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week 2 Flashcards

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1
Q

Invasion

A

growth by infiltration and
destruction of surrounding
tissues

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2
Q

Metastasis

A

spread of tumour to - and
growth at - ectopic sites, via
blood, lymphatics, intraepithelial
route, or transcoelomic

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3
Q

Carcinoma

A

malignant tumour derived from epithelial cells

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4
Q

Sarcoma

A

malignant tumour derived from mesenchymal cells

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5
Q

Melanoma

A

malignant tumour derived from neural crest cells

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6
Q

Leukaemia

A

malignant tumour derived from circulating white

blood cells

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7
Q

Lymphoma

A

malignant tumour derived from the lymphatic system

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8
Q

80% of malignancies

A

are carcinomas

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9
Q

the basement membrane has to be overcome to become acarcinoma

A

delineates epithelial or endothelial tissues. hte basement membrane of blood vessels

bm secreted by basal epithelial
cells/ endothelial cells
• a layer of extracellular
matrix (ECM)
• fibronectin, type IV
collagen, laminin, etc.
• a barrier to spread (esp.
carcinoma cells)
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10
Q

metastatic cascade

A

1local invasion -push through BM and interstitial stroma.

  1. Angiogenesis - VEGF to overcome 1mm
  2. intravasation - into bloodstream
  3. extravasation - out of blood
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11
Q

Properties of metastatic tumour cells

A
  1. reduced cell-cell adhesion
  2. altered cell-substratum adhesion
  3. increased motility
  4. increased proteolytic ability
  5. angiogenic ability
  6. ability to intravasate and extravasate
  7. ability to proliferate (locally and in ectopic sites)
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12
Q
  1. reduced cell to cell adhesion
A

e cadherin has to be destructed , (homotypic adhesion ?)

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13
Q

what is HGF

A

is a mitogen , motogen and a morphogen. it is produced by the stromal cells in a tumour

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14
Q

what binds with hgf

A

binds to c-met , leads to increase in tyrosine phosphorylation of beta cadherin in tumour epithelial cells - >disrupted ECD-mediated adhesion

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15
Q

serine proteases

A

urokinase plasminogen , plasmin bind to receptor on tumour cell surface

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16
Q

matrix metalloproteinases

A

collagenases , gelatinases , stomelysins , membrane-type
soluble forms with ECM homology can bind to integrins
produced by WBCs associated with tissue /wound repair

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17
Q

what is selectin

A

are a family of cell adhesion molecules

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18
Q

mental state exam

A

gather evidence fo or against someone having a mental illness

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19
Q

speech

A

rate, rhythm and tone

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20
Q

speech

A

rate, rhythm and tone .

pressure of speech

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21
Q

ways to describe affect

A

reactive
flattended
blunted
labile

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22
Q

persecutory

A

perceived threat from others

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23
Q

grandiose

A

considerable overestimate of abilities or possessions of special powers

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24
Q

nilihistic

A

belief that they are dead or do not exist

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25
Q

thought interference

A

insertion withdrawl broadcast

26
Q

over valued idea

A

a false belief - anorexia

27
Q

obsessions

A

recurrent , intrusive, distressing ideas - patient recognises it on their own

28
Q

hallucination

A

perception with no stimulus

29
Q

cognitive function

A

orientation - time place and person

30
Q

insight q

A

the persons understanding of their presentation and their needed treatment

31
Q

what is personalised medicine

A

drugs which are designed/ targeted for specific groups of patients
targets can be found by looking for molecular markers

32
Q

name some predicitve markers

A

predict which patients will benefit from specific treatment

help chose which drug to use

the basis of precision medicine

eamples include EGFR mutations in lung cancer , RAF mutations in melanoma

33
Q

prognostic markers

A

inform about outcome regardless of treatment

may help chose which patients to treat , but now how to treat them

examples include CTCs in breast cancer

34
Q

what problems are there with targeted medicine

A

we don’t have targeted drugs for most patients
cancer usually isn’t a single mutation disease but more a complex cascade of events
to understand tumour biopsy is needed , not ll patients will have one and they cant always be performed
KEY TO SUCCESS - precise matching of the right drug for the right patient at the right time

35
Q

chronic myeloid leukemia

A

cancer of bone marrow - myeloid cells-
average age diagnosis 65
incidence 1:100000

36
Q

what is imatinib

A

a drug that inhibits the action of Abl . it is a tyrosine kinase inhibitor . once daily oral meds . overall survival at 5 yrs is doubled to 60%

37
Q

what is the Philadelphia translocation .

A

the most common eaxmple of chromosomal rearrangement - bcr-Abl gene translocation . the abl gene codes for tyrosine kinase . with the mutated brc-abl gene, the kinases are constantly turned on which stimulates downstream pathways to make cells divide.

38
Q

CHROMOSOMAL REARRANGEMENT

A

where a section of a gene coding for one protein is physically attaching to a section of another gene coding for another protein. which gives rise to a hybrid protein.

39
Q

targeted therapy in cancer part 1

A

drugs which target a specific process in an aberrant molecular pathway.- not all targets are in the cancer cell.

40
Q

Targeted therapy in cancer

Part 2:

A 
Targeting specific groups of patients using targeted
therapies
Aka
“personalized medicine”
“precision medicine”
41
Q

problem with precision medicine

A
  1. we dont have a targeted drug for most patients

2. cancer isnt usually a single mutation disease

42
Q

Enzalutamide

A

is an AR signalling inhibitor that
directly targets three stages of the AR
signalling pathway

43
Q

clonal

A

Some mutations were present throughout individual

tumour

44
Q

subclonal

A

Some were only present in a subset

of copies

45
Q

mental state exam format

A 
appearance and behaviour
speech
mood and affect
thought form and content
perception
cognition 
insight
46
Q

mood assessment

A 
 Subjective: how the person tells you they feel
in their own words
 Objective: your impression of the person’s
mood during the interview
 Euthymic (normal)
 Elevated/elated
 Low/depressed
 Anxious
47
Q

affect assessment

A

 Reactive – appropriate reaction to the
situation or topic being discussed
 Flattened – limited emotional reaction
 Blunted – no observed emotional reactions
(specifically associated with psychosis)
 Labile – excessive emotional fluctuations

48
Q

Persecutory

A

perceived threat from others

49
Q

Delusions of reference –

A

belief that external
events/objects are directly related to them (e.g.
TV programme)

50
Q

Thought interference

A

– insertion, withdrawal or

broadcast

51
Q

illusion

A

false perception of a real stimulus

52
Q

cognition assessment

A

alertness
orientation
attention/concentration
memory

53
Q

insight

A

The patient’s understanding of their

presentation and their need for treatment

54
Q

clinical features depression

A

↓ mood +/- anhedonia +/- fatigue
Every day >2 weeks

Biological:
Diurnal variation, insomnia, ↓ appetite,↓ weight, ↓
libido, constipation, amenorrhoea

55
Q

Cotard’s syndrome

A

self / part of self is dead

56
Q

dysthymia

A

persistent mild depression.

57
Q

Cyclothymia

A

Cyclothymia – or cyclothymic disorder – is a relatively mild mood disorder. In cyclothymic disorder, moods swing between short periods of mild depression and hypomania, an elevated mood

58
Q

Kübler-Ross Model

A 
Denial
Anger
Bargaining
Depression
Acceptance
59
Q

ECT treatment for depression

A 
electrotherapy 
controlled seizure and anaesthetic 
depression, mania , catatonia 
more effective than drugs 
side effect mem loss - rare
60
Q

other treatment for depression

A 
CBT 
OT
SW- housing , financial , employment 
psycotherapy
fam therapy

people and illness (5 decks)

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