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Nursing Science 3 > WEEK 5 - Malignancies > Flashcards

WEEK 5 - Malignancies Flashcards

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1
Q

What is apoptosis?

A

Natural programmed cell death

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2
Q

What is necrosis?

A

Cell death due to injury or disease progression

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3
Q

What is the cell cycle and what does it consist of?

A

The division of one parent cell into two daughter cells

Consists of interphase and the mitotic phase

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4
Q

Describe the three subphases of interphase

A 
G1 = growth phase, new daughter cells grow to adult size and duplicate organelles
S = DNA synthesis phase, DNA replicates
G2 = 2nd growth phase, cells grow and more organelles are added to the cytoplasm
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5
Q

What is mitosis?

A

Nuclear division such that each daughter cell has the same DNA as the parent cell

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6
Q

Cancer is characterised by?

A

Uncontrolled reproduction of cells that can arise from ANY cell type

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7
Q

Why does risk of cancer increase with age?

A

Incidence of gene mutations via epigenetic and genetic mechanisms increases

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8
Q

What is epigenetics?

A

Environmental factors that can turn genes on or off - changes how genes are read but does not change the actual gene itself

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9
Q

What is a neoplasm?

A

A new growth, swelling or tumour, may be benign (well differentiated) or malignant (poorly differentiated)

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10
Q

What is an adenocarcinoma?

A

A cancer arising from the glandular epithelium

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11
Q

What is a sarcoma?

A

Cancer arising from connective tissue

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12
Q

What is a lymphoma?

A

Cancer arising from lymphatic tissue

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13
Q

What is leukemia?

A

Cancer of white blood cells, proliferation of cancerous WBCs

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14
Q

What are the defining characteristics of cancers?

A
  • Have autonomy, ca produce their own growth factors and blood vessels, survive independently
  • Have an unlimited life span - vary in size and shape (pleomorphic), lack apoptosis due to telomerase
  • Are anaplastic - loss of differentiation, lack organisation, internal structure is not recognisable
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15
Q

What are neoplastic markers?

A

Substances produced by neoplastic cells, can also be produced by benign cells.

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16
Q

Describe the four stages of cancer?

A
  1. Confined to tissue of origin
  2. Locally invasive - poorly differentiated cells present
  3. Spreads to regional structures such as lymph nodes
  4. Metastasis to distant sites
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17
Q

Define carcinogenesis

A

The transformation of healthy cells to malignant cells.
Triggered by gene mutations as a result of risk factors, mutations stimulate growth promoting pathways and inhibit host antigrowth signals

18
Q

What are risk factors for cancer? (x7)

A
  1. Chronic inflammation
  2. Viruses and bacteria
  3. Smoking
  4. Alcohol
  5. Radiation
  6. Obesity
  7. Physical inactivity
19
Q

Symptoms of cancer?

A
  1. Pain
  2. Fatigue - unknown mechanism
  3. Weight loss - altered metabolism, loss of fat stores and muscle
  4. Infections - decreased granulocytes and lymphocytes
  5. Blood dyscrasias - anaemia (chronic bleeding), thrombocytopenia (cancer in bone marrow), leukopenia (cancer in bone marrow)
20
Q

Describe the physiology of the pain response

A

Stimulation of nociceptors under the dermis and within deep tissues
Mediated by substance P, PGs, histamines and bradykinin
Arises from actual or potential tissue damage

21
Q

How is cancer pain managed?

A

ALWAYS with opioid and narcotic analgesics

22
Q

MOA of morphine?

A

Acts on mu-receptors in the CNS = reduces pain transmission, slow onset
Longer duration than fentanyl due to high water solubility

23
Q

MOA of fentanyl?

A

Mainly acts on mu-receptors in the CNS, more potent than morphine due to high lipid solubility
Short onset and duration of analgesia

24
Q

MOA of heroin?

A

Morphine analogue

Rapidly converted to morphine, greater lipid solubility, can cross the BBB

25
Q

MOA of bupenorphine?

A

For terminal cancer pain

Partial agonist of mu-receptors = strong analgesic effects

26
Q

What three blood abnormalities occur in cancer?

A
  • Anaemia
  • Leukopenia
  • Thrombocytopenia
27
Q

How do chemotherapy drugs work?

A
  • Target cell cycle and metabolic pathways = aim to kill cells that are in interphase or that are dividing
  • Using more than one chemo drug = synergistic effects
  • Chemo drugs have a narrow therapeutic effects and a low therapeutic index
28
Q

Side effects of antineoplastic agents?

A
  • Bone marrow suppression
  • Decreased WBCs
  • Nausea and vomiting
  • Hair loss
29
Q

What do alkylating and platinum drugs do?

A

Interfere with cellular replication (cell cycle)

30
Q

What does doxyrubicin do?

A

Inhibits DNA and RNA synthesis

31
Q

What does bleomycin do?

A

Inhibits DNA and to a lesser extent RNA synthesis. Also breaks DNA strands via ROS

32
Q

What do antimetabolites do and what are the three subgroups?

A

Incorporate into DNA during replication - misreading of DNA = DNA breakage, acts on dividing cells

Subgroups:

  1. Folic acid analogues
  2. Pyrimidine analogues
  3. Purine analogues
33
Q

Adverse effects of antimetabolites?

A
  • Bone marrow suppression
  • N & V
  • GI damage
34
Q

What are the two types of hormonal antineoplastics?

A
  • Antiandrogenic

- Antioestrogenic

35
Q

How does chronic inflammation cause cancer?

A

Induces growth factors = gene mutations and cellular proliferation
Induces ROS = increases DNA damage

36
Q

How do viruses and bacteria cause cancer?

A

Trigger inflammation

37
Q

How does smoking cause cancer?

A

Increases inflammation and induces CRP that isn’t normally present in blood unless there is an inflammatory response

38
Q

How does alcohol cause cancer?

A

Increases the concentration of acetaldehyde = induction of cytochrome P450 = increases ROS = causes altered cell cycle

39
Q

Radiation inducing damage to DNA and thus causing cancer depends on?

A

Dose
Repair mechanisms
Antioxidants

40
Q

How does obesity cause cancer?

A

By increasing:

  • Free fatty acids
  • Tumour necrosis factors (TNF)
  • Insulin resistance
  • Insulin-like growth factors (IGF)

By decreasing:
- Sex hormone binding globulins (SHBGs) = unbound hormones able to decrease apoptosis and anti-cancer mechanisms in sex hormone sensitive tissues

41
Q

How does physical inactivity cause cancer?

A

By promoting insulin resistance and IGFs, decreasing SHBGs, increasing cytokine and inflammatory mediator production

42
Q

Regardless of antineoplastic agents used, what should be monitored in cancer patients?

A
  • Blood count

- Renal and liver function

Nursing Science 3 (21 decks)

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