Patho 2 Flashcards
Cancer definition
Highly invasive and destructive neoplasms
Neoplasm
Tumour
Benign
Malignant
Cells formed from irreversible deviant cell division
Collection of cells that have lost genetic control of proliferation and differentiation
Localised and closely resembling cells of origin, lost control of proliferation
Invasive and destructive cells that dont resemble cell of origin
Cell proliferation
Cell differentiation
Normal cell
Over proliferation
Undifferentiated
Cancer cell
Due to unrepaired gene malfunction, alters genes that control
Reproduction
Growth
Differentiation
Death
Impact of cancer on tissues, organs, organ systems
Loss of cell communication Increased energy expenditure Increased mortality Rapid angiogenesis Substance secretion Present foreign antigens
Categories of cancer genes
Mutator genes- repair mutated DNA, protect genome
Protooncogens- regulate cell function
Tumour suppressor cells- prohibit over proliferation, regulate apoptosis
High energy ionizing radiation
Hormones
Chemicals
Viruses and bacteria
Carcinogens
Spread of cancer
Local- proliferation of neoplasm in tissue of origin
Direct extension- tumour cells move into adjacent tissues and organs
Seeding- malignant tumours move along membranes of peritoneal and pleaural cavities
Metastases- neoplasms spread to distant sites by lymphatics or blood vessels
Colon——> liver Breast ——> bone Lung ——> brain Prostate ——> bone Malignant melatoma- lung, liver, brain, lymph nodes
Organ tropism of cancer
Well differentiated
Resemble origin tissue
Grade 1-2 cancer
Highly differentiated
Little to no resemblence
Grade 3-4 cancer
Cancer warning signs
Unusual bleeding Change bowl/bladder habits Change in wart/mole Sore that doesnt heal Unexplained weight loss Anaemia, low Hb, fatigue Persistent cough or hoarseness Solid lump
General manifestations of cancer
Systemic and Immune response- fever, anorexia, weight loss
Increase metabolic rate
Paraneoplastic symptoms
Local effects of tumour on neighbouring cells
Diagnostic tests of cancer
Complete history Physical examination Imaging studies Biopsy and cytology Tumour markers Blood, urine, tissues test
Cancer treatment
Eradicate neoplasm
Control growth and spread
Reduce symptoms no cure
Types of cancer treatment
Surgery Chemotherapy Radiotherapy Hormones Immunotherapy Bone marrow transplant Stem cell transplant Adjuvant therapy
Cancer Prevention
Screening Exercise Balance healthy lifestyle Maintain healthy weight Vaccinations Skin protection Avoid tobacco Avoid heavy alcohol use Protect against carcinogens
Diabetes definition
Metabolic disorder
The absence, deficit or resistance to insulin resulting in hyperglycaemia
Type 1
Insulin dependent
Family history or viral infection
Type 2
Non insulin dependent
Obesity, HTN, poor lifestyle, diet
Pancreatic cells roles
Alpha- secrete glucagon, utilise glycogen and suppresses insulin secretion
Beta- secrete insulin, promotes uptake of glucose in blood
Delta- somatostatin and gastrin- regulates A+B cells
Type 1-IDDM process
Beta cell destruction by autoimmune process
Type 2- NIDDM process
Genetic+environment affect B cell function and insulin tissue sensitivity
Management of diabetes
Type 1- insulin injections
Type 2- insulin tablets
Life style changes- HITT + starvation diets
Physio interventions of diabetes
Awareness of complications e.g. healing, hyperglycaemia
Education of lifestyle changes
High msk pain
Falls (peripheral neruopathies)
Definition of obesity
Individual who is overweight with lots of body fat
BMI
Measures if they are healthy weight for height
Waist circumference
Measure for excess fat
Women >94cm (37inches)
Men > 80 (31.5inches)
Obesity causes
High calories intake Poor diet Decreased physical activity Genetics Medical reasons
Total energy expenditure
8% thermic effect
20-40% physical activity and recovery (EPOC)
55% basal energy expenditure
Obesity health implications
Hypertension Stroke Cataracts Pulmonary disease Coronary heart disease Diabetes Cancer Gout Osteoarthritis Gall bladder disease
Physio implications of obesity
Staffing levels and manual handling
Bariatric equipment
Treatment reaction may be different
Physio role with obese patient
Post bariatric surgery care
Safe physical activity
Life style advice and education
Emerging roles
Definition of parkinsons disease
Chronic, progressive neurodegenerative disorder
Degeneration of dopamine producing neurones in the substantia nigra in basal ganglia
Role of basal ganglia
Regulate planning, initiation and termination of movement
Regulate muscle tone required for body movements
Control subconscious contractions of skeletal muscles
Act to inhibit antagonistic or unnecessary movements
Pathophysiology of PD
Substantia nigra main source of dopamine
Basal ganglia series of parallel loops involving thalamus and cerebral cortex
Direct pathway- promotes movement
Indirect pathway- inhibits movement
Dopamine excites direct and inhibits indirect pathway
What does lack of dopamine lead to
Lack of excitement of direct pathway
Lack of inhibition of indirect pathway
Lack of overall movement
Cardinal signs of PD
Bradykinesia/ Akinesia
Resting tremor
Rigidity
Bradykinesia/Akinesia
Paucity or slowness of movement
Slower initiation and progressive decrease in speed
Resting tremor (pill rolling)
Relaxed muscle, shake when at rest
Tremor inhibited during movement
Rigidity
Stiff or inflexible muscles
Resistance to passive movements
Lead pipe or cog wheel
Secondary clinical features
Difficulty initiating/terminating movement Freezing when walking Festinating gait pattern Loss of stereotyped movements Difficulty with motor tasks Monotone speech Micrographia Problems swallowing and drooling Sleep disorders Depression
Postural instability of PD
Flexed posture- hips/knees
Unable to access balance reactions
Medication for PD
Dopamine replacements- drugs that cross blood brain barrier e.g. sinemet
Dopamine copycats- dopamine agonists e.g. apomorphine
Dopamine protectors- block enzymes that break dopamine down
MAO-B inhibitors e.g. selegiline.
COMT inhibitors e.g. Entacapone
Anticholingergics- correct balance between dopamine and acetylcholine e.g. arpicoline
Problems with dopamine drugs
Effect decreases over time
Increase dose needed- side effects
Problems with on/off
PD surgery
Deep brain stimulation
Palidotomy
Stem cell research
Principles or cueing in PD
Rely on external stimulus
Kinaesthetic- movement cues
Auditory
Visual
