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NYCC Physiopathology > Metastasis & Manifestation > Flashcards

Metastasis & Manifestation Flashcards

1
Q

What is metastasis?

A

The invasive nature of neoplasms which allows them to penetrate into blood vessels, lymphatics, and body cavities to travel to distant anatomical territories

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2
Q

metastasis unequivocally marks a neoplasm as ____

A

malignant
(benign do not metastasize)

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3
Q

What are the main pathways of metastasis?

A
  • Hematogenous
  • lymphatic
  • direct seeding/extension
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4
Q

What are the most common metastatic patterns of renal cell carcinoma?

A

Kidney ——> Lung
Kidney ——> Bone

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5
Q

What percentage of newly diagnosed cancer patients with solid malignant neoplasms clinically present with metastasis?

A

50%

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6
Q

what factors of a neoplasm increase the likelihood that it will metastasize?

A

the more aggressive, rapidly growing, and larger the neoplasm

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7
Q

What is the metastatic pattern of breast adenocarcinoma?

A

Breast ——> Axillary lymph nodes via lymphatics

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8
Q

what is the most common site of hematogenous metastatic spread?

A

liver (all venous drainage here)

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9
Q

What is the metastatic pattern of colon cancer?

A

Colon ——> liver via hematogenous spread

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10
Q

Metastatic spread strongly reduces the possibility of cure (TRUE/FALSE)?

A

TRUE

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11
Q

What is reactive hyperplasia?

A

Response to persistent infection often in the lymph nodes
(evidence of a processed infection)

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12
Q

Reactive hyperplasia is neoplastic (TRUE/FALSE)?

A

FALSE

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13
Q

name 4 features/tissue changes associated with neoplastic disease

A
  • hyperplasia
  • metaplasia
  • dysplasia
  • tumor giant cells
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14
Q

What is the sequence of events in the evolution of a neoplasia of epithelial cell origin?

A

Hyperplasia ——> Dysplasia ——> Carcinoma in situ ——> Malignant Neoplasia

(dysplasia redux)

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15
Q

Dysplasia is non-reversible (TRUE/FALSE)?

A

FALSE

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16
Q

What are general local clinical manifestations of neoplasia?

A

Swelling
Irritation
Blood vessel damage
Visceral damage
Compromised organ function

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17
Q

what is hematochezia? what is it indicative of?

A

frank red blood in stool due to lower GI bleed (sigmoid, rectum)

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18
Q

What is the most common cause of hematochezia?

A

Hemorrhoid

19
Q

What is melena? What is it indicative of?

A

Black tar stool indicative of an upper GI bleed

20
Q

What are examples of clinical presentations of blood vessel damage?

A

Ulceration
Hemorrhage
Hematuria
Melena
Thrombosis
Necrosis
Secondary infection
Hematochezia

21
Q

What are examples of clinical presentations of visceral damage?

A

Obstruction
Intussusception
Perforation

22
Q

What is intussusception?

A

Bowel swallows in on itself and clamps or pinches leading to bowel strangulation and gangrenous necrosis

23
Q

What is perforation in regards to visceral damage?

A

Organ contents begin to spill out into the peritoneal cavity

24
Q

Benign neoplasms only function in indigenous hormonal secretion? (TRUE/FALSE)

A

TRUE

25
Q

name 2 types of hormone production/secretion by malignant tumors

A

indigenous
ectopic

26
Q

What is an indigenous hormonal secretion?

A

When a benign or malignant tumor secretes a hormone that is native to the tissue of origin

27
Q

What are examples of indigenous hormonal secretions by neoplasms?

A
  • Pancreatic neoplasm secreting insulin
  • Parathyroid neoplasms secreting PTH
  • Pheochromocytoma secreting aldosterone
28
Q

What is an ectopic hormonal secretion?

A

When a malignant tumor secretes a hormone that is NOT native or normally produced by the that tissue

29
Q

What are examples of ectopic hormonal secretions by malignant neoplasms?

A
  • Lung neoplasm secreting ACTH (Cushing Syndrome)
  • Lung neoplasm secreting PTH
30
Q

What is a paraneoplastic syndrome?

A

Syndromes that a patient does not have but is caused by a neoplasm

31
Q

What are examples of paraneoplastic syndromes?

A
  • Endocrinopathies (Cushing syndrome, hypercalcemia)
  • Neuromyopathologies (myasthenic syndrome)
  • Vascular disorders: thrombosis (diffuse intravascular coagulation/clotting, Trousseau syndrome)
32
Q

What is cachexia?

A

Extreme wasting and malnutrition causing net loss of body mass, fat, and muscle due to TNF increasing muscle breakdown and decreasing fat storage

33
Q

Cachexia is only a symptom of malignant neoplasms (TRUE/FALSE)?

A

TRUE

34
Q

What cytokine is responsible for cachexia?

A

TNF

35
Q

What leukocyte is responsible for cachexia?

A

Macrophage

36
Q

What mechanisms of neoplasms can cause hypercalcemia?

A
  • Primary bone neoplasm
  • Metastasis to bone (from lungs or brain)
  • PTH-secreting tumor
37
Q

What is myasthenic syndrome?

A
  • Paraneoplastic (neuromyopathic) syndrome
  • lung carcinoma tumor cells elicit antibody formation
  • Ab to tumor cells “cross-react” with neuronal endings
  • results in blockage of presynaptic calcium channels preventing ACh production (flaccid paralysis)
38
Q

What is Cushing syndrome?

A

Increased cortisol often (but not always) caused by increased production of ACTH

39
Q

What neoplasm can cause Cushing syndrome?

A

Lung carcinoma

40
Q

A lactotrope pituitary adenoma would cause an increase in what secretion? Would this secretion be considered indigenous or ectopic?

A

Prolactin
indigenous

41
Q

What is the number one indicator of malignancy?

A

Invasion

42
Q

What is trousseau syndrome?

A

Paraneoplastic syndrome where clotting factor is exhausted and a patient exsanguinates and bleeds out of every pore

43
Q

how could a tumor cause vascular paraneoplastic symptoms?

A

thrombosis as a result of increased synthesis of coagulation proteins induced by malignant cells

NYCC Physiopathology (27 decks)

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