Oncology and haematology Flashcards
Describe the difference between a benign tumour and a malignant tumour
Benign:
-grow slowly
-encapsulated, not invasive
-tissue resembles parent tissue
-remains localised, doesn’t metastasise
Malignant:
-grows rapidly
-irregular in shape and invades local structures and tissues
-tissue is poorly differentiated and does not resemble parent tissue
-if left untreated the malignant tumour is likely to spread to distant areas of the body (via the blood and lymph systems)
What is a ‘well differentiated’ tumour equivalent to in grades
Grade 1
resembles parent cell, low grade
What is a ‘moderately differentiated’ tumour equivalent to in grades
Grade 2
some similarities to parent cell
What is a ‘poorly differentiated’ tumour equivalent to in grades
Grade 3
very immature, little resemblance to parent cell
What is a ‘undifferentiated’ tumour equivalent to in grades
Grade 4
no resemblance to original tissue, high grade
What does the T in the TNM classification system represent?
T= size of tumour
-1 being small
-4 being large
What does the N in the TNM classification system represent?
N= whether the cancer has spread to the lymph nodes
-0 being no lymph nodes infected
-3 being lots of lymph nodes infected
What does the M in the TNM classification system represent?
M= whether the cancer has spread to a different part of the body (metastatic)
-0 meaning cancer hasn’t spread
-1 meaning cancer has spread
What does each stage of the cell cycle do?
-growth phase 1= growth, produces double organelles
-synthesis= DNA replication
-growth phase 2= protein synthesis
G0= resting
How does a benign tumour develop into a malignant tumour?
-in normal tissues, the rate of new cell growth and old cell death are kept in balance
-in cancer, this balance is disrupted, resulting from uncontrolled cell growth or loss of cell’s ability to undergo apoptosis (programmed cell death)
-the tumour becomes malignant when the cells are no longer encapsulated and cell growth becomes rapid
List some carcinogenetic agents that can cause DNA to mutate, but that can be prevented.
-tobacco
-diet
-obesity
-ultra violet radiation
-viruses
-bacteria
List some carcinogenetic agents that can cause DNA to mutate, but are not so easy to change
-ionising radiation
-asbestos exposure
-inflammation
-birth weight
-parasites
-pollution
-industrial processes and chemicals
-cytotoxic agents
-sex hormones
What is carcinogenesis?
the initiation of cancer formation
What is angiogenesis?
The development of new blood vessels
What is autonomy?
A cell that works independently from other cells (such as a cancer cell)
What is a carcinogen?
A substance, organism, or agent capable of causing cancer
What is carcinoma?
A type of cancer that starts in the skin or in tissues that line internal organs
What is chemotherapy?
A treatment that kills cancer by stopping the DNA, RNA and protein synthesis, which prevents the uncontrolled cell division occurring
-this includes a mix of medications: alkylating agent, antimetabolite, cytotoxic agent, steroids, and anti-emetics
What is differentiation?
When cells become specialised to carry out a specific function
What is lymphoma?
A type of cancer that develops in the white blood cells of the lymphatic system which is part of the immune system
What is metastases?
-Cancer cells spread from the primary site to distant cites
-common sites for the cancer to spread to are the liver, lungs, brain, adrenal, bone marrow
What is neoplasm?
A new and abnormal growth of tissue in a part of the body especially as a characteristic of cancer
What is proliferation?
An increase in the number of cells as a result of cell growth and cell division.
What is sarcoma?
A tumour that arises in connective tissue
What is a stem cell?
The basic cells that can reproduce and then develop into different types of specialist cells
What is transformation?
-a process that involves inserting genes into an organism to alter its traits.
-this is also known as genetic engineering
What is a tumour marker?
Substances that might be raised if there is a cancer, usually proteins.
What is a mutation?
a specific change in the gene, which can be random and cumulatively may contribute to the development of a cancer. A cancer needs 5-7 mutations in genes before it can develop
What is a wilm’s tumour?
-a type of kidney tumour
-composed of three cellular types: stromal, epithelial and blastemic
-can either be sporadic or inherited
What is leukaemia?
A type of blood cancer that affects blood cells in your bone marrow
What are the 5 stages of a wilms tumour?
-stage 1=tumour limited to the kidney, removable via surgery
-stage 2= tumour extends beyond kidney into the vessels in the renal sinus, removable via surgery
-stage 3= residual tumour is only in abdomen
-stage 4= metastases to lung, liver, brain, bone
-stage 5= bilateral disease, each kidney needs to be staged
How can leukaemia diagnosed?
by analysis of peripheral blood smears and bone marrow aspirations
What are the 4 main types of leukaemia?
(ALL) Acute Lymphoblastic Leukaemia
(AML) Acute Myelogenous Leukaemia
(CLL) Chronic Lymphoblastic Leukaemia
(CML) Chronic Myelogenous Leukaemia
What are the major differences between acute and chronic leukaemia?
-acute are typically found more in children (ALL most common)
-acute has an abrupt onset and more rapid progression
-acute consists of less mature blast cells in the blood and bone
-chronic more often in adults (CLL most common)
-chronic has a subtle onset and progresses more slowly
-chronic consist of more differentiated cancer cells
What is sickle cell anaemia?
an autosomal recessive genetic condition caused by a mutation of mRNA
How does sickle cell anaemia affect haemoglobin and the blood?
sickle haemoglobin doesn’t absorb as much oxygen therefore changes its shape, which can stick together and block blood vessels
What is a sickle cell crisis?
-where parts of the body don’t receive enough blood supply, therefore they become painful
-a sickle cell crisis can last longer then a few days depending on where it is, usually in joints and bones, but this can be very dangerous if in the chest
What are the common triggers for a sickle cell crisis?
-dehydration
-infection
-stress
-over exhaustion
How is a sickle cell crisis managed?
-antibiotics and painkillers are used to manage sickle cell e.g penicillin and folic acid to prevent infection (spleen overworked and doesn’t fight infections well)
-blood transfusions may also be conducted however there is risk of iron overload and antibodies against future blood transfusions
What is intravascular haemolysis?
red blood cells are broken down much faster then normal due to a weakened cell membrane
What is the composition of blood?
55% plasma
-water
-proteins
-other solutes
45% formed elements
-erythrocytes
-haemogolobin
-leucocytes
What are the symptoms of anaemia?
-yellow eyes
-pale, cold skin
-shortness of breath
-weak muscles
-changed stool colour
-fatigue, dizziness, fainting
-low blood pressure
-rapid heart rate
What problems can people with sickle cell disease have that require immediate care?
- Acute chest syndrome- caused by inflammation of small blood vessels in lung=chest pain, trouble breathing
- aplastic crisis- body temporarily doesn’t make enough RBC= severe anaemia, and infection
- priapism- males with sickle cell disease can have painful long erections, if not treated quickly it can cause problems later on
- stroke- sickle shaped cells can block small blood vessels in the brain causing a stroke
What are the 3 types of sickle cell crisis?
-vaso-occlusive
-acute sequestration
-aplastic
