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ClinMed_I > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

What are characteristics of normal cells?

A

Small, uniformly shaped nuclei
Large cytoplasmic volume
Conformity in cell size, shape, arrangement
Differentiated cell structures, normal cell surface markers
Lower levels of dividing cells
Clear boundaries

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2
Q

What are characteristics of cancer cells?

A

Large, variable shaped nuclei
Small cytoplasmic volume
Variation in size, shape, arrangement
Loss of specialized features
Increased expression of certain cell markers
Large number of dividing cells
Poorly defined tumor boundaries

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3
Q

How many deaths in the US are caused by cancer?

A

1 in 4

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4
Q

What is the second leading cause of death in the US? Whats the first?

A

Cancer

CVD (first leading cause)

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5
Q

What are the 4 most common cancers?

A

Lung
Colon
Breast
Prostate

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6
Q

What are the current treatment techniques for cancer?

A

Surgery
Radiation therapy
Chemotherapy
Biologic therapy

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7
Q

What ethnicity are cancers the most deadly for?

A

African Americans

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8
Q

What is the most significant risk factor for cancer?

A

Age

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9
Q

What are the burdens of cancer? (3)

A

Physical morality
Emotional distress
Reduction in QoL

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10
Q

What are some factors that makes a person susceptible to cancer?

A

Exposure to a certain environmental factor (how long and often)
Genetic makeup
Age and gender

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11
Q

Improved understanding of carcinogenesis has allowed for what?

A

Specific interventions
Effective screening

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12
Q

What do we concern with for cancer prevention?

A

Identification and manipulation of…
Biologic factors
Environmental factors
Social factors
Genetic factors

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13
Q

What is the focus of primary prevention?

A

Prevent a cancer from developing
Delay the development on a malignancy

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14
Q

If an individual has a high risk for cancer, what are the primary prevention methods?

A

Chemopreventative agents
Prophylactic surgery

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15
Q

What is the most preventable cause of cancer death?

A

Tobacco

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16
Q

How many cancer deaths are due to tobacco?

A

30%

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17
Q

What is the most linked cancer with smokers?

A

Lung cancer

> 80% of lung cancer cases

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18
Q

How can smokers harm other people?

A

Secondhand or passive smoke

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19
Q

Smoking 1 or 2 cigars increases what the risk of what cancers? What about 3 or 4 cigars?

A

1/2 cigars have 2x risk of oral and esophageal cancers
3/4 cigars have 8x risk of oral and esophageal cancers

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20
Q

What health problems are smokeless tobacco linked with?

A

Dental caries
Oral Leukoplakia
Gingivitis
Pancreatic cancer
Oral cancer
Esophageal cancer

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21
Q

What are some primary prevention methods?

A

Physical activity
Dietary modifications
Avoid alcohol

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22
Q

Physical activity reduces the risk of what cancers?

A

Colon and breast cancer

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23
Q

The risk of cancers increases with what BMI?

A

> 25

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24
Q

What cancers are linked to obesity?

A

Breast
Endometrium
Gallbladder
Liver
Pancreas
Ovary
Colon
Kidney
Esophagus
Thyroid

BEGLPOCKET

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25
Q

High fat diets have an increased of what cancers?

A

Breast
Colon
Prostate
Endometrium

Weight gain which increase risk of cancers

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26
Q

What are the benefits of dietary fiber in relation to cancer?

A

Reduced risk of colonic polyps
Invasive cancer of colon

27
Q

Alcohol consumption increase the risk of what cancers?

A

Mouth
Throat
Liver
Voice box
Esophagus
Stomach

28
Q

What is secondary prevention?

A

Early detection and treatment

29
Q

What are some screenings for secondary prevention?

A

Physical examinations
Self-examinations
Radiologic procedures
Lab tests

30
Q

What does screening mean?

A

Early detection in asymptomatic individuals with the goal of decreasing morbidity and mortality

31
Q

What are the components of screening tests?

A

Sensitivity
Specificity
Positive predictive value
Negative predictive value

32
Q

What is sensitivity?

A

Proportion of persons with the disease who test positive in the screen

33
Q

What is specificity?

A

Proportion of persons who do not have the disease that test negative in the screening test

34
Q

What is a positive predictive value?

A

Proportion of persons who test positive that actually have the disease

35
Q

What is a negative predictive value?

A

Proportion testing negative that do not have the disease

36
Q

What cancers screenings are more beneficial for certain age groups?

A

Cervical
Prostate
Breast

37
Q

When and what screening tools should be used to find breast cancer?

A

Starting at age of 40 for women
CBE every 2 years 20-30s, every year start at 40
Breast self-exam(BSE) option for women in 20s
MRI for women with higher risk(genetics, family hx)

38
Q

When and what screening tools should be used to find colorectal cancer and polyps?

A

Both men and women at 45
Flexible sigmoidoscopy every 5 years
Colonoscopy every 10 years
Double-contrast barium enema every 5 years
CT colonography (virtual colonoscopy) every 5 years

Specifically for only cancer
Yearly fecal occult blood test (gFOBT)
Yearly fecal immunochemical test (FIT) every year
Stool DNA test (sDNA)

39
Q

When and what screening tools should be used to find cervical cancer?

A

Start at age 21
21-29 Pap test every 3 years
39-65 Pap test, HPV test (co-testing) every 5 years
65+ with normal results form regular testing should NOT be tested
Hx of cervical pre-cancer continue testing for at least 20 years, no matter the age

40
Q

What is “CAUTION” (warning signs of cancer)?

A

Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in the breasts, testicles or elsewhere
Indigestion or difficulty swallowing
Obvious change in the size, color, shape or thickness of a wart, mole, or mouth sore
Nagging cough or hoarseness

41
Q

What other findings would you find to suspect cancer?

A

Night sweats
Unexplained weight loss/loss of appetite
Repeat infection
Skin changes (hyperpigmentation, jaundice, erythema, itching, hirsutism)
Persistent low-grade fever
Chronic pain (bones)
Persistant fatigue, N/V

42
Q

What test is HEAVILY relied on for diagnosing cancer?

A

Invasive tissue biopsy

43
Q

What does a tissue biopsy tell us?

A

Histology of tumor
Grade of tumor
Invasiveness/characteristics of tumor

44
Q

What is staging? Purpose?

A

Determining the extent of disease

For prognosis and treatment plan

45
Q

What is monitoring?

A

Detecting reappearance and progression of cancer

46
Q

What is the rate of depression in cancer pts?

A

25%

47
Q

Depressed cancer patients are usually diagnosed with what?

A

Depressed mood(dysphoria)
Loss of interest in pleasure(anhedonia)

For at least two weeks

48
Q

How many more symptoms do depressed pts? What are there?

A

Appetite change
Sleep problems
Psychomotor retardation/agitation
Fatigue
Feelings of guilt or worthlessness
Inability to concentrate
Suicidal ideation

49
Q

What is the treatment for depression?

A

SSRI (fluoxetine, sertraline, paroxetine)
TCA (amitriptyline, desipramine)

Continued at least 6 more months after resolution

50
Q

What non meditational interventions are used to treat depression?

A

Support groups
Psychotherapy

51
Q

What are the types of staging?

A

Clinical staging
Pathologic staging

52
Q

What tests do you run in clinical staging?

A

Physical exams
Radiographs
Isotopic scans
CT scans
Other imaging procedures

53
Q

What information do you obtain to determine pathologic staging?

A

From surgical procedure…
Intraoperative palpation
Resection of regional lymph nodes or tissue adjacent to tumor
Inspection/biopsy of organ involved

54
Q

What terms are used to define the extend of disease?

A

Localized
Regional
Metastic

55
Q

What system of staging is most used?

A

TNM system (Tumor, node, metastasis)

56
Q

For lung cancer, after determining TNM system?

A

Overall stage 0, I, II, III, IV

This process is called stage grouping.

57
Q

What is a physiological reserve?

A

Determinant of how likely to cope with the physiologic stresses imposed by cancer and its treatment

58
Q

What are some markers for physiological reserve?

A

Pt’s age
Karnofsky performance status
Eastern cooperative oncology group (ECOG) performance status

59
Q

What are treatment recommendations based on?

A

Extent of disease
Prognosis
Pt wishes

60
Q

What are the types of treatment?

A

Curative
Palliative

61
Q

What is the difference between partial or complete remission?

A

In complete remission all signs and symptoms of cancer have disappeared

62
Q

What are the treatment of a relapse known as?

A

“Salvage” therapy

63
Q

What is the goal of palliative care?

A

Improve QoL

NOT to cure

64
Q

What are the tumor markers best used for?

A

Used to assess response to a treatment

ClinMed_I (15 decks)

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