Patho Quiz 2

Front 1

What happens to aldosterone, H+, Cl-, Na+ and H2O when you vomit?

Back 1

Increased aldosterone to try to replace Na+, Lose H+, Lose Cl-, Decreased Na+, Decreased H20

Front 2

What type of solution is given in an IV for a patient who has been vomiting uncontrollably?

Back 2

Isotonic or hypertonic solution

Front 3

Define neoplasia

Back 3

New growth

Front 4

Define tumor

Back 4

Swelling

Front 5

What are 2 exceptions to the rule that the terms neoplasia and tumor can be used interchangeably?

Back 5

Hematoma - not new growth, just blood clot (tumor) & leukemia - not a tumor -neoplasia (too many WBC's)

Front 6

Name 6 characteristics of benign tumors

Back 6

Well differentiated, low mitotic index, covered by a capsule, not invasive or metastatic, grows slowly, can still be harmful

Front 7

Why can a benign tumor still be harmful if it is slow growing and non-invasive?

Back 7

It can be pressing on vital organs/vessels causing life-threatening problems

Front 8

What is the mitotic index based on?

Back 8

Looking at cells under a microscope, how many cells are currently undergoing mitotic division. If too many it is probably malignant.

Front 9

Name 6 characteristics of malignant tumors

Back 9

Poorly differentiated, high mitotic index, no capsule (harder to remove surgically), metastasize or invade tissue, often ulcerated, grows very fast

Front 10

What are the 3 types of skin cancer?

Back 10

Melanoma, basal cell carcinoma and squamous cell carcinoma

Front 11

What is the word ending that means benign?

Back 11

OMA

Front 12

Name 2 types of benign cancers

Back 12

Fibroma, lipoma

Front 13

What are 2 word endings that mean malignant?

Back 13

Carcinoma and sarcoma

Front 14

Name 3 types of malignant cancers

Back 14

Basal cell carcinoma, squamous cell carcinoma, liverc ell carcinoma

Front 15

What type of cell do ALL cells begin as?

Back 15

Stem cell

Front 16

What is a pluripotent stem cell?

Back 16

Less differentiated it can become any type of cell

Front 17

What is a multipotent stem cell?

Back 17

More differentiated, for example a hematogenous stem cell can become any blood cell, but not a liver cell

Front 18

What are 3 things that control growth in a normal cell?

Back 18

Genetics, nearby cells, chemicals from the body

Front 19

Define transformation

Back 19

Process by which a normal cell becomes a cancer cell

Front 20

What is happening in a cancer cell that lacks contact inhibition?

Back 20

The cell is ignoring the signal from neighboring cells that tells it NOT to reproduce

Front 21

What does it mean that a cancer cell is anchorage independent?

Back 21

The anchor protein that holds the cell in place in the area is not present so the cell can float free and metastasize to another part of the body

Front 22

What does it mean if a cancer cell is immortal?

Back 22

It does not undergo apoptosis

Front 23

Define anaplasia

Back 23

A cell that doesn't look OR act like it should

Front 24

Define pleomorphic

Back 24

A cell that doesn't look like it should - wrong size or shape

Front 25

Define clonal expansion

Back 25

When 1 bad cell is not recognized and killed so it makes copies of itself. Happens due to multiple mutations

Front 26

What are 7 characteristics of a cancer cell?

Back 26

Transformation, lack of contact inhibition, anchorage independent, immortal, anaplasia, pleomorphic and clonal expansion

Front 27

What are the three types of mutation?

Back 27

Replicate without a growth signal, inactivates the growth signal or prevents apoptosis

Front 28

What are 3 ways that a cancer cell can replicate without normal growth signals?

Back 28

Makes it's own growth signal to reproduce (autocrine stimulation), increased receptors for growth signals, or a mutated ras gene (can then grow w/o any signal at all

Front 29

Define autocrine stimulation

Back 29

When a cell makes its own growth signal

Front 30

What happens to a cell with a mutated ras gene

Back 30

It can grow without a signal

Front 31

How does a cell inactivate the anti-growth signal?

Back 31

Tumor suppressor genes are turned off by the cancer cell

Front 32

How does a cancer cell prevent apoptosis?

Back 32

A mutation in the p53 gene

Front 33

What does the p53 gene do?

Back 33

It causes apoptosis

Front 34

Ischemia can result in this type of acid/base disorder.

Back 34

Metabolic acidosis (lactic acid buildup)

Front 35

If the lungs compensate for metabolic alkalosis, they do so by (hyperventilation, hypoventilation) choose one

Back 35

Hypoventilation

Front 36

This term describes the conversion of a normal body cell into a cancerous cell

Back 36

Transformation

Front 37

These genes are responsible for correcting genetic damage

Back 37

Caretaker genes

Front 38

Immortality is possible because of the presence of this particular enzyme

Back 38

Telomerase

Front 39

A mutation in the p53 gene results in rapid growth because the cell can no longer undergo this process

Back 39

Apoptosis

Front 40

The lack of this anchoring molecule is what allows cancer cells to detach from the underlying tissue and undergo metastasis.

Back 40

Integrin/ fibronectin

Front 41

This substance is the carcinogen in tobacco products

Back 41

Nitroso

Front 42

DRAW or DESCRIBE THE METHOD BY WHICH THE KIDNEY REGULATES ACIDOSIS. BE SURE TO INCLUDE THE CARBONIC EQUATION IN YOUR ANSWER

Back 42

Co2 + H20 = H2Co3 = HCo3- + H+

Front 43

Will vomiting result in metabolic/respiratory acidosis/alkalosis?

Back 43

Metabolic alkalosis

Front 44

Vomiting results in metabolic alkalosis. Explain why the loss of chlorines in the vomit worsens this acid/base disorder.

Back 44

Cl- is negatively charged. When Cl- is lost in vomit, HCO3- is retained in blood to maintain electronegativity. Increased levels of HCO3- in blood worsens the metabolic alkalosis

Front 45

List 2 ways that neoplasia can grow in the absence of growth signals

Back 45

Autocrine stimulation (makes its own growth signal), increased growth receptors in the cells, mutated ras gene (cells grow without any signals)

Front 46

If a patient has the following blood gas values: pH7.44, Normal O2, Elevated HCO3-, Decreased CO2 what is acid/base disorder?

Back 46

Metabolic alkalosis - compensation??? Maybe typo! Decreased CO2 =alkalosis but pH normal - full compensation CO2 should be elevated!

Front 47

Define cachexia

Back 47

Extreme weight loss

Front 48

Why do cancer patients exhibit signs of cachexia?

Back 48

Cancer cells stimulate the release of TNF-alpha (Tumor Necrosis Factor Alpha) which has a side effect of extreme weight loss. Altered metabolism due to Ca, anorexia - not eating because they don’t feel well, tumors use protein and carbs.

Front 49

Why do cancer patients often have edema?

Back 49

Hypoalbuminemia - (low blood protein) Albumin maintains BP. Edema is due to the decreased blood onchotic pressure because of the lack of blood proteins. Blood not pulling enough H2O out of tissues

Front 50

In addition to bicarbonate and phosphates, what other substances can bind with H ions in the filtrate?

Back 50

Ammonia

Front 51

When compensating for metabolic acidosis, would you expect to see someone hypoventilating or hyperventilating?

Back 51

Hyperventilating

Front 52

Give an example of a tumor that is NOT a neoplasia

Back 52

Hematoma

Front 53

This term describes a single cancerous cell giving rise to multiple similar cancerous cells.

Back 53

Clonal expansion

Front 54

A mutation in this gene allows cancer cells to undergo mitosis in the absence of growth signals.

Back 54

RAS

Front 55

This type of gene prevents mitosis when a damaged piece of DNA is discovered.

Back 55

Caretaker

Front 56

Nitroso results in a variety of cancers because it generates these substances that can do genetic damage.

Back 56

Free radicals

Front 57

Obesity can lead to an increased risk of breast cancers because it produces this hormone.

Back 57

Estrogen

Front 58

The presence of this particular protein allows cancer cells to attach to basement membranes.

Back 58

Laminin

Front 59

What type of acid/base disorder does vomiting cause? Why?

Back 59

Metabolic alkalosis, H+ & Cl- ions lost in vomit, body compensates for loss of Cl- ions by reabsorbing HCO3- making the alkalosis worsen.

Front 60

Why does the loss of water worsen metabolic alkalosis when a person is vomitting?

Back 60

Decreased H20 in the blood causes release of aldosterone which causes more K to be lost in urine

Front 61

Would someone who is vomitting hyperventilate or hypoventilate in order to compensate for the acid/base disorder caused?

Back 61

Hypoventilate

Front 62

Is it a good idea to give a patient with severe emphysema high flow oxygen? Why or Why not?

Back 62

Not a good idea! Lungs and blood can not uptake the O2 fast enough due to the emphysema. This would cause O2 to begin to build up and be detected by the O2 sensors which could trigger the stimulus to STOP breathing altogether

Front 63

List 4 characteristics of benign neoplasia

Back 63

Well differentiated, non-invasive, non-metastasizing, surrounded by capsule

Front 64

List 4 characteristics of Malignant neoplasia

Back 64

Not well differentiated, invasive, metastasizing, not surrounded by capsule

Front 65

T or F Cigarette smoking can lead to cancer through a single mutation

Back 65

False - always through multiple mutations

Front 66

T or F Pluripotent cells can differentiate into any cell type

Back 66

True

Front 67

T or F the lack of laminin is what prevent neoplastic cells from being anchor dependent

Back 67

False - Integrin/ Fibronectin

Front 68

T or F cancer patients often develop edema because of an increase in BHP

Back 68

False - due to decrease in BOP

Front 69

T or F TNF-alpha induces apoptosis of neoplastic cells

Back 69

True

Front 70

Define Angiogenesis

Back 70

Creation of new blood vessels

Front 71

What is the substance secreted by tumors to create new blood vessels in order to get more nutrients for itself.

Back 71

Tumor Angiogenic Factors

Front 72

What is the name for the arms of a chromosome?

Back 72

Telomeres

Front 73

What is the enzyme that produces the telomere?

Back 73

Telomerase

Front 74

When the telomere is gone what happens to the chromosome?

Back 74

It undergoes apoptosis

Front 75

Cancer cells have an overabundance of this enzyme which gives it the ability to be immortal

Back 75

Telomerase

Front 76

What is the abnormal form of a gene that causes cell replication?

Back 76

Oncogenes

Front 77

What is the term that means a normal gene has become a cancer gene?

Back 77

Transformation

Front 78

What is the gene turned off in cancer cells that in a normal cell would keep a tumor from growing?

Back 78

Tumor suppressor genes

Front 79

What are 4 types of mutation that can cause cancer?

Back 79

Point mutations, chromosome translocation, gene amplification and loss of heterozygosity

Front 80

What is the gene that fixes mutations in DNA?

Back 80

Caretaker gene

Front 81

What is the type of gene mutation that happens in 1 base only?

Back 81

Point mutation

Front 82

What is the type of gene mutation that involves a whole chunk of chromosome being moved to a new place on the chromosome?

Back 82

Chromosome translocation

Front 83

What is the type of gene mutation that involves making extra copies of the same gene?

Back 83

Gene amplification

Front 84

What is the type of gene mutation that involves the loss of the ability to have 2 copies of the same gene?

Back 84

Loss of heterozygosity

Front 85

How does inflammation increase the incidence of cancer? 2 reasons

Back 85

Increases the rate of cell replication, WBC's fight infection by releasing free radicals (ROS)

Front 86

What are 3 viruses that can cause cancer?

Back 86

Human Papilloma virus, Hepatitis B and C

Front 87

What is the substance in tobacco smoke that is the cause of cancer?

Back 87

Nitroso

Front 88

Define carcinogen

Back 88

Cancer causing agent

Front 89

How can UV light cause cancer?

Back 89

Causes ROS buildup which targets the p53 gene

Front 90

What is the condition that produces increased estrogen causing female reproductive cancers and breast cancer in women and men?

Back 90

OBESITY

Front 91

Name 2 drugs linked to cancer in women

Back 91

HRT - hormone replacement therapy - too much estrogen, DES

Front 92

What was the drug DES used for in the 40's-70's? Why don't we use it any longer?

Back 92

To prevent complications of pregnancy. There were no problems for the mother but caused cancer in the daughter later in life.

Front 93

What happens in Phase I metastasis?

Back 93

Cancer cells lack integrin/fibronectin - the float free

Front 94

What happens in Phase II metastasis? (3 steps)

Back 94

1. attach to basement membrane with laminin 2. degrade the basement membrane by secretion of proteolytic enzymes 3. Move into degraded region by using pseudopodia

Front 95

What happens in Phase III metastasis?

Back 95

Enters lymph or blood vessels (lymph most common)

Front 96

What happens in Phase IV metastasis?

Back 96

Attachment at new site

Front 97

What the term that means a cell is attracted to certain types of organs?

Back 97

Organ trophism

Front 98

What are 4 main clinical manifestations of cancer?

Back 98

Pain - late in disease, fatigue, cachexia, anemia