week 2 Flashcards

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
thought interference
insertion withdrawl broadcast
26
over valued idea
a false belief - anorexia
27
obsessions
recurrent , intrusive, distressing ideas - patient recognises it on their own
28
hallucination
perception with no stimulus
29
cognitive function
orientation - time place and person
30
insight q
the persons understanding of their presentation and their needed treatment
31
what is personalised medicine
drugs which are designed/ targeted for specific groups of patients targets can be found by looking for molecular markers
32
name some predicitve markers
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
prognostic markers
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
what problems are there with targeted medicine
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
chronic myeloid leukemia
cancer of bone marrow - myeloid cells- average age diagnosis 65 incidence 1:100000
36
what is imatinib
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
what is the Philadelphia translocation .
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
CHROMOSOMAL REARRANGEMENT
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
targeted therapy in cancer part 1
drugs which target a specific process in an aberrant molecular pathway.- not all targets are in the cancer cell.
40
Targeted therapy in cancer | Part 2:
``` Targeting specific groups of patients using targeted therapies Aka “personalized medicine” “precision medicine” ```
41
problem with precision medicine
1. we dont have a targeted drug for most patients | 2. cancer isnt usually a single mutation disease
42
Enzalutamide
is an AR signalling inhibitor that directly targets three stages of the AR signalling pathway
43
clonal
Some mutations were present throughout individual | tumour
44
subclonal
Some were only present in a subset | of copies
45
mental state exam format
``` appearance and behaviour speech mood and affect thought form and content perception cognition insight ```
46
mood assessment
```  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
affect assessment
 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
Persecutory
perceived threat from others
49
Delusions of reference –
belief that external events/objects are directly related to them (e.g. TV programme)
50
Thought interference
– insertion, withdrawal or | broadcast
51
illusion
false perception of a real stimulus
52
cognition assessment
alertness orientation attention/concentration memory
53
insight
The patient’s understanding of their | presentation and their need for treatment
54
clinical features depression
↓ mood +/- anhedonia +/- fatigue Every day >2 weeks Biological: Diurnal variation, insomnia, ↓ appetite,↓ weight, ↓ libido, constipation, amenorrhoea
55
Cotard’s syndrome
self / part of self is dead
56
dysthymia
persistent mild depression.
57
Cyclothymia
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
Kübler-Ross Model
``` Denial Anger Bargaining Depression Acceptance ```
59
ECT treatment for depression
``` electrotherapy controlled seizure and anaesthetic depression, mania , catatonia more effective than drugs side effect mem loss - rare ```
60
other treatment for depression
``` CBT OT SW- housing , financial , employment psycotherapy fam therapy ```