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Unit 5- Intro Exam
Pathophysiology
| Question | Answer |
|---|---|
| Cancer is a disease caused by an _______________ division of ______________ cells in a part of the body. | uncontrolled; abnormal |
| Oncogenes | The genes that regulate the development and growth of cancerous tissues |
| Oncogenes are also known as? | cancer genes |
| Anti-Oncogenes | these genes tell cells to stop multiplying and help control cell growth |
| Anti-Oncogenes are also known as? | tumor supporting genes |
| Proto-Oncogenes | the normal genes that play a part in controlling normal growth and cellular differentiation |
| Carcinogens | any substance or agent that produces or increases the risk of developing cancer |
| What are some examples of carcinogens? | pesticides, processed foods, artificial sweeteners, spicy foods, body piercings, vinyl, paint, viruses |
| What is the process in which a normal cell is transformed into a malignant cell? | carcinogenesis |
| What are the steps in carcinogenesis? | 1. Initiation 2. Promotion 3. Transformation 4. Progression |
| Initiation in carcinogenesis | a carcinogen causes genetic change or damage to the DNA in a normal cell |
| Does the initiation stage in carcinogenesis cause cancer? | No but the initiatied cell can cause genetic changes which could result in malignancy |
| Promotion in carcinogenesis | the genetic change replicates |
| In the promotion phase of carcinogenesis, exposure to additional carcinogens increases the risk of _______________. | malignancy |
| What does the risk of malignancy depend on in the promotion phase of carcinogenesis? | upon the dose and duration of exposure to the carcinogen |
| Transformation in carcinogenesis | latency period; the malignant cells begin to replicate within a capsule |
| The time between exposure and the development of a malignancy is called the ______________ period. | latency |
| If the replicated cells remain in the tumor capsule then this is referred to as? | carcinoma in situ |
| Progression in carcinogenesis | the malignant cells begin to grow, invade the surrounding tissue, and eventually spread to distant sites |
| The amount of time it takes for one cell to divide or for a group of cells (such as a tumor) to divide in size. | double timing |
| T or F. It may take years for a tumor to double in size that can be felt, seen, or cause pressure or pain. | True |
| How big must the tumor be to be seen on an xray? | 1/2" in diameter |
| What are 4 theories of disease causation? | 1. Supernatural 2. Hippocratic 3. Miasma/Contagion/Germ 4. Classic Epidemiology |
| Supernatural Theory | fate, ominous sensations, mystical retributions |
| Hippocratic theory | believed that disease resulted from an imbalance of the four bodily humors; blood-air, phlegm-water, yellow bile-earth, black bile- fire |
| According to the Hippocratic theory, disease should be treated how? | through diet, hygiene, and activity (any additional tx was given only in drastic situations) |
| Miasma/Contagion/Germ Theory | a vaporous inhalation believed to cause disease |
| Miasma means | pollution |
| Classic Epidemiology Theory | according to this theory, exposure to an agent does not necessarily lead to disease. It was believed that disease is the result of an interraction between the agent, host, and environment. |
| What is the frequency of occurrence of a disease over a given period of time and within a given population? | incidence |
| Why is incidence important? | because it clearly expresses propbability or risk |
| Incidence Rate: | # of persons diagnosed over time/general population during that time |
| The number of deaths within a given population as a result of some disease (cancer). | mortality rate |
| Survival rate | the number of people surviving a given disease |
| To be considered a survivor how long must a patient be cancer free? | 5 years |
| What does the survivial rate depend on? | the type of cancer, stage at diagnosis, how the cancer responds to treatment |
| The study of the cause of a disease. | Etiology |
| Generally speaking, what are the 3 things that cause a disease? | genetics (who you are), environment (where you live), and lifestyle (how you live) |
| What is general adaptation syndrome? | describes the body's short-term and long-term reactions to stress |
| Stress causes the body to go through many physiological changes. How do people cope? | -drinking, smoking, binge eating |
| Epidemiology | the study of the factors determining and influencing the frequency and distribution of disease (the study of the origin) |
| Why is it important to collect and study cancer statistics? | etiologically- it is important for prevention epidemiologically- increases awareness for a certain population |
| Cancer statistics are ______________. | stratified |
| Why are cancer stats stratified? | because subgroups within a given population are at different levels of risk |
| What are cancer stats categories based on? | sex, age and race |
| What is considered primary prevention? | -education, healthy lifestyle, limiting exposure to risk factors, immunizations |
| What is considered secondary prevention? | -self examination, regular checkups, medical screening and testing |
| What is considered tertiary prevention? | -management of existing conditions, rehabilitation, support groups |
| Embryonic development layers | ectoderm: outer layer mesoderm: middle layer endoderm: inner layer |
| What is found in the ectoderm? | nervous system, special senses |
| What is found in the mesoderm? | connective tissues - mesenchymal sarcomas |
| What is found in the endoderm? | respiratory system |
| This is the process by which normal cells undergo physical and structural changes as they develop to form the different tissues of the body. | differentiation |
| Differentiation is also known as? | the maturation of a cell |
| The more differentiated a cell is the more ________________ it is, and the ________ likely it is to divide. | specialized; less |
| Normal cells reproduce in an orderly ___________ manner. | controlled |
| New cells are produced as they are needed and this keeps the total number of cells at a ____________ rate. | constant |
| Normal cells grow at different rates based on what? | tissue type |
| Give examples of cells that reproduce in order to compensate for the high rate of loss. | skin cells, mucous membranes |
| Give examples of some cells that reproduce as needed, usually in response to injury. | bone, liver to some extent |
| Give an example of a cell type that lack the ability to regenerate if injured. | neurons |
| What 4 things would a cell do when injured? | adapt, repair, suffer, die |
| Inflammation is characterized by what? | redness, warmth, swelling and pain |
| Apoptosis | the death of cells that occurs as a normal and controlled part of an organisms growth or development |
| Edema | represents the accumulation of excess liquid in the interstitial (extracellular) spaces of a tissue or in pre-existing cavities |
| Where does edema occur at? | It may affect any organ, but most often it appears in : subcutaneous tissues, lung and brain. |
| Hyperemia | (congestion) represents the increase of blood in a territory, due to dilatation of small vessels |
| What are the 2 types of hyperemia? | active and passive |
| Active hyperemia | (congestion) is a result of arteriolar distension (e.g., skeletal muscle activity, inflammation, local neuro-vegetative reaction) |
| Passive hyperemia | (congestion), also termed stasis, is a consequence of an impaired venous drainage (heart failure, compression or obstruction of veins), followed by dilatation of venules and capillaries. |
| Hemorrhage | loss of blood from a damaged blood vessel |
| Thrombosis | Thrombosis occurs when blood clots block your blood vessels |
| What are the 2 main types of thrombosis? | venous and arterial |
| Venous thrombosis | when the blood clot blocks a vein |
| Arterial thrombosis | when the blood clot blocks an artery |
| Embolism | an obstruction or blockage in a blood vessel |
| Infartion | an area of tissue that is undergoing or has undergone necrosis as a result of obstruction of a localized blood supply as by a thrombus or embolus |
| Shock | a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss or an allergic reaction. It also may result from severe infection, poisoning, severe burns or other causes. |
| Leading cause of death globally and in the US is? | heart disease |
| What type of tissue covers the whole body? | epithelial |
| Epithelial tissue is packed closely with little or no ________________ material. | intracellular |
| Are there blood vessels found in epithelial tissue? | No |
| What are the functions of epithelial tissue? | protection (stratified squamous), excretion (simple columnar), absorption (simple squamous) |
| What are some examples of epithelial tissue? | epidermis, lining of intestines, lining of respiratory tract, lining of abdominal cavity |
| Cancer arising in epithelial tissue is classified as ___________________. | carcinoma |
| Cancer arising in glandular epithelial tissue is classified as _______________________. | adenocarcinoma |
| Which tissue type is the most abundant and widely spread in the body? | connective |
| What does connective tissue consist of? | elastic, fibrous, and collagenous tissue (including blood, lymph and bone marrow |
| What are the functions of the connective tissue? | holding together, storage (lipids), strength and flexibility, transportation (blood, lymph, and bone marrow) |
| What are some examples of connective tissue? | bone, cartilage, adipose tissue, blood, tendons, ligaments |
| Cancer arising in connective tissue is classified as _________________. | sarcomas |
| Which type of tissue is slow to heal and are frequently replaced with scar tissue? | muscle |
| What are the functions of muscle tissue? | produce voluntary, controlled movement; involuntary movement |
| Skeletal muscle is _____________, and promotes ________________ movement. | striated; voluntary |
| Smooth muscle promotes ______________ movement. | involuntary |
| Cardiac muscle promotes ________________ movement. | involuntary |
| Cancer arising in muscle tissue is classified as _________________. | sarcomas |
| Nerve tissue consists of what 2 cell types? | neurons and glial cells |
| What are the functions of nerve tissue? | rapid communication between body structures and control of body functions |
| Cancer arising in nerve tissue is classified how? | based on the cell involved |
| If tumor cells closely resemble the cells of origination they are what? | well differentiated |
| If tumor cells slightly resemble the cells of origination (enough to determine where the cells came from) they are what? | moderately differentiated |
| If the tumor cells have changed so that you can't really determine their origin then they are what? | poorly differentiated |
| Tumor cells that are extremely bizarre looking and have changed so much that it is virtually impossible to determine their origin they are what? | undifferentiated (anaplastic) |
| Characterisitic of tumor cells that are well differentiated. | highly specialized, slow growing, low mitotic rate, radioresistant, and some are easy to cure |
| Characterisitics of tumor cells that are undifferentiated. | unspecialized, fast growing, high mitotic rate, radiosensitive, hard to cure (they often metastasize quickly) |
| T or F. Tumors arising in non-endocrine tissue can sometimes acquire the ability to produce and secrete hormones. | True (an ex. is SCLC which can produce ACTH and cause Cushing's syndrome) |
| Why is the growth rate of malignant cells considered to be faster than normal cells? | Malignant cells, or cancer cells, grow faster than normal cells because they have genetic mutations that disrupt the normal cell cycle controls, allowing them to divide rapidly without the usual signals to stop, and they can also evade apoptosis. |
| 3 natural routes of spread | local growth, blood stream, lymphatic system |
| Unnatural route of spread | seeding |
| All tumors have a ________ supply. | blood |
| ______________ spread through the blood stream. | sarcomas |
| _______________ spread through the lymphatic system. | carcinomas |
| Complete blood count (CBC) includes what when evaluated? | WBCs, RBCs, platelets, hemoglobin, and hematocrit |
| Alkaline phosphate | an enzyme present in the bone, the kidneys, intestines, plasma and teeth |
| Bilirubin | the orange-yellow pigment of bile (formed by the breakdown of hemoglobin and following the death of RBCs) |
| Bilirubin often accumulates in the blood and tissues causing ______________. | jaundice |
| Uric acid | a product of protein metabolism |
| Uric acid is present in ________ and ___________. | blood and urine |
| Where is creatnine found? | blood, urine, and muscle tissue |
| Blood Urea Nitrogen (BUN) | measure of the amount of urea in the blood |
| Calcium | 5th most abundunt element in the body; found in bone; essential for nerve transmission, muscle contraction, and clotting |
| Electrolytes | elements that when dissolved break into ions and are able to conduct electric currents |
| What are some examples of electrolytes? | potassium or sodium |
| Why are electrolytes monitored? | to detect metabolic and endocrine disease and evaluate nutritional status |
| Amylase | pancreatic digestive enzyme |
| Where is amylase found? | saliva, pancreatic juice, certain bacteria and molds |
| What are tumor markers? | substances produced in large amounts by cells |
| Are tumor markers used to diagnose? | No |
| Tumor markers may what? | indicate a possible cancer or may detect recurrent cancer |
| Urinalysis | physical, chemical, and microscopic evaluation of urine |
| What is examined for a urinalysis? | color and clarity, turbidity, specific gravity, pH (<7) |
| Centesis/Aspiration | puncturing a body cavity or organ with a hollow needle in order to draw out fluid |
| When would a centesis be needed? | pleural effusion |
| Spinal Tap/Lumbar puncture | needle is inserted between the vertebrae and spinal fluid is withdrawn |
| Bone Marrow Analysis | bone marrow is withdrawn from the sternum or iliac crest |
| Occult blood test | done to test for blood in the stool that cannot be seen with the naked eye-- this can detect bleeding anywhere along the digestive tract |
| Cytological studies: sputum | to look for blood (sampled by coughing) |
| Cytological studies: smears/cultures | to look for infection and in some cases cancer (obtained by scraping the surface) |
| Cytological studies: washing | to look for malignant cells (sample obtained through bronchoscope) |
| In diagnostic radiography, tumors can be seen if? | they involve bone (lytic or blastic), if they are calcified, or if they displace normal structures |
| Nuclear medicine tests are used primarily for _______________ workup. | metastatic |
| In PET, radioactive sugar (FDG) is injected into the patient why? | bc cancer cells readily metabolize sugar |
| Ultrasound is used to differentiate between what 2 types of masses? | cystic and solid |
| CT is used to evaluate the _________ of the tumor. | extent |
| What is helpful in precisely locating tumors of the brain, pancreas, and liver? | angiography |
| What types of biopsies are there? | fine needle aspiration, core needle, incisional, and excisional |
| Fine needle aspiration advantages | uses readily available material and uses local or no anesthesia |
| Fine needle aspiration disadvantages | results in cytological diagnosis, mass must be large enough to make a reliable target, and must not be near major blood vessels or hollow viscera (could cause seeding) |
| Core need biopsy advantages | local anesthesia and provides a histological diagnosis |
| Core need biopsy disadvantages | requires a large tumor and is not definitive if only normal tissue is received |
| Incisional biopsy advantages | provides a histological diagnosis, local anesthesia is outpatient setting, and preferred for large lesions |
| Incisional biopsy disadvantages | risk of seeding the tumor |
| Excisional biopsy advantages | provides a definite diagnosis, serves as adequate treatment if lesion is benign, and minimal trauma to the lesion |
| Excisional biopsy disadvantages | may require general anesthesia and may require a deeper plane of dissection |
| CAUTION acronym for warning signs of cancer | Change in bowel/bladder habits; A sore that does not heal; Unusual bleeding/discharge; Thickening or lump in the breast or elsewhere; Indigestion or difficulty swallowing; Obvious changes in warts or moles; Nagging cough or hoarseness. |
| What cancers are associated with the alpha-feto protein (AFP) tumor marker? | liver, ovarian, and testicular |
| What cancers are associated with the CA 125 and CA 72-4 tumor marker? | ovarian |
| What cancers are associated with the carcinoembryonic antigen (CEA) tumor marker? | colorectal |
| What cancers are associated with the prostate specific antigen (PSA) tumor marker? | prostate |
Created by:
lheard
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