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PathoPharm > lewis ch 15 (cancer) > Flashcards

lewis ch 15 (cancer) Flashcards

1
Q

what are the 2 major dysfunctions present in the process of cancer development

A

proliferation

differentiation

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2
Q

what rate do cancer cells multiply at

A

the same as the rate of the location they originated from

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3
Q

sometimes cancer cells produce more than 2 cells

through mitosis. 1 x 2 x 4 x 8 x 16

A

pyramid effect

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4
Q

which are more malignant: undifferentiated cancer cells or differentiated cancer cells

A

undifferentiated cancer cells

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5
Q

alterations in these tumor suppressor genes cause increased incidence in breast & ovarian cancers

A

BRCA 1 and 2

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6
Q

what is the process of the development of cancer

A
  • -initiation–
    1) carcinogen invades target cell
    2) altered cell: dysfunction in differentiation and proliferation
    3) cancer cell
  • -promotion–
    4) proliferation
  • -progression–
    5) evidence of clinical disease
    6) evidence of regional spread and metastasis
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7
Q

Cancer-causing agents capable of producing

cell alterations

A

carcinogens

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8
Q

examples of carcinogens (5)

A
  • poor diet
  • radiation
  • environmental toxins
  • viruses, bacteria, parasites
  • chemicals in tobacco goods
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9
Q

first stage of development of cancer, mutation of cell’s genetic structure

A

initiation

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10
Q

second stage of development of cancer, characterized by reversible proliferation of altered cells

A

promotion

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11
Q

what are some examples of reversible proliferation activities

A
  • obesity
  • smoking
  • alcohol use
  • dietary fat
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12
Q

the amount of time in the
initiation and promotion stage. The cancer is
not yet clinically evident.

A

latent period

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13
Q

third stage of development of cancer, characterized by increased growth of tumor, invasiveness, and metastasis

A

progression

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14
Q

what are the main sites of metastasis (6)

A
  • brain
  • CSF
  • bones
  • lung
  • liver
  • adrenals
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15
Q

what is it called when the primary tumor develops its own blood supply

A

tumor angiogenesis

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16
Q

what is the role of lymphocytes in response to tumor associated antigens

A

check cell surface
antigens and detect and
destroy abnormal cells

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17
Q

what is the role of cytotoxic T cells in response to tumor associated antigens

A

Kill tumor cells directly, Produce cytokines

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18
Q

what is the role of NK cells and macrophages in response to tumor associated antigens

A

lyse tumor cells

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19
Q

what is the role of B cells in response to tumor associated antigens

A

make antibodies that bind to tumor cells

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20
Q

what are some characteristics of benign tumors

A
  • encapsulated
  • differentiated
  • normal cell characteristics
  • slight vascularity
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21
Q

what are some characteristics of malignant tumors

A
  • not encapsulated
  • poorly differentiated
  • abnormal cells
  • moderate to marked vascularity
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22
Q

what are four things tumors can be classified by

A
  • anatomic site
  • anatomic extent (TNM classification)
  • histology
  • extent of disease
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23
Q

3 anatomic sites tumors can be classified by

A
  • carcinoma: skin and glands, mucous membranes
  • sarcoma: CT, bone, muscle, fat
  • lymphoma and leukemia: blood
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24
Q

what are the three parameters that classify anatomic extent (TNM classification)

A

T: tumor size and invasiveness
N: spread to lymph nodes
M: metastasis

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25
Q

what does T^0 mean

A

no evidence of primary tumor

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26
Q

what does T^is mean

A

carcinoma in situ

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27
Q

what does T^1-4 mean

A

ascending degrees of increase in tumor size and involvement

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28
Q

what does T^x mean

A

tumor cannot be found or measured

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29
Q

what does N^0 mean

A

no evidence of disease in lymph nodes

30
Q

what does N^1-4 mean

A

ascending degrees of nodal involvement

31
Q

what does N^x mean

A

regional lymph nodes unable to be assessed

32
Q

what does M^0 mean

A

no evidence of distant metastases

33
Q

what does M^1-4 mean

A

ascending degrees of metastatic involvement including distant nodes

34
Q

what does M^x mean

A

cannot be determined

35
Q

staging done at completion of diagnostic workup to

guide effective treatment selection (Bone and liver scans, ultrasonography, CT, MRI, PET scans)

A

clinical staging

36
Q

staging determined by surgical excision, exploration,

and/or lymph node sampling

A

surgical staging

37
Q

what does clinical stage 0 mean

A

Cancer in situ (localized cancer
cells that show no tendency to invade
or metastasize)

38
Q

what does clinical stage 1 mean

A

Tumor limited to tissue of origin;

localized tumor growth

39
Q

what does clinical stage 2 mean

A

Limited local spread

40
Q

what does clinical stage 3 mean

A

Extensive local and regional

spread

41
Q

what does clinical stage 4 mean

A

metastasis

42
Q

7 warning signs of cancer (CAUTION)

A 
C: change in bladder/bowel habits
A: a sore that won't heal
U: unusual bleeding or discharge
T: thickening or lump
I: indigestion or trouble swallowing
O: obvious change in wart or mole
N: nagging cough or hoarseness
43
Q

3 goals of cancer treatment

A
  • cure
  • control
  • palliative
44
Q

Study of genomic variation associated

with drug responses

A

pharmacogenomics

45
Q

Use of chemicals given as a systemic

therapy for cancer, used for solid tumors and hematologic cancers

A

antineoplastic therapy (chemo)

46
Q

methods of admin for chemo (3)

A
  • oral
  • IM
  • IV (most common)
47
Q

type of chemo: Delivery of drug directly into
tumor site, higher concentrations of drug can
be delivered with less systemic
toxicity

A

regional chemo

48
Q

what normal cells are most affected by chemotherapy

A
  • bone marrow stem cells
  • epithelial cells in GI tract
  • hair
  • neutrophils
  • ova/testes
49
Q

One of the oldest nonsurgical
methods of cancer treatment, emission of energy
from a source and travels through
space or some material

A

radiation

50
Q

Implantation or insertion of radioactive

materials into or close to tumor, minimal exposure to healthy tissue

A

internal radiation

51
Q

common side effects of radiation therapy (6)

A
  • bone marrow suppression
  • fatigue
  • GI problems
  • integumentary and mucosal reactions
  • pulmonary effects
  • reproductive effects
52
Q

type of cancer treatment: Boost or manipulate the immune system and create an
environment not conducive for cancer cells to grow, attacks cancer cells directly

A

immunotherapy

53
Q

type of cancer treatment: Interferes with cancer growth by targeting specific cell receptors and pathways that
are important in tumor growth, does less damage to normal cells

A

targeted therapy

54
Q

side effects with immunotherapy and targeted therapy (8)

A
  • flulike symptoms (pretreat with acetaminophen)
  • anorexia/weight loss
  • fatigue, weakness
  • nausea/vomiting
  • photosensitivity
  • hepatotoxicity
  • tachycardia
  • orthostatic hypotension
55
Q

two examples of hormone therapy used to treat cancer

A
  • sex hormones

- corticosteroids

56
Q

supportive med for cancer treatment for anemia

A

erythropoietin (epoetin alfa)

57
Q

supportive med for cancer treatment for neutropenia

A

granulocyte colony-stimulating factor (filgrastim)

58
Q

supportive med for cancer treatment for myeloid cell recovery after bone marrow transplant

A

Granulocyte-macrophage colony-stimulating factor

sargramostim

59
Q

supportive med for cancer treatment for thrombocytopenia

A

interleukin 11 platelet growth factor (oprelvekin)

60
Q

allogeneic donor

A

matched donor

61
Q

syngeneic donor

A

identical twin

62
Q

autologous donor

A

patients own stem cells

63
Q

problems associated with cancer and chemotherapy

A
  • nutritional (malnutrition, altered taste sensation, cancer cachexia)
  • infection
  • oncologic emergency
  • cancer pain
64
Q

oncologic emergency: obstructive:
-Intense, localized, and persistent back pain with vertebral tenderness.

  • Motor weakness, sensory paresthesia and loss.
  • Autonomic dysfunction (e.g., change in bowel or bladder function).
A

spinal cord compression

65
Q

oncologic emergency: obstructive:
• Facial edema, periorbital edema.

  • Distention of veins of head, neck, and chest.
  • Headache, seizures.
  • Mediastinal mass on chest x-ray.
A

superior vena cava syndrome

66
Q

oncologic emergency: obstructive:

• Signs of hypovolemia: hypotension, tachycardia, low central venous pressure, decreased urine output.

A

third space syndrome

67
Q

oncologic emergency: metabolic:
• Serum calcium higher than 12mg/dL (3mmol/L) often produces symptoms.

  • Apathy, depression, fatigue, muscle weakness, ECG changes, polyuria and nocturia, anorexia, nausea, vomiting.
  • High calcium elevations can be life threatening.
  • Chronic hypercalcemia can result in nephrocalcinosis and irreversible renal failure.
A

hypercalcemia

68
Q

oncologic emergency: metabolic:
• Water retention and hyponatremia (hypotonic hyponatremia) .

• Weight gain without edema, weakness, anorexia, nausea, vomiting, personality changes, seizures, oliguria, decrease in reflexes, coma.

A

syndrome of inappropriate antidiuretic hormone

69
Q

oncologic emergency: metabolic:
• Hallmark signs: hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia.

  • Weakness, muscle cramps, diarrhea, nausea, vomiting.
  • Occurs within 24–48 hr after starting chemotherapy.
  • May last 5–7 days.
  • Metabolic abnormalities and concentrated uric acid (which crystallizes in distal tubules of kidneys) can lead to acute kidney injury.
A

tumor lysis syndrome

70
Q

oncologic emergency: infiltrative:
• Heavy feeling over chest, shortness of breath, tachycardia, cough, dysphagia, hiccups, hoarseness.

  • Nausea, vomiting, excessive perspiration.
  • Decreased level of consciousness, distant or muted heart sounds.
  • Extreme anxiety.
A

cardiac tamponade

71
Q

oncologic emergency: infiltrative:

• Bleeding: ranges from minor oozing to spurting of blood in the case of a “blowout” of artery.

A

carotid artery rupture

PathoPharm (42 decks)

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