Neoplasia Flashcards
1
Q
list the major cause of death in the US in 2005
A
- heart disease 26.6%
- malignant neoplasms (cancer) 22.8%
- cerebrovascular disease (stoke) 5.9%
- chronic lower respiratory disease 5.3%
- accidents 4.8%
- diabetes 1.3%
- Alzheimer’s disease 2.9%
- influenza & pneumonia 2.6%
- kidney disease 1.8%
- septicemia 1.4%
2
Q
what does the incident of cancer rise with
A
age
3
Q
at what age is the peak of cancer incidents
A
75
4
Q
what happens after the age of 25, every 5 years
A
the risk of developing cancer doubles
5
Q
at what age do half of all cancers become clinically evident
A
people over 70 years old
6
Q
what can double in the next 50 years due to an increase in the elderly population
A
worldwide number of deaths due to cancer
7
Q
what is neoplasia
A
an abnormality of cell growth and multiplication
8
Q
what is the abnormality and multiplication of cell growth characterized by in neoplasia
A
- excessive cellular proliferation usually producing a tumour
- uncoordinated growth occurring without apparent purpose
- persistence of excessive cell proliferation and growth even after inciting stimulus is removed
9
Q
what is the abnormality and multiplication of cell growth characterized by in neoplasia at a molecular level
A
neoplasia is a disorder of growth regulatory genes:
- oncogenes eg can code for tissue growth factors
- tumour suppressor genes, on the other hand might downgrade the cell cycle & stop division
10
Q
which gene dominates in neoplasia and enhances cell division
A
oncogenes causing lumps of tumours & tissues
11
Q
what can neoplasia be triggered by
A
- viruses
- hereditary factors
- failure of immune system
- chemical carcinogens
- exposure to UV, or X-ray radiation
12
Q
give an example of a hereditary factor which triggers neoplasia
A
retinoblastoma which is seen in children is due to an inherited abnormal chromosome 13
13
Q
give an example of a virus which triggers neoplasia
A
retrovirus which are bits of RNA eg HIV
14
Q
give an example of chemical carcinogens which can trigger neoplasia
A
- smoking
- soot
- asbestos
15
Q
what type of neoplasia can exposure to UV cause
A
malignant melanoma
16
Q
what 3 factors can neoplasms be classified as
A
- site of origin
- biological behavior
- cell of origin
17
Q
how is the site of origin of the neoplasm described
A
eg tumours in the breast, uterus etc were different from eachother which were first recognized by Egyptian embalmers
18
Q
list the most common new cases of cancer in the US in 2008
A
- non-melanoma skin cancer - over 1 million
- lung cancer - over 250,000
- prostate cancer - over 186,000
- breast cancer (female) - over 182,000
- colon and rectal cancer - nearly 149,000
- bladder cancer - nearly 69,000
- non-Hodgkin lymphoma - over 66,000
- melanoma - over 62,000
- kidney (renal cell) cancer - over 46,000
- leukemia - over 44,000
- endometrial cancer - over 40,000
- pancreatic cancer - over 37,600
- thyroid cancer - over 37,000
19
Q
what are the 2 main types of biological behavior of neoplasms
A
- benign
- malignant
20
Q
how is benign neoplasms in relation to their origin
A
they stay at the site of origin
21
Q
how is benign neoplasms in relation to danger and damage
A
less dangerous
but can do damage by compressing neighboring tissue
22
Q
what is the appearance of a benign neoplasm
A
smooth surface with fibrotic capsule (capsulated in a sheet so it is smooth)
23
Q
what is the rate of growth of a benign neoplasm
A
slow
24
Q
what do the cells appear to look like of a benign neoplasm
A
resemble normal tissue
25
how are malignant neoplasms in relation to origin
they invade other tissue
26
what are malignant neoplasms which invade other tissues
secondary tumours are metastases
27
how dangerous are malignant neoplasms
fatal if not treated
28
what are untreated malignant neoplasms referred to as
cancers
29
what is the appearance of a malignant neoplasm
irregular and not encapsulated
30
what do cells appear to look like of a malignant neoplasm
cells have many abnormalities and do not resemble normal tissue
31
list the properties of benign tumours
- slow growth rate
- no infiltration
- no metastasis
- high patient survival rates after successful removal
32
list the properties of malignant tumours
- rapid growth rate
- infiltrative
- metastasizing
- poor patient survival rates:
tendency for local and distant recurrence (metastasis)
33
list the properties of tumours that are inbetween benign and malignant
low-grade malignant locally aggressive borderline
- variable growth rate
- locally infiltrative
- low or no metastatic potential
- intermediate patient survival rates:
tendency for local recurrence after successful surgical removal
34
list the types of neoplasms which are from the cell of origin and state what they are the uncontrollable division of
- neuroma - neural
- lipoma - fat cells
- adenoma - glandular eg liver, renal, endocrine
- osteoma - bone
- schwannoma - schwann cells
- meningioma - meninges
35
which neoplasm causes cancer and which doesn't
- malignant neoplasm causes cancer
| and benign neoplasm does not cause cancer
36
what suffix does a benign neoplasm generally end with
oma
37
what suffix does a malignant neoplasm generally end with
sarcoma/carcinoma
38
give example of which neoplasms with the suffix oma (generally for benign) can be malignant
lymphoma
| meningioma
39
which common cancer has very successful survival rates
nonmelanoma skin cancer
40
list in order from most to least rate of survival probabilities where if survived for 5 years, will be most likely to survive there after
- testis
- melanoma
- Hodgkin's lymphoma
- breast
- uterus
- cervix
- bladder
- larynx
- prostate
- NHL
- rectum
- colon
- kidney
- leukemia
- ovary
- multiple myeloma
- brain
- stomach
- esophagus
- lung
- pancreas
41
how much % of survival chance is there for pancreas cancer if survive for 5 years
5%
42
what is the most common ocular tumour
melanoma
43
what are melanocytes found in
uvea (choroid, ciliary body and iris)
&
conjunctiva & eyelid (extra ocular)
44
what are the two types of ocular melanoma called
uveal melanoma
&
extraocular melanoma
45
what can intracranial tumours effect
any point in the visual pathway, as well as other areas in the brain associated with visual reflexes
46
what is the area of the brain where intracranial tumours can effect visual reflexes
brain stem
47
what type of tumour can intracranial tumours be
benign or malignant
48
what else can intracranial tumours be
primary or metastatic
49
how many new primary intracranialneoplasms a year in the US are there
13,000
50
which cell types can intracranial neoplasms arise from
glial cells
or
meninges
51
in which case can an intracranial neoplasm arise from tumours of neurons
in childhood called medulloblastoma
52
how many % of all brain tumours are of glial origin
65%
53
what is the name of the brain tumours which are of glial origin
gliomas
54
how many % of all brain tumours originate from meninges
10%
55
what is the name of brain tumours which originate in the meninges
meningiomas
56
how many % of intracranial tumours does an acoustic neuroma account for
6-10%
57
which type of brain tumour is an acoustic neuroma incident rate similar to
meningiomas
58
acoustic neuroma occurs in what ratio of the population
1 in 100,000 people
59
what type of tumour is an acoustic neuroma
benign and slow growing
60
which period of life is an acoustic neuroma likely to be in
4th and 5th decades of life
| avg age 46 years old
61
which cell is an acoustic neuroma the result of
Schwann cells
| ie is a Schannoma of vestibular part of the 8th cranial nerve
62
where does the acoustic neuroma originate in
internal acoustic meatus
63
where does the 8th cranial nerve com from and where does it go
comes from the ear and goes to the brain stem
64
what is the name of the 8th cranial nerve
vestibulo cochlea
65
what two parts is the vestobulo cochlea CN coming from
the ear
&
the cochlea
66
explain why the name acoustic neuroma, does not reflect the actual origin of the intracranial tumour itself
the tumour comes from a branch of the vestibular system so it is not acoustic, but is actually vestiublar.
its not a neuroma (which is uncontrollable division of nerve cells) but is an uncontrollable division of Schwann cells which are found around the 8th CN in the internal auditory meatus.
67
what is the internal auditor meatus
the hole which the 8th CN goes through
68
what does the internal auditory meatus connect
the ear to the brain stem
69
what effect does the acoustic neuroma have
it squats the 8th CN in the internal auditory meatus
70
what is the 4th ventricle
a space located behind the internal auditory meatus
71
what happens with the growth of the acoustic neuroma tumour in relation to the 4th ventricle
the tumour bulges out into the cerebella pontine angle and carries on growing & squashing the 8th CN
72
list the various sizes of an acoustic neuroma
- intracanalicular
- 1cm
- 2cm
- 3cm
73
what is a 1cm acoustic neuroma referred to as
small
74
what is a 2cm acoustic neuroma referred to as
medium
75
what is a 3cm acoustic neuroma referred to as
large
76
what is the intracanalicular acoustic neuroma referred to as
very small, stuck in the canal
77
what does a large size acoustic neuroma do
squeezes the cerebellum
78
list the 8 symptoms of an acoustic neuroma
- loss of hearing
- disturbances of balance
- facial palsy
- disturbances of taste
- odd facial sensations
- difficulty swallowing
- ataxia
- raised intracranial pressure
79
which CN is loss of hearing linked with
8th vestibulocochlear nerve
80
which CN is facial palsy linked with
7th facial nerve
81
which CN is disturbances of taste linked with
7th facial nerve
82
which CN is disturbance of balance linked with
8th vestibulocochlear
83
which CN is odd facial sensation linked with
5th trigeminal nerve
84
which CN is difficulty swallowing linked with
10th vagus nerve
85
what does the vestibulocochlear CN control
balancing & hearing
86
what is the ringing noise in ears associated with acoustic neuroma
tinnitus
87
what do you need in order to localise sound
two ears
88
which other CN also goes through the internal auditory meatus, as well as the 8th CN
the 7th facial CN
89
what happens as a cause of damage to the 7th facial CN
it effects muscle tone which looses so that side of the face droops down
90
how is the disturbance of taste linked to damage to the 7th facial CN
the 7th facial CN is also a sensory nerve of the front 1/3rd of the tongue
91
what is the 5th trigeminal CN involved with
facial sensation
92
what is the 10th vagus CN involved with
swallowing
93
what is the cause of the ataxia from the acoustic neuroma
the tumour squashes the cerebellum, which controls sensory, motor and coordination
e.g. can't walk through a door
94
what is raised intracranial pressure due to the blockage of
blocked cerebellopontine angle
95
list the series of production and drainage of CSF
- CSF is produced by choroid plexus in the lateral ventricles
- it passes through the foramen of monro into the 3rd ventricles
- through the aquaduct of sylvius into the 4th ventricle
- passage through foramina of luschka and megendie into subarachnoid space
- absorption into venous system by arachnoid villi
96
so what does a acoustic neuroma block
the drainage of CSF hence pressure builds up in cranium
97
what is placed in order to drain the CSF which is built up in the cranium
ventriculoperitoneal shunt
98
what is the tube of the ventriculoperitoneal shunt placed into
the lateral ventricle
99
what is the CSF drained through and into
drained through the tube and into the gut
100
where does the catheter lie
underneath the skin
101
which muscle raises the upper eyelid and which CN
the levator palpebrae
| 3rd CN oculomotor
102
which are the two smooth muscles (muscles of muller)
- superior tarsal muscle
| - inferior tarsal muscle
103
which muscle is the eye closed by and which CN is that associated with
orbicularis oculi
| 7th facial CN
104
what happens if the orbicularis oculi muscle is damaged
cannot shut the eye
105
list the ocular symptoms of acoustic neuroma
- inability to lower the eyelid
- lower eyelid ectropion
- epiphora
- reduced tear secretion
- loss of corneal sensation
- loss of stability of the surface of the cornea
- affect on lateral rectus
106
list the ways of how to alleviate symptoms of lack of eyelid closure
- ointment, taping at night
- surgical tarsorrhaphy (sewing eye shut)
- botulinum toxin tarsorrhaphy (inject botox into elevator palpebrae)
- insertion of weight into upper eyelid
107
how does inserting a weight into the upper eyelid work
inserted onto upper tarsal plate which pulls the eyelid down and patient can learn to contract elevator palpebrae to open the eye, so the patient can use the 3rd oculomotor CN
108
what is the cause of lower lid ectropion
due to loss of innervation by 7th facial CN
109
what is lower eyelid ectropion
lower lid falls down
110
how is an ectropion alleviated
a teflon plate is placed in the lower eyelid to keep it in place
111
what is the danger of ectropion
cornea is exposed as eyelid cannot sit completely
112
what is epiphora
watering of the eyes due to ectropion tears pool in the eyelid and then splash out
113
what is the cause of reduced tear secretion
tears not distributed as the eye cannot blink due to damage of the 7th facial CN
114
damage to which CN causes the loss of corneal sensation
5th trigeminal CN
115
what can loss of corneal sensation cause
a damaged tear film
116
damage to which CN causes an effect on the lateral rectus muscle
6th abducens nerve
117
what does an effect on the lateral rectus muscle cause
inability of the eye to turn out
118
what % of intracranial tumours are pituitary adenomas
10-12%
119
where is the pituitary gland located
below the optic chiasm
120
which way does a pituitary tumour grow and why
upwards, as the pituitary sits on a bony saddle/sella, which impacts the chiasm
121
which fibres will a pituitary tumour compress
fibres originating from the nasal inferior retina of both retinae
122
what type of field defect will a pituitary tumour cause
bitemporal superior field defect
123
which fibres will a pituitary adenoma compress
fibres of the ventral surface of the chiasm causing bilateral superior scotomas
124
which part of the chiasm does a chromophobe adenoma push up
infront of the chiasm
125
which fibres are most vulnerable from a pituitary tumour
duscussating fibres
126
list the things which can be done about a non-functional 7th facial CN
- 7th CN often regenerates
- a nerve graft to connect the functional 7th CN on the side of the face to the muscles on the non-functional side (using the leg's sural nerve)
- facelift eg
gold weight in upper eyelid
teflon plate in lower eyelid
attachment of mouth to ear
127
what does the length of the optic nerve effect the relative position of
the chiasm and seller structures
128
list the three types of relative positioning of the optic chiasm and seller structures due to optic nerve head
- prefixed chiasm - short optic nerve
- normal chiasm
- postfixed chiasm - long optic nerve
129
Which type of neoplasm is generally primary and why
Benign as they stay where they originated
130
Which type of neoplasms are secondary and metastatic
Malignant
131
list from first to last, which cranial nerves get effected by an acoustic neuroma (i.e. from small to large)
```
- 8th CN vestibulo cochlea
loss of hearing
disturbance of balance
- 7th CN facial nerve
facial palsy
disturbance of taste
- 5th CN trigeminal nerve
odd facial sensation
- 10th CN vagus nerve
difficulty swallowing
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