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Pathophysiology > Week 4 (ch. 20) > Flashcards

Week 4 (ch. 20) Flashcards

1
Q

Describe neoplasm cell growth

A

no longer responds to normal body controls

    • continue to reproduce even though no need for them
    • deprives surrounding cells of nutrients
    • expanding mass create pressure on surrounding structures
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2
Q

neoplasms consist of what kind of cells

A

atypical or immature

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3
Q

characteristics of neoplasms depend on what

A

cell type

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4
Q

tumors are names according to what

A

system its in

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5
Q

benign tumor names vs malignant tumor names

A

benign: have tissue name plus the suffix -oma (adenoma)

malignant tumors (cancers) have the tissue name plus the suffix -carcinoma (adenocarcinoma)

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6
Q

characteristics of benign tumors

A

differentiated cells
reproduce higher than normal rate
encapsulated (expand but does not spread)
freely moveable on palpation

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7
Q

damage of benign tumors is from what

A

compression of adjacent structures

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8
Q

characteristics of malignant tumors

A

Undifferentiated cells, nonfunctional cells
Reproduce rapidly
Infiltrate or spread into surrounding tissues
Metastasize

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9
Q

Maligant tumors are composed of what cells

A

dysplastic cells

  • absent of normal cell function
  • surface antigens altered
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10
Q

malignant tumors compress nearby blood vessels, which causes what

A

necrosis and inflammation, increase pressure on surrounding structures

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11
Q

Do maligant cells adhere to each other

A

no - break lose from the mass, infiltrating into surrounding tissue

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12
Q

malignant tumors secrete enzymes, which do what

A

add to destruction and facilitate spread

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13
Q

Malignant tumors cause inflammation and loss of normal cell, which does what

A

progressively reduce the organ function

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14
Q

What happens as a malignant tumor enlarged

A

inner cells are frequently deprived of blood and nutrients (they die)

which leads to more inflammation

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15
Q

Some malignant tumors secrete growth factors, which does what

A

stimulates angiogenesis (development of new capillaries in the tumor) - promotes tumor development

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16
Q

Malignant tumors “trap” nutrients depriving normal cells, which does what

A

prevents tissue regeneration

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17
Q

Malignant tumors “in situ” =

A

preinvasive stage

  • months or years
  • offers early diagnosis for cervical or oral cancers
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18
Q

Warning signs of cancer

A
  1. bleeding / discharge at site
  2. change in BM or Bladder habits
  3. change in wart or mole
  4. sore that does not heal
  5. weight loss
  6. anemia / low hemoglobin
  7. fatigue
  8. cough or horseness without reason
  9. lump, painless, in breast, testes or anywhere in body
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19
Q

Local effects of cancer: pain

A

May be absent until well advanced

Severity depends on the type and location

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20
Q

Local effects of cancer: obstruction

A

Occurs when tumor compresses a duct or passageway

blood supply or lymphatic flow may be restricted (ulceration, edema)

digestive tract
airflow in bronci

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21
Q

Local effects of cancer: tissue necrosis and ulceration

A

may lead to bleeding or infectoin around the tumor

– increased in areas of normal flora become opportunistic

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22
Q

Systemic effects of cancer: weight loss and cachexia

A

severe tissue waisting

- increased demands placed on body

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23
Q

Systemic effects of cancer: anemia

A

Common problem

  • due to anorexia, chronic bleeding, bone marrow depression
  • causes poor tissue regeneration
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24
Q

Systemic effects of cancer: fatigue

A 
Inflammatory changes
psychological factors (life threatening illness, depression)
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25
Q

Systemic effects of cancer: infections

A

host resistance declines

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26
Q

Systemic effects of cancer: bleeding

A

Tumor cells may erode blood vessels or cause tissue ulceration

bone marrow depression –> poor clotting

common site – GI tract –> mucosa slow to regenerate

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27
Q

Systemic effects of cancer: paraneoplastic syndromes

A

Certain tumor types

– tumor cells release substances that affect neurological function and may have hormonal effects

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28
Q

Cancer diagnostic tests: routine screening

A

Educate patients

  • essential for early detection
  • following treatment to detect any further tumors
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29
Q

Cancer diagnostic tests: self examination

A

Educate patients

  • early detection, if done consistently
  • breast, testicular, skin
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30
Q

Cancer diagnostic tests: blood tests

A

RBC and hemoglobin
Measure blood cell levels during treatment
Tumor markers…may detect tumor markers (PSA test), BRAC-1

31
Q

Cancer diagnostic tests: radiologic, ultrasound, MRI, CT

A

Methods of visualizing changes in tissues or organs

32
Q

Cancer diagnostic tests: cytological test

A

Require biopsy or cell sample
— determine degree of differentiation and tumor type
— may be test for growth promoter sensitivities (e.g. estrogen dependent tumors)
— most dependable confirmation of malignancy

33
Q

Cancer diagnostic tests: genomic tumor assessment

A

ID genomic mutations that are independent of heredity but only occur with the disease itself

34
Q

Spread of Malignant tumors: secondary tumors

A

Cells identical to primary tumor

35
Q

Spread of Malignant tumors: invasion

A

Local spread - grows to adjacent tissues

— ex. Uterine carcinoma invaded vagina

36
Q

Spread of Malignant tumors: metastasis

A

Spread to distant sites by blood or lymphatic channels

Cells erode into vein/lymphatic vessel traveling until lodge into hospitable environment (typically lymph nodes near by)

Ex. Carcinoma of colon spreads to liver

37
Q

Spread of Malignant tumors: seeding

A

Spread of cancer cells in the body fluids or along membranes
— typically within cavities
— ovarian to throughout peritoneal cavity

38
Q

Why is staging of cancer essential

A

To standardize comparative studies of treatments and outcomes
- used to estimate prognosis

39
Q

Staging of cancer: most common system used in TMN system

A
  1. Size of primary tumor (T)
  2. Involvement of regional lymph nodes (N)
  3. Spread (metastasis) of tumor (M)
40
Q

Staging of cancer: stage 1 and stage 4

A

Stage 1: small, well localized, easy to treat, good prognosis
Stage 4: well advanced at multiple sites, difficult to treat, poorer prognosis

41
Q

Carcinogenesis

A

Process by which normal cells form into cancer cells

Combination of factors or repeat exposure to single risk factor leads to changes - activates or changes gene expression - leading to transformation of normal cell to malignant cell

42
Q

Cancer is thought to be a multi factorial disease because of what

A
  • environmental effects
  • changes in gene expression (heredity)
  • infection in some cases
43
Q

Stages of carcinogenesis

A
  1. Initiating factors —> procarcinogens cause the first irriversible change in cellular DNA
    A. Do not create an active neoplasm
  2. Exposure to promoters causes further damage
    A. Less differentiation and increase mitosis and or lack of apoptosis
    B. Includes hormones and environmental Cham
    C. Dysplasia or analysis may be evident
    D. Process may lead to tumor dev.
  3. Continued exposure — malignant tumor capable of growth and invasion
  4. Changes in regulation of growth factors - cells capable of detaching and spreading, metastasis
  5. Tumors with metastasize readily and reproduce quickly (aggressive)
44
Q

Cancer host defences

A

Cancer suppressor genes inhibit neoplastic growth
Immune system ID foreign neoplastic material
Immunodeficiency shown to increase risk of cancer

45
Q

Cancer treatment

A

Depends on type and location
- surgery, chemo, radiation, immunotherapy
Can be combination of these

46
Q

Cancer treatment: surgery

A

Removal of tumor and surrounding tissue

- laparoscope (minimizes tissue damage, improves recovery time)

47
Q

Removal of adequate surrounding tissue may result in what

A

Changes in function

48
Q

Cancer surgery: radiofrequency ablation (RFA)

A

Alternative surgery for small single tumors in solid or fluid-filled organs, but not the lungs
- heat in form of radio waves

49
Q

Cancer treatment: radiation

A

Causes mutation in DNA
— prevents mitosis or causes immediate death
— damages blood vessels which cuts off blood supply to tumor cells and starves them

Some types of cancer are radio resistant

50
Q

Radiation: methods of administration

A

External sources,
Internal insertion
Instill radio scope in solution into body cavity

51
Q

Radiation precautions

A

Minimize radiation exposure of support people, shielding material for body regions not affected

52
Q

Radiation adverse effects

A

Bone marrow depression: decreased leukocytes - increase risk for infection

Decrease RBC: fatigue, tissue breakdown, decreased platelets, excessive bleeding

Epithelial cell damage: damage to blood vessels and skin, hair loss

Infertility - caused by abdominal radiation

Nonspecific fatigue and lethargy - leads to depression

53
Q

Chemotherapy

A

Anti neoplastic drugs
Usually combination of two to four drugs
- given at periodic intervals

54
Q

Chemotherapy classifications

A

Antimitotics
Antimetabolites
Alkyating agents
Antibiotics

55
Q

How do chemo drugs work

A

Interfere with protein synthesis and or DNA replication

56
Q

Chemo adverse effects

A
  1. Bone marrow depression: If cell number low may need transfusions or cessation of therapy until bone marrow recovers
  2. Vomiting: Occurs at any point, anti-emetic drugs may help
  3. Epithelial cell damage: hair loss, breakdown of skin, mouth sores, diarrhea, candidiasis infection in mouth (thrush)
  4. Damage to specific areas within antineoplastic drugs
57
Q

Cancer treatments: hormones

A

Tamoxifen estrogen blocking agent used in breast cancer treatment

58
Q

Cancer treatment: glucocorticoid

A

Decrease mitosis and increase erythrocyte counts

59
Q

Cancer treatment: blocking agents

A

Act to block receptors for the growth promoters on cancer cells

60
Q

Cancer treatment: biological response modifiers (BRM)

A

Augment the natural immune response

61
Q

Cancer treatment: angiogenesis inhibitors

A

Inhibit stimulus for growth of blood vessels

62
Q

Cancer treatment: analgesics

A

Prescribed to alleviate pain

May be used In high doses

63
Q

Cancer treatment: gene therapy

A

Experimental cancer treatment design to replace mutated jeans with a healthy copy of the gene, and activate a mutated gene, introduce a new gene

64
Q

Cancer treatment: nutrition

A

Patients with advanced cancer are often malnourished. Many contributing factors for this

65
Q

Cancer treatment: complimentary therapies

A

Healthcare workers need to be aware of these different types of therapies to advise patients. Massage, meditation, counseling, exercise, therapeutic touch

66
Q

Remission

A

No clinical signs of cancer

- client may experience several remissions

67
Q

Cancer free states generally defined as _____ survival without reoccurance

A

5-year

68
Q

Some cancers such as childhood leukemia s can be considered cured after a _____, cancer free period

A

10 year

69
Q

Most common cancer in men

A

Prostate
Lung
Colorectal

70
Q

Most common cancer in females

A

Breast
Lung
Colorectal

71
Q

Examples of malignant tumors: skin cancer

A

Visible, easily diagnosed and treated

Excellent prognosis with exceptions of malignant melanoma

72
Q

Malignant tumors: ovarian cancer

A

Poor prognosis because of hidden nature of cancer. High mortality rates

73
Q

Malignant tumors: brain tumors

A

Both benign and malignant tumors Are life-threatening because of compression of brain tissue. Primary tumor usually fatal, no metastases

Pathophysiology (11 decks)

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