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pathophysiology > Mod 2 Cancer and genetics > Flashcards

Mod 2 Cancer and genetics Flashcards

1
Q

Abrasion

A

an injury caused by rubbing or scraping that results in the loss of the superficial layer of skin

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2
Q

Angiogenesis

A

the process of forming new blood vessels.
Occurs in the granulation phase of healing in wound repair.
Or in cancer when cancer cells stimulate blood vessel growth to feed a tumor by sending out growth signals

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3
Q

Approximation

A

Word used to describe when wound edges are touching (all wound margins are approximated)
All surfaces need to be touching to heal.
Applies to wounds healing by 1st or 3rd intention

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4
Q

Avulsion

A

a wound that results from tissue being torn away in large piece
REQUIRES HEALING BY SECONDARY INTENTION

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5
Q

Cellulitis

A

inflammation or infection of the cells in tissues characterized by SHARP

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6
Q

Debridement

A

the removal of devitalized or dead tissue and foreign material from the wound bed
A wound should be clear of dead or revitalized tissue to support healing and reduce the risk of infection
there are many ways to debride a wound

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7
Q

Dehiscence

A

The splitting open of a surgical wound (a wound that had been sutured closed)

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8
Q

Erythema

A

redness of the skin
caused by vasodilation related to inflammation, infection, or injury

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9
Q

Exudate

A

Fluid that comes from wounds. can be clear (serous) sanguineous (bloody) or purulent (pus)

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10
Q

Granulation Tissue

A

forms in the wound base which fills in wound with scar tissue.
The tissue is red or pink and has a lumpy appearance like small grapes.
The tissue is necessary to fill in wounds for healing.

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11
Q

Ischemia

A

A deficiency of blood supply to an area of tissue or an organ

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12
Q

Laceration

A

a wound that is produced by the tearing of cutting of the skin

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13
Q

Maceration

A

a softening, whitish look to the intact skin around wounds caused by excessive moisture. Often occurs when exudate is not well managed by dressings
also occurs when briefs are not changed often enough.

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14
Q

Necrotic Tissue

A

dead tissue that usually presents as black or brown and is hard or leathery in texture (eschar) Must be removed for the wound to heal. Very prone to infection

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15
Q

Purulent

A

Containing or forming pus. Usually yan opaque white, green, or yellow exudate

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16
Q

3 Types of Healing Intention

A

Primary intention
Secondary Intention
Tertiary Intention

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17
Q

Primary Intention

A

Wound margins are brought together by any means
(sutures, steri-strips, glue, band-aid, staples)
and heals with minimal scaring or infection
incisions, cuts, and puncture wounds, are likely to heal by primary intention

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18
Q

Secondary intention

A

missing tissues requires margins to contract, and then fills-in, resulting in a large scar. Cannot be sutured closed because too much tissue is missing. High infection potential
*Larger wounds with loss of tissue and contamination (such as experienced in a bicycle crash) are likely to heal by secondary intention. Also pressure ulcers

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19
Q

Tertiary Intention

A

Wound margins either separate after being closed (surgery incisions dehisces) or are intentionally left open (to allow infection to drain out of the wound) then brought together (and closed with stitches) after granulation tissue appears. This is a combination of primary and secondary closure
*This type of closure is preferred when wound in heavily contaminated to reduce the risk of wound infection. The wound is cleansed and is watched closely for several days. When the wound appears to be clean on its way to healing it is closed surgically (dog bites etc.)

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20
Q

Nutritional Status effect on wound healing

A
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21
Q

Blood flow/ O2 delivery effect on wound healing

A
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22
Q

Impaired Inflammatory/ immune response effect on wound healing

A
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23
Q

Infection effect on wound healing

A
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24
Q

Wound separation effect on wound healing

A
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25
Q

Foreign Bodies effect on wound healing

A
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26
Q

Benign Characteristics

A

Cell characteristics: Well differentiated
cellular cohesiveness: Stays together
growth mode: expands and pushes on surrounding tissue
growth pattern: encapsulated
growth rate: generally slow
metastatic potential: does not metastasize
tumor mobility: movable

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27
Q

Malignant Characteristics

A

cell characteristics: Poor differentiation
Cellular cohesiveness: Breaks apart, sluffs off easily
Growth mode: infiltrates into tissue
Growth pattern: infiltrates tissues
Growth rate: usually rapid
metastatic potential: eventually metastasizes
tumor mobility: fixed

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28
Q

Differentiation with cancers

A

Tumors lose differentiation features over time as they multiply and become more “malignant”
Poor cellular differentiation increases the growth rate. A tumor neoplasm that is well differentiated (retains most of the cellular characteristics of the tissue it is from)
*well differentiated = benign
*poorly differentiated = malignant
if it is malignant it loses the characteristics that made it a unique type of cell and it no longer functions as normal tissue

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29
Q

Contact inhibition with cancers

A

the cessation of growth after a cell comes in contact with another cell. blocking the synthesis of DNA, rna, and proteins.
When cell membranes come in contact with each other, they stop reproducing.
*cancer cells tend to grow rampantly despite coming into contact with other tissue

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30
Q

Cohesiveness with cancers

A

normal cell membranes help support each other by sticking together when they come in contact with each other. Malignant cells lack this cohesiveness
this is why malignant cells SPREAD EASILY. they do not have cellular support from the other cells. the least little bump or contact can cause the cancer cells to shed and spread

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31
Q

Anchorage independence with cancers

A

Normal cells must be “anchored” to a membrane or matrix of some kind to grow (except blood cells). Cancer cells can move freely (and therefore metastasize)

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32
Q

Faulty Cell to Cell communication with cancers

A

Chemical messengers bind to specific cell surface receptors, control cell growth, and modify cell behavior.
It may interfere with the formation of intercellular connections and responsiveness of membrane-derived signals.
*The cancer cell does not get the message to stop growing

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33
Q

Antigen Expression with cancers

A

Cancer cells express a number of cell surface molecules or antigens that are immunologically identified as foreign.
Tumor antigens may be used clinically as markers to indicate the presence or progressive growth of a cancer

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34
Q

Enzymes with cancers

A

Most cancers synthesize and secrete enzymes (proteases and glycosidase). breaks down proteins involved in insuring intracellular organization and cell to cell cohesion. may contribute to the breakdown of intercellular matrix

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35
Q

Sentinel node

A

the initial lymph node to which the primary tumor drains. Once the sentinel node is identified, it is examined to determine the presence or absence of cancer cells which indicates how far the cancer has spread

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36
Q

Benign tumors nomenclature

A

usually are named by adding the suffix -oma

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37
Q

Malignant tumors of epithelial origin nomenclature

A

usually named by adding the suffix -carcinoma
Carcinoma is the more common form affecting epithelial tissues, skin and mucous membranes lining body cavities

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38
Q

Malignant tumors of mesenchymal nomenclature

A

mesenchymal = connective tissue tumors (bone, muscle, and cartilage)
called sarcomas
sarcoma is the less common cancer but it spreads more rapidly and is highly malignant

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39
Q

Rapidly growing tumors

A

show little diffentiation and this lack of form is referred to as anaplasia (meaning without form)
*they are most responsive to radiation treatment

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40
Q

Oncogenesis

A

the genetic mechanism whereby normal cells are transformed into cancer cells

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41
Q

Oncogene

A

mutated gene that now has the potential to cause cancer

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42
Q

Oncogene types

A

Proto-oncogene
-cellular oncogenes
-viral oncogenes
Mutated anti-oncogene

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43
Q

Proto-oncogene

A

an otherwise normal gene with a “genetic weakness”
more susceptible to being converted into an oncogene due to mutations from either inherited predispositions or external causes
the mutations in proto-oncogene disable normal apoptosis of cells which then results in over production of cells which is what will lead to cancer

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44
Q

Proto-oncogene (Cellular oncogenes)

A

cancer characteristics that are coded on the host’s inherited genes. Most human cancers are due to new mutations of cellular oncogenes to the oncogene form (also called cellular proto-oncogene)

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45
Q

Proto-oncogene (viral oncogene)

A

Some viruses are known to cause cancer by transmitting their DNA or RNA into host cells which damages the cells’ genes

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46
Q

Mutated anti-oncogene

A

When anti-oncogenes (tumor supressing genes) are damaged by mutation this leads to under production of cancer preventing cells

47
Q

Host factors

A

Heredity
hormone
faulty immunologic mechanisms
obesity
smoking
alcohol

48
Q

Environmental factors

A

Chemicals
radiation (including sun)
pollution
food
molds
tanning beds

49
Q

oncogenic viruses

A

mutation of oncogenes by viruses can be linked to cancer formation
-Human papilloma Virus
-human t-cell lymphotropic virus

50
Q

Methods of metastasis

A

Direct extension
seeding
circulation

51
Q

Direct extension

A

tumor cells spread to tissues adjacent to the primary tumor by sending out projections (tentacles) into the surrounding tissue or growing pseudopodia to “walk “ to the nearest cells

52
Q

Seeding

A

Tumor cells slough off from the primary tumor and develop into more tumors
ex: during surgery to remove a tumor some tumor cells remain in the tissue after the main tumor is removed and provide the seed for more tumor cells to grow

53
Q

Circulation

A

(through blood and/ or lymph) a secondary tumor develops in a site distant from the primary tumor

54
Q

staging definition

A

describes the severity of a person’s cancer based on the size and/ or extent (reach) of the original (primary) tumor and whether or not cancer has spread in the body

55
Q

staging is important for several reasons like:

A

-staging helps the doctor plan the appropriate treatment
-cancer stage can be used in estimating a person’s prognosis
-staging helps health care providers and researchers exchange information about patients

56
Q

TNM staging system stands for

A

T- Tumor
N- Lymph Nodes
M- Metastasis

57
Q

TNM staging purpose

A

-To see the size or reach of the tumor
-Whether it reached to lymph nodes
-whether there is the presence of metastasis or secondary tumors formed by the spread of cancer cells to the other parts of the body.

58
Q

TNM staging systems numbers meaning

A

a number is added to each letter to indicate the size and or extent of the primary tumor and the degree of cancer spread

59
Q

Primary Tumor abbreviation meanings

A

TX: primary tumor cannot be evaluated
T0: no evidence of primary tumor
Tis: Carcinoma in situ
T1, T2, T3, T4: Size and/ or extent of the primary tumor

60
Q

Regional Lymph Nodes abbreviation meanings

A

NX: regional lymph nodes cannot be evaluated
N0: No regional lymph node involvement
N1,N2,N3: Degree of regional lymph node involvement (number and location of lymph nodes)

61
Q

Distant Metastasis Abbreviation meanings

A

MX: Distant metastasis cannot be evaluated
M0: No distant metastasis
M1: Distant metastasis is present

62
Q

Stage 1 Staging system def

A

Location of tumor: In situ

Definition: Abnormal cells are present only in the layer of cells in which they developed

63
Q

Stage 2 Staging system def

A

Location of tumor: Localized

Definition: Cancer is limited to the organ in which it began - no evidence of spread

64
Q

Stage 3 staging system def

A

Location of tumor: regional

Definition: Cancer has spread beyond the primary site to nearby lymph nodes or tissues and organs

65
Q

Stage 4 staging system def

A

Location of tumor: Distant/ metastatic

Definition: Cancer has spread from the primary site to distant tissues or organs or to distant lymph nodes

66
Q

Unk

A

Location of tumor: Unknown

Definition: There is not enough information to determine the stage

67
Q

Tumor grade

A

NOT THE SAME AS THE STAGE OF CANCER
-tumor grade is the description of a tumor based on how abnormal the tumor cells and the tumor tissue look under a microscope
-it is an indicator of how quickly a tumor is likely to grow and spread

68
Q

Tumor grading scale

A

GX
Grade 1
Grade 2
Grade 3
Grade 4

69
Q

GX

A

Grade cannot be assessed (undetermined grade)

70
Q

Grade 1

A

Well differentiated, least aggressive

71
Q

Grade 2

A

Moderately differentiated

72
Q

Grade 3

A

Poorly differentiated

73
Q

Grade 4

A

Very poorly differentiated. More likely to progress quickly, highly malignant

74
Q

Fatigue

A

The most frequently reported symptom
Causes of fatigue:
-sleep disturbance
-biochemical changes secondary to disease and treatment
-psychological factors
-activity
-nutritional status
-environmental and physical factors

75
Q

Pain

A

Caused by:
-pressure/stretching
-obstruction
-invasive tissues by tumor
Manifests in later stages
Pain management is a major concern in cancer treatments

76
Q

Blood dyscrasias

A

Blood component disorders
caused by: bone marrow damage from various cancer treatments

77
Q

Examples of blood dyscrasias

A

Anemia
Leukopenia
thrombocytopenia

78
Q

Anemia

A

Low red blood cell count
caused by:
bleeding
malnutrition
cancer treatments (especially radiation)
tumor may ulcerate or erode blood vessels (bleeding)
causes:
decreased delivery of oxygen to tissues and least to patient fatigue and s/s of low O2

79
Q

Leukopenia

A

Low white blood cell count
caused by:
bone cancers
cancer treatments
Cancer patients are prone to infections

80
Q

Thrombocytopenia

A

Low platelet count
caused by:
bone cancers
cancer treatments
causes:
thrombocytopenia (bleeding disorders) which turns into anemia

81
Q

Infection

A

The most significant cause of mortality of cancer patients
Increased risk due to:
malnutrition
blood dyscrasias
bone marrow suppression (immunosuppression from radiation and chemo treatments)
Tissue breakdown occurs and the patients immune system is weakened
becoming less mobile causes secretions to build up in lungs (pneumonia)

82
Q

Cachexia

A

Wasting Syndrome related to malnutrition due to INCREASED BMR (basal metabolic rate) caused by growing tumors
-results in loss of skeletal muscle mass that cannot be fully reversed by nutrition.
-Loss of skeletal muscle leads ultimately to loss of body function.
Multifactorial causes including:
fatigue, stress, anorexia, and rapidly growing tumor “stealing nutrition” from the body

83
Q

Cachexia commonly caused by

A

Tumors: Increase the patient’s basal metabolic rate (more calories are needed to maintain muscle mass)

Chemo: Taste buds are destroyed, patients don’t wanna eat, also causes severe nausea and vomiting (CINV = “Chemotherapy-induced nausea and vomiting)

Immunosuppressed: Allows overgrowth of opportunistic pathogens such as oral yeast that causes mouth sores (mucositis or stomatitis) patients will not eat because it is too painful

84
Q

Curative

A

Cancer will be eliminated from the individual. Treatment is intended to bring out a COMPLETE CURE of the cancer (doesn’t always work)

85
Q

Control

A

if the cancer is treated but does not completely go away it can be controlled and managed as a chronic disease

86
Q

Palliative

A

treatment given ONLY TO RELIEVE CANCER SYMPTOMS AND REDUCE THE SUFFERING caused by cancer

87
Q

Adjuvant Therapy

A

Treatment that is given IN ADDITION to the primary treatment to make sure the cancer is eradicated

88
Q

Chemotherapy TX

A

not selective in the cells it kills
-*chemo drugs kill ALL FAST GROWING cells whether they are cancerous or not
Other normal fast-growing cells are damaged
- *GI Tract cells and bone marrow

89
Q

Adverse reactions of chemotherapy

A

GI Tract
Bone Marrow Suppression
Secondary malignancies
Alopecia

90
Q

Adverse reactions of chemotherapy: GI tract

A

the lining of the GI tract consists of fast growing cells
-Severe nausea/ vomiting (CINV)
-Mucositis/ stomatitis
-diarrhea or constipation (bowel obstructions can cause death)

91
Q

Adverse reactions of chemotherapy: Bone Marrow Suppression

A

Bone marrow: fast-growing blood cells
chemo can result in a reduction of ALL blood components- RBC, WBC, and platelets

92
Q

Adverse reactions of chemotherapy: Secondary malignancies

A

can be caused by the caustic chemotherapy agents used to treat the primary tumor

93
Q

Adverse reactions of chemotherapy: Alopecia

A

Hair loss because hair follicles are fast-growing cells.

94
Q

Mucositis (stomatitis)

A

Chemotherapy-induced mucositis common complication of therapy
3-10 days after the initiation of chemotherapy and lasts 7-14 days
causes ulcers in the mouth
ulcers act as a site for local infection
contributes to: Pain, Malnutrition, Cachexia, and infection

95
Q

Radiotherapy (radiation) TX

A

ionizing radiation may be used externally or internally (implants) most effective for rapidly growing, poorly differentiated tumor cells
-usually used with chemotherapy and or surgery as adjuvant therapy
-can be used to reduce the size of a tumor and provide comfort

96
Q

adverse reactions of radiotherapy

A

Skin burns
GI tract
Bone marrow suppression
Alopecia

97
Q

Surgery TX

A

May be curative, adjuvant, or palliative therapy
Surgery may be done to assist with TNM
Adverse outcomes are related to:
-the nature of the surgery
-how far advanced the cancer has progressed
-blood loss
-patients general condition prior to surgery etc.

98
Q

Biotherapy (immunotherapy) TX

A

Medications stimulate the immune system to identify and destroy cancer cells without damaging surrounding normal cells.
BRMs are a class of drugs that are used to treat cancer by altering or augmenting naturally occurring processes within the body

99
Q

BRM Medications:

A

Enhance: an immune response (as might be needed to stimulate “seek and destroy” actions against cancer cells
Suppress: suppresses the immune system as might be needed to treat autoimmune disorders where a person’s immune system is over active

100
Q

Advantaged of immunotherapy

A

-High specificity for antigens - means less damage to healthy tissue (but there are still negative side effects)

-immune memory cells give long protection

101
Q

Disadvantages of immunotherapy

A

-Negative side effects are similar to chemotherapy and radiotherapy

-Side effects include: Nausea and vomiting, diarrhea, loss of appetite, fever and chills, muscle aches, weakness, skin rash, and increased tendency to bleed or swelling

-Patients need to be instructed to AVOID CROWDS OR PLACES WEHRE EXPOSURE TO PATHOGENS IS MORE LIKELY BECAUSE THEY ARE IMMUNOSUPPRESSED when taking these drugs

102
Q

Types of BRMs

A

MAB = Must Avoid Bugs
Monoclonal Antibodies (Mab drugs)
Interleukin-2 (a cytokine)
Alpha interferon (IFN)

103
Q

When a MONOCLONAL ANTIBODY attaches to a cancer cell:

A

Make the cancer cell more visible to the immune system
Block growth signals
stop new blood vessels from forming (blocks angiogenesis)
Deliver radiation to cancer cells
deliver chemotherapy to cancer cells

104
Q

Adult Cancers

A

Greater than 99%
environmental cause high
80% can be prevented
found during routine screening exams
intolerant to treatment
less responsive to chemo

105
Q

Pediatric cancer

A

Diagnosed during peak growth times
less than 1%
genetic cause, not much environmental
few can be prevented
found accidentally
tolerant to treatment but long term consequences
very responsive to chemo

106
Q

Teratogens

A

chemical, biological, or physical factors that might cause an abnormal development of a fetus in the mother’s womb (congenital birth defects)

107
Q

When are teratogens most effective

A

First week of pregnancy (all-or-nothing)
-baby either dies from tetratogens or survives without any harm
Three to with weeks of pregnancy
-considered the most critical. Organs start to form and are sensitive to harmful factors

108
Q

Examples of teratogens

A

Diseases (maternal illness): chicken pox, herpes, german measels, HIV, AIDS, infections etc.

Drugs/ chemicals: tetracycline, acne medication, aspirin, antacids, diet pills, alcohol, etc.

Environmental: mercury (even small amounts in fish) lead, radiation (like x-rays)

109
Q

Fetal Alcohol Syndrome

A

-One drink for mom = ten for the baby

-Harmful effects to the fetus from maternal alcohol use will happen * throughout the pregnancy and is the #1 cause of mental retardation in children

-defects caused by fetal alcohol syndrome irreversible

-Distinctive facial features, including wide set eyes, an exceptionally thin upper lip a short upturned nose and a smooth skin surface between nose and upper lip

110
Q

Alchohol sydrome in fetal also causes

A

developmental delays
physical defects
seizures during withdrawl
behavioral problems
intellectual impairment
brain malformation

111
Q

TORCH infections

A

perinatal infections account for 2% to 3% of all congenital anomalies

TORCH includes
Toxoplasmosis
Other (syphilis, varicella-zoster, parvovirus B19)
Rubella
Cytomegalovirus (CMV)
Herpes Infections

112
Q

TORCH causes

A

Mild maternal morbidity but have serious fatal consequences

113
Q

Epigenetics

A

“on top” of genetics
Epigenetic changes are modifications of DNA
*Which occur without any alteration in on or off and how much of a particular message is made

Child abuse has been shown to alter the epigenetic profile of the brain when examined post-mortem

epigenetic changes can also be handed down from mother or father

114
Q
A

pathophysiology (14 decks)

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