Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
94 Cards in this Set
- Front
- Back
|
what can neoplasms do the host
|
palpable or detectable mass; critical location which can impinge on adjacent structures; bleeding and infections when tumor ulcerates; infarction; rupture; functional activity such as hormone synthesis (endocrine activity) or paraneoplastic syndromes; cathexia or wasting
|
|
|
what is another name for wart
|
verrucae
|
|
|
what is a neurofibroma
|
A neurofibroma is a benign nerve sheath tumor in the peripheral nervous system
|
|
|
what is intussusception
|
An intussusception is a medical condition in which a part of the intestine has invaginated into another section of intestine, similar to the way in which the parts of a collapsible telescope slide into one another.[1] peristaltic movement + tumor = telescoping. This can often result in an obstruction. The part that prolapses into the other is called the intussusceptum, and the part that receives it is called the intussuscipiens.
|
|
|
what is burkitt lymphoma
|
Burkitt lymphoma is a very fast growing form of non-Hodgkin's
lymphoma. it can cause intussusception; adolescents or young adults with extranodal masses; uncommonly presents as leukemia; aggressive |
|
|
what clinical features does stomach cancer have
|
iron deficiency, bloody stools
|
|
|
what can happen with a person with an ovarian teratoma
|
it can exist for a long time and then it torques and then you have acute presentation (infarction) of something that's been there for a long time
|
|
|
what can happen with a hepatocellular carcinoma
|
hepatocellular carcinoma had been there a long time and then it ruptures (acute presentation intraperiotoeal hemorrhage)
|
|
|
what is cushing syndrome caused by
|
an endocrinopathy. any condition that produces elevated glucocorticoid levels (hypercortisolism). E.g. adrenal cortex tumor or paraneoplastic syndrome
|
|
|
what are the symptoms of cushing syndrome
|
emotional disturbance (depression, anxiety, or changes in behavior), enlarged sella turcica (A depression in the upper surface of the sphenoid bone in which the pituitary gland rests in vertebrates), moon facies (round red full face), osteoporosis, cardiac hypertrophy (HTN), buffalo hump, obesity, adrenal tumor hyperplasia, thin, wrinkled skin, abdominal striae (stretch marks), amenorrhea, muscle weakness, purpura, skin ulcers (poor wound healing)
|
|
|
what are paraneoplastic syndromes
|
A paraneoplastic syndrome is a disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells. These phenomena are mediated by humoral factors (by hormones or cytokines) excreted by tumor cells or by an immune response against the tumor. syndrome with signs and symptoms not explainable based on local disease, distant spread, hormones indignous to tissue of origin
|
|
|
what types of cancers are paraneoplastic syndromes seen in
|
benign & malignant neoplasms (10% of cancer patients have PNS)
|
|
|
how can a small cell carcinoma of the lung cause cushing syndrome
|
it can release a corticotropic substance than causes adrenal cortex hyperplasia that results in elevated cortical hormones being released. These hormones lead to ATYPICAL CUSHING'S SYNDROME WITH FACIAL EDEMA, CACHEXIA, HYPOKALEMIC ALKALOSIS (Hypokalemic alkalosis is caused by the kidneys' response to an extreme lack or loss of potassium, which can occur when people take certain diuretic medications.); this mechanism is probably how the other cancer causes of cushing syndrome cause their symptoms
|
|
|
what are the some direct cancer causes of paraneoplastic cushing syndrome
|
small cell lung cancer, thymoma, pancreatic carcinoma
|
|
|
what is hypercalcemia in cancer patients due to
|
can be due to PNS but usually its due to bone metastasis (skeletal metastases that cause hypercalcemia are not a PNS)
|
|
|
how does PNS lead to elevated CA++
|
endocrinopathy that causes ectopic secretion of PTH and PTH-rp (parathyroid hormone related protein)
|
|
|
what are some possible PNS endocrinopathy symptoms
|
cushing syndrome, elevated Ca, decreased Na, decreased glucose, carcinoid syndrome, polycythemia
|
|
|
what are the possible effects of hypercalcemia
|
acute renal failure, cardiac arrhythmia, stupor, coma
|
|
|
what are some of the cancers that cause the ectopic secretion of PTH and PTH-rp
|
SCCA lung, lymphoma, kidney CA, uterine cervical CA, breast CA. in contrast to PTH, PTHrp is produced in small amounts by many normal tissues, including keratinocytes, muscles, bone, and ovary.
|
|
|
what is hyponatriemia and what is it caused by
|
hyponatremia is a metabolic condition in which there is not enough sodium (salt) in the body fluids outside the cells. decreased Na+ due to ectopic secretion of ADH and atrial natriuretic hormones (it is released when the body is dehydrated and causes the kidneys to conserve water, thus concentrating the urine, and reducing urine volume.)
|
|
|
how does SCCA lead to hyponatriemia
|
it releases ADH which acts on the kidney
|
|
|
what does hyponatriemia lead to in the patient
|
irritability, confusion, weakness, seizures if extreme
|
|
|
what are some common cancer causes of hyponatriemia
|
small cell lung cancer, intracranial neoplasm
|
|
|
what are some common cancer causes of hypoglycemia
|
sarcoma, hepatocellular carcinoma
|
|
|
what is the mechanism of hypoglycemia
|
low glucose in the blood caused by ectopic secretion of insulin and insulin-like factors
|
|
|
what are the symptoms of carcinoid syndrome
|
paroxysmal flushing, wheezing, right-sided heart failure, diarrhea, abdominal pain
|
|
|
what is a common cancer cause of carcinoid syndrome
|
carcinoid (pretty benign malignant tumor) tumor with liver metastases
|
|
|
what is the mechanism of carcinoid syndrome
|
ectopic secretion of serotonin, bradykinin, and (histamine?)
|
|
|
what is polycythemia
|
blood that's too thick
|
|
|
what are the cancer causes of polycythemia
|
renal cell carcinoma, cerebellar hemangioma, hepatocellular carcinoma
|
|
|
what is the mechanism of polycythemia
|
ectopic secretion of erythropoietin
|
|
|
what are the PNS: Neuromyopathic types
|
myasthenia, CNS white matter degeneration, peripheral neuropathy
|
|
|
what are the symptoms of myasthenia (Eaton-Lambert) syndrome
|
weakness of proximal muscle groups (often manifested by difficult in rising from chair)
|
|
|
what are some cancer causes of myasthenia syndrome
|
small cell lung cancer, other lung cancer, thymoma
|
|
|
what is the mechanism of myasthenia syndrome
|
antibody (directed to tumor antigen) reacts with other (non-tumor) cells. some neural antigens are ectopically expressed by some visceral cancers. if the immune system recognizes these Ag as foreign it mounts an immune response. this type of mechanism may explain the other neuromyopathic paraneoplasic syndrome effects as well.
|
|
|
what is a common cancer cause of CNS white matter degeneration
|
lymphoma
|
|
|
what is a common cancer cause of peripheral neuropathy
|
lung cancer, breast cancer
|
|
|
what are broad general categories of PNS
|
endocrinopathy, neuromyopathic, dermatologic, hypertrophic osteoarthritis, hematologic & vascular, renal
|
|
|
what and where is acanthosis nigricans
|
verrucous hyperkeratosis (thickening of the stratum corneum) on the skin that may be associated with some form of cancer. classically in groin and axilla
|
|
|
what are some common cancer causes of acanthosis nigricans
|
lung cancer, stomach cancer, uterus cancer, breast cancer
|
|
|
what is dermatomyositis
|
inflammation of skeletal muscle and skin, not always PNS but can be. E.g. gottron papule (Discrete erythematous papules overlying the metacarpal and interphalangeal joints), heliotrope rash (symmetric, confluent, purple-red, macular eruption of the eyelids and periorbital tissue)
|
|
|
what are some common cancer causes of dermatomyositis
|
lung cancer, breast cancer, gut cancer
|
|
|
what are the two types of dermatologic PNS
|
acanthosis nigricans, dermatomyositis
|
|
|
what is a common cancer cause of hypertrophic osteoarthropathy
|
lung cancer and a lot of chronic lung disease
|
|
|
what are the clinical manifestations of hypertrophic osteoarthropathy
|
periosteal new bone formation (distal long bones) especially at the distal ends of long bones, metatarsal, metacarpals, and proximal phalanges, arthritis of adjacent joint, clubbing of the digits
|
|
|
what are the types of hematologic and vascular PNS
|
migratory thrombophlebitis, DIC, nonbacterial thrombotic endocarditis, changes in cell counts
|
|
|
what is migratory thrombophlebitis
|
thrombosis in places you typically don't have them, e.g DVT in places other than the leg
|
|
|
what are some cancer causes of migratory thrombophlebitis
|
deep seated cancers, most often carcinomas of the pancreas or lung
|
|
|
description of DIC
|
DIC: because many of the small vessels are filled with thrombi. aka consumptive coagulopathy (you bleed cause you've used up all your thrombi)
|
|
|
what cancers cause DIC
|
APL (acute prolymphocytic leukemia), mucinous cancer (lung, pancreas), prostate cancer
|
|
|
what are some cancers that cause nonbacterial thrombotic endocarditis
|
(aka marantic endocarditis). Advanced (esp. mucinous) cancer aka advanced mucin-secreting adenocarcinomas
|
|
|
what is nonbacterial thrombotic endocarditis
|
bland,small, nonbacterial fibrinous vegetations sometimes form on the cardiac valve leaflets (more often on left-sided valves). these vegetations are potential sources of emboli that can further complicate the course of cancer
|
|
|
what are the general categories of PNS: Hematologic and vascular
|
anemia, polycythemia, thrombocytosis (too many platelets), granulocytosis (granulocytosis is the presence in peripheral blood of an increased number of granulocytes, a category of white blood cells. Often, the word refers to an increased neutrophil granulocyte count, as neutrophils are the main granulocytes), eosinophilia, not cytopenia (decrease in number of blood cells. usually reflects bone marrow replacement rather than PNS)
|
|
|
what are some cancer causes of thrombocytosis
|
carcinoma, lymphoma, thymoma
|
|
|
what are some cancer causes of granulocytosis
|
thymoma
|
|
|
what are some causes of eosinophilia
|
hodgkin disease, T-cell lymphoma
|
|
|
what are some causes of anemia
|
aplastic (thymoma); hemolytic (CLL, lymphoma)
|
|
|
what are some renal PNS illnesses
|
nephrotic syndrome, glomerulonephritis
|
|
|
what is the mechanism of membranous glomerulonephritis
|
neoplasms make Ag, Ag-Ab complexes get to the kidneys and slam in.
|
|
|
what are the four types of laboratory diagnoses of cancer
|
clinical data, morphology, molecular techniques, flow cytometry
|
|
|
how can you procure tissue
|
incisional biopsy, excisional biopsy, fine needle aspiration biopsy (finer needle than incisional biopsy, suck out cells not chunk of tissues), exfoliative cytology
|
|
|
what are some examples of exfoliative cytology
|
spinal tap, pap smear or lung pleural sac
|
|
|
is a rush job for large specimen slides possible?
|
not possible
|
|
|
what is one way to do a real fast slide prep for surgery
|
freeze it
|
|
|
how do you figure out which section to take from a sample
|
look at gross specimum
|
|
|
after you section a tissue what do you do with it
|
put cassettes into tissue fixation bucket. Bucket has formulin in it, etc
|
|
|
what do you do after tissue fixation bucket
|
put it into tissue processing machine. Formulin, then alcohol (dehydration), xylen (replace where water was), then paraffin, then cool it, now the tissue is inside the wax box
|
|
|
what do you do with the paraffin wax tissue
|
you put into a microtome to make ribbons which you then float to get the wrinkles out, then you mount the ribbon onto a slide
|
|
|
what are the two types of immunohistochemistry methods
|
direct IF (antibody has tag on it) and indirect IF (antibody is attached to Ag then another Ab is attached to the first Ab which has a tag on it). PAP method (super indirect method, amplification procedure)
|
|
|
what is immunohistochemistry used for. Limitation
|
helps identify cell/tissue type. But doesn't indicate whether benign or malignant
|
|
|
how do you know you're looking at an immunohistochemical stain
|
blue (counterstain) and brown staining
|
|
|
what immunohistochemical stain for melanoma
|
HMB-45
|
|
|
what immunohistochemical stain for lymphoma
|
LCA
|
|
|
what immunohistochemical stain for astrocytoma
|
GFAP
|
|
|
what immunohistochemical stain for sarcoma
|
desmin is positive for muscle sarcomas but negative for non-muscle sarcoma
|
|
|
what immunohistochemical stain for carcinoma
|
keratin
|
|
|
what does vimentin test positive for
|
sarcoma, lymphoma, melanoma, astrocytoma, everything except carcinoma
|
|
|
what is TEM used for
|
characterize cell type by ID of cytoplasmic organelles, matrix constituents, and other structures below LM resolution
|
|
|
what are TEM limitations
|
not used much anymore cause of immunohistochemistry, sampling problem (because 1 mm sample needs to include the tumor), cannot distinguish benign from malignant
|
|
|
how does FISH work to detect translocations
|
some tumors have classic translocation patterns (e.g. Burkitt's Lymphoma). Tag chromosomes with red and green tag. The red and green should be right next to each other. Yellow is also normal. But if they are too far apart that means translocation
|
|
|
what is spectral karyoptyping
|
paint chromosomes different colors
|
|
|
how does PCR help with cancer
|
you look for certain genes by amplifying them
|
|
|
how does DNA microarray work
|
aka cancer fingerprinting. mRNA is turned into green or red cDNA. then you put it on an array with individual genes on one axis and different samples on the other axis. then you see which is red and which is green. ie which DNA is sticking to which cDNA. then you get a fingerprint of the tumor (ie only some of the genes that hybridized were tumor genes).
|
|
|
what types of cells work for flow cytometry
|
you need cells to be in a cell suspension so carcinomas won't work. for example leukocytes don't stick together so they work.
|
|
|
what are the two types of flow cytometry
|
diagnostic flow cytometry and dna flow cytometry
|
|
|
how does diagnostic flow cytometry work
|
requires fresh (ie not-fixed) material. Immunofluorescence labeling of single cell suspension then you count with a computer. You can evaluate lymphoma and leukemias this way
|
|
|
how does DNA flow cytometry work
|
you use it to quantify DNA content of cells. It can be done on fresh, frozen, or fixed tissue. by looking at how many cells have how much DNA you can determine if there are a lot of cells with aneuploidy (shifts peak), s-phase, hyperplasia, G1/G2, etc
|
|
|
what are tumor markers
|
substance in blood or body fluid indicating presence of cancer. Such as cell surface Ag, cytoplasmic proteins, enzymes, hormones
|
|
|
do tumor marker presence always indicate cancer
|
no other things than cancer can cause these markers to manifest. Therefore tumor markers are especially useful to check cancer progression if you know that a patient also has a particular type of cancer (check response to therapy, check to see if cancer reoccured)
|
|
|
what populations does tumor marker screening work for
|
not general population but it does work for high-risk populations
|
|
|
what is a cancer grade
|
it assesses degree of differentiation of a cancer. Different neoplasms have different rules. Less useful than stage. Use LM to determine grade
|
|
|
what is cancer stage
|
determines the extent of disease. Examines T (size of primary lesion), N (extent of regional lymph node metastases), M (presence or absence of distant metastases). Stage I-IV. Look at patient itself
|
|
|
are all cancer stagings the same
|
every tumor has its own staging
|
|
|
what does getting N1 mean for most tumors
|
anytime you get N1 = stage IV
|
