Overview/Terminology - H/O Flashcards
1
Q
Labile cells
A
- constantly dividing cells
- G0 is short or absent
- Bone marrow cells, immune cells, GI tract cells, skin cells
2
Q
Stable cells
A
- multiply only when needed with irritation, stimulation, or injury
- Spend most of the time in GO
- Liver, proximal tubules of the kidney, endocrine glands
3
Q
Permanent cells
A
- No ability to regenerate, replace by scar tissue when injured
- Heart
4
Q
What cells do cancer normally arise from?
A
Labile and stable cells
5
Q
Hyperplasia
A
- increased number of cells
- Preneoplastic response to stimuli
- Cells maintain normal regulatory control
- Benign prostatic hyperplasia, Cushing’s (increased ACTH), endometrial hyperplasia, breast hyperplasia, compensatory liver hyperplasia (after donor transplant)
- Benign, generally not increased risk for developing cancer
- Cell types: skin after loss, breasts with pregnancy, BPH, Cushing’s
6
Q
Neoplasia
A
- abnormal growth of cells
- Growth persists even after stimuli is removed
- Benign (uterine fibroids, moles), pre-malignant (carcinoma in situ), or malignant (tumor)
7
Q
Carcinoma
A
- Origin- epithelial tissue
- Spread: through lymph fluid more commonly
8
Q
Sarcoma
A
<1% of total cancers
- Origin- musculoskeletal: bone, muscle, connective tissue
- Spread: through blood more commonly to lung, liver, brain, and other areas
9
Q
Oncogenes
A
- a gene that has the potential to cause cancer, often with mutation, virus (EBV, HPV) or high expression rates in tumor cells
- Newer therapies are meant to target these mutations
10
Q
Grading
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)
- Margins: clear or not and by what distance
- Angiolymphatic invasion (spread into blood and lymph vessel)
- Lymph node involvement
11
Q
Principles of Chemotherapy
A
- Systemic treatment (unlike radiation and surgery, which are local treatments)
- Kills cells in a particular phase of the cell cycle: affect DNA and/or RNA
- Adjuvant and neoadjuvant: both often used to kill microscopic disease
12
Q
Clinical Trials
A
- Phase I: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
- Phase II: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
- Phase III: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
- Phase IV: Studies are done after the drug or treatment has been marketed to gather information on the drug’s effect in various populations and any side effects associated with long-term use.
13
Q
Anemia and thrombocytopenia
A
-Anemia- outpatient transfuse if hemoglobin less that 8
Symptoms: fatigue, headache, tachycardia, dyspnea
-Thrombocytopenia- outpatient transfuse if platelets less than 20
Symptoms: sometimes none, easy bruising, petechiae, mucosal bleeding
14
Q
Neutropenic Fever
A
- Life threatening
- Fever of 100.4F or higher and neutrophils < 1.5 (severe neutropenia <0.5)
- Risk for invasive infections
- Fever may be only sign of infection in neutropenic patient
- Treat with IV antibiotics (vancomycin (gram+) & Ceftaz (gram - ))
15
Q
Pulmonary embolus or DVT
A
- Cancer patients hypercoagulable
- Low threshold for evaluation
- DVT: edema, erythema, warmth, pain
- Pulmonary embolus (life threatening): dyspnea, tachycardia, hypoxia, pleuritic chest pain
- Positive D-dimer in active cancer patients – meaning no real value of doing this test
- Evaluate for DVT with ultrasound, for PE with chest CT
- Treat upfront with Lovenox (may use heparin inpatient) +/- Coumadin, do NOT use Coumadin alone upfront
