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188 Cards in this Set
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- Back
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In adults, most cells are (proliferating or quiescent?)?
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quiescent
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In some tissues, cells can never re-enter the cell cycle & divide. They are so specialized they can't divide or proliferate. This means they are:
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terminally differentiated
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Name two types of terminally differentiated cells
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heart cells & neurons
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Some cells can become any type of cell this means they are considered
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pluripotent
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When a wound occurs in the CNS or heart, the cells that fill in the wound are____, which are cells that live in all tissues & secrete _____; a gristle-like substance that holds us together
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fibroblasts; collagen
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wound healing in terminally differentiated tissues is the result of filling in of the wound with scar tissue, which is ____, secreted by____
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collagen, fibroblasts
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Other tissues in body have cells that proliferate all the time. Examples include epithelial tisssue such as (name 5)
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epithelial cells in
skin GI pulmonary bladder glands |
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This is tightly regulated in both children & adults & occurs only to heal a wound, replace lost cells, or normal growth in children
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cell division
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Cell division occurs only to:
1) 2) 3) |
1)heal a wound
2) replace lost cells 3)normal growth in kids |
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the process by which a cell is transformed into a more specialized cell type
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differentiation
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T/F cells are interchangeable
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false. The cells are not interchangeable--brain cells can't do the same things a liver cell can do
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The fertilized ovum was considered____ & _____
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undifferentiated & pluripotent; able to become any cell type
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Generally speaking, can differentiated cells go back to being undifferentiated?
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no
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Are differentiated cells pluripotent?
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no
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Name two types of cells that are pluripotent
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1) hematopoietic stem cells can differentiate into any blood cell type
2) stem cells |
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This is the process by which the cell increases in size & replicates its chromosomes before undergoing mitosis
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cell cycle
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T/F cells are interchangeable
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false. The cells are not interchangeable--brain cells can't do the same things a liver cell can do
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The fertilized ovum was considered____ & _____
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undifferentiated & pluripotent; able to become any cell type
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Name the 4 phases of cell cycle
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G1: increase in size
S phase: replicate G2: gets ready for mitosis M-cell division |
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the cell is increasing in size, which phase
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G1
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Generally speaking, can differentiated cells go back to being undifferentiated?
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no
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Are differentiated cells pluripotent?
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no
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Cell is replicating its chromosomes by synthesizing new DNA. At beginning, the cell is diploid, at the end, it is___. What phase?
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S phase
tetraploid |
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Name two types of cells that are pluripotent
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1) hematopoietic stem cells can differentiate into any blood cell type
2) stem cells |
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the cell is finished with DNA replication & gets ready for mitosis by synthesizing enzymes
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G2
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This is the process by which the cell increases in size & replicates its chromosomes before undergoing mitosis
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cell cycle
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Name the 4 phases of cell cycle
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G1: increase in size
S phase: replicate G2: gets ready for mitosis M-cell division |
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the cell is increasing in size, which phase
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G1
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Cell is replicating its chromosomes by synthesizing new DNA. At beginning, the cell is diploid, at the end, it is___. What phase?
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S phase
tetraploid |
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the cell is finished with DNA replication & gets ready for mitosis by synthesizing enzymes
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G2
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cell undergoes cell division; at end of this phase, cell is diploid again
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M
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regulation of cell cycle is accomplished by proteins called
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cyclins
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the unrestrained growth of cancer cells is due to the loss of cell cycle control that can occurs for variety of reasons, sometimes d/t mutations with the ____, their inhibitors or activators
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cyclins
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These stimulate entry into the cell cycle from G0. They have cell type specificity & bind to specific receptors that are expressed only on certain cell types
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growth factors
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Dysregulation of these pathways is very important in cancer
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growth factor pathways
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An abnormal growth is a
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neoplasm
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When cells of neoplasm look similar to tissue in which it arises, it is considered
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well differentiated
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when cells of neoplasm look different from tissue from which it arises they are
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poorly differentiated
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The single characteristic that reliably differentiates a malignmant neoplasm in a solid tissue (vs blood) from a benign one is the
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ability to invade nearby tissues & possibly to metastasize to distant sites
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If benign neoplasms don't look exactly like the cells of tissues of origin, but have lost a little of their differentiation, they are called
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dysplastic
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cells that are extremely poorly differentiated are called
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anaplastic
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as they proliferate, the cells of benign neoplasm pile up to form a thickened area. The lump is called a tumor or a___lesion
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hyperplastic
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with one exception, benign lesions never spread beyond their original location except for this
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endometriosis
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benign lesions are named by their tissue of origin, followed by the suffix
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oma
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benign fatty tumors are
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lipomas
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benign epithelial lesions are called___if they come from glandular epithelium or ___if they come from another type of epitheium
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adenomas
papillomas |
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the large majority of neoplasms are (benign/malignant?)
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benign
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The single characteristic that distinguishes a malignant tumor from benign one is
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the ability of malignant tumor to invade nearby tissues & metastasize to distant organs
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Cancer cells do not resemble the cells of their tissue of origin very closely (dysplatic or anaplastic) & so are considered
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poorly differentiated
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cancer cells have variable rates of growth but their growth is
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unremitting
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malignant tumors may causes extensive tissue destruction because they require extensive___supplies
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blood
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cancer causes death by variety of means, most having to do with 1) requiring a lot of ___ & ___ supply & 2) robbing the rest of the body of these things, or by occupying space & crowding out normal cells that are performing vital functions
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nutrients & blood supply
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the vast majority of CA in adults arise in ___tissues
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epithelial
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cancers of epithelial tissues are called
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carcinomas
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CA that arise in glandular epithelium are called
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adenocarcinomas
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carcinomas or adenocarcinomas are further named by their tissue of origin. Epithelial CA of colon is called
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carcinoma of colon
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CA in glandular tissue of colon is called
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adenocarcinoma of colon
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CA arising in pulmonary epithelium is called___vs glandular epithelium of lung is called ___
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carcinoma of lung
adenocarcinoma of lung |
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CA from nonepithelial solid tissues are called__ & are named for their tissue of origin
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sarcomas
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CA of muscle
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rhabdomyosarcoma
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CA of the fibroblasts
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fibrosarcoma
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CA of fat cells
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liposarcoma
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most sarcomas arise in (kids/adults?)
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kids
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CA that arise in bone marrow are called
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hematopoietic CA
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CA arise in the CNS are named for cell of
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origin
astrocytoma glioma |
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are carcinomas or sarcomas more comon?
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carcinomas more common
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a benign tumor may be extremely dysplastic so that the cells resemble CA cells, but it it has not invaded nearby tissue or metastasized, it is not considered malignant & are called
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carcinoma in situ (or noninvasive cancer)
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is carcinoma in situ benign?
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yes, but considered premalignant condition
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these malignancies arise in bone marrow from any blood cell precursor
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leukemias
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the malignant precursors do not differentiate further but proliferate wildly in their undifferentiated state in this
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leukemia
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arise from RBC precursors
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erythroleukemias
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arise from monocyte precursors
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monocytic leukemia
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arise from precursor cells that give rise to all blood cells except lymphocytes
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myeloid leukemias
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arise from precursors of lymphocytes
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lymphocytic leukemia
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these are 'liquid tumors' that do not have significant solid components
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leukemias
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S/S leukemia:
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1) fever b/c low wbc (infection)--leukopenia/neutropenia;
2) brusing/petechiae/bleeding--low/no PLT 3) pale-anemia lack of RBC |
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these are CA of lymphocyte precursors that have significant solid components
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lymphomas
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lymphomas form solid aggregates in
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lymph nodes
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multiple enlarged lymph nodes caused by aggregates of tumor cells b/c these are mobile cells that migrate between lymph nodes
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lymphocytes
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these are very well differentiated B-cell lymphomas that make antibodies
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plasmacytomas
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this can cause significant bone destruction & can present with a pathological spinal fracture
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multiple myeloma
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multiple swollen lymph nodes such as in Hodkins is or is not an indication of poor prognosis
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is not an indication of poor prognosis
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submitting the population to a test to see if they have CA in a particular organ is known as
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screening
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the gold standard for a screening test is that it
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improves outcome (such as mammography)
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screening will only produce improved outcome if the earlier diagnosis increases the likelihood of
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cure
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at present, we have effective screening for these 3 CA
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cervical (pap)
colorectal (FOB test) Breast CA (mammography) |
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has the PSA screening test for prostate CA been shown to improve outcome?
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no
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the type of CA that causes the most CA deaths in both men & women is this__ do we have a screen for it?
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lung CA
no screen |
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are there screens for pancreatic & ovarian CA
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no, no
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An ___is the surest way to diagnose solid CA or lymphoma & a ____is the surest way to dx leukemia or multiple myeloma
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open excisional biopsy
bone marrow puncture |
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frequent sites for metastasis of many CA types including breast, prostate, lung
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marrow & bony part of spine
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two methods of determining the severity of a particular pt's CA, predicting prognosis, determining treatment options
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staging & grading
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histological examination of CA cells
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grading
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Grading takes into account these 3 things
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1) degree of differentiation (more differentiated-better prognosis)
2)nuclear grade--big, irregular w/multiple nuclei--poor prognosis; small, regular nuclei w/one small nucleolus: good prognosis 3)number of mitoses visible: many mitoses=poor prognosis |
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rating the pt cancer illness according to 3 criteria: T=tumor, N=nodes, M=metastasis
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staging
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size of tumor
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T
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most tumors have Ts 1 to 4 with the smallest tumor being__ & largest__
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smallest=1
largest=4 |
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T0 means
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CA discovered b/c metastasis & no primary tumor found
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Tx
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when primary tumor cannot be assessed
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T 'is'
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carcinoma in situ
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By definition, a Tis tumor must have an N rating of __ & M rating of__
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N0
M0 |
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refers to number of nearby (regional) lymph nodes with CA cells in them
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N
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no CA cells found in regional lymph nodes
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N0
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N ratings of 1-3 denote
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increasing numbers of involved lymph nodes
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presence or absence of metastases
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M
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no distant metastases
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M0
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distant metastases were detected at one or more sites
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M1
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process by which genetic change produces CA
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genetic carcinogenesis
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genetic change is called___ & is caused by agents (also known as___) that make chemical changes in DNA
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mutation, mutagens
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UV light, radiation, cigarette smoke, free radicals, some viruses are examples of
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carcinogens/mutagens
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for most part mutations that cause CA occur in individual body cells are called
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somatic mutations
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some individuals have genetic predisposition to CA b/c mutation inherited from parents. This is called___mutation b/c it is transmitted through the sperm or egg
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germ-cell mutation
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T/F
Most mutations cause cancer |
false
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Cancer-causing mutations occur in 2 types of genes
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oncogenes
tumor suppressor genes |
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these are genes whose protein products are involved in promotion of growth
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oncogenes
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these are genes whose protein products are either involved in the inhibition of growth or in DNA repair
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tumor suppressor genes
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this is a sequence of DNA that contains directions for how to make a protein
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gene
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The consequence of a particular mutaton in a particular gene is a ___of the protein product of that gene
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change in function
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for most mutations in proteins, the change in function will be a
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loss of function
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if the protein is active all the time instead of being subject to regulation, this mutation results in a
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gain of function
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In a gain in function mutation, an enzyme might be active all the time instead of being turned off & on appropriately, this is called
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constitutive activity
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these are genes whose protein products are active in promoting cell growth
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oncogenes
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oncogenes include
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growth factors
growth factor receptors cytoplasmic proteins transcription factors |
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tumor suppressor genes come in 2 classes
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1) genes whose protein products are important in inhibiting growth
2) genes whose protein products are involved in DNA repair |
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this is the process of cell suicide & is going on all the time
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apoptosis
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one stimulus for cell to enter apoptosis is
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DNA damage
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This protein is a major regulatory of entry into apoptosis
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P53
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the gene for P53 is mutated in approximately __% of CA
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50%
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this is the name of the protein that normally inhibits the transition from G1 to S
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Rb
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Do mutations in DNA repair genes cause CA?
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no, they predispose people to CA
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one cause of familial colon cancer syndromes is
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mutations in DNA repair enzymes
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loss of growth control in CA is caused by mutations in
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oncogenes
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for many types of CA, this is the only curative option
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surgery
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If a tumor is completely removed before it has spread, will the patient be cured?
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yes
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does radiation cure pt w/cancer? what is the exception?
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rarely
prostate cancer, which can be cured by radiation |
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this cancer is curable with chemotherapy
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testicular ca
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this works by interfering with cell division, but is not specific for cancer cells, but affects all dividing cells
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chemotherapy
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The prominent side effects of chemotherapy are the result of its___effects
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anti-proliferative
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chemotherapy is immunosuppressive. Pt need protection from infection. If pt receiving chemo has fever/signs of infection what should happen
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very serious--call oncologist, treat with IV antibiotics STAT, admit to hospital
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these can stimulate various blood cell precursors to proliferate & ameliorate the anemia, thrombocytopenia, leukopenia
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cytokines or growth factors
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this drug is a pharmacologic form of erythropoietin & used to stimulate RBCs & lessen anemia caused by chemo
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Procrit
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this type of treatment is when a pt dx w/CA who has M0 can be treated after potentially curative surgery on the assumption they have occult metastasis
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adjuvant cancer treatment
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these two treatments can be used in adjuvant setting
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radiation &/chemotherapy
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3 types of CA for which adjuvant therapy has been shown to be beneficial are
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breast
colon prostate |
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a carcinoma that arises in glandular tissue
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adenocarcinoma
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cells that appear much less well differentiated than their tissue of origin
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anaplastic
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a hyperplastic, localized lesion
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benign
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malignancy of epithelial cells
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carcinoma
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a benign lesion in which cells have same appearance as cancer cells, but have not invaded nearby tissue
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carcinoma in situ
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cells that appear like cells of their particular tissue
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differentiated
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process of cell changing into specific cell type with specific capabilities
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differentiation
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cell that has 2 of each homologous chromosomes & either 2 X or 1 X & 1 Y chromosome
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diploid
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cells that appear less well differentiated than their tissue of origin
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dysplastic
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cells that line body cavities & cover the body
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epithelial cells
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process by which cell leaves its normal location & travels through tissue
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invasion
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lesion in which cells are proliferating abnormally
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hyperplastic
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malignancy arises in hematopoietic precursor cells & has no significant solid component
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leukemia
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malignancy that arises in B or T cell precursors that has solid aggregates of malignant cells within lymph nodes
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lymphoma
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solid lesion that has capability of invading into nearby tissues or metastasizing to distant sites OR a 'liquid' tumor of blood cell precursors that proliferates wildly & fills marrow & circulation w/immature cells OR a tumor in B/T cell aggregates in lymph nodes
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malignant
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process by which ca cell spreads to distant sites in body, usually by way of blood stream
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metastasis
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a 'new growth' these can be divided into benign (noncancerous) or malignant (cancerous)
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neoplasm
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not proliferating
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quiescent
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cell that is able to differentiate into many cell types
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pluripotent
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cell division
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proliferation
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solid malignancy of nonepithelial, nonhematopoietic cells
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sarcoma
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submitting the general population to a test to see if they have cancer in particular organ
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screening
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cell that cannot re-enter the cell cycle & divide. These cells in mammals are in these two things
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terminally differentiated
heart & neurons |
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cell that has replicated its chromosomes prior to undergoing mitosis so that it has 4 of each homologous chromosome & either 4X or 2X & 2 Y chromosomes
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tetraploid
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are cells in terminally differentiated tissues able to proliferate?
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no
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a raised skin or colonic polyp is called
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papilloma
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cervical cancer is thought to be d/t infection with specific strains of the __virus, which is sexually transmitted
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HPV
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The HPV vaccine prevents infection by the most common oncogenic HPV strains. It is important to vaccinate before infected & recommended in girls at age
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11 years
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what 3 things constitute a good screening test
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1) high specificity (no false positives)-if test says you have CA, then you do
2) high sensitivity (no false negatives)-if test says you do not have Ca, then you don't 3) shown to improve outcome |
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approved screening tests for colon ca include
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FOB
sigmoidoscopy colonoscopy barium enema |
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genes whose protein products are important in inhibiting growth fall into 2 classes
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apoptosis-promoting
cell-cycle inhibiting |
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proteins that inhibit cell-cycle progression prevent the cell from entering___ & making daughter cells
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mitosis
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DNA damage & failure of DNA repair lead to unregulated cell differentiation & growth by these 3 mechanisms
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1) activation of growth-promoting oncogenes
2) inactivation of tumor suppressor genes 3) alterations in genes that control apoptosis |
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tumors are genetically ___ & continue to accumulate___
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unstable
mutations |
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Tumor progression starts with transformation to angiogenesis to _____&____to embolism & circulation to arrest in capillary beds to adherence to____ to proliferation, angiogenesis & metastasis
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motility & invasion
extravasation |
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cell injury can lead to these 3 things
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1)reversible recovery return of normal function
2) apoptosis-programmed cell removal 3) cell death & necrosis |
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Fertilization of the egg/ovum occurs in the ....
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fallopian tubes
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As the fertilized ovum moves through the fallopian tube to the uterus it undergoes ....
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cell division
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Proliferation = _____________ _______________
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cell division
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lining up of chromosomes in the center of the cell & splitting the cell into 2 daughter cells, each with a complete set of NEW chromosomes
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mitosis
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Non-dividing cells are called ....
They are _______ cells. What is their role? |
quiescent
They are TISSUE cells, doing the job of the tissue ex: liver cells doing liver things; lung cells doing lung things |
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Except for heart muscle and nerve tissues, when a tissue is wounded _____________ cells of that tissue fill in the wound.
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Except for heart muscle and nerve tissues, when a tissue is wounded FUNCTIONAL cells of that tissue fill in the wound.
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If a cell has divided 3 times, how many cells are there?
How about 4 times? |
*cell divided 3 times = 8 cells
*cell divided 4 times = 16 cells |
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After how many embryonic cell divisions do the cells start to differentiate?
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*4 cellular divisions
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