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Pathology > P3- Disorders of Growth and Neoplasia > Flashcards

P3- Disorders of Growth and Neoplasia Flashcards

1
Q

What is the size of the cell population in adult tissues determined by?

A

rates of cell proliferation, differentiation and death by apoptosis

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2
Q

What can cell numbers be altered by?

A

rates of stem cell input, by cell death due to apoptosis or by changes in the rate of proliferation or differentiation

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3
Q

What is the key to regeneration of a cell population?

A

control of the cell cycle

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4
Q

what is the cell cycle controlled by?

A

chemical factors in the microenvironment of the cell :

-stimulation and inhibitors

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5
Q

what can growth result from?

A

– Shortening cell cycle time

– Recruiting cells from resting or quiescent population

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6
Q

What cells are not capable of replicating?

A

Terminally differentiated cells e.g. myocytes

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7
Q

What happens to cells in the liver/kidney?

A

differentiated cells are normally quiescent but can proliferate when needed

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8
Q

What happens to epithelia of oral cavity, gut and the skin?

A

the mature cells are terminally differentiated, short-lived and incapable of replicating but may be replaced by new cells arising from stem cells

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9
Q

Name 3 inhibitors of apoptosis.

A

– Growth factors
– Cell matrix components
– Viral proteins

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10
Q

Name 3 inducers of apoptosis.

A

– Withdrawal of growth factors
– Loss of matrix attachment
– Viruses

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11
Q

Name the molecular mediators and regulators of apoptosis.

A 
– Extrinsic pathway
• Death receptors 
– Intrinsic pathway
• Increased mitochondrial permeability
• Can induce OR inhibit
– Caspases - cascade
– p53
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12
Q

What is hypertrophy?

A 
• An increase in cell size
• Physiological and pathological
• Muscle: 
– Skeletal
– Cardiac
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13
Q

What is hyperplasia?

A 
• An increase in cell number
• Physiological and pathological.
• Hormonally sensitive organs:
– Endometrium 
– Breast
– Thyroid
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14
Q

What happens in hyperplasia?

A
  • Enlargement of gingival tissues
  • Hyperplastic responses within epithelium and underlying connective tissue
  • Various causes including certain drugs
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15
Q

What is atrophy?

A

• Reduction in cell size by loss of cell substance
• Manycauses
• Physiological (thyroglossal duct)and pathological
– Ageing
– Lack of use / stimulation
• Mechanical
• Functional

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16
Q

What is hypoplasia?

A
  • Reduced size of an organ that never fully developed to normal size
  • Adevelopmental defect
  • e.g. pulmonary hypoplasia
17
Q

What is metaplasia?

A
  • REVERSIBLE change in which one adult cell type is replaced by another adult cell type
  • Can be part of an adaptive response to stress
  • Reprogramming of stem cells
  • Barrett’s oesophagus,
  • Cervix, Bronchus,
  • Salivary ducts (sialometaplasia)
18
Q

What can metaplasia also effect?

A
  • Can also affect mesenchymal tissues
  • Not in itself a neoplastic disorder
  • Environmental changes leading to metaplasia may if persistent lead to further changes that can manifest as dysplasia and progress to malignancy (cancer) – e.g. Barrett’s oesophagus
19
Q

What disorder of growth and neoplasia are reversible?

A 
o Hypertrophy 
o Hyperplasia 
o Atrophy
o Metaplasia 
o Dysplasia 
o Neoplasia
20
Q

What disorder of growth and neoplasia are irreversible?

A

hypoplasia

21
Q

What does dysplasia mean?

A

disordered growth

22
Q

Describe dysplasia.

A 
• A pre-malignant process
• Can be identified in
many tissues
• Epithelia are a good example
– Squamous 
– Glandular
23
Q

What happens to do the epithelium in dysplasia?

A

Atypical epithelial alterations limited to the surface epithelium

Alterations in:

  • Architecture
  • maturation
  • Differentiation
24
Q

What are the 3 different degrees of dysplasia?

A

– Mild
– Moderate
– Severe / carcinoma in situ

25
Q

what do more severe forms of dysplasia have a significant risk for?

A

progressing to invasive malignancy

26
Q

What does neoplasia mean?

A

New growth

27
Q

What is neoplasia?

A

A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues, and persists in the same excessive manner after cessation of the stimuli that evoked the change

28
Q

What does neoplasia result from?

A

Aberration of the normal mechanisms that control cell number ie

  • Cell production by cell division
  • Cell loss by apoptosis
29
Q

What are features of most tumours?

A

Most tumours are monoclonal ie all the cells in a tumour appear to arise from one parent cell which has undergone a genetic change. This is then passed on to all the progeny

30
Q

What do tumour cells lack?

A

the normal control mechanisms thus the clone expands due to uncontrolled proliferation

31
Q

What are the two types of tumour?

A
  • Benign

- Malignant

32
Q

What is epidemiology?

A

Study of the distribution of diseases in different populations over time
(incidence, prevalence, geographical distribution)

33
Q

What is incidence?

A

Number of new cases

34
Q

What is Prevalence?

A

Number of existing cases

35
Q

What do patients have in common?

A
  • Rare cancers can show strong links

- Common cancers may be less easily associated with a putative causal agent

36
Q

What can be understood about the risk factors and pathogenesis of cancer by studying?

A

geographic distribution, racial prevalence, occupation of those affected etc

37
Q

What affects epidemiology and cancer?

A
  • Age
  • Sex (reproductive history)
  • Culture/ religion
  • Hobbies/recreation
  • Geographic location (environment, local industry, occupation)
  • Family history
  • Medical history
  • Diet
  • Smoking
38
Q

Name some major risk factors for oral cancer.

A 
– Smoking
– Alcohol
– Betel/areca nut
– Immunosuppression 
– Previous oral cancer

Pathology (9 decks)

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