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Patho: Cellular Adaptation > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Cancer

A

disorder of altered cell differentiation and growth

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2
Q

Neoplasim

A

the new growth

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3
Q

Tumor

A

swelling that can be caused by a number of conditions, including inflammation and trauma

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4
Q

Polyp

A

growth that projects from a mucosal surface, such as the intestine

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5
Q

Carcinoma

A

term used for malignant tumors of epithelial in origin

(bronchogenic carcinoma, adenocarcinoma)

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6
Q

Sarcoma

A

term used for malignant tumors of mesenchymal/connective tissue in origin

(liposarcoma, angiosarcoma)

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7
Q

Benign tumors

A

usually end with the suffix “oma”,

except for lympfoma, hepatoblastoma, neuroblastoma, myeloma, melanoma.

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8
Q

Lymphomas

A

Cancers of the lymphatic tissue

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9
Q

leukemia

A

cancer of blood forming cells

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10
Q

Carcinoma in SITU

A

Pre-invasive epithelial malignant tumors of glandular or epithelial origin that has not broken through the basement membrane or invaded the surrounding stroma (cervix, skin, oral cavity, esophagus & bronchus)

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11
Q

Epithelial Benign Tumors

A

Papilloma

Adenoma

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12
Q

Epithelial Malignant Tumors

A

Squamous cell carcinoma

adenocarcinoma

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13
Q

Connective tissue benign tumors

A

fibroma

lipoma

chondroma

osteoma

hemangioma

lymphangioma

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14
Q

Conncective tissue malignant tumors

A

fibrosarcoma

liposarcoma

chondrosarcoma

osteosarcoma

hemangiosarcoma

lymphangiosarcoma

lymphosarcoma

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15
Q

Muscle benign tumors

A

leiomyoma

rhabdomyoma

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16
Q

Muscle malignant tumor

A

leiomyosarcoma

rhabdomyosarcoma

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17
Q
A
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18
Q

Neural Tissue benign tumor

A

Neuroma

glioma

neurilemmoma

meningioma

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19
Q

Neural tissue malignant tumor

A

neuroblastoma

glioblastoma

medulloblastoma

oligoendroglioma

neurilemmal sarcoma

meningeal sarcoma

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20
Q

Hematological malignant tumor

A

myelocytic leukemia

erythrocytic leukemia

mulitple myeloma

lymphocytic leukemia

lymphoma

monocytic leukemia

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21
Q

endothelial benign tumor

A

hemangioma

lymphangioma

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22
Q

endothelial malignant tumors

A

hemangiosarcoma

lymphangiosarcoma

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23
Q

a malfunction in any part of ________can lead to rapid proliferation of immature cells

A

the cell cycle

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24
Q

cell characteristic of benign tumors

A
  • well differentiated
  • resemble normal cells from which tumor originated
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25
Q

Mode of growth benign tumors

A

tumor grows by expansion and does not infiltrate surrounding tissues

usually encapsulated

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26
Q

benign tumor rate of growth

A

usually slow

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27
Q

malignant cell characteristics

A

undifferentiated

usually do not ressemble normal cells of tissue from which they arose

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28
Q

malignant tumor mode of growth

A

grows at periphery and send out processes that infiltrate and destroy surrounding tissue

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29
Q

Malignant rate of growth

A

variable and depends on level of differentiation

more anaplastic=faster growth

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30
Q

benign tumor metastasis

A

None- negative

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31
Q

malignant tumor metastasis

A

gains access to blood and lymph channels and metastasizes to toher areas of the body

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32
Q

benign tumore general effects

A

usually localized phenomenom

does not cause generalized effects unless localtion interfers with normal/vital function

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33
Q

malignant tumor general effects

A

anemia

weakness

weight loss

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34
Q

benign tumor destruction

A

does not cause destruction unless location interferes with blood flow

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35
Q

malignant tumor destruction

A
  • often causes tissue damage as the tumor outgrows its blood supply or blocks blood flow to the area
  • may also produce substances that cause cell damage
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36
Q

invasion and metastisis

A
  1. Cancer cell expresses surface adhesion molecules (capable of invasion)
  2. tumor adhesion molecules bind to underlying extracellular matrix
  3. tumor cells disrupt and invade extracellular matrix

Phagocytic enzymes-repeated disruption of extracellular matrix by binding=dissalution of matrix

  1. tumor cells metastasize by way of blood and lymph
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37
Q

Metastasis types

A

direct invasion

diffusion

lymphatic spread

hematologic spread

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38
Q

metastasis: lymphatic spread

A

Local or distant lymph nodes via lymphatic drainage
Migratory nature also be carried by lymphatic drainage to local or distant lymph nodes

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39
Q

metastasis: direct invasion

A

Nearby organ and tissue
Through a structure such as pelvis or abdomen
May cause skin changes and ulcerations of involved tissue
Not orderly spread
Surgical removal must include margins

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40
Q

metastasis diffusion

A

Serous cavities such as pelvis

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41
Q

metastasis: heamtological spread

A

Tumor cells are carried to distant sites through blood flow

Colon cancer commonly spreads to the liver

Normal circulation carries blood from the intestines to the liver through the hepatic portal vein.

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42
Q

Major Metastatic sites

A

lung

brain

liver

bone

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43
Q

breast cancer common metastasis sites

A

lung

bone

44
Q

colorectal cancer common metastasis sites

A

liver

45
Q

prostate cancer common metastasis sites

A

bone

spine

legs

46
Q

lung cancer common metastasis sites

A

brain

47
Q

brain tumors common metastasis site

A

CNS

48
Q

cancer risk factors

A

smoker

obesity

nutrition

alcohol

some chemical/drugs

some viruses/bacteria

radiation

Nonmodifiable: age, immune condition, hormones, heredity

49
Q

Alcohol increase the risk of cancer in

A

mouth, pharynx, larynx, esophagus, liver, colorectum, and breast

50
Q

Warning signs of cancer

A
  • Change in bowel or bladder habits
  • Any sore that does not heal
  • Unusual bleeding or discharge
  • Thickening lump in breast or anywhere
  • Indigestion
  • Obvious change of wart or mole
  • Nagging cough or hearseness
51
Q

Cancer early detection screenings

A

mammogram

PAP smear

stools for occult blood

sigmoidoscopy

colonoscopy ( polyps=5 years, no polyps=10 years)

breast self exam

testicular self exam

skin inspection

52
Q

What are Tumor Markers??

A

Tumor cell markers (biological markers) are substances produced by cancer cells or that are found on tumor plasma cell membranes, in the blood, SF, or urine
Hormones
Enzymes
Genes
Antigens
Antibodies

53
Q

How are tumor markers used?

A

Tumor markers are used to:

Screen and identify individuals at high risk for cancer

Diagnose specific types of tumors

Observe clinical course of cancer

54
Q

What are the three steps in carcinogenesis

A

Initiation

promotion

progression

55
Q

Explain Carcinogenesis Initiation Step

A

Carcinogens such as chemicals, physical factors, and biologic agents escape normal enzymatic mechanisms and alter the genetic structure of the cellular DNA

  • DNA DAMAGE
  • CELL MUTATION
56
Q

Explain Carcinogenesis Promotion step

A

Repeated exposure to promoting agents causes the expression of abnormal or mutant genetics information

-activation of oncogenes by promoter agent

57
Q

Explain Carcinogenesis Progression step

A

The altered cells exhibit increased malignant behavior; they now have the propensity for invasion and metastasis

=malignant tumor!!

58
Q

Will every dna damage to a cell lead to mutation?

A

NO

59
Q

Malignant Grading definiton

A

According to the histologic or cellular characteristics of the tumor
Degree to which the tumor cells retain the functional and structural characteristics of the tissue of origin

60
Q

Malignant staging definition

A

According to the clinical stage of the disease, including tumor size and spread or metastasis to distant sites

61
Q

TNM Classification: Tumor

A

Tx - Primary tumor cannot be assessed
T0 - No evidence of primary tumor
Tis - Carcinoma in situ; intraepithelial or invasion of lamina propria
T1 - Tumor invades submucosa
T2 - Tumor invades muscularis propria
T3 - Tumor invades through muscularis propria into subserosa or into non-peritonealized pericolic or perirectal tissues.
T4 - Tumor directly invades other organs or structures and/or perforate visceral peritoneum

62
Q

Primary tumor cannot be assessed is what on TNM classification?

A

Tx

63
Q

No evidence of primary tumor is what on TNM classification

A

T0

64
Q

Carcinoma in Situ is what on the TNM classification?

A

Tis

intraepithelial or invasion of lamina propria

65
Q

A tumor that invades submucosa would be classified as what on the TNM

A

T1

66
Q

A tumor that invades muscularis propria would be classified as what on the TNM scale?

A

T2

67
Q

A tumor that invades musularis propria into the subserosa or into non-peritonealized perocolic or perirectal tissues would be classified as what on the TNM scale?

A

T3

68
Q

A tumor that directly invades other organs or structures and/or perforate visceral peritoneum would be classififed as what on the TNM

A

T4

69
Q

Regional Lymph Nodes TNM classification

A

Nx - Regional lymph nodes cannot be assessed
N0 - No regional lymph node metastasis
N1 - Metastasis in 1 to 3 regional lymph nodes
N2 - Metastasis in 4 or more regional lymph nodes

70
Q

what is the TNM classification when regional lymph nodes cannot be assesed

A

Nx

71
Q

What is the TNM classification when there is no regional lymph node involvement?

A

N0

72
Q

What is the TNM classification when there is metastasis in 1-3 lymph nodes?

A

N1

73
Q

What is the TNM classification when there is metastasis in 4 or more regional lymph nodes?

A

N2

74
Q

TNM- distant metastasis

A

Mx - Distant metastasis cannot be assessed
M0 - No distant metastasis
M1 - Distant metastasis

75
Q

What is the TNM classification if distant metastasis cannot be assessed?

A

Mx

76
Q

What is the TNM classification if there is no distant metastasis

A

M0

77
Q

What is the TNM classification is there is distant metastasis

A

M1

78
Q

what influences pain in malignancy

A

fear, anxiety, sleep loss, fatigue, and overall physical deterioration

79
Q

what are the mecahnisms of pain in malignancy?

A

Pressure,

obstruction,

invasion of sensitive structures,

stretching of visceral surfaces,

tissue destruction,

inflammation

80
Q

what are some clinical manifestations of malignancy

A

pain

fatigue

cachexia

anemia

leukopenia

thrombocytopenia

infection

81
Q

what are components of fatigue in malignancy

A

psychogenic cultural and physiologic comnponents.

82
Q

what are suggested causes of fatigue in malignancy

A

Sleep disturbance

biochemical changes from circulating cytokines

secondary to disease and treatment

psychosocial factors

level of activity

nutritional status

environmental factors

83
Q

what is cachexia syndrome?

A

severe form of malnutrition

84
Q

What are the compnents of cachexia syndrome?

A

Anorexia

early satiety

weight loss

anemia

asthenia

taste alterations

altered protein, lipid, and carbohydrate metabolism

85
Q

what are the mechanisms of anemia in malignancy

A

Chronic bleeding resulting in iron deficiency

severe malnutrition

medical therapies

malignancy in blood-forming organs

86
Q

what are mechanisms of leukopenia and thrombocytopenia in malignancy

A

Direct tumor invasion to the bone marrow causes both leukopenia and thrombocytopenia
Chemotherapy drugs are toxic to the bone marrow

87
Q

when does infection risk increase?

A

Risk increases when the absolute neutrophil and lymphocyte counts fall

88
Q

what are the 3 treatment modalities for oncology?

A

chemo

radiation

surgery

89
Q

what are the purposes of surgery in the oncologic patient?

A

diagnose, stage and treat cancer

90
Q

what are the types of surgery in the oncologic patient

A

Prophylactic surgery
Curative surgery
Control (cytoreductive) surgery
Palliative surgery
Reconstructive or rehabilitative surgery

91
Q

what are the side effects of surgery?

A

Loss or loss of function of a specific body part
Reduced function as a result of organ loss
Scarring or disfigurement
Grieving about altered body image or imposed change in lifestyle

92
Q

what does chemotherapy do?

A

Kills or inhibits the reproduction of neoplastic cells

93
Q

Does Chemotherapy effect healthy cells or malignant cells?

A

BOTH

The effects are systemic and affect both healthy cells and cancerous cells

94
Q

What are the normal healthy cells mostly effected by chemotherapy treatment?

A

the skin,

hair,

lining of the GI tract,

spermatocytes

hematopoietic cells

95
Q

What are chemotherapy side effects

A

alopecia

nausea and vomiting

mucositis

skin changes

immunosuppression

anemia and thrombocytopenia

96
Q

what are the two most common typers of radiation therapy?

A

teletherapy

brachytherapy

97
Q

Does radiation therapy effect both healthy and cancer cells?

A

Destroys cancer cells with minimal exposure of normal cells to the damaging effects of radiation; the cells damaged either die or become unable to divide
Effective on tissues directly within the path of the radiation beam

98
Q

Does the patient remit radiation when getting teletherapy?

A

The client does not emit radiation and does not pose a hazard to anyone else

99
Q

What is beam radiation?

A

AKA teletherapy

radiation source is external

patient does not emit radiation

100
Q

Teletherapy education

A

Wear soft clothing over the area avoiding belts, buckles, straps, or any clothing that binds or rubs the skin
Avoid sun and heat exposure
Monitor for moist desquamation (weeping of the skin)
If moist desquamation occurs, cleanse the area with warm water and pat dry, apply antibiotic ointment or corticosteroid cream as prescribed, and expose the site to air

Wash area with water or mild soap and water using the hand rather than a washcloth; rinse the soap thoroughly, and pat dry using a soft towel or cloth
Do not remove the radiation markings from the skin
Use no powders, ointments, lotions, or creams on the area unless prescribed

101
Q

DO clients receiving brachytherapy emit radiation

A

YES
The radiation source is within the client; for a period of time, the client emits radiation and can pose a hazard to others

102
Q

brachytherapy unsealed sources

A

Administered via the oral or IV routes, or as an instillation into body cavities
The source is not completely confined to one body area, and it enters body fluids and is eventually eliminated via various excreta, which is radioactive and harmful to others
Most of the source is eliminated from the body within 48 hours; then the client nor the excreta are radioactive or harmful

103
Q

Sealed Brachytherapy

A

SEALED RADIATION SOURCES
A sealed, temporary or permanent radiation source (solid implant) placed within the tumor target tissues
The client emits radiation while the implant is in place, but the excreta is not radioactive

104
Q

what is sealed brachytherapy usually used for

A

cervical/prostate cancer

105
Q
A

Patho: Cellular Adaptation (3 decks)

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