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HLSC 222 > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Describe the classification & staging of cancer (the 4 stage system)

A

Stage 1 – confined to the organ of origin
Stage 2 – locally invasive
Stage 3 – Spread to regional structures, such as lymph nodes
Stage 4 – spread to distant sites, liver to lung, prostate to bone

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2
Q

Explain how bacteria & viruses can increase the chance of developing cancer

A
  • 15-20% of tumours have a viral cause
  • Link between H Pylori & gastric cancer
  • Herpes virus also increases the risk of nasopharyngeal cancer
  • Hepatitis B & C increase the risk of liver cancer
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3
Q

Explain why chronic inflammation increases the chance of developing cancer

A
  • Cytokine release from inflammatory cells
  • Free radicals
  • Mutation promotion
  • Decreased response to DNA damage
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4
Q

(Lifestyle/environmental risk factors) This factor is associated with high risk occupations that expose the individual to a variety of carcinogenic agents, such as ionizing radiation, diesel engine exhaust, asbestos, arsenic compounds, cadmium, formaldehyde, wood dust, & lead compounds.

Explain why these carcinogenic agents cause cancer

A

Occupational hazards
- Bladder (diesel exhaust), Bone, Esophagus, & Brain (Ionizing radiation), Colon & Lung (asbestos, arsenic compounds), Mesothelioma (covering many organs) – (Asbestos – most common in lungs), Liver (hepatitis), & breast (circadian rhythm)

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5
Q

(Lifestyle/environmental risk factors) Explain why a lack of physical inactivity increases cancer risk

A

Physical inactivity
- Increases insulin & insulin-like growth factors: Which higher insulin levels trigger rapid cell division, decreasing in DNA regulator genes which Inhibits cells from initiating steps towards cell death (apoptosis)

  • Increases obesity = increased risk for cancer
  • Increases inflammatory mediators & free radicals: Therefore creates cellular proliferation, genomic instability, angiogenesis, resistance to apoptosis, invasion, & metastasis
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6
Q

(Lifestyle/environmental risk factors) This factor is sourced from nutrient intake, such as toxic, mutagenic, and carcinogenic chemicals in food.

Provide examples of said factor.

A

Diet
- High fat content, preservatives, smoked, & low fibre foods.

  • Chemicals found in tobacco smoke, plastic, refined flour & sugars
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7
Q

(Lifestyle/environmental risk factors) This factor primarily comes from sunlight & promotes skin inflammation & the release of free radicals

What does it cause? (3 main types of malignant skin lessions)

A

Ultraviolet radiation
- Causes basal cell carcinoma, squamous cell carcinoma, & melanoma

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8
Q

(Lifestyle/environmental risk factors) This factor has enough energy to damage DNA & cause cancer (gene mutation). With exposure causing cell death, gene mutations, & chromosome aberrations.

Provide examples of sources of this kind of factor

A

Ionizing radiation

  • Emission from x-rays, radioisotopes, and other radioactive sources
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9
Q

(Lifestyle/environmental risk factors) This term refers to sexual promiscuity, and how it increases the chance of developing cancer.

List & describe the 3 examples where this behaviour can be detrimental

A

Sexual reproductive behaviour

  • Age of first sexual intercourse: Before the age of puberty increases the risk, since the cervix is changing in puberty & more vulnerable to damage
  • Having multiple sexual partners increased risk of exposure to carcinogenic types of human papillomavirus (hpv) & also increased chance of STIs
  • Late age of first pregnancy or no pregnancy: Since breast cells don’t fully mature until the first pregnancy (in no pregnancy) & cells take longer to fully mature increasing chance of cancer (in late age)
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10
Q

(Lifestyle/environmental risk factors) The consumption & then subsequent metabolism of this drug creates a toxic chemical called acetaldehyde, which is a human carcinogen, that damages the DNA & protein

State the areas in the body at risk for developing cancer due to the consumption of this drug

A

Alcohol consumption
- Risk factor for oral cavity, pharynx, hypopharynx, larynx, esophagus, liver, breast, & colorectal cancers

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11
Q

What are some biological risk factors for developing cancers?

A

Age: Since the median age for cancer diagnosis is 66 years

Hereditary: Born with a gene mutation that may make you more likely to develop certain cancers (5-10% of cancers are hereditary). Most common is colorectal cancer, such as lynch syndrome, which can develop noncancerous polyps, & may develop into cancer. Down syndrome – more likely to develop acute lymphocytic leukemia

Hormones: Post menopausal women taking hormone replacement therapy are at an increased risk of developing breast cancer, since estrogen promotes growth in breast & uterus

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12
Q

(Clinical manifestations of cancer) The majority of patients with advanced cancer present with a multiple of symptoms of this syndrome, including, anorexia, early satiety, weight loss, asthenia (physical weakness), taste alterations, & altered protein, lipid, & carbohydrate metabolism. What is this term called?

A

Cancer Anorexia-Cachexia syndrome

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13
Q

(Clinical manifestations of cancer) Which term refers to the most significant complication and cause of death in people with a malignant disease, since malignancies are immunosuppressive?

List & describe the 3 variables that increase the rate of said term

A

Risk of infection (infection)

  • Age: Older people have decreases immune function & inadequate nutrition
  • Tumours: Depends on the type & location
  • Surgical treatment/hospitalizations: Tissue removal = dead spaces, thus poor tissue perfusion causing infection & also greater risk of hospital acquired infections
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14
Q

(Clinical manifestations of cancer) Which term refers to a decrease of hemoglobin in the blood?

Describe the mechanisms that cause this manifestation, including:
- Chronic bleeding resulting in iron deficiency
- Severe malnutrition
- Cytotoxic chemotherapy
- Malignancy in blood-forming organs

A

Anemia
- Colorectal & genitourinary malignancy
- Gastric, pancreatic, or upper intestinal cancer = malabsorbed iron
- methotrexate treatments can cause large red cell anemia, called megaloblastic anemia, large RBC, but fewer – RBCs aren’t produced properly
- Bone marrow primarily, also the thymus, spleen & lymph nodes (lymphocyte production)

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15
Q

(Clinical manifestations of cancer)
Which term refers to decreased WBC count ?

Which term refers to direct invasion of bone marrow?

Which term refers to a lack of granulocytes - innate immune system

Which term refers to a decrease in platelets, where the tumour is invading bone marrow or our treatment with chemotherapy?

A
  • Leukopenia
  • Leukemia
  • Granulocytopenia
  • Thrombocytopenia
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16
Q

(Clinical manifestations of cancer) What is the #1 manifestation of cancer, characterized by less energy, weakness, depression tiredness, exhaustion, lethargy, inability to concentrate, sleepiness, boredom, and lack of motivation?

& what are some potential causes?

A

Fatigue

  • Sleep disturbance, biochemical changes from circulating cytokines, secondary to disease and treatment, psychosocial factors, level of activity, nutritional status, & environmental factors
17
Q

(Clinical manifestations of cancer) Little or no __ is associated with early stages of malignancy(cancer).

List the mechanisms that are responsible for this clinical manifestation

& what is can be influenced by as well

A

Pressure, obstruction, invasion of sensitive structures, stretching of visceral surfaces, tissue destruction, & inflammation

Influenced by fear, anxiety, sleep loss, fatigue, depression, & overall physical deterioration

18
Q

Explain how cancers invade genes that control cell growth, replication & repair

A

Cancer cells have the ability to evade growth suppressors – there is an inactivation of tumour suppressor genes (growth factor brakes). As tumour-suppressor genes are inactivated, Oncogenes are activated in cancer (accelerators). Angiogenesis-promoting genes – stimulates the process of new vessel formation – creating its own blood supply (tumour)

19
Q

How do cancers develop? & name & describe the characteristics of cancer cells

A
  • There has a been a mutation in the genes that control growth/replication/repair
  1. Anaplasia: Poor cellular differentiation – losing the characteristics of the mature cells – advanced dysplasia – not reversible. They are primitive, and don’t wait until they mature
  2. Autonomy: independent, not following any normal rules, not regulated by normal physiological influences – no internal control for normal apoptosis, nor will it stop its growth when it butts up against another cell.
20
Q

Describe the progression of cancer

A

– Change our terminology as we progress – but progression is not always from mutation to invasive cancer at the hyperplasia & dysplasia stage it can be reversed

– Cancer in situ are in epithelial cells – precancerous state – the cell growth is closely monitored – cervical cancer – repeated pap smear test to assess. Early stage they have not become invasive – not considered malignant. Seen in cervix, mouth, stomach, breast and large bowel

21
Q

How are benign & malignant skin tumours differentiated?

A

Malignant skin tumours are asymmetrical, have disoganized borders, have diff colours, a larger diameter than 6mm, & is constantly evolving in size, shape, elevation, or colour

22
Q

List the differences between benign & malignant tumours

A

Benign – named after location. Cells well differentiated, grows slowly, encapsulated, local effects, not invasive, & does not metastasize

Malignant – named after type of cell. Poorly differentiated, grows rapidly, non-encapsulated, generalized effects, greek word karkinoma for crab formation – ‘claw’ like formation that reach into other tissues

23
Q

What are the 2 most common forms of cancers called?

Provide their description & their location

A

Sarcoma: Rising from mesenchymal, which grows in connective tissues, such as lymphatic, circulatory & musculoskeletal systems
Carcinoma: Rising from epithelial tissue , which grows in skin or tissue cells that line the body’s internal organs, such as the kidneys and liver

24
Q

Malignant cells have 2 characteristics, what are they called & what doe they mean?

A

Anaplasia – loss of cellular differentiation
Pleomorphic – variability of size & shape

25
Q

Name the 2 states that neoplasia occurs in & provide a description of each

Also provide examples if possible

A
  • Benign: Which is a non-invasive, well-differentiated, well organized, & they are also encapsulated. Named for tissues where they arise e.g. lipoma is tumour of fat cells. & can become life threatening depending on the location
  • Malignant: Proliferate rapid growth, loss of differentiation – not anymore similar to the original tissue – (very disorganized) absence of normal tissue organization, lack a capsule and grow to invade neighbouring tissues & even get into lymph or blood circulation and spread throughout our body
26
Q

Which term refers to pre-invasive epithelial tumours: which are a group of abnormal cells that are found only in the place where they first formed in the body?

A

Carcinoma in Situ (CIS)
- These abnormal cells may become cancer and spread to nearby normal tissue, or can remain stable, & egress & disappear

27
Q

How is metaplasia caused by chronic injury or irritation? & provide an example.

A

Metaplasia is reprogramming of stem cells in response to signals generated from cell’s environment – best example is the effect smoking has on the airway. Normal cells are replaced over time with squamous epithelial cells – don’t operate the same as original cells – if the person stops smoking the metaplasia can be reversed – if they don’t it can progress to dysplasia and cancer

28
Q

What are some examples of pathological & physiological hyperplasia?

A

Physiological: There is a compensatory adaptive mechanism that allows for regeneration (e.g. in liver donation it grows back). Then there is a hormonal mechanism, where the endometrium thickens in anticipation of pregnancy, such a hyperplasia in the epithelial cells of the uterus
- Pathologically: Abnormal proliferation of normal cells, such as in heavy menstrual bleeding & enlargement of prostrate as the result of a hormonal imbalance

29
Q

What are some examples of pathological & physiological hypertrophy?

A

Physiological: skeletal muscle due to exercise, uterus in pregnancy, kidneys when the body only has one kidney due to -disease, donation, injury - so the remaining kidney hypertrophies to accommodate
- Pathological: Extended period of time can lead to pathological hypertrophy, such as left ventricular hypertrophy

30
Q

How can atrophy be caused pathologically & physiologically?

A

Pathologically: Decreases in workload (altered demand), decrease in blood supply & nutrition, decrease hormonal stimulation & decrease in/ lack of nervous system stimulation, pressure, & can also be due to neurological problems
Physiologically: Through not using skeletal muscles

31
Q

Which term refers to Uncontrolled, abnormal growth of cells or tissues in the body?

A

Neoplasia

32
Q

Which term refers to the presence of abnormal cells within a tissue or organ or the abnormal size, shape, and organization of cells? (also called an atypical hyperplasia) & provide an example of this occurring in the cervix

A

Dysplasia
- Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Considered a precancerous due to sexually transmitted infection (Human Papillomavirus (HPV).

33
Q

Which term refers to the conversion of one adult tissue type into another, related and more durable, tissue type? The most prevalent examples areconversion of fibrous tissue into bone

A

Metaplasia

34
Q

Which term refers to an increase in the number of cells in an organ or tissue?

A

Hyperplasia

35
Q

Which term refers to an increase of cell size , common to think about increases in skeletal muscles (e.g. as a result of working out)

A
  • Hypertrophy
36
Q

Which term refers to a decreasing of cell size, not cell numbers, leading to a decrease in the size of the organ?

A
  • Atrophy
37
Q

What are some examples of cellular adaptations? & examples of non-adaptive ones?

A
  • Atrophy, hypertrophy, hyperplasia, metaplasia
  • Dysplasia & neoplasia
38
Q

Which term refers to reversible functional and structural responses to physiologic stress and some pathogenic stimuli?

A

Cellular adaptation

39
Q

A - …means
Troph - …means
- plasia … means
Dys - … means
Meta - … means
Neo - … means

A
  • Without
  • Nourishment
  • Growth/ formation
  • Disordered
  • Beyond
  • New

HLSC 222 (19 decks)

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