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36 Cards in this Set
- Front
- Back
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Oncology terminology
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Malignant= abnormal growth that tends to spread Cancer = malignant tumor that tends to invade healthy tissue and spread to new sites Oncology - study of tumors, medical specialty focused on cancer treatment Neoplasia = new growth, uncontrolled cell proliferation Neoplasia includes: Benign and malignant tumors |
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Cancer stats
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Lung, breast/prostate, colon, pancreatic |
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DNA insults (sources)
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Electromagnetic damage (UV, x-rays, gamma rays) Cosmic rays Chemicals (free radicals, others) |
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DNA repair*
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2-3 errors per genome copy Sensitive to ageing* (cumulative errors, diminished repair efficiency) |
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Genetic influence on cancer
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Cancer is a genetic disease! 1. Oncogenes: activation of growth promoting genes: growth when not supposed to 2. Tumor repressor genes (BRCA 1 and 2) |
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Proto oncogenes, oncogene
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a) stimulate proliferation b) increase blood supply c) block apoptosis Oncogene: proto-oncogene with a gain of function* mutation |
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Tumor suppressor genes
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Caretaker genes: repair DNA damage, maintain genome integrity |
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BRCA genes
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P53 - guardian angel gene, tumor suppressor. Cancer cannot occur until P53 knocked out. |
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Multi step theory of oncogenesis
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2. Several mutations must occur in one cell before malignant transformation occurs (oncogene activated, tumor suppressor gene inactivated). 3, Normal immune surveillance fails 4. Requires long time to occur (years-decades) |
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Viruses and cancer
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Hep B/C - Liver cancer HPV - Cervical, Rectal, Oral Human herpes virus 4 (Epstein Barr) - Lymphoma Human herpes virus 8 - Kaposi's sarcoma |
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Cells vulnerable to neoplasia
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2. Rapidly dividing tissues Most vulnerable: epithelium (skin, respiratory, GI), endothelium. Less vulnerable: mesoderm derived tissue (bone, connective tissue, fat) |
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Cancer nomenclature
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Endothelian (endoderm) = adenocarcinoma Mesodermal = sarcoma Hematopoetic: leukemia, lymphoma Germ cell: various, <40 age Undetermined: anaplastic |
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Characteristics of neoplastic cells
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2. Large nuclear/cytoplasm ratio 3. Frequent mitosis 4. Loss of orderly maturation, differentiation 5. Loss of cell-cell cohesion 6. Loss of vulnerability to apoptosis - "immortality" - ex: HeLa cells from woman with cervical cancer |
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Special features of malignant cells
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1. Much less able to repair intracellular damage than normal cells 2. Various genetic abnormalities 3. Most display unique antigens |
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Multi-modality therapy
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Radiation therapy Chemotherapy Immunotherapy |
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Factors in cancer treatment success
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1. Age and health of pt 2. Type of cancer 3. Quality of healthcare 4. Extent of cancer at time of diagnosis - staging. |
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Staging (two ways)
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1. Tumor - mainly size of primary tumor 2. Nodes - lymph node chain involvement 3. Metastases - spread to distant organs Conventional stage system: Stage I = small primary tumor, no-minimal spread to nodes Stage 2 = bigger primary tumor, significant spread to nodes Stage 3 = Large tumor, spread to distant nodes Stage 4 = Distant organ metastases (5-10%) *Most common sites = Brain, bone, lungs, liver. *Major shift in cancer treatment: brute force to finesse, targeted therapy |
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*Major shift in cancer treatment
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Brute force Cytotoxic therapy - damages all cells, counting on idea that normal cells have better repair capabilities and damages more to cells undergoing division. TO finesse, targeted therapy: monoclonal antibodies, blocking immune evasion, in vitro treatment of lympcytes to react against cancer antigens. |
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Immune evasion
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EX: PD-1 ligand, when presented to T-cell by APC, leads to apoptosis of T cell. New drugs target immune evasion. |
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Infections disease descriptions
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Epidemic = clusters of cases in area or region, rapid spread Pandemic = extensive epidemic, continental or world-wired in scope |
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Common cause of epidemics/pandemics
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Small pox (NA) Measles (NA) Typhus Influenza HIV Tuberculosis creates many endemics (pockets) throughout world. |
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Civilization hypothesis*
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We are descendents of survivors *Strong selection pressure for defense against infection disease has resulted in: Less protection against neoplasia Increased risk of autoimmune diseases |
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Microbes
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1. Human microbiome project 2. Microbiome diversity - much more diverse than our genome. Big differences between body parts, people, geographical area. 3. Many disorders will be found to be caused by alterations to the microbiome. Future therapy restoring microbiome. (CDIFF) |
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Infectious agents
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1. Transmissible cause of disease* 2. Includes both living and non-living entities - microbes, prions (structure change), viruses |
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What is a microbe
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Classic classification: bacteria, fungi, unicellular eukaryotes (protists) 1. Eukaryotes - nucleus. Protists, fungi. 3. Non living pathogens - viruses, prions |
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Prokaryotes
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2. Small bacteria without cell wall: mycoplasma 3. Obligate intracellular bacteria: Chlamydia, Rickettsia |
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Eubacteria classification
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1. Gram stain - positive or negative - Blue = gram positive. Pink = gram negative. 2. General shape: a) Round = cocci b) cylindrical = bacilli c) spiral = spirochetes 3. Oxygen requirement - aerobes (most pathogenic), anaerobes (clostridia, abscesses, necrotic itssue) |
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Examples of gram + cocci and bacilli
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Staph aureaus (MRSA) Strep. pyogenes (strep throat) Enterococcus faecalis (post GI surgery) Bacilli: Corynebacterium diphteriae Clostridium (anaerobes)- C. botulinum, C. perfinigens, C. tetani, C. Difficile. |
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Gram negative cocci and bacilli
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Cocci: Neisseria gonorrhoeae, meningitides Bacilli: UTI. E. coli, Enterobacter aerogenes, proteius mirabilis salmonella enterica TYPHOID klebsiella species. |
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Pharmacology : FDA approval
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Meaning of FDA approved: Benefit outweigh risks, but every drug approved still has risks! Company must provide data from phased trials to prove utility and safety: Preclinical trials (patent, animal testing) Phase 1 study (how drug is dispersed in body) Phase 2 study (small patient trial) Phase 3 study (larger trial depending on disease) EXAMPLE: drug for tension headaches needs to be VERY non-toxic, since problem itself isn't deadly. Drug for small cell lung cancer can kill 20% pts, but 50% survive - more lenient the more deadly disease is. |
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Drug nomenclature (4)
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Generic name: atorvastatin Trade name: Lipitor Our convention: atorvastatin (Lipitor) |
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Generic drugs, patents
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Then, other companies sell their version - bioequivelant - much cheaper, under new trade name. |
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Routes of administration
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A) oral - tablets, capsules, liquids Pros: cheap, easy, concentrated effect (stomach, esophagus). Cons: Absorption issues - nausea, emesis, acid tolerance, lipid solubility. liver transit - first pass effect - degraded before reaching blood. B) Rectal. Parenteral: Intravenous, intramuscular, subcutaneous, transfermal, inhaled, transmucosal |
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Drug class
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Biochemistry Indications Mechanisms of actions Potential side effects/toxic reactions EXAMPLES ACE inhibitors Loop diuretics Thiazide diuretics Calcium channel blockers Statins Beta blockers Alpha blockers SSRIs Benzodiazepines |
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Antimicrobial drugs
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2. Antiviral 3. Antifungal 4. Anti-protozoa drugs Not a lot of overlap - only treat what they say. |
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Antibiotic mechanisms/classification
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Attack cell wall synthesis Target enzyme to make folic acid Bacterial protein synthesis Inhibit nucleic acids All absent in humans (need to preserve human cells) (Know concept of different classes, don't memorize types) |
