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Block 1 Week 3 > Neoplasia (Cancer) > Flashcards

Neoplasia (Cancer) Flashcards

1
Q

Neoplasia

A
  • Greek for “new growth”
  • Abnormal growth
  • No useful function
  • Expense of the host
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2
Q

Neoplastic spectrum?

A

-from benign to malignant

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3
Q

Benign Neoplasms?

A
  • Not very aggressive
  • Easily removed
  • mild
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4
Q

Benign neoplasms nomenclature?

A
  • End in “-oma” (Lymphoma-exception)

- Prefix usually dictates location of benign tumor

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5
Q

Benign neoplasms treatment?

A

1) Excisional
- Snare polypectomy
- Endoscopic Mucosal Resection
- Surgery
- Colectomy

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6
Q

Where cancer usually found?

A
  • usually in polyps
    1) pedunculated polyp (sticking out)
    2) sessile polyp (under tissue)
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7
Q

How treat pedunculated polyp vs sessile polyp

A

pedunculated- just cut/excise
sessile- inject water, then excise
-can also do partial/full colectomy (remove collon, sections of colon)

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8
Q

Harder benign lesions to remove?

A
  • based on location
  • face, uterine fibroids and bone lesions are hard to remove
  • due to infertility, complications in surgery (nerve damage)
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9
Q

Malignant Neoplasms

A
  • a bad kind
  • Aggressive; grow very fast
  • Metastasis = displacement (Mets
  • Primary neoplasm leads to a secondary neoplasm
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10
Q

Primary vs secondary neoplasm

A

1) Primary: where cancer starts

2) Secondary: is when cancer get into blood/lymph/CSF, infect different areas/organs

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11
Q

Routes of mets? (metastasis)

A

1) Hematogenous
- colon cancer
2) Lymphomatous
- breast cancer
3) CSF (cerebrospinal fluid)

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12
Q

Bone Mets

A

1) Osteoblastic Lesions

2) Osteolytic Lesions

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13
Q

Osteoblastic Lesions

A

bone forming

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14
Q

Osteolytic Lesions?

Results?

A

-Bone breakdown
-Hypercalcemia due bone breakdown & release of extra Ca
Pathological Fractures

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15
Q

PB KTL Mnemonic

A

Lead Kettle Mnemonic
Prostate = blastic
Breast = both
Kidney, Thyroid & Lung = Lytic

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16
Q

Sarcoma

A
  • Malignant Neoplasms

- Originate from connective tissue, muscle, or bone

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17
Q

Carcinoma

A
  • Malignant Neoplasms

- Originate from epithelial tissue

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18
Q

Staging mean in malignant neoplasms?

A
  • the spread of the cancer

- larger the number (1-4) means more advanced cancer, means worse prognosis

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19
Q

What does staging determine? How determine the stage of the cancer?

A

1) Determines prognosis and treatment plan

2) Done by physical exam or may require surgery

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20
Q

Grading in malignant neoplasms?

A
  • degree of anaplasia (lack of differentiation)
  • or degree of differentiation
  • nuclear features that tell us how invasive the CA is
  • more undifferentiated (more anaplasia= bad)
21
Q

What are the grades and what do they mean?

A 
GX Grade cannot be assessed
G1 Well differentiated (Low grade)
G2 Moderately differentiated (Intermediate grade)
G3 Poorly differentiated (High grade)
G4 Undifferentiated (High grade)
22
Q

What does anaplasia mean?

A
  • more differentiated cells are, slower they grow

- anaplasia means are embryonic cells, have no differentiation and huge growth rates

23
Q

How does cancer usually move in regards to differentiated vs undifferentiated cells?

A

-Cancer usually begins in differentiated tissue; works backward toward more undifferentiated state

24
Q

How Cancer Starts?

A
  • is a multistep process, requires many mutations over many levels to accumulate over time
    1) mutations in inherited genetics, germ cells, or somatic cells
    2) Mutations in key regulatory genes
    • protooncogenes, tumor suppressing genes, apoptosis, DNA repair
25
Q

What causes cancer?

A

1) external factors (diet, smoking, carcinogens, sun/UV exposure
2) internal factors (genetics)
3) unknown env exposure
4) viruses (like HPV)

26
Q

How do we diagnose cancer?

A

1) Physical exam, labs, imaging
2) gold standard= Microscopic examination by pathologist (cytology)
3) Fine needle aspiration
4) PAP smear
5) CT-guided biopsy

27
Q

Why is cancer bad?

A

1) destruction of tissue structure
2) cancer cachexia (catabolic state, breaking down muscle and tissue so look anorexic/wasted)
3) hormonal effects

28
Q

Why is tissue destruction a bad thing?

A
  • as the cancer grows in an organ it can invade it and take over so that organ’s own cells are destroyed
  • In time the organ or structure can no longer do its job
  • can squish the brain, cause edema and swelling from inflammatory response
29
Q

Cancer Cachexia?

A
  • the state of ill health, malnutrition, and wasting
  • is catabolic rxt
  • tumors release certain proteins (cytokines) that decrease appetite and alter fat metabolism
  • can even release hormones saying aren’t hungry even though are starving to death
30
Q

Cancer and Hormonal Effects?

A
  • cancers produce hormones, if produce too much can have effect on the whole body
  • can cause overproduction of inulin if in the pancreas therefore leading to hyperglycemia
31
Q

Cushing’s Syndrome causes and presentation?

A
  • to much ACTH due to cancer in pituitary or adrenal
  • cancer in thyroid/ lungs can cause it
  • plrual neuroplastic syndrome
  • emotional surges
  • hump in back
  • stria/stretch marks
  • acne
32
Q

Polycythemia Vera

A
  • Myleoproliferative blood disorder; too much RBCs
  • can be due smoking, decrease oxygenation, increase RBC
  • cancer in RBC proliferation
33
Q

Anemia; types & causes?

A
  • Anemia of chronic disease
    - Iron Deficiency (colon CA)
  • Myelophthisic anemia (cause immature stem cell–> lead to mature RBC/unusable RBC)
34
Q

How tell myelophthisic anemia?

A

Nucleated RBCs

Tear drop RBCs

35
Q

Paraneoplastic Syndromes?

A

-Distant effects of a tumor not related to metastasis; mimic metastasis but usually due to ectopic hormone secretions

36
Q

Paraneoplastic Syndrome examples?

A

1) Acanthosis Nigricans (stomach Ca)
2) Eaton-Lambert myasthenic Syndrome (small cell carcinoma of lungs)
3) Seborrheic keratosis
(Stomach CA)
4) Superficial migratory thrombophlebitis
(Pancreatic CA)
5) Nephrotic Syndrome
(Lung, breast, stomach CA)

37
Q

How is cancer treated

A

1) Surgery
2) Radiation (XRT)
cancer cells more sensitive to it
3) Radiosurgery-Gamma Knife
4) Chemotherapy

38
Q

Chemotherapy and types?

A
  • antineoplastic drugs, kill rapidly dividing cells
    1) Alkylating
    2) Anti-metabolites
    3) Topoisomerase inhibitors
    4) Cytotoxic antibioties
39
Q

Why chemo a double-edged sword:

A

have:
1) Bone marrow myelosupression–> have no WBC/neutrophils
2) Digestive tract degradation of mucositis
3) Hair follicles die–> alopecia (hair loss)

40
Q

How do we prevent cancer?

A

1) Lifestyle modifications
2) Immunizations
3) Screening
4) Treat predisposing conditions
(GERD, Barrots esophogous

41
Q

Dysplasia is characterized by what 4 major pathological microscopic changes?

A

1) Anisocytosis (cells of unequal size)
2) Poikilocytosis (abnormally shaped cells)
3) Hyperchromatism (excessive pigmentation)
4) Presence of mitotic figures (an unusual number of cells which are currently dividing).

42
Q

Anisocytosis

A

-cells of unequal size

43
Q

Poikilocytosis

A

-abnormally shaped cells

44
Q

Hyperchromatism

A

-excessive pigmentation

45
Q

Presence of mitotic figures

A

-illustrates an unusual number of cells which are currently dividing

46
Q

Carcinoma in situ,

A
  • low grade dysplasia
  • means “cancer in place”,
  • represents transformation of neoplastic lesion to one in which cells undergo no maturation; cells divide rapidly but have no differentiation
  • are thus considered cancer-like
  • they remain in place
47
Q

high vs low grade dysplasia…how to test for it/treat?

A

-Dysplasia is earliest form of pre-cancerous lesions
-high grade= more likely to become malignant, low grade= less likely, usually treated and are ok

48
Q

high grade dysplasia?

A
  • Invasivecarcinoma

- cancer has invaded beyond basement membrane & has potential tometastasize

Block 1 Week 3 (8 decks)

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