N211 -Health Differences Across the Life Span 1 Flashcards

Question

Loop Diuretics

Answer 1

can cause volume depletion . NOT first line. After Thiazines tried.

Answer 2

can cause Hyper Kalemia.

Answer 3

Hydralazine (Apresoline)

Answer 4

reduce cholestoerol in blood

Answer 5

MAKE CARDS

Answer 6

eficacy of Heparin

Answer 7

Efficacy of Coumadin

Answer 8

it will increase circulation. If arterial problem, yes warm. you want blood to go down to extremeties. in venous, the blood is pooling and we need to elevate legs to help move up blood.

Answer 9

when person walks, not enough blood flow to legs. sever pain, heavy , sharp. they stand still , then it goes away, then it starts again when they walk

Answer 10

-asymptomatic Watch for clotting emboli rx for clotting SS: Abdominal pain, low back pain, feel heart beat

Answer 11

Bruit, swooshing over consicted artery. | Pain: abdominal/loabdomin

Answer 12

Tx Angina, HBP affect movement of ca in cells of heart

Answer 13

stronger heart contraction

Answer 14

Control catacholoamines

Answer 15

Control catacholoamines

Answer 16

digoxinase ?

Answer 17

Kayexalate

Answer 18

protamin sulfate

Answer 19

diff between top and bottom

Answer 20

cardiomyopathy

Answer 21

loss of hearts ability to pump enough blood to heart

Answer 22

loss of large amount of blood or fluid

Answer 23

loss of vascular tone causing decreased peripheral resistance, larger vascular bed, result in hypovolemia

Answer 24

non selective vs selective

Answer 25

exertion or stress

Answer 26

frequent times daily with increasing severity

Answer 27

hypoxia and hypercapnia

Answer 28

dig glycoside

Answer 29

allows heart to work less but beat stronger

Answer 30

review ABG

Answer 31

.UP Pulse, resp, BP .Mental cloud see rest

Answer 32

inadequate excretion of CO2 w inadequate vent

Answer 33

occurs w pulmonary diiseases

Answer 34

.lo flo O2 | .monitor consiousnee, abg, ekg for dysrythmias

Answer 35

HCO3 is Bicarb not H2CO3

Answer 36

body become used to it. It's stops becoming the hi CO2 that makes the breath, but the lo O2 levels.

Answer 37

Carbonic Acid deficit .body loses CO2, decrease in acid, increases ph level .occurs w hyperventilation, leads to loo CO2 ......

Answer 38

.tx underlying cause

Answer 39

.ABG .lo bicarb .lo ph

Answer 40

.hi ph > 7.45 .hi plasma bicarb (HCO3 > 26) .paCO2 INC as lungs attempt to compensate for excess bicarb by retaining CO2 compensate by blowing it off

Answer 41

.peripheral vasodilation and decrease cardiac output w Ph drops to <7.0 .chronic metabilic acidosis usually seen wtih chronic renal failure .closemonits K leves. hypokalemia

Answer 42

look at old ABG slides

Answer 43

.see P57 in book . lo bicarb .hyperkalemia

Answer 44

MAKE SLIDES

Answer 45

beta antagonist | corticosteroids

Answer 46

drying secretions | .......

Answer 47

``` community hospita incompromised host aspiration pna ? ? ```

Answer 48

.INcreased Sympathetic stimulation .UP blood volume d.t increased renal reabsorption of Na+, CL- and H2o retention .UP activity of RAAS system, caused expansion of extracellular fluid volume. causing systemic vascular resistance .Dysfx of vascular endothelium causing decreased vasodilation of arterioles .resistance to Insulin

Answer 49

adenocarcinomas will go through stomach and into other organs

Answer 50

adenocarcinomas will go through stomach and into other organs

Answer 51

Captopril ACE inhibitor

Answer 52

Benazepril

Answer 53

Lisinopril

Answer 54

Spironolactone ARB - Aldosterone Receptor Blocker

Answer 55

Losartin ARB

Answer 56

vasoconstrict

Answer 57

Metaprolol Beta Blocker

Answer 58

Atenolol BB

Answer 59

Amlodipine CCB

Answer 60

Felodipine CCB

Answer 61

Nifedipine

Answer 62

Clonidine Central Alpha 2 agonist

Answer 63

Carvedilol | alpha and BB

Answer 64

Hydralazine (direct vasodilator) helps body loose excess water by releasing excess salt

Answer 65

Hyrochlorothiazide Diuretic

Answer 66

Lisinopril / HCTZ (Lisinopril/HCTZ) {=Thiazide diuretic and ACE inhibitor} causes the blood vessels to loosen and dilate. This decreases the strain on the arterial walls. Therefore, the speed and pressure inside the artery walls decreases {=Vasodilators}

Answer 67

Lisinopril / HCTZ (Lisinopril/HCTZ) {=Thiazide diuretic and ACE inhibitor} causes the blood vessels to loosen and dilate. This decreases the strain on the arterial walls. Therefore, the speed and pressure inside the artery walls decreases {=Vasodilators}

Answer 68

most common alteration in ventricular contractoin

Answer 69

stiff noncompliant heart muscle

Answer 70

Ejection Fraction, vol blood ejected w each contraction of ventricular volume (normal 55-65%) determines Systolic or Diastolic heart failure HF = low EF

Answer 71

Pulmonary Edema SS: dyspnea, wet lung, cough, fatigue, tachy, anxiety, restlessness, confusion, paroxysmal nocturnal dyspnea (sudden attacks at nght), orthopnea (diff breathing lying down) Frothy pink sputum = severe Pulm Edema Dominant feature of heart failure is decreased tissue perfusion to kidney, brain, and GI system

Answer 72

Peripheral Edema SS: peripheral edema, weight gain, distended neck vain, anorexia, nausea, nocturia, weakness

Answer 73

``` .decreased cardiac output .impaired urinary elim d/t decreased perfusion .activity intolerance .anxiety .ineffective tissue perfusion ``` Tx: restrict Na, to reduce salt and water retention, reducing vascular volume .assess/monitor q4hrs .assess/mon apical hr .assess for hypoxia (restlessness, tachy, chest pain) .auscultate lungs for pulmon edema (crackles/wet sounds) .admin O2

Answer 74

.observe ss of edema (daily weight, monitor i&O, measure abdom girth, observe ankles/fingers for swelling. .elevate HOB to assist w breathing and limit Na intake. .check apical HR before Digitalis, HOLD if <60. .diuretics in AM .periods of rest after activity

Answer 75

Disease of myocardium 1. Dilated (most common) • Causes diffuse cellular necrosis and fibrosis • Leads to decreased contractility (systolic failure) 2. Hypertrophic (rare) • A chronic disorder in which the heart muscle becomes abnormally thick. 3. Restrictive cardiomyopathies lead to decreased distensibility and ventricular filling (diastolic failure)

Answer 76

• Altered cardiac and peripheral circulation related to decreased cardiac output • Ineffective tissue perfusion from altered circulation • Anxiety related to lack of knowledge and fear of the unknown • Activity intolerance related to decreased cardiac output

Answer 77

Preatrial Contraction normal electrophysiological phenomenon frequent PACs may cause palpitations, or sense of "skipping a beat" can trigger afib, aflutter etc.

Answer 78

Electrocardiogram – Chaotic activity from the AV node – No true P wave visible – Irregular ventricular rhythm TX: – Anticoagulant therapy due to risk of stroke – Antidysrhythmic drugs – Cardioversion to treat atrial dysrhythmia – Ablation of atria

Answer 79

Ectopic firing

Answer 80

Electrocardiogram – Wide bizarre QRS – Pulse erratic and with impaired cardiac output Treatment: – Synchronized cardioversion if pulse present – If no pulse, treat as ventricular fibrillation – Antidysrhythmics

Answer 81

``` Cardiac Emergency Electrocardiogram – Irregular undulations of varyious amplitudes from coarse to fine – No cardiac output Treatment: – CPR – Defibrillation as quickly as possible – Antidysrhythmic drugs ```

Answer 82

Part of myocardium permanently destroyed ``` • Caused by reduced blood flow in coronary artery • Due to rupture of atherosclerotic plaque • Subsequent occlusion of artery by thrombus ```

Answer 83

Unstable Angina: plaque rupture, but artery not completely occluded or also ``` • Vasospasm (sudden narrowing) • Decreased oxygen supply (from acute blood loss, anemia, or low BP) • Increased demand for 02 (rapid heart rate, thyrotoxicosis, or ingestion of cocaine) ```

Answer 84

1. Troponin (cTc1 and cTnT) – will be evident 3-4 hours after a heart attack, peak in 12-16 hrs and stay elevated for 2 – 3 weeks 2. Myoglobin (Mb) can elevate in other conditions; troponin level is taken to confirm MI (1-3 hrs and peaks in 12 hrs) 3. Creatine kinase (CK), an enzyme found in heart muscle cells and other cells of the body, so a more specific level of elevation in cardiac cell must be obtained (peaks in 24 hrs)

Answer 85

1. Troponin, 3-4 hrs after attack 2. Myoglobin 3. Creatine Kinase

Answer 86

note dysrhythmias, changes in T wave and SG segment and presence of Q wave

Answer 87

to assess cardiac muscular function and valves

Answer 88

Cardiogenic: loss of heart ability to pump Hypovolemic: loss of blood Distributive: loss of vascular tone

Answer 89

.sinus tachycardia, weak, thready pulse, tachypnea .S3 and S4 heart sound .hypotension .Oliguria (<30ml/hr) ``` NI: NPO, reduce risk of aspiration .admin/monitor fluids to avoid fluid overload .admin 02 to maximize cardiac .mon pulmonary and renal fx .monitor intra-aortic balloon pump (IABP) .Digitalis .Vasoconstriction agents .dopamine ```

Answer 90

MEN: Normal 13-31 Umole/L WOMEN: 11-29 umole/L

Answer 91

.caused by deficiencies of Vit B12 or Folic Acid .changes in bone marrow, peripheral blood .abnormally large Erythrocytes called Megaloblastic red cells SS: weakness, listlessness, fatigue NI: DO NOT admin RBC transfusion because body w compensate and go into fluid overload.

Answer 92

heart compensates by pumping faster/harder to deliver more blood to hypoxic tissue SS: tachy, palpitation, dyspnea, dizzy, orthopnea, exertional dyspnea

Answer 93

.inherited Autosomal Recessive disorder of HgB .African/eastern mediterranean descent .after 6 mos age .hemoglobin S replace all or part of normal HgB, causes RBCs to sickle w O2 is released into tissue

Answer 94

if both parents have sickle cell train, children may inheri 2 abnormal HbS genes and w have sickle cell anemia, most severe form of disease

Answer 95

.bone marrow expand in childhood, compensate to offset anemia .anemia (7-10 g/dL) .jaundice .enlarged facial bones and skull .tachy, enlarged heart, murmurs

Answer 96

swollen hands

Answer 97

1. Sickle cell crisis: tissue hypoxia and necrosis in tissue or organ 2. Aplastic crisis: infec w human parvovirus 3. Sequestration crisis: other organs pool sickled cells Most kids with SC will have a Splenic Infarction by age 10 and it becomes non functional (liver and lungs in adults)

Answer 98

a condition in which oxygen supply to the spleen is interrupted, leading to partial or complete infarction (tissue death due to oxygen shortage) in the organ. Splenic infarction occurs when the splenic artery or one of its branches are occluded, for example by a blood clot.

Answer 99

Rapid decrease in hemoglobin, fever, tachi, bilateral inflitrates .mimics infection but are infarctions withing pulmonary Image result for acute chest syndromethorax.bmj.com

Answer 100

sequel to sickle cell disease

Answer 101

``` .Bone Marrow Trans .Hydroxyurea: (Hydrea): chemotherapy agent – increases hemoglobin F levels and decreased formation of sickled cells .Arginine: antisickling properties; used in combination with Hydrea to manage pulmonary hypertension .Long-term RBC transfusions ```

Answer 102

manage pain, swollen joints, elevate extremities .relaxation .manage infection .promote coping skills

Answer 103

``` • Increased RBCs • .Leukocytosis • Thrombocytosis • Increased hemoglobin concentration • Occurs between ages 40-60 in males of Jewish ancestry (mortality high if not treated) ```

Answer 104

``` SS: • Clubbing of digits • Dizziness • Headache • Hypertension • Ruddy cyanosis of nose • Thrombosis of smaller vessels • Visual disturbances ``` ``` Tx: • Phlebotomy • Chemotherapy • Myelosuppressive drugs • Anti-gout agents (Allopurinol) • Replace fluid volume lost during procedure ```

Answer 105

``` SS: • Clubbing of digits • Dizziness • Headache • Hypertension • Ruddy cyanosis of nose • Thrombosis of smaller vessels • Visual disturbances ``` ``` Tx: • Phlebotomy • Chemotherapy • Myelosuppressive drugs • Anti-gout agents (Allopurinol) • Replace fluid volume lost during procedure ```

Answer 106

Auto Immune .Idiopathic SS: – Too few platelets – Bruising, petechiae, and internal bleeding TX: – Steroids – Immune globulins – Splenectomy

Answer 107

.lo platelet production in marrow .up destruction of platelets .up consumption of platelets SS: .<20K/mm3 petechiae .nasal/gum bleeding .hi menstrual bleed .monitor dental and Sx. Tx: .teach avoid substance that lo platelet fx. (i.e. otc meds, herbs, supplements etoh) .inform med providors

Answer 108

massive amt of tiny clots form in microcirculatotion triggered by: trauma, sepsis, shock, ca, abruptio placentae, toxins, allerg reactions Initially normal clotting time, then as the many clots forming use u the plateletes and clotting factors, coag time starts to fail. PARADOXICAL result of up clotting is bleeding

Answer 109

pt bleed from mucous membranes, venipuncture site, gi, urinary tract

Answer 110

bleeding disorder, males contracted by x-linked recessive chromosome (mother carrier) normla factor activity 50-200%, Hemophelia 0-25% Dx: PTT prolonged, factor VIII assays <25% of normal factor

Answer 111

A device that detects and terminates life-threatening episodes of ventricular tachycardia (VT) or fibrillation (VF)

Answer 112

an electronic instrument that supplies electrical stimuli to the heart muscle

Answer 113

.facilitate UP myocardial O2 supply | .LO myocardial O2 demand

Answer 114

``` Transient loss of peripheral pulse Limb ischemia; compartment syndrome Thromboembolism; cardiac tamponade Compartment syndrome Aortic dissection Local vascular injury— false aneurysm, hematoma, bleeding from the wound Infection Balloon rupture (can cause gas embolus) or balloon entrapment Hematological changes, i.e., thrombocytopenia Malpositioning causing cerebral or renal compromise ```

Answer 115

.monitor pulmonary pressure .treat arrhythmias. >106 .monitor HgB and Hct for anemia .monitor complication of cardiogenic shock .monitor for impending renal compromise <30cc/hr

Answer 116

stent placed in artery to maintain patency.

Answer 117

``` .bleeding/hematoma .weak pulse distal to insertion site .pseudoaneurysm and arteriovenous fistula .retroperitoneal bleeding .acute renal failure ```

Answer 118

pH 7.35 – 7.45 Kids 7.36 – 7.44 PCO2 34 – 45 mmHg (ACID) PO2 80 – 100 mmHg HCO3 21 – 28 mEq/L (BASE)

Answer 119

response to HYPOventilation 1. pH < 7.53 2. PaCO2 > 45mmHg 3. UP CO2, UP Carbonic Acid 4. Hyperkalemia COMPENSATION: .UP respirations to blow off CO2 .Bicarb UP to compensate Med Tx: Calcium, Insulin, glucose, NaO2, Dialysis

Answer 120

h/a, sleepiness, confusion, loc, coma, sob, cough, seizure, weakness, diarrhea, arrhythmia, up hr, N/V

Answer 121

Hypoventilation .severe pna, ards, impairment of resp muscles, pulmonary edema, aspiration of foreign object, atelectasis, pneumothorax, od sedatives, sleep apnea, non therapeutic O2, COPD pts

Answer 122

COPD pts gradually accumulate CO2 over time, may not develop hypercapnia d/t compensatory renal changes.

Answer 123

Carbon Acid deficit lo CO2, decrease in acid, UP pH >7.45, PaCO2 < 38mmhg .HYPERventilation, LO CO2 .Lo Carbonic Acid

Answer 124

``` .extreme anxiety . blow off excess CO2 .Hypoxemia .Gram Neg bacteremia .salicylate intox, ventilator settings ```

Answer 125

ha, sleepy, confusion, loc, coma, sob, cough, arrhythmia, up hr, seizures, weakness, n/v/d, light headed, stupor, coma, hand tremor, parestesia, twitching, spasms,

Answer 126

Dx: .UP Ph >7.45 .

Answer 127

sudden, life threat deterioration of gas exchange of O2 for CO2 in lungs can not keep up w rate of O2 consumption and CO2 production CONDITION not a disease. any disease w disorder of nerves, spinal cord, muscles or neuromuscular junction involved in respiration Muscular dystrophy, myasthenia gravis, poliomyelitis, ALS (amyotrophic lateral sclerosis, Guillain-Barre syndrome, and cervical spinal cord injuries

Answer 128

CRF is a deterioration in the gas exchange function of the lung, which develops insidiously, OR has persisted for a long period after an episode of ARF

Answer 129

severe form of acute lung injury Major cause of death: non pulmonary multiple system organ failure

Answer 130

.apply suction ONLY when REMOVING catheter, gently rotating while withdraw .NO more than 10-15sec, 3-4 times .O2 1-2 min before and after suction

Answer 131

Nasal Cannula, Simple face mask, non rebreather mask, partial rebreather mask, , venturi mask

Answer 132

pt w .alteration in LOC .LO/NO gag reflex .immobile Raise head of bed when feeding.

Answer 133

Inflammation of lower resp track. Bacterial, Viral, Fungal (rare), Chemical

Answer 134

.community acquired . hospital acquired .PNA in immunocompromised host .aspiration pna

Answer 135

Community Aquired PNA .reside naturally in upper resp tract, then colonizes. .causes lobar or bronchopneumonia . after recent resp illness

Answer 136

``` Streptoccal (pneumococcal) PNA: .sudden onset of chills .rapid fever (101-105) .patient severely ill .tachypnea (25-45bmp) .UP plulse ```

Answer 137

Ventilator Assisted PNA

Answer 138

``` .bradycardia (viral) .mycoplasma infection .legionella organim .may URI, Mucopurulent sputum .h/a, lo fever, pleuritic pain, myalgia, rash, pharyngitis ``` .SEVERE: flushed cheeks, OLDER adults: .lethargy, confusion, anorexia, rapid hr .pain/dullness during percussion over affected lung area .bronchial breath sounds, crackles Xray: infiltrates w consolidation or pleural effusion

Answer 139

``` .monitor abx .deep breathing q 2hrs .humidity to loosen secretions .suction airway PRN .up to 3L/day fluid .encourage flu shot ```

Answer 140

``` .chronic sputum w cough production on daily basis for min of 3 mos - 1yr .chronic hypoxemia . UP mucous .UP bronchial wall thickness . ```

Answer 141

``` chronic bronchitis .excessive mucous .airway obstruction .hypoxia .residual lung volume UP ```

Answer 142

``` emphysema .hyperventilation .muscle wasting .weight loss .less hypoxia, work neck and chest muscles ```

Answer 143

sitting in chair, hands on knees (tripod)

Answer 144

infection w Mycobacterium Tuberculosis bacteria .AIRBORNE .after initial exposure, bacteria encapsulates (form GHON lesion) .bac dormant until later when ss appear.

Answer 145

``` .asymptomatic .fever, night sweats .anorexia .malaise .cough, sputum .dyspnea, pleuritic chest pain .cavitation or calcification per Xray .positive sputum culture ```

Answer 146

Bacillus Calmette Guerin (BCG) vaccine test w be positive positive = induratio 10mm or greater in 48-72hrs

Answer 147

``` • Risk for infection • Ineffective Airway Clearance • Activity Intolerance • Anxiety • Imbalanced nutrition: less than body requirements • Impaired Gas Exchange • Knowledge deficit ```

Answer 148

``` .H, isolation .cough into tissue and dispose immediately in to special basket .meds for 9-12mos .hand washing .report ss of deteriorating/hemorrhage .collect sputum culture .return to work after 3 neg cultures ```

Answer 149

.Autosomal recessive disease, cause dysfx of exocrine gland .tenacious mucus production, obstructs vital structures .lung insufficiency .pancreatic insuff .UP los of Na+ and Cl- in sweat

Answer 150

usually dx in white infant or child ``` .meconium ileus at birth (10-20%) .chronic resp infection .pulmonary congestion .steatorrhea (fatty stool) .foul smelling stool .LO growth and weight .skin salty when kissed ```

Answer 151

.monitor respiration .IV abx .pancreatic enzymes .fat soluble vits A, D, E, K in water soluble form .nebulizer and O2 tx .percussion and postural drainage .DIET: HI cal, HI protein, MOD/HI fat, MOD/LO carbs child needs 150% of usual calorie intake for normal growth and dev.

Answer 152

sleeping, loud snoring, breathing cessation for 10sec or longer .awaken abruptly w loud snort as O2 level drops .5-several hundred events per night. .HI risk for CAD, cerebrovascular disease, premature death .repeated apneic events cause hypoxia and hypercapnia .daytime sleepiness and fatigue

Answer 153

Central and Obstructive

Answer 154

most common .reduced diameter of upper airway or reduced upper airway muscle tone TX: nasal CPAP or BiPAP w supplemental O2 for severe hypoxia and hypercapnia .weight loss recommended for obese .no ETOH and sedatives

Answer 155

simultaneous suspension of both airflow and respiratory mvmt Sx: – Uvulopalatopharyngoplasty to correct obstruction – Tracheostomy to bypass obstruction for respiratory failure or life-threatening dysrhythmias; unplugged during sleep NI: .avoid ETOH and respiratory suppressive drugs .weight loss .notify re potential daytime sleepiness

Answer 156

• Modafinil (Provigil) to reduce daytime sleepiness • Protriptyline (Triptil) HS to increase respiratory drive; improve upper airway muscle tone • Patient may require nasal continuous positive airway pressure (CPAP)

Answer 157

``` .Croup .Epiglottis tis .Laryngotracheobronchitis .Spasmodic Laryngitis .Tracheitis ```

Answer 158

infection of epiglottis. caused by H. Influenzae type B ``` SS: .sudden onset .restlessness .hi fever .dysphagia .drooling .muffled voice .child assumes upright position w chin out and tongue protruding ```

Answer 159

• Epiglottis cherry red, swollen and edematous and can obstruct airway • Secretions pool in pharynx and larynx above epiglottis • Child has sore throat and unable to swallow • Can have airway obstruction within 2-6 hours • Hib vaccine has reduced incidence

Answer 160

RSV, Respiratory Syncytial Virus .young infants . HIGHLY contagious .thick secretions .paroxysmal coughing, nasal flaring, prolonged expiratory phase, wheezing, rales .deteriorates to rapid, shallow respiration

Answer 161

``` .upright position .intubation/Trach .IV abx .NPR, I7o .antipyretics, cotiscosteroids to decrease edema .manage sore throat pain ```

Answer 162

Laryngotracehobronchitis

Answer 163

viral infection inflammation, edema and narrowing of larynx, trachea and bronchi .3mos - 8yrs .most common croup syndrome .inspiratory stridor and suprasternal retractions upon inhalation (barking cough)

Answer 164

``` sore throat fever snoring diff swallow enlarged adenoids cause mouth breathing, head colds, earaches ```

Answer 165

Severe Acute Respiratory Syndrome

Answer 166

.discovered asia, 2/2003 .RESPIRATORY, droplet .spread by contaminated surfaces then touching mucous membranes

Answer 167

``` .HI fever .H/a body aches .mild respiratory ss . 10-20% have diarrhea .after 2-7 days, dry cough ```

Answer 168

``` • More contagious when symptoms present • Most contagious during second week of illness • Limit contact until ten days after fever no longer present and respiratory symptoms improved • Treatment same as CAP ```

Answer 169

ADPIE ``` Assess Dx Planning Implementation Evaluation ```

Answer 170

Lung, Prostrate, Colorectal

Answer 171

Lung, Breast, Colorectal

Answer 172

proteins tha develop over tikme called "tumor-specific antigens" i.e. prostate-specific antigen (psa)

Answer 173

.grow and divind w glucose, O2 | .mali`gnant cells us ANEROBIC metabolism

Answer 174

attract fibrin, platelets and clotting factors to seal off from immune system. Endothelium retracts, mal cells secret LYSOSOMAL ENZYME tha destroys body sys and allow implantation

Answer 175

development of new capillaries from host tissue by release of growth factors and enzymes such as vascular endothelial growth factor (VEGF) .These proteins rapidly stimulate formation of new blood vessels that help malignant cells obtain nutrients and oxygen • Through vascular network, the tumor emboli enter systemic circulation and travel to distant sites. Therapies target VEGF or its receptors.

Answer 176

malignant transformation .Imitation: chemicals, physical factors, biologic agents, escape normal enzymatic mechanisms and alter genetic structure of cellular DNA .Promotion: repeated exposure to promoting agents (co-carcinogens) causes expression of abnormal or mutant genetics information (different latency periods) .Progression: • cells that changed during imitation and promotion invade adjacent tissues and metastasize