narrow and cause heart attack
- )abdominal aorta can develop aneurysm
- )arteris of lower limbs can cause decreased blood flow leadng to intermittent claudication
what is hypertension
high blood pressure above 140/90
primary hypertension
- hypertension that is the main problem
- majority of cases
- idiopathic
secondary hypertension
- hypertension that is due to another disease
- EX: tumor on adrenal causes extra cortisol which increase blood pressure
what organ systems are effected by hypertension?
- ) CNS: more likely to have stroke
- ) cardiovascular system
- ) kidneys: main cause of dialysis
aortic dissection
- tunica media of the aorta splits into two
- fatal
- feels like ripping sensation in chest anf dizziness
medication for hypertension
- ) diuretics
2. ) ACE inhibitors
diuretics
increase urination which decreases cardiac output by lowering mean arterial pressure
ACE inhibitors
- cause lower levels of angiotensin 2
- increases TPR
- lowers cardiac output by causing less sodium and water retention
treatments of hypertension that is not medication
- ) physical activity
- ) diet: reduce sodium, increase fruits and veggies (magnesium and potassium)
- parts of DASH diet
risk factors of atherscelrosis
- ) major:
- elevated blood lipids
- hypertension
- cigarette smoking
- diabetes
- obesity - ) Minor:
- age
- gender
- stress
- family history
venous thrombus
- thrombophlebits
- clot forming in deep leg veins bc blood os stationary
- caused by prolonged bed rest, cramped position for long time, genetic factors
what is the risk for a venous thrombus?
deep vein thrombus: peice of clot comes off and can get into heart causing pulmonary embolsim
varicose veins
- dialted, cury veins
- due to incompetent valve
- causes: genetics, standing
- complication: pain and visibility
- treatment is surgery
what is shock
failure to maintain adequate blood pressure
how is shock manifested?
- decreased blood flow
- increased heart rate
- decreased urine output
- altered state of conscicousness
cardiogenic shock
pump fails due to heart attach
hemorrhagic shock
loss of blood volume, usually due to truama
anaphylactic shock
- systemic allergic reaction causing WBC’s to release vasodilators everywhere
- blood pressure drops quickly
septic (sepsis) shock
-blood infections leading to massive vasodilation
treatment of shock
- remove stressor
- fluids (saline)
- vasoconstriction agents
- antibiotics
- surgically repair beelding arteries
where is the mitral valve located?
between the left atrium and ventricle
where is the tricuspid valve located?
between the right atrium and ventricle
where is the pulmonary valve located
between the right ventricle and pulmonary artery
where is the aortic valve located
between the left ventricle and aorta
angina
chest pain
cardiomyopathy
disorder involving the chambers of the heart
valvular stenosis
valves doesn’t open all of the way
valvular regurgitation
valve doesn’t close all the way
echcardiography
uses ultrasound to see the heart and look for valve and chamber abnormalities
angiogram
a catheter is placed up the femoral artery and into the heart to view it
fibrillation
“quivering” of the chambers instead of contractions
what are the most common cardiac disorders?
- ) athersclerosis
- ) hypertension heart disease
- ) aortic stenosis
- ) Afib
- ) heart failure
signs and symptoms of heart faillure
- fluid build up in lungs and other tissues
- shortness of breath due to pulmonary edema
- edema in extremities
Chest X-ray
can view if there is any fluid in lungs
serum enzyme level
when cells die via infarct they release enzymes
electrocardiogram (ECG/EKG)
- looks at the electrical activity of the heart
- track rhythm and look arrythmia
- detect heart attack
what is the P wave
atrial depolarization
what is the QRS complex
ventricular depolarization
what is the T wave
ventricular repolarization
atrial and ventricular septal defects
- defect in the septum between the atria and ventricle
- mixes CO2 and O2 blood
manifestations of atrial and ventricle septal defects
- murmur
- easily fatigues
- heart failure: due to hypertrophy of ventricles
defects of Tetralogy of Fallot
- ) ventricular septum defect
- ) pulmonary stenosis: pulmonary valve can’t open all the way
- ) hypertrophy of right ventricle
- ) overriding aorta: aorta is located above both ventricle
manifestations of tetralogy fallot
- ) cyanosis (blue)
- ) slow growth
- ) heart failure
- )reduced like expectancy
pulmonary circuit
on the right side of heart
-receives and pumps CO2 blood from body to lungs
systemic circuit
on left side of heart
-recieves O2 blood from the lungs and pumps it to the body
Aortic regurgitation
- most common vavlular disorder
- leaflets of aortic valve undergo changes that restrict mobility
- causes left ventricle to work harder resulting in hypertrophy
- can lead to heart failure
Rheumatic Fever (scarlet fever)
- streptococcal bacteria
- WBC’s invade the
- valves look like the bacteria so WBC’s attach to valve and cause damage
- disease does not cause the damage the immune system does
what is the most common cause coronary heart disease?
arrhythmia’s
hypertensive heart disease
- hypertension causes an increase in work load on the heart
- in order for heart to drive blood flow it must overcome the systolic pressure
manifestations of hypertension heart disease
- enlarged heart
- heart failure
- ischemia
Myocardial infarct
- death of cells due to ischemia
- “heart attack”
symptoms of Myocardial infarct
- angina
- sympathetic NS response: increased HR, anxiety, vomiting
- Hypotension and shock: weakness in arms/legs
symptoms of MI in men and women
men are more likely to have the symptoms than women
diagnosis of MI
- ) EKG: look to see if in between the S and T wave is abnormal
- ) enzyme serum test (creatine kinase, lactase dehydrogenase, and troponin)
- ) coronary angiogram
treatment of MI
- stent: holds wall of coronary artery open
- angiopasy: destroys clot
- cardiac bypass
- lifestyle changes
what is the goal of treatment in MI
restore blood flow immediately
Bradycardia
slow resting heart rate
tachycardia
increased resting heart rate
Atrial Fibrillation
- atria “quivers” instead of contracting
- blood will stay in the atria
- increased risk for thrombus
- caused by a disorganized electrical impulse
ventricular fibrillation
- more serious
- there is no coordination in the electrical impulses at all
- no blood flow to body
- need to use paddles to shock and reset the heart
dilated cardiomyopathy
- dilation of the chamber
- causes problem when contracting (systole)
- muscles too far apart
hypertonic cardiomyopathy
- chamber wall thickens
- chambers can’t hold as much blood
- can lead to sudden cardiac arrest
- leading cause of death in young athletes
restrictive cardiomyopathy
- chambers are rigid which restricts stretching
- chambers can’t relax and fill with blood (diastolic)
