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Pathology > Neoplasia > Flashcards

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%
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2
Q

what does the incident of cancer rise with

A

age

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3
Q

at what age is the peak of cancer incidents

A

75

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4
Q

what happens after the age of 25, every 5 years

A

the risk of developing cancer doubles

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5
Q

at what age do half of all cancers become clinically evident

A

people over 70 years old

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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

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7
Q

what is neoplasia

A

an abnormality of cell growth and multiplication

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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
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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
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10
Q

which gene dominates in neoplasia and enhances cell division

A

oncogenes causing lumps of tumours & tissues

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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
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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

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13
Q

give an example of a virus which triggers neoplasia

A

retrovirus which are bits of RNA eg HIV

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14
Q

give an example of chemical carcinogens which can trigger neoplasia

A
  • smoking
  • soot
  • asbestos
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15
Q

what type of neoplasia can exposure to UV cause

A

malignant melanoma

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16
Q

what 3 factors can neoplasms be classified as

A
  1. site of origin
  2. biological behavior
  3. cell of origin
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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

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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
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19
Q

what are the 2 main types of biological behavior of neoplasms

A
  • benign

- malignant

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20
Q

how is benign neoplasms in relation to their origin

A

they stay at the site of origin

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21
Q

how is benign neoplasms in relation to danger and damage

A

less dangerous

but can do damage by compressing neighboring tissue

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22
Q

what is the appearance of a benign neoplasm

A

smooth surface with fibrotic capsule (capsulated in a sheet so it is smooth)

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23
Q

what is the rate of growth of a benign neoplasm

A

slow

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24
Q

what do the cells appear to look like of a benign neoplasm

A

resemble normal tissue

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25
Q

how are malignant neoplasms in relation to origin

A

they invade other tissue

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26
Q

what are malignant neoplasms which invade other tissues

A

secondary tumours are metastases

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27
Q

how dangerous are malignant neoplasms

A

fatal if not treated

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28
Q

what are untreated malignant neoplasms referred to as

A

cancers

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29
Q

what is the appearance of a malignant neoplasm

A

irregular and not encapsulated

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30
Q

what do cells appear to look like of a malignant neoplasm

A

cells have many abnormalities and do not resemble normal tissue

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31
Q

list the properties of benign tumours

A
  • slow growth rate
  • no infiltration
  • no metastasis
  • high patient survival rates after successful removal
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32
Q

list the properties of malignant tumours

A
  • rapid growth rate
  • infiltrative
  • metastasizing
  • poor patient survival rates:
    tendency for local and distant recurrence (metastasis)
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33
Q

list the properties of tumours that are inbetween benign and malignant

A

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

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34
Q

list the types of neoplasms which are from the cell of origin and state what they are the uncontrollable division of

A
  • neuroma - neural
  • lipoma - fat cells
  • adenoma - glandular eg liver, renal, endocrine
  • osteoma - bone
  • schwannoma - schwann cells
  • meningioma - meninges
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35
Q

which neoplasm causes cancer and which doesn’t

A
  • malignant neoplasm causes cancer

and benign neoplasm does not cause cancer

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36
Q

what suffix does a benign neoplasm generally end with

A

oma

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37
Q

what suffix does a malignant neoplasm generally end with

A

sarcoma/carcinoma

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38
Q

give example of which neoplasms with the suffix oma (generally for benign) can be malignant

A

lymphoma

meningioma

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39
Q

which common cancer has very successful survival rates

A

nonmelanoma skin cancer

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40
Q

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

A
  • testis
  • melanoma
  • Hodgkin’s lymphoma
  • breast
  • uterus
  • cervix
  • bladder
  • larynx
  • prostate
  • NHL
  • rectum
  • colon
  • kidney
  • leukemia
  • ovary
  • multiple myeloma
  • brain
  • stomach
  • esophagus
  • lung
  • pancreas
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41
Q

how much % of survival chance is there for pancreas cancer if survive for 5 years

A

5%

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42
Q

what is the most common ocular tumour

A

melanoma

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43
Q

what are melanocytes found in

A

uvea (choroid, ciliary body and iris)
&
conjunctiva & eyelid (extra ocular)

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44
Q

what are the two types of ocular melanoma called

A

uveal melanoma
&
extraocular melanoma

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45
Q

what can intracranial tumours effect

A

any point in the visual pathway, as well as other areas in the brain associated with visual reflexes

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46
Q

what is the area of the brain where intracranial tumours can effect visual reflexes

A

brain stem

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47
Q

what type of tumour can intracranial tumours be

A

benign or malignant

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48
Q

what else can intracranial tumours be

A

primary or metastatic

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49
Q

how many new primary intracranialneoplasms a year in the US are there

A

13,000

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50
Q

which cell types can intracranial neoplasms arise from

A

glial cells
or
meninges

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51
Q

in which case can an intracranial neoplasm arise from tumours of neurons

A

in childhood called medulloblastoma

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52
Q

how many % of all brain tumours are of glial origin

A

65%

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53
Q

what is the name of the brain tumours which are of glial origin

A

gliomas

54
Q

how many % of all brain tumours originate from meninges

A

10%

55
Q

what is the name of brain tumours which originate in the meninges

A

meningiomas

56
Q

how many % of intracranial tumours does an acoustic neuroma account for

A

6-10%

57
Q

which type of brain tumour is an acoustic neuroma incident rate similar to

A

meningiomas

58
Q

acoustic neuroma occurs in what ratio of the population

A

1 in 100,000 people

59
Q

what type of tumour is an acoustic neuroma

A

benign and slow growing

60
Q

which period of life is an acoustic neuroma likely to be in

A

4th and 5th decades of life

avg age 46 years old

61
Q

which cell is an acoustic neuroma the result of

A

Schwann cells

ie is a Schannoma of vestibular part of the 8th cranial nerve

62
Q

where does the acoustic neuroma originate in

A

internal acoustic meatus

63
Q

where does the 8th cranial nerve com from and where does it go

A

comes from the ear and goes to the brain stem

64
Q

what is the name of the 8th cranial nerve

A

vestibulo cochlea

65
Q

what two parts is the vestobulo cochlea CN coming from

A

the ear
&
the cochlea

66
Q

explain why the name acoustic neuroma, does not reflect the actual origin of the intracranial tumour itself

A

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
Q

what is the internal auditor meatus

A

the hole which the 8th CN goes through

68
Q

what does the internal auditory meatus connect

A

the ear to the brain stem

69
Q

what effect does the acoustic neuroma have

A

it squats the 8th CN in the internal auditory meatus

70
Q

what is the 4th ventricle

A

a space located behind the internal auditory meatus

71
Q

what happens with the growth of the acoustic neuroma tumour in relation to the 4th ventricle

A

the tumour bulges out into the cerebella pontine angle and carries on growing & squashing the 8th CN

72
Q

list the various sizes of an acoustic neuroma

A
  • intracanalicular
  • 1cm
  • 2cm
  • 3cm
73
Q

what is a 1cm acoustic neuroma referred to as

A

small

74
Q

what is a 2cm acoustic neuroma referred to as

A

medium

75
Q

what is a 3cm acoustic neuroma referred to as

A

large

76
Q

what is the intracanalicular acoustic neuroma referred to as

A

very small, stuck in the canal

77
Q

what does a large size acoustic neuroma do

A

squeezes the cerebellum

78
Q

list the 8 symptoms of an acoustic neuroma

A
  • loss of hearing
  • disturbances of balance
  • facial palsy
  • disturbances of taste
  • odd facial sensations
  • difficulty swallowing
  • ataxia
  • raised intracranial pressure
79
Q

which CN is loss of hearing linked with

A

8th vestibulocochlear nerve

80
Q

which CN is facial palsy linked with

A

7th facial nerve

81
Q

which CN is disturbances of taste linked with

A

7th facial nerve

82
Q

which CN is disturbance of balance linked with

A

8th vestibulocochlear

83
Q

which CN is odd facial sensation linked with

A

5th trigeminal nerve

84
Q

which CN is difficulty swallowing linked with

A

10th vagus nerve

85
Q

what does the vestibulocochlear CN control

A

balancing & hearing

86
Q

what is the ringing noise in ears associated with acoustic neuroma

A

tinnitus

87
Q

what do you need in order to localise sound

A

two ears

88
Q

which other CN also goes through the internal auditory meatus, as well as the 8th CN

A

the 7th facial CN

89
Q

what happens as a cause of damage to the 7th facial CN

A

it effects muscle tone which looses so that side of the face droops down

90
Q

how is the disturbance of taste linked to damage to the 7th facial CN

A

the 7th facial CN is also a sensory nerve of the front 1/3rd of the tongue

91
Q

what is the 5th trigeminal CN involved with

A

facial sensation

92
Q

what is the 10th vagus CN involved with

A

swallowing

93
Q

what is the cause of the ataxia from the acoustic neuroma

A

the tumour squashes the cerebellum, which controls sensory, motor and coordination
e.g. can’t walk through a door

94
Q

what is raised intracranial pressure due to the blockage of

A

blocked cerebellopontine angle

95
Q

list the series of production and drainage of CSF

A
  • 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
Q

so what does a acoustic neuroma block

A

the drainage of CSF hence pressure builds up in cranium

97
Q

what is placed in order to drain the CSF which is built up in the cranium

A

ventriculoperitoneal shunt

98
Q

what is the tube of the ventriculoperitoneal shunt placed into

A

the lateral ventricle

99
Q

what is the CSF drained through and into

A

drained through the tube and into the gut

100
Q

where does the catheter lie

A

underneath the skin

101
Q

which muscle raises the upper eyelid and which CN

A

the levator palpebrae

3rd CN oculomotor

102
Q

which are the two smooth muscles (muscles of muller)

A
  • superior tarsal muscle

- inferior tarsal muscle

103
Q

which muscle is the eye closed by and which CN is that associated with

A

orbicularis oculi

7th facial CN

104
Q

what happens if the orbicularis oculi muscle is damaged

A

cannot shut the eye

105
Q

list the ocular symptoms of acoustic neuroma

A
  • 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
Q

list the ways of how to alleviate symptoms of lack of eyelid closure

A
  • ointment, taping at night
  • surgical tarsorrhaphy (sewing eye shut)
  • botulinum toxin tarsorrhaphy (inject botox into elevator palpebrae)
  • insertion of weight into upper eyelid
107
Q

how does inserting a weight into the upper eyelid work

A

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
Q

what is the cause of lower lid ectropion

A

due to loss of innervation by 7th facial CN

109
Q

what is lower eyelid ectropion

A

lower lid falls down

110
Q

how is an ectropion alleviated

A

a teflon plate is placed in the lower eyelid to keep it in place

111
Q

what is the danger of ectropion

A

cornea is exposed as eyelid cannot sit completely

112
Q

what is epiphora

A

watering of the eyes due to ectropion tears pool in the eyelid and then splash out

113
Q

what is the cause of reduced tear secretion

A

tears not distributed as the eye cannot blink due to damage of the 7th facial CN

114
Q

damage to which CN causes the loss of corneal sensation

A

5th trigeminal CN

115
Q

what can loss of corneal sensation cause

A

a damaged tear film

116
Q

damage to which CN causes an effect on the lateral rectus muscle

A

6th abducens nerve

117
Q

what does an effect on the lateral rectus muscle cause

A

inability of the eye to turn out

118
Q

what % of intracranial tumours are pituitary adenomas

A

10-12%

119
Q

where is the pituitary gland located

A

below the optic chiasm

120
Q

which way does a pituitary tumour grow and why

A

upwards, as the pituitary sits on a bony saddle/sella, which impacts the chiasm

121
Q

which fibres will a pituitary tumour compress

A

fibres originating from the nasal inferior retina of both retinae

122
Q

what type of field defect will a pituitary tumour cause

A

bitemporal superior field defect

123
Q

which fibres will a pituitary adenoma compress

A

fibres of the ventral surface of the chiasm causing bilateral superior scotomas

124
Q

which part of the chiasm does a chromophobe adenoma push up

A

infront of the chiasm

125
Q

which fibres are most vulnerable from a pituitary tumour

A

duscussating fibres

126
Q

list the things which can be done about a non-functional 7th facial CN

A
  • 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
Q

what does the length of the optic nerve effect the relative position of

A

the chiasm and seller structures

128
Q

list the three types of relative positioning of the optic chiasm and seller structures due to optic nerve head

A
  • prefixed chiasm - short optic nerve
  • normal chiasm
  • postfixed chiasm - long optic nerve
129
Q

Which type of neoplasm is generally primary and why

A

Benign as they stay where they originated

130
Q

Which type of neoplasms are secondary and metastatic

A

Malignant

131
Q

list from first to last, which cranial nerves get effected by an acoustic neuroma (i.e. from small to large)

A 
- 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

Pathology (20 decks)

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