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NUR 326 Exam 4 > Oncology > Flashcards

Oncology Flashcards

1
Q

proto-oncogenes

A

–genes that control cell replication
–result in cell growth and proliferation
–when mutated, proto-oncogenes become oncogenes that stimulate constant, unrelenting cell proliferation and cell cycling

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2
Q

difference between regular and cancer cell cycles

A

regular = checkpoints/rest phase
cancer = no checkpoints/rest phase

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3
Q

consequences of no checkpoints in cancer cell cycle

A

–no DNA errors recognized
–no apoptosis

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4
Q

growth in cancer cells

A

–cancer cells disregard the growth inhibitors released by neighboring cells
–as these cells proliferate, they stack on top of each other, take over boundaries of organs, crowd out normal cells, and may break free and travel to other sites in the body

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5
Q

differentiation

A

the extent that neoplastic cells resemble normal cells both structurally and functionally

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6
Q

anaplasia

A

total cellular disorganization, abnormal cell appearance, and cell dysfunction

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7
Q

anaplasia and proliferation

A

more anaplastic = faster proliferation

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8
Q

differentiation with benign and malignant tumors

A

benign = well-differentiated; resembles tissue of origin

malignant = poorly differentiated; does not resemble tissue of origin

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9
Q

rate of growth with benign and malignant tumors

A

benign = progressive, slow

malignant = erratic, slow to rapid

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10
Q

local invasion with benign and malignant tumors

A

benign = cohesive cells, well-demarcated tumor, often encapsulated making it movable

malignant = invasive and infiltrating, surrounding normal tissue

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11
Q

metastasis with benign and malignant tumors

A

benign = none

malignant = frequent

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12
Q

tumor care with benign and malignant tumors

A

benign = no necrosis

malignant = can have necrotic core

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13
Q

what are tumor markers?

A

biologic substances

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14
Q

what type of substances make up tumor markers?

A

hormones, enzymes, antigens, genes

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15
Q

where can tumor markers be found?

A

blood, urine, CSF, tumor plasma membrane

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16
Q

what are tumor markers useful for?

A

screening or diagnosis

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17
Q

are tumor markers diagnostic of cancer?

A

not always

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18
Q

examples of tumor markers

A

–prostate specific antigen
–BRCA gene mutation

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19
Q

grade I malignant tumor

A

cells are well-differentiated

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20
Q

grade II malignant tumor

A

cells are moderately differentiated

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21
Q

grade III malignant tumor

A

poorly differentiated or anaplastic cells

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22
Q

staging (T)

A

tumor size, location, and involvement

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23
Q

staging (N)

A

lymph node involvement

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24
Q

staging (M)

A

metastasis to distant organs

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25
T0
no evidence of primary tumor
26
TIS
tumor in situ
27
T1-4
progressive increase in tumor size or involvement
28
N0
no spread to regional lymph nodes
29
N1
spread to closest or small number of regional lymph nodes
30
N2
spread to most distant or numerous regional lymph nodes
31
M0
none
32
M1
yes
33
stage 1
confined to organ of origin
34
stage 2
locally invasive (> 3 cm tumor)
35
stage 3
regional spread
36
stage 4
spread to distant sites
37
four phases of carcinogens
--initiation --promotion --progression --metastasis
38
initiation
mutation of genes, spontaneous or induced by carcinogenic agent
39
promotion
actively proliferating cells accumulate; reversible
40
progression
further mutation of cells; invasive with metastatic potential
41
metastasis
spread of cancer
42
tumor suppressor genes in cancer cells
--brake pedal --normally function to restrain cell growth (apoptosis) --can also become defective and lose the ability to inhibit cell growth and division = cancer formation
43
oncogenes
--gas pedal --mutated = gas pedal stuck --growth signal permanently on
44
p53 gene
tumor suppressor gene in cells that controls cellular apoptosis
45
carcinogens
--substances that cause development of cancer --can alter cell DNA --damage = cumulative
46
classification of carcinogens
--known --probable --possible
47
promoters
agents that promote development of cancer
48
examples of promoters
--diet --alcohol --tobacco --hormones
49
viral induced cancer
always involve the activation of growth-promoting pathways or inhibition of tumor suppressors in infected cells
50
examples of viruses that can cause cancer
--HIV --HPV --Hep B --Hep C
51
vascular endothelial growth factor
a substance that gives cancer cells the capability to develop new blood vessels
52
primary tumor
site of origin
53
secondary tumor
anywhere that is not the site of origin --need nutrients and oxygen --need access to blood
54
seeding
tumor erodes and sheds into body cavities
55
implantation
direct expansion of tumor into adjoining tissue
56
two primary routes of metastasis
(1) lymphatic (2) vascular
57
lymphatic spread
--cells trapped in lymph nodes --three possible scenarios: (1) death (2) dormancy (3) flourish/proliferate
58
vascular spread
--spread by vascular drainage --> penetrate local veins --first stop = liver
59
why is the liver often the first stop in vascular spread?
because the liver receives the most blood through the portal vein before it circulates through the body
60
what happens in the liver during vascular spread?
clumping, trapping, proliferating
61
angiogenesis
complete own blood supply
62
most common places for secondary tumors
--lungs --bone --liver --brain
63
lung cancer common site of metastasis
bone, brain
64
colon cancer common site of metastasis
liver
65
breast cancer common site of metastasis
bone, brain, liver, lung
66
prostate cancer common site of metastasis
vertebrae
67
melanoma common site of metastasis
brain
68
lung cancer
--leading cause of cancer-related death --early diagnosis is key to treatment --most often in > 65 years --African Americans more often affected
69
lung cancer etiology
--cigarette smoking** --passive smoke --COPD --asbestos --radon --arsenic --genetics
70
patho of lung cancer
--carcinogen overload --genetic --paralyze the cilia --lesion development progresses to cancer --activation of oncogenes --deactivation of tumor suppressor genes --rapid proliferation/destruction/invasion
71
non-small cell lung cancer
makes up about 85-90% of all lung cancers; slow-growing
72
small cell lung cancer
rapidly growing tumor that tends to metastasize quickly
73
s/s of lung cancer
--cough --hemoptysis --wheeze or stridor --chest pain --dyspnea --weight loss --excessive fatigue --weakness --hoarseness --pneumonia-like secretions --often asymptomatic
74
what might be the first sign of lung cancer?
paraneoplastic syndrome
75
paraneoplastic syndrome
too much of a specific hormone showing up somewhere it shouldn't be --ACTH secretion from lung --ACTH chemically resembles MSH --stimulates melanocytes, giving patients with lung cancer a tanned appearance
76
breast cancer
--most develop from lining in ducts --overexpressed estrogen receptors --overexpressed human epidermal growth factor receptor
77
risk factors of breast cancer
--age > 50 --prolonged reproductive life --hormone replacement therapy --obesity --late childbirth --nulliparous --family hx of breast or ovarian cancer --Ashkenazi Jewish women --BRCA1 and BRCA2 mutation
78
procedures associated with BRCA genes
preventative mastectomy and oophorectomy
79
cancer risks associated with BRCA genes
--breast --ovarian --colon --pancreatic cancer --prostate cancer
80
s/s of breast cancer
--single tumor --nontender tumor --firm tumor --irregular borders --adherence to the skin or chest wall --upper, outer quadrant of breast --nipple discharge --swelling in one breast --nipple or skin retraction --peau d'orange --Paget's disease of the breast
81
peau d'orange
a thickening of skin that resembles an orange peel
82
Paget's disease of the breast
involves redness, crusting, pruritis, and tenderness of the nipple
83
cervical cancer risk factors
--smoking --history of STDs --HPV infection --two or more lifetime sexual partners --immunosuppression --genetics
84
high risk HPV
causes persistent infection that progresses to cervical cancer
85
low risk HPV
condylomata (genital warts) but does not cause cervical cancer
86
cervical cancer clinical course
--long asymptomatic period --abnormal pap = dx
87
colorectal cancer screening
beginning at age 50, all adults should have a colonoscopy every 10 years
88
polyps
tumorous mass that projects into the intestinal lumen
89
familial adenomatous polyposis
well-defined hereditary disorder that predisposes an individual to intestinal polyps
90
colorectal cancer risk factors
--obesity --tobacco --physical inactivity --insulin resistance --low fiber in diet --high amount of animal fat in diet --diets low in vit. A, C, and E --UC --heavy alcohol use
91
s/s of colorectal cancer
--fatigue --weakness --weight loss --iron deficiency anemia --changes in bowel habits --melena --diarrhea --constipation --hematochezia (rectal bleeding) and narrowing of stool caliber

NUR 326 Exam 4 (5 decks)

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