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247 Cards in this Set
- Front
- Back
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Pathophysiology |
The study of abnormalities in physiology The study of abnormal functioning of diseased organs Physiology is the science of how the body functions Pathophysiology is the study of how the body functions during disease |
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Framework for Pathophysiology |
Four aspects of a disease process from the core of pathophysiology: etiology, pathogenesis, clinical manifestations and treatment implications |
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Eiology |
Term for the cause of a disease |
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Congenital |
Means existing at birth Due to prenatal (in utero life) influences |
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Inherited |
Due to genes received from the parents Note that genetic disorder means the condition is caused by mutated genes. These genes could be inherited from the parents or from a new mutation in that individual so not all genetic disorders are inherited from the parents |
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Metabolic |
Due to abnormalities bin chemistry of body cells Often due to malfunctioning enzyme required for a metabolic reaction |
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Detgenerative |
Tissue cells breakdown Can be part of the normal aging process |
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Neoplasia |
New growth due to abnormal cells division These new growths can be benign or malignant cancer |
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Immunologic |
Immune system under reacts (AIDS) or over reacts (autoimmune disease) |
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Nutritional |
Typical nutritiy disease is due to nutritional deficiencies |
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Psychgenic |
Mental origin Emotional stress contributes to many diseases or alters it's course |
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Infectious |
Disease caused by pathogen |
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Pathogen |
Disease causing organisms (under infectious etiology) |
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Physical agents |
Toxic chemicals, mechanical injury, radiation |
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Latrogenic |
Condition caused by medical treatment Physician or Heath care provider caused |
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Idiopathic |
Unknown etiology Cause of disease is not known |
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Pathogenesis |
The term for the process involved with the development of a disease The progress and mechanisms involved in the disease development Sequence of events that occurs to cause a disease |
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Clinical manifestations |
How the disease process becomes apparent (manifest itself) in the person Functional and structural consequences of the disease process Signs and symptoms of the disease |
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Sign |
Objectively identifiable abberation of disease can be detected by observer Objective data that can be gathered by clinical exam or laboratory testing E.g. fever, reddening of the skin, palpable mass |
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Symptoms |
Subjective feelingbof discomfort felt by subject that can be reported to an observer Things that must be described by the patient E.g. nausea, pain etc. |
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Syndrome |
A collection of different signs and symptoms that occur together |
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Treatment implications |
Understand that eitology, pathogenesis and clinical manifestations allows decisions to be made regarding treatment options Goal is to understand general not specific treatment options |
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Miscellaneous terms |
Hmjkb |
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Acute |
Brief, short course Sometimes refers to condition with relatively severe manifestations but running short courses |
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Chronic |
Condition that lasts for a long period of time |
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Systemic |
Wide spread |
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Local |
Confined to one region |
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Exacerbation |
Increase in signs and symptoms of a disease |
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Remission |
Decline in signs and symptoms if disease |
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Convalescence |
Recovery stage after a disease |
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Sequela |
Condition caused by and following a disease |
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Epidemiology |
The study of disease and patterns of disease within a population The focus is on the population rather than the individual |
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Chapter 2 |
Homeostasis |
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Homeostasis |
The maintenance of your bodys internal environment within acceptable ranges Homeostasis is dynamic not absolute |
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Homeostasis control mechanisms |
Homeostasis is maintained by the use of feedback systems |
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Components of a feedback system |
Receptors Control center Effectors |
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Receptors (sensors) |
A receptor that monitors the condition being controlled They send a signal or input about the condition to a control center |
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Control center (3 + location) |
Area that integrates the information from the receptors and determines if the controlled condition is within acceptable ranges Determines the normal set point Sends out put to effectors if condition needs to be changed Often located in the brain or spinal cord |
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Effectors |
Muscles or glands that can cause a change in the controlled condition |
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Negative feedback systems |
System in which the effectors cause the change in the controlled condition to reverse and return to the normal This is the way homeostasis is usually maintained within the body |
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Chapter 3 |
Cell structure and function |
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Cytoskeleton |
A protein network that maintains the cell's shape, allows cell to move and directs movement if substances within the cell Composed of proteins; such as actin filaments, microtubules, intermediate filaments |
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Nucleus (2+ functions of protiens made) |
Contains DNA Controls the cell by regulating protein synthesis The protiens made can function as enzymes, be a structural component of the cell, part of the membrane receptors, and other functions |
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Section of DNA that codes for a protein |
Gene |
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Ribosomes |
Where protein synthesis occurs They are part RNA and part Protien Found free in cytoplasm or as part of rough endoplasmic reticulum |
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Endoplasmic Reticulum |
Interconnecting membrane network within cell Rough and Smooth |
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Rough ER |
Contains ribosomes Used for making protiens that will be exported out of the cell or will become part of the cell membrane |
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Smooth ER |
Lacks ribosomes Site of lipid metabolism or storage of calcium ions |
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Golgi apparatus |
Modifies and packages protiens and lipids into vesicles for transport |
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Lysosome |
Visicles formed by the Golgi that are filled with digestive enzymes (also called hydrolytic enzymes) |
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Mitochondria |
Converts chemical energy into ATP Aerobic respiration occurs in mitochondria and are the reactions where energy of glucose and other food molecules are converted into ATP ATP is not stable and cannot be stored. It must be continuously synthesized, therefore if a cell is deprived of oxygen it cannot make sufficient ATP to meet it's energy demands and can die |
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Plasma (cell) membrane structure |
Composed of phospholipid bilayer Embedded protiens preform many membrane functions |
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Function of cell membrane (6) |
Regulates what gets in/out Generates membrane potential Cell to cell recognition Communication between cells Sensor to environment Growth (cell division) regulation |
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Types of membrane transport (5) |
Simple diffusion Facilitated diffusion Active transport Osmosis Vesicles formation |
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Simple diffusion (4) |
Occurs when molecules can freely cross the plasma membrane Non-polar lipid soluble substances like steroids, gases, and alcohols No energy or carrier proteins are required Always moves from high to low concentration "with or down" concentration gradient |
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Facilitated Diffusion |
Used by small polar molecules like amino acids and glucose No energy required moves with concentration gradient Requires carrier protiens |
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Carrier proteins |
Bind to the molecule to be transported and undergoes shape change which transport molecule across the membrane Highly specific due to shape of binding site |
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The number of carrier protiens in the cell membrane |
Limits the rate of diffusion by facilitated diffusion |
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Active transport |
Requires energy ATP or ion gradient provide the energy Against the concentration gradient Requires a carrier protien Allows cell to concentrate certain ions either inside or outside the cell |
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Why is it important for a call to be able to concentrate certain ions inside or outside the cell |
Maintaining normal resting membrane potential Na/k pumps are important active transport pumps used to maintain the normal concentration gradient of sodium and potassium. |
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Osmosis |
The movement of water across plasma membrane No energy is required High to low concentration |
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Channels water molecules can cross the membrane through |
Aquaporins |
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Vesicles formation and two types |
This is how large polar molecules like whole protiens, polysaccharides (carbohydrates) or even whole cells or cell fragments can be transported across the call membrane Endocytosis Exocytosis |
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Endocytosis + 2 type |
Ingestion if molecules into the cell Pinocytosis Phagocytosis |
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Pinocytosis |
Cell drinking Occurs in most cells For taking water soluble substances in like polypeptides (protiens) |
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Phagocytosis |
Cell eating Occurs in some cells like WBC For taking in very large molecules, cell fragments, or microbes |
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Exocytosis +type |
Opposite of endocytosis Moves vesicles out of cell Cell secretion |
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Intercellular communication and growth +three means |
The coordination between cells that allows for growth, cell division, and the functions of various tissues and organ systems is accomplished by one of three means Gap junctions Direct cell to cell contact of plasma membrane Secretion of chemical mediators that influence distance cells |
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Gap junctions |
Direct connection of cytoplasm of adjacent cell Allows direct passage of small molecules and ions between cells Allows a group of cells to act in unison (cardiac muscle contractions) |
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Direct cell to cell contact of plasma membrane (contact signal) |
Glycoproteins of glycolipids on the cell membrane are used to identify cells Identifies cells for the immune system |
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Four types of secretion of chemical mediators that influence distance cells |
Synaptic signalling Paracrine Endocrine Autocrine |
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Synaptic signalling |
Only found in the nervous system Neuron secretes nuerotransmitter that diffuses across synaptic cleft and acts on postsynaptic receptors |
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Paracrine |
Cells secrete chemicals that only affect local cells before the chemical signals are destroyed Ex. Growth factors that promote healing w/o affecting entire organism but only the local cells grow to repair wound |
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Endocrine |
Cells secrete hormone that travels throughout bloodstream influencing only those cells which have the appropriate receptor for that hormone (target cells) |
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Autocrine |
Cells respond to molecules that they secrete Malfunction in this path may be a mechanism involved with some cancers |
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Random pages not in a chapter |
Cellular environment |
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Distribution of body fluids |
Intracellular Extracellular |
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Intracellular |
All of the fluids within the cell |
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Extracellular |
All of the fluids outside the cells |
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Components of extracellular fluid |
Interstitial Intravascular Others including lymph, CSF, Synovial urine etc |
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Interstitial |
Fluid between cells and outside of blood |
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Inrevascular |
Plasma |
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The primary function of osmotic forces |
Movement if fluid between intracellular and interstitial space |
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Osmolality |
A measure of the number of solutes in a solution (osmoles/kg of water) |
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Osmoles |
Number of solutes in solution |
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Normal osmolality of plasma |
285-295 mOsm (osmolality in milliosmole) |
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Normally the intracellular fluid and interstitial fluid have _____ osmolality |
The same |
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There is a difference between the ______ __ ______ ____ in intercellular fluid and interstitial fluid. In other words the total ion concentration is the ____ ____ v ____ of the cell but a _____ _____ of ion may be found more inside the cell than outside |
Concentration of specific ions Same inside v outside Specific type |
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Intracellular fluid cation and anions |
Main cation is K+ Main anions are phosphates, anion protiens |
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Interstitial fluid cation and anion |
Main cation is Na+ Main anion is Cl- |
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Osmosis |
The cell membrane is selectively permeable to electrolytes (ions) but not to water. Water can move freely across the cell membrane Osmosis is diffusion of water across a membrane from high to low until equally distributed |
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Types of solution strengths |
Hypertonic Hypotonic Isotonic |
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Hypertonic |
The solution has more solutes (electrolytes) than inside the cell Water moves outside of the cell by osmosis Cell will shrink |
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Hypotonic |
The solution has fewer solutes than inside of the cell Water moves into the cell by osmosis Cell will swell |
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Isotonic |
The solution has the same solute concentration as inside the cell Water moves in and out at the same rate or NO net movement This is the normal homeostatic condition |
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Osmotic pressure |
The pressure required to prevent the movement of water by osmosis across a cell membrane Due to the number of solutes in solution not their size or weight (osmalality) |
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An increase in solute concentration inside of a cell _____ the osmotic pressure |
Increases |
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A cells with higher osmotic pressure tends to |
Have water move into the cell by osmosis |
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Solutes too large to pass through the cell membrane are important to osmotic pressure because |
They can't reach equilibrium by diffusing across the membrane like some smaller solutes |
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_____ which are very large and can't move across the cell membranes contribute significantly to the osmotic pressure |
Protiens |
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Fluid movement between plasma capillaries and the interstitial fluid regulates +cause +what determines amount and direction |
°the relative amounts of fluid in plasma vs. interstitial fluid °Is due to the filtration of fluids across the capillary walls °And the amount and direction is determined by the Net flitration Pressure (NFP) |
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Most of the fluids that is forced out at the _____ end of the capillaries returns into the blood at the _____ end of the capillaries |
Arteriole Venous |
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Forces that determine the net flitration pressure |
Hydrostatic Pressure Colliod Osmotic pressure |
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Hydrostatic pressure +two types |
The pressure exerted by a fluid on the walls of it's container Blood hydrostatic pressure Interstitial Fluid Hydrostatic pressure |
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Blood hydrostatic pressure (3) |
Tends to push fluids out of capillaries and into the interstitial fluid Is equal to the blood pressure of the capillaries BHP is higher at the arteriole end vs the venous end of capillary |
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Interstitial Fluid Hydrostatic pressure (2) |
Tends to push fluid out if the interstitial space and into the capillaries Normally a minor force because fluid that enters the interstitial space can move into lymphatic vessels, go into cells, or back into blood, and therefore doesn't build up pressure in the interstitial space |
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Colliod Osmotic pressure (oncotic pressure (4) |
°primarily due to nondiffusable protiens Osmotic force °note that plasma protiens are too large to diffuse out if a normal capillary °the more concentrated the protiens the greater the oncotic pressure °note that this pressure "pulls" water towards the protiens due to osmosis |
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Two types of oncotic pressure |
Blood colliod Osmotic pressure (BCOP) Interstitial fluid colliod Osmotic pressure (IFCOP) |
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BCOP |
Tends to pull fluid into capillaries Due to the presence of plasma protiens |
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IFCOP |
tends to pull fluids into the interstitial fluid Normally a minor force because very few protiens are in the interstitial space because they are too large to cross membranes |
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Net flitration Pressure +equation |
Determines the amount and direction of fluid movement at any given point along the capillary NFP=(BHP + IFCOP) - (BCOP +IFHP) |
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A positive NFP means |
Fluid is leaving the plasma and going into the interstitial fluid |
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A negative NFP means |
Fluid will enter the capillary from the Interstitial fluid |
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Edema +cause |
An accumulation of fluid in the Interstitial space Caused by anything that increases NFP so that more fluid is leaving the plasma and entering the Interstitial fluid, therefore increasing the amount of Interstitial fluid |
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Some edema causes (3) |
°An increase in blood pressure °A loss or diminished production of plasma protiens (liver disease, malnutrition, burns, loss from kidney disease) °An increase in capillary permeability and subsequent loss of plasma protiens into the Interstitial fluid |
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Chapter 4 |
Cell injury |
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Cells can respond to environmental changes or injury in three general ways |
Reversible cell injury Adaptation Death |
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Reversible cell injury occurs when. The cell may |
The injury stimulus is mild or short-lived Withstand the injury and completely return to normal |
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Regardless of the injury, reversible injuries usually result in |
Cellular swelling caused from lack of ATP |
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Manifestations of reversible cell injury |
Hydropic swelling Intracellular accumulations |
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Most common manifestation of reversible cell injury and cause |
Hydropic swelling Lack of ATP within the cell |
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Why does lack of ATP cause swelling |
°Lack of ATP cause Na/K pump failure °Na diffuses into cell °water enters cell via osmosis °water accumulation causes swelling |
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Under a microscope swollen cells apear |
Swollen and cloudy |
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Megaly |
The suffix indicating organ enlargement |
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Intracellular accumulations may, or |
Damage the cell Simply be an indicator of cell injury |
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Four types of intracellular accumulations |
°lipid accumulation °Glycogen Storage °Protien accumulation °pigments and inorganic particle accumulation |
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Two types of lipid accumulation |
Fatty liver Tay-Sachs disease |
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Fatty liver (1+ etiology+why) |
°liver is common site for fat accumulation °common etiology is alcohol consumption °alcohol is toxic to enzymes used in normal lipid metabolism in liver |
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Tay-Sachs Disease (3) what+etiology+infantile form |
°Lipid accumulation in nervous tissue °Recessive genetic disorder-found primary in Jews °Lethal infantile form causes lipids to accumulate in brain neurons leading to death by age 4 |
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Most common cause of glycogen storage +explain |
Diabetes melitus Renal tubule cells reabsorb excess glucose and store it as glycogen |
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Glycogen storage disease + cause |
A group of genetic disease Caused by faulty enzymes needed for normal glycogen metabolism |
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Protien accumulation cause |
Cell injury can cause denatured protiens to accumulate leading to cell dysfunction or death |
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Mechanisms cells have to repair/remove unfolded protien accumulation (2 + explain) |
Chaperone protiens- refold protiens Ubiquitin protiens- transport to proteasome to be digested |
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Pigments that can accumulate + derived from + excess amounts indicate |
Hemosiderin and billrubin Pigments dervided from hemoglobin Indicate abnormal breakdown of RBC/ prolonged iron administration/ helatobillary disorders |
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Inorganic particle accumulation (particles + inhaled dust causes + dead and dying tissue often become filled with __) |
°calcium, tar, coal, sillica, iron, lead, silver °chronic inflammation of lungs °calcium |
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Cellular adaptation is (3) |
Cells response to persistent sublethal injury or stress Stress may be due to an increased functional demand or a reversible cellular injury Potentially reversible if injury stimulus is removed |
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Five types of cellular adaptations |
Atrophy Hypertrophy Hyperplasia Metaplasia Dysplasia |
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Atrophy + represents + causes (7) |
°decrease in cell size and therefore function °represents an effort by the cell to minimize it's energy and nutrient consumption °Can be caused by- disuse, denervation, ischemia, nutrient starvation, interruption of endocrine signals, persistent cell injury, aging |
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Disuse atrophy |
Due to reduction in functional demand Immobilization of skeletal muscle (bedrest, cast) |
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Atrophy from ischemia |
Ichemia is an insufficient blood flow to tissue resulting in inadequate oxygen to cells If total block if blood flow cell will die, if chronic cell will atrophy |
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Lack of endocrine stimulation |
Some glands depend on stimulating hormones to maintain size Thyroid, adrenal cortex, gonads depend on trophic hormones from pituitary and will atrophy without |
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Hypertrophy + due to + cause |
Increase in cell size Due to increased physiological demand on cell (normal or pathological demand) Increase in cell size caused by increased protien content in cell |
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Hyperplasia + due to + why |
Increase in number of cells Due to increased demand, hormonal influence or persistent cell injury Cells that are able to divide will generally increase their functional capacity by hypertrophy or hyperplasia |
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Metaplasia + due to + if reversible + often is ___ replaced with ___ + Cancerous transformation can occur from |
Replacement of one differentiated cell type with another Almost always due to chronic injury with replacement cells better able to tolerate injury stimulus Reversible when stimulus is removed Glandular epithelium with stratified squamous Metabolic epithelium |
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Dysplasia + most common + have potential to + if reversible |
Disorganized appearance due to variation in size, shape, and arrangement of cells Most common in simple squamous epithelium Have a significant potential to transform into cancerous cells (sometimes called precancerous lesions) Mild forms may be reversible |
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Irreversible cell injury |
Death occurs when injury is too severe or prolonged to allow adaptation or repair |
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Two types of cellular death |
Necrosis Apoptosis |
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Necrosis + usually occurs as a result of |
Death and degradation of cells or tissues due to disease (pathological cell death) Usually occurs as a result of ischemia or toxic injury |
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Necrosis is characterized by |
Cell rupturing, spilling contents into extracellular fluid and triggering inflammation |
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Sequence of events of necrosis (5) |
>Hypoxia leads to lack of atp and hydropic swelling >Continued lack of atp causes Ca2+ pumps to fail >Influx of Ca2+ activates enzymes that lead to degradation of cell molecules >Organelle membrane becomes damaged and organelles lose ability to function >Cell membrane ruptures |
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Histological changes of necrosis (5) |
°swelling and rupture of organelles °pyknotic (shrunken) nucleous °Karyorrhexis (fragmentation of nucleus) °karyolysis (degraded nucleus) °cell membrane defects |
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How to find location /extent of damage |
Intracellular contents are released as cell breaks down. The presence of specific intracellular contents or enzymes in the blood are used as indicator |
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5 types of necrosis |
>coagulative necrosis >Liquefactive necrosis >Fat necrosis >Caseous necrosis >Gangrene |
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Coagulative necrosis commonality + typical of + composed of + tissue is + eventually |
>most common type of necrosis >typical of hypoxic injury as seen in infracted areas (except brain) >Composed of denatured protiens, relatively solid > Tissue is firm, slightly swollen >Coagulative area is eventually dissolved by proteolytic enzymes and often replaced by scar tissue |
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Liquefactive necrosis occurs with + often seen in + how |
>bacterial infections or infarction of brain >Ischemic injury to brain >Bacterial infections trigger local collection of WBCs that contain digestive enzymes resulting bin liquid debris forming collection of pus or an abscess |
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Fat necrosis refers to + results from + how + appears as |
>refers to death of adipose tissue > Usually results from trauma to adipose tissue or from pancreatitis >Lipases are released from injured cell or pancrease and breakdown cell membrane of fat cells releasing their stores of triglycerides, which are broken down into fatty acids the fatty acids combine with calcium to form soaps >Appears as solid chalky white areas |
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Caseous necrosis is a characteristic of + resembles + dead cells vs cell debris + dead cells become + dead cells are not + how long debris persists |
Characteristic of Lung cancer Resembles Clumpy cheese Dead cells disintegrate but cell debris is not digested Dead cells become walled off from rest of Lung tissue by WBC The dead cells are not totally degraded but do lose cell structure Necrotic debris may persist indefinitely |
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Gamgrene + result of |
Describes cellular death involving a large area of tissue Usually the result of interruption of major blood supply to a particular part |
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Three types of gamgrene |
Dry Wet gas |
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Dry gangrene appears + is a form of + location |
>Blackened, dry, wrinkled tissue that is separated from from healthy tissue by obvious demarcation line >Form of coagulative necrosis >Generally occurs on the extremities |
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Wet gamgrene Location + appearance + form of + severity |
>location: internal organs but also extremities >appears cold, black, under tension, and may be foul smelling >Form of liquefactive necrosis >Life threatening due to potential rapid spread of damage and release of bacterial toxins into bloodstream |
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Gas ganrene forms+ location + due to + severity |
>Forms gas bubbles (hydrogen sulfide ) >Damaged muscle tissue >Due to infection of necrotic tissue by anaerobic bacteria of clostridium family >May be fatal if not treated rapidly and aggressively |
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Apoptosis +when occurs + normality +distribution + inflammation |
>Programmed cell suicide > Occurs when cell injury triggers cell suicide > Can be normal process >Typically effects single, scattered cells >Does not trigger inflammation |
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Apoptosis v necrosis |
Apoptosis cell shrinks then fragment Necrosis swells then lyses |
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Ischemia |
Lack of blood flow to an area causing tissue hypoxia |
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Hypoxia |
Below normal levels if oxygen in tissue (most common cause of cell injury) |
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Reperfusion injury to cells occurs when |
Oxygen supply is restored to hypoxic area creating free radicals |
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Free raticals damage + triggers + ultimately leads to |
The cell and organelles membranes and triggers inflammation and ultimately the destruction of the cell |
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Chapter 7 |
Neoplasia |
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Neoplasia means + the term is commonly used to mean + neoplasia is a ____ of cell division caused by |
>means new growth >Used to mean abnormal cell growth and is offer used interchangeably with tumor >Malfunction of cell division caused by the expression of mutated genes that normally are used to control cell division and differentiation |
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Term used to describe Malignant neoplasia |
Cancer |
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Primary difference between malignant and Benign tumor |
Malignant tumors invade adjacent tissue and can spread to different sites |
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Benign tumor histology |
Well differentiated Few mitotic figures |
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Benign tumor remains + often ____ by ____ + rarely becomes + very little + often retains + speed of growth + chance of reccurance |
>remains localized >encapsulated by connective tissue >Rarely becomes necrotic > Very little vascularization >Often retains function of normal tissue >Slow growing > Less reccurance after treatment |
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Malignant histology |
>Anaplasia (lack of differentiation) >>Abnormal cell size and shape >>More anaplasia usually means more aggressive spread >Enlarged nuclei >Many mitotic figures |
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Malignant tumors infiltrate __ + M___ + common for ___ to occur + often become ___ + ability to perform normal function + growth rate + reccurance rate |
>infiltrates adjacent tissue >Metastasizes >Common for necrosis to occur >Often become vascular >Dysfunctional >Rapid growth rate >Common to recur after treatment |
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Metastasizes |
Spread to distant sites via blood or lymphatics |
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Angiogenesis |
Tumors initiate vessel growth into tumor |
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Tumor nomenclature |
General rules of naming tumors indicate the tissue of origin (prefix) and benign or malignant (suffix) |
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Nomenclature of benign tumor (suffix + lip, chondr, Aden) |
"Oma" Lipoma- benign tumor of fat tissue Chonroma- benign tumor of cartilage Adenoma- benign gladular tumor |
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Tumor nomenclature of malignant tumor of epithelial tissue origin + examples |
Uses term carcinoma Squamous cell carcinoma Adenocarcinoma (glandular) |
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Tumor namenclature of malignant tumor of connective + cartilage, bone, and fat example |
Uses term "sarcoma" Chondrosarcoma Osteosarcoma Liposarcoma |
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Exceptions to the tumor namenclature |
Lymphoma and melanoma are Malignant even though they use "oma" suffix |
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Grading and staging if neoplasia are used to |
Predict the behavior (prognosis) of a tumor and also used to help select treatment options |
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Grading refers to (determines and grade levels) + predicts |
>Histological characteristics >>Determines degree of anaplasia >>Uses 3-4 grade levels with the higher number being more anaplasia therefore greater malignancy potential >Predicts tumor behavior and therefore prognosis |
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Staging is used to select + describes (based on 4) + system used |
>Used to select treatment choice and help determine prognosis >Describes the location and pattern of spread based on tumor size, extent of local infiltration, lymph node involvement, and if metastases present >TNM staging system |
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TNM |
T> describes the original (primary) tumor. N> describes whether or not cancer has reached nearby lymph nodes M>whether there are distant metastases |
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Malignant phenotype; tumor cells have escaped ____ which allows them to ___ |
>escaped the normal mechanisms of growth control >Allows them to proliferate at the expense of other cells and tissues |
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Malignant phenotype; cancer cells ____ despite lack of ____ |
>proliferate >Despite lack of growth signals from surrounding cells |
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Malignant phenotype; cancer cells may escape ____ ___ to die and can be capable of __ ___ ___ |
>apoptotic signals >Unlimited cell division |
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Malignant phenotype; cancer cells can lose their ____ features and contribute ____ or __ __ __ to the function of their tissue |
>differentiated >Poorly or not at all |
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Malignant phenotype; cancer cells are genetically ____ and accumulate new ____ at a ___ rate than normal cells |
>unstable >Mutations >Faster |
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Malignant phenotype; cancer cells invade __ ___ and may gain the ability to ___ ___ ___ ___ ___ ____ to ___ ___ ___ |
>adjacent cells > To migrate from their site of origin to colonize distant sites |
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Genes and neoplasia (2) |
Cancerous cell characteristics due to genes Neoplasia is primarily a disorder if a cells DNA |
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Oncogenesis> neoplasia is a malfunction in __ __. Cancer is due to ___ ___ that allow for ___ ___ _ _ ___. |
>malfunction in cell division >Due to altered genes that allow for uncontrolled growth of a cell |
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Oncogenesis> carcinoma + mutagen + oncogenes |
>carcinoma: cancer causing agent >Mutagen: substance that causes Gene mutation >Oncogene: genes that cause cancer |
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Cell division regulation; for a cell to undergo mitosis requires |
Coordination of growth signals and activation of genes controlling cell division |
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Cell division regulation; growth pathway (5) |
Growth factor > cell receptor > intracellular growth pathway> transcription factors > transcription of growth genes |
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Cell division regulation; some genes code for ___+ dysfunction in these genes |
>Protiens used in the regulation of cell division >Is the basis of most forms of cancer |
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Cell division regulation; for a cell to become cancerous It must generally suffer mutations in a combination of these genes (2) |
Proto-oncogenes Suppressor genes |
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Proto-oncogenes are + code for +in normal cell + if permanently mutated + are like |
>are normal genes that are important in the normal embryonic growth and differentiation of cell >Code for enzymes involved in activating growth cycle >In a normal cell they are highly regulated by suppressor genes >If mutated and permanently "turned on" the growth of the cell can become completely unregulated (gene is now considered oncogene) >Are like the accelerators of cell division |
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Suppressor genes also called + are + when turned off + are like |
>anti-oncogenes >Normal genes that inhibit cell division by suppressing proto-oncogenes >Cancer can occur when genes are turned off >are like the brakes of cell division |
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Proto-oncogenes become __ __ when |
Activated oncogenes when they undergo mutation or when normal controls that keep them in check are disrupted |
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These activated oncogenes (mutated proto-oncogenes) can influence the cell in (4) ways |
>production of abnormal growth factors >Production of abnormal growth factor receptors >Abnormal intercellular pathway >Abnormal transcription factors |
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Production of abnormal growth factors; growth factors are + normally a differentiated cell + a mutation may cause |
Growth factors: chemicals secreted by one cell to bind to another cell's growth receptors stimulating that cell to divide >Does not produce growth factors it can respond to (don't have receptors for their own) >May produce a growth factor the cell has receptors for causing self stimulated growth |
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Production of abnormal GF receptors; a gene mutation may allow + may cause excessive + receptors may have __ or become active in __ |
>production of receptors that shouldn't be present >Number of receptors >High affinity for growth factors or become active in absence of growth signals |
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Abnormal intracellular pathway; involves numerous + gene mutation may cause + an oncogene could cause |
>numerous enzymes that transmit growth signals from activated receptors >Mutation may cause production of excessive or abnormal components of pathway >Could cause activation of pathway without growth signal received |
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Gene family in gene mutation that stimulates the intracellular pathway and is involved in leukemia, lung, ovarian, colon, and pancreatic cancer |
The ras gene family |
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Abnormal transcription factors; transcription factors are + mutation in proto-oncones that code for transcription factors may cause |
Transcription factors: are protiens that assemble at the promotor region of a gene and cause that gene to be transcribed (turned on) >May cause overproduction of transcription factors or interfere with normal mechanisms that keep them in check |
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Example of genes that code for transcription factors and are associated with lung and breast cancer |
Myc genes |
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Proto-oncogenes become activated oncogenes when |
Mutations alter the normal controls that keep the proto-oncogenes in check |
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Proto-oncogenes can become activated and become oncogenes in 4 ways |
1. Oncogenes may become introduced to host cell by a virus 2. proto-oncogenes within cell undergo mutation due to mutagen 3. Loss of suppressor genes activity 4. Amplification of proto-oncogenes > Error in DNA replication may cause extra copies |
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To become malignant, cells must lose__. It is not enough to overstimulate ___ _____ pathways as in most cancers the ____ or ___ pathways are defective as well |
>the normal inhibitory mechanisms that keep the brakes applied to the cell division pathway >Overstimulate growth promoting >Supresser or inhibiting |
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Rb gene produces __ protien that is considered + what protien does |
Produces a Protien (pRb) that is considered "master brake" of cell cycle. This protien binds to transcription factors preventing them from allowing transcription of growth genes |
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P53 gene commonality + over ____ of all types of human tumors involve lack of functionality. + Function + a defect disrupts __ and can allow __ |
>The most common tumor suppressor gene defect involves P53 gene. >Over half >stops cell division to allow time for mutation repair or can initiate apoptosis > Disrupts this checkpoint and can allow a genetically damaged and unstable cell to survive and replicate Disrupts this checkpoint and can allow a genetically damaged and unstable cell to survive and replicate |
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BRCA 1 and BRCA 2 are + produce __ used to __ or ___ |
Tumor suppressor genes involved with breast cancer Produce protiens used to repair DNA or kill cell if it can't be repaired |
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Steps of carcinogenesis (3) |
1.initiation 2. Promotion 3. Progression |
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Steps of carcinogenesis; initiation |
Mutation of proto-oncogenes and tumor suppressor genes |
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Steps of carcinogenesis; promotion. Cells must + may require (3ish kinda 4) factors before promotion will occur |
Cells must proliferate (divide) for cancer to develop May require several gene mutations, environmental factors, hormonal stimulation, or other factors before promotion will occur |
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Fully differentiated cardiac muscle cells or nuerons rarely become cancerous because |
They typically lack the ability to divide |
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Steps of carcinogenesis; progression |
Cells begin to show malignant behavior. As proliferation continues, evolved tumor cells are generated that differ significantly from the original parent cell. |
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Loss of inhibition |
Normal cells stop growing when space is limited Cancer cells continue to divide when they contact other cells |
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Loss of Anchorage dependence |
Normal cells in culture must have a solid substance to grow on Cancer cells will grow in suspension |
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Escape from tissue of origin |
Cancer cells can produce receptors that allow attachment and migration towards the basement membranes of a tissue. They then produce enzymes that digest protiens to form a rift in the membrane and migrate out by ameoboid action. |
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Chemotaxis |
Chemical attractant |
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Patterns of spread |
May prefer specific organs maybe due to chemotaxis Some related to blood flow Some related to lymphatic flow |
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Tumor markers |
Tumors have a varying degree of differentiation, or resemblance to tissue of origin Tumor markers are substances that help identify tissue of origin |
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Effects of cancer on host (6) |
-asymptomatic -pain -cachexia -bone marrow suppression -complications due to treatment -death |
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Benign tumors can cause harm as |
Space occupying lesions. |
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Cachexia |
Weight loss and weakness |
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Leukopenia |
A decrease in WBCs which impairs immune system abilty to fight infection |
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Thrombocytopenia |
Decreased platelets |
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Most chemotherapeutics work by |
Interfering with cell division |
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Most mucosal cell loss also causes |
Pain, anorexia, and makes it easier to acquire infections |
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Death is primarily from |
Infection, hemorrhage or organ failure |
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Cancer treatments (6) |
Surgery Radiation Chemotherapy Immunotherapy Gene and molecular therapy Stem cell transplantation |
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Main advantage of surgery |
You can remove cancer cells with minimal damage to normal cells You can check lymph nodes for metastasis |
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Ration uses (3) |
-kill tumor cells that can't be removed surgically due to location -kill cells that may have escaped removal -reduce size of tumor |
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Radiation is most effective at |
Killing small groups of tumor cells found in one region |
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Radiation kills cells by |
Damaging DNA |
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Chemotherapy is used to treat |
Cancers that have disseminated because they go everywhere |
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Chemotherapy interferes with |
Cell division |
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Monoclonial antibodies |
Antibodies with identical structure |
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Antibodies can be used to (2) |
-deliver cytotoxic drugs >Direct other cytotoxic cells to tumor cells -deliver radioactive labels >Used to screen for recurrence of growth |
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Currently gene therapy is used to |
Make tumor cells more susceptible to cytotoxic drugs or immune cell recognition |
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Primary difficulty with gene |
Finding ways to effectively deliver new genes to Target cell |
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Stem cell transplantation |
Used to replace bone marrow damaged from treatment or from hematologic malignancies |
