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What is another name for neoplasms?
tumors
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What are neoplasms?
cells with unchecked reproduction which do not respond to normal cell controls.
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Neoplasms can become large masses & interfere with? (4)
- 1. nearby organs
- 2. pressure
- 3. cutting off circulation
- 4. pressing on nerves->pain, numbness
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Neoplasms often have no useful?
function
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Neoplasms may secrete what?
abnormal levels of hormones
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What can neoplasms cause because of their growth?
bleeding
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What do neoplasms take from healthy cells?
nutrition
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What is benign tumors?
tumors that won't spread to other sites
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What is metastasize?
a spreading of cancer
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Under a microscope benign tumors appear?
"well-differentiated"
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Is benign tumors mitosis normal?
yes, just unchecked
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What are malignant tumors? (2)
- 1. tumors that will metastasize
- 2. may kill the host
-
What is the greek word for cancer?
CRAB
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What is another name for cancer?
carcinoma
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What are the 8 warning signs of cancer?
- 1. unusual bleeding or discharge anywhere
- 2. change in bowel or bladder habits
- 3. a change in a wart or mole
- 4. a sore that does not heal
- 5. unexplained weight loss
- 6. anemia, persistant fatigue
- 7. persistant cough or hoarseness
- 8. cell lump in the breast or testes or anywhere(often painless)
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What does "in situ" mean?
cells have not spread and are localized to that site
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Under a microscope, Ca cells appear?
"poorly differentiated"
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Do Ca cell use apoptosis?
No
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What is apoptosis?
normal process of cells self-destructing when old.
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What is angiogenesis?
process of stimulating blood vessels to supply the tumor to promote their own survival.
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What is H&P?
History and physical
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What is the H&P for diagnosing cancer? (2)
- 1. weight loss
- 2. any of the 8 warning signs
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What should be looked for in lab tests to find out if a patient has cancer? (4)
- 1. anemia
- 2. abnormal CBC
- 3. increase/decrease in WBC
- 4. blood in stool
-
What is CBC?
complete booold count (includes Hgb levels)
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What are the tests to check for blood in stool? (2)
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What does "Stool For OB" mean?
check stool samples for occult
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What is occult?
microscopic traces of blood in stool.
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The antigen specific tests look for specific antigens in blood that help diagnose cancer, what are these antigens? (3)
- 1. PSA- Prostate specific antigen
- 2. CEA -Carcinogenic Embryonic antigen
- 3. CA 125 -ovarian
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What is U/A?
urine analysis
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What are the other tests they may use to diagnose cancer? (4)
- 1. X-rays
- 2. CT scans
- 3. MRI's
- 4. US
-
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What is a biopsy?
taking samples of cells and examaning in lab for final dx
-
What is the only certain way to dx cancer and determine best type of chemotx?
biopsy
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What is usually biopsied to check for metatases?
lymph nodes
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What results in staging of Ca?
lymph nodes biopsy
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What is staging of cancer based primarily on? (3)
- 1. Size of tumor
- 2. Involvement of lymph nodes
- 3. presence of metatases
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What is carcinogenesis?
The progressive development of a cell to cancer.
-
What are the 3 general concepts of carcinogenesis?
- 1. Ca develops over time
- 2. often requires a genetic predisposition
- 3. often requires multiple triggers for the cells DNA to become Ca
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What is another name for chemotherapy?
antineoplastic drugs
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What are some actions of the chemotherapy drugs? (3)
- 1. interfere with cell division
- 2. interfere with angiogenesis
- 3. interfere with hormones that "feed" the tumor
-
What is important to note about the medications for a specific tumor?
need multiple meds
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Does chemotherpy kill both Ca and normal cells?
yes
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What are the side effects of chemotherapy? (5)
- 1. hair loss
- 2. mucosal damage
- 3. decrease in WBC
- 4. decrease in platelets
- 5. GI irritation
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What is Radiation therapy (RT)?
beamed target radiation into sites
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RT has similar side effects to?
chemotherapy, except for the "Burns" (red, leathery appearance of skin)
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What is an alternative to radiation therpay?
RT "beads"
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If someone has RT beads, what should they be aware of?
RT precautions
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What are the ways side effects of Ca tx are managed? (8)
- 1. anti-emetic drugs to reduce nausea/vomiting
- 2. pain control
- 3. avoid exposure to people with infections
- 4. do not get vaccines
- 5. good nutrition
- 6. increase protein meals
- 7. increase fluids
- 8. closely motitor CBC and platelets
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What are 2 characteristics of erythrocytes?
- 1. lifespan of 120 days
- 2. biconcave disc shaped
-
New RBC's are made via?
erythropoiesis
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How many RBc's are made per minute?
200 billion
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RBC production requires? (7)
- 1. erythropoietin from kidney
- 2. Fe
- 3. folic acid
- 4. Vit B12
- 5. Copper
- 6. protein
- 7. other nutrients
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Fe is part of what molecule?
Hgb
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What times does the body secrete extra erythropoietin?
- 1. blood loss
- 2. anemia
- 3. hypoxia
-
What are the erythropoietin drugs? (2)
- 1. procrit
- 2. epogen drugs
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What is the normal range for Hgb in males and females?
- MALES: 14-16 g %
- FEMALES: 12-14 g %
-
What is the normal range for RBC in males and females?
- MALES: 5.5 x 106
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1. how many oxygen molecules can Hgb hold? 2. When Hgb is full of these oxygen atoms, what is it called?
-
What 2 events happen after O2 dissociates from Hgb at a cellular level in capillaries?
Oxygen enters cells for metabolism-> becomes deoxyhemoglobin
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CO2 is not heavily bound to Hgb, mostly is carried in the form of?
HCO3 (bicarbonate ions)
-
What is anemia?
Low Hgb (due to decreasing number of RBC's)
-
Low RBC's and then low Hgb means there will be?
impaired O2 transport
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What are the GENERAL S&S of all anemia's? (5)
- 1. pallor
- 2. easy fatigue
- 3. SOB (shortness of breath)
- 4. increase P
- 5. possible syncope
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What is pernicious anemia?
due to lack of intrinsic factor is the stomach, which is needed for Vitamin B12 absorption.
-
What is Fe deficiency anemia?
due to nutritional/hemorrhagic loss of Fe in body.
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What is aplastic anemia?
temporary or permanent shutdown of hematopoisis (blood cell production) in bone marrow.
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What are the internal S&S of aplastic anemia? (5)
- 1. anemia
- 2. leukopenia
- 3. thrombocytopenia->ecchomyosis
- 4. petichiae
- 5. pancytopenia
-
What is leukopenia?
decrease in WBC
-
What is thrombocytopenia?
decreasing platelets
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What is petichiae?
small, pinpoint hemmorhages in skin
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What is pancytopenia?
decrease in all blood cell types
-
What is Thalassemia? (2)
- 1. GENETIC impairment in Hgb
- 2. type varies for different races
-
What is sickle cell anemia?
INHERITED HgbS form, which causes RBC to "sickle"->clogs blood vessels
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What events trigger sickle cell anemia? (3)
- 1. stress
- 2. hypoxia
- 3. illness
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What are the S&S of sickle cell anemia? (2)
- 1. severe pain
- 2. jaundice
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What are the 5 anemia's?
- 1. pernicious anemia
- 2. Fe deficiency anemia
- 3. aplastic anemia
- 4. thalassemia
- 5. sickle cell anemia
-
What is the tx for pernicious anemia?
Vitamin B12 injection
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What is the tx for Fe deficiency anemia? (2)
- 1. identify/treat underlying cause
- 2. iron supplements
-
What is the tx for aplastic anemia? (4)
- 1. Fast tx of underlyign cause
- 2. removal of any bone marrow suppresents
- 3. blood transfusion
- 4. bone marrow transplant
-
What is the tx for thalassemia?
blood transfusion
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What is the tx for sickle cell anemia? (3)
- 1. drugs that reduce sickling
- Avoidance of:
- 2. strenuous activity
- 3. high altitudes
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What is carbon monoxide poisoning?
Due to CO having higher affinity to Hgb than O2
-
What does CO poisoning lead to? (2)
no O2 available to cells-> death
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What are the 3 characteristics of thrombocytes?
- 1. like to stick to eachother:agglutination
- 2. lifespan of 1 week
- 3. main function is to coagulate blood-> "thrombus"
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What is a "thrombus"?
A blood clot
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1. Where are thrombocytes made? 2. They are made when stimulated by what hormone?
- 1. Red bone marrow
- 2. thrombopoietin from liver and kidney
-
What are the normal ranges for thrombocytes in males and females?
BOTH: 150,000-400,000 per ml of blood
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What is hemostasis?
stopping of blood flow, not just by platelet aggregation
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Hemostasis involves what 2 things at the site of the clog?
- 1. vasoconstriction
- 2. edema
-
What is "fibrinolysis"?
dissolution of a hemostasis clot
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What triggers hemostasis? (5)
- 1. injury to vessel
- 2. plaques
- 3. slowed blood flow
- 4. venous stasis
- 5. SURGERY
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What are the clotting disorders? (4)
- 1. DIC
- 2. thrombocytopenia
- 3. hemophilia
- 4. thrombi formation
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What is DIC?
too much fibrin forms
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What is DIC due to? (5)
- 1. infection
- 2. obstetric complications
- 3. burns
- 4. Ca
- 5. trauma
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What is the result of DIC?
massive bleeding
-
In DIC, too much fibrin forms causing what 3 things?
intravascular clots-> tissue hypoxia, organ failure->all clotting factors are used up
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What is thrombocytopenia due to? (3)
- 1. chemotx
- 2. auto-immune
- 3. virus (esp. in kids)
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What is hemophilia?
genetic disorder causing lack of clotting factor (Factor VIII)
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What is the usual result of hemophilia? (2)
- 1. fatal hemmorhages
- 2. minor injuries
-
What is unusual about hemophilia?
platelet count is NORMAL
-
hemophilia is a sex linked disease in which?
femlaes carry the gene, but males get the disease.
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What is thrombi formation?
When clots form and may be fatal(not really a clotting disorder)
-
What are the thrombi formation predisposes factors? (2)
- 1. atherosclerosis
- 2. venous stasis
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What does atherosclerosis predispose to?
clot formation in blood vessels around damaged endothelium
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What is the difference between thrombus and embolus?
- thrombus: a clot forms and STAYS in place
- embolus: a clot forms and TRAVELS elsewhere
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What does venous stasis predispose to?
a clot formation in veins (blood pooling-bed rest)
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What happens if a clot travels to the brain?
Stroke
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What happens if a clot travels to the heart?
Heart attack
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What happens if a clot travels to the lungs?
Pulmonary embolus
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What are the main characteristics of leukocytes(WBC's)? (2)
- 1. stain and grandular presence/absence help subcategorize into 5 types
- 2. life-span is about 8 hours
-
What is the main function of WBC's?
infection control
-
Where are WBC's made?(2)
- 1. red bone marrow
- 2. lymph tissue
-
What is the normal range of WBC's for males/females?
5.0 X 103 - 9.0 X 103
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What are the WBC disorders? (2)
- 1. Leukopenia
- 2. Leukemias
-
What is Leukopenia due to? (4)
- 1. chemotx
- 2. drug reaction
- 3. RT
- 4. decrease in folic acid
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What are the subtypes of leukopenia? (2)
- 1. neutropenia
- 2. lymphcytopenia
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What is neutropenia?
Decrease of neutrophils in the blood
-
What is lymphcytopenia?
decrease lymphocytes in blood
-
What is the risk of leukopenia? What does it lead to?
Infection which leads to death
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What is leukemias?
group of malignant disorders characterized by abnormal reproduction and maturation of one or more types of WBC's
-
Leukemias can be acute in which age group?
kids
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What is AML?
Acute myelocytic leukemia
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What is ALL?
acute lymphocytic leukemia
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What types of acute leukemia would be found on charts?(2)
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Leukemia can be chronic in which age group?
adults
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What types of chronic leukemia would be found on charts? (2)
-
What is CML?
Chronic myelocytic leukemia
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What is CLL?
chronic lymphocytic leukemia
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What are the S&S's of leukemia?(13)
- 1. weigh loss
- 2. fatigue
- 3. anemia
- 4. thrombocytopenia
- 5. multiple infections
- 6. increased bleeding
- 7. severe hemorrhage
- 8. kidney stones
- 9. fever
- 10. lymphadenopathy
- 11. splenomegaly
- 12. hepatomegaly
- 13. bone pain
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What are the Lymphatic disorders? (2)
- 1. Lymphomas
- 2. multiple myeloma
-
What is lymphoma?
too many lymphocytes
-
What does lymphoma cause?
enlarged, painless lymph nodes
-
What is required to determine the true DX of lymphomas?
biopsy
-
What are the 2 types of lymphomas? (2)
- 1. Hodgkins
- 2. Non-Hodgkins
-
What is Hodgkins? (3)
- 1. nodes usually in same area of body
- 2. quite curable with chemotx or RT
- 3. Reed- Sterrnberg cells in biopsy
-
What is Non-Hodgkins? (4)
- 1. nodes usually throughout body
- 2. more difficult to cure
- 3. NO Reed- Sternberg cells in biopsy
- 4. sometimes associated with HIV
-
In lymphomas, abnormal lymphocytes lead to what?
increased risk of infection
-
What is splenomegaly?
enlarged spleen (usually filters blood)
-
What is hepatomegaly?
enlarged liver
-
What has the similair S&S of leukemia?
lymphomas
-
what are the advance SS of lymphomas?(4)
- 1. decreased weight
- 2. low grade fevers
- 3. night sweats
- 4. pruritis
-
what is pruritis?
itchiness
-
what is mutiple myeloma?
excessive, non stoppable production of B-Lymphocytes
-
what is B-lymphocytes function?
they are plasma cells which infiltrate into bone marrow
-
what does multiple myeloma usually result in?
pathological fractures (fracture in bone due to cancer)
-
what age group does multiple myeloma usually effect?
adults
-
what are the internal SS of multiple myeloma?(6)
- 1.hypercalcemia
- 2.pain
- 3.infection
- 4.anemia
- 5.bleeding
- 6.proteinuria
-
what is proteinuria?
protein in urine
-
what are not uncommon in multiple myleoma due to the high calcium levels?
kidney stones
-
what is the treatment for multiple myeloma?
chemotx(difficult to cure)
-
what are 2 facts about multiple myeloma?
- 1.metastases common
- 2. cause unknown (idiopathic disease)
-
What are the 4 steps to hemostasis?
- 1. vasoconstriction(limits flow of blood to injury site)
- 2. Platelets activated by thrombin and aggregrate at injury site (forming temporary, loose platelet plug-the protein Fibrinogen triggers platelet clumping)
- 3. Fibrin Mesh(the clot) forms & entraps the plug
- 4. clot must dissolve for normal blood flow to resume
-
The dissolution of the clot occurs through the action of what?(1A)- takes time but enhances with what kind of drugs?(1B)
- 1A. action of plamin (fibrinolysis)
- 1B."Clot buster" drugs
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What are the 4 current relevant drug therapies for Lymphatic disorders?
- 1. anti platelet aggregation (plavix, ASA, NSAID's)
- 2. thrombolytics (streptokinase)
- 3. heparin (slows clot growth-no dissolve)
- 4. warfarin (slows clot formation)
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YAYY now we're done :):)
:):):)
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