Patho Week 4 Ch 5&17
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What is another name for neoplasms?
What are neoplasms?
cells with unchecked reproduction which do not respond to normal cell controls.
Neoplasms can become large masses & interfere with? (4)
- 1. nearby organs
- 2. pressure
- 3. cutting off circulation
- 4. pressing on nerves->pain, numbness
Neoplasms often have no useful?
Neoplasms may secrete what?
abnormal levels of hormones
What can neoplasms cause because of their growth?
What do neoplasms take from healthy cells?
What is benign tumors?
tumors that won't spread to other sites
What is metastasize?
a spreading of cancer
Under a microscope benign tumors appear?
Is benign tumors mitosis normal?
yes, just unchecked
What are malignant tumors? (2)
- 1. tumors that will metastasize
- 2. may kill the host
What is the greek word for cancer?
What is another name for cancer?
What are the 8 warning signs of cancer?
- 1. unusual bleeding or discharge anywhere
- 2. change in bowel or bladder habits
- 3. a change in a wart or mole
- 4. a sore that does not heal
- 5. unexplained weight loss
- 6. anemia, persistant fatigue
- 7. persistant cough or hoarseness
- 8. cell lump in the breast or testes or anywhere(often painless)
What does "in situ" mean?
cells have not spread and are localized to that site
Under a microscope, Ca cells appear?
Do Ca cell use apoptosis?
What is apoptosis?
normal process of cells self-destructing when old.
What is angiogenesis?
process of stimulating blood vessels to supply the tumor to promote their own survival.
What is H&P?
History and physical
What is the H&P for diagnosing cancer? (2)
- 1. weight loss
- 2. any of the 8 warning signs
What should be looked for in lab tests to find out if a patient has cancer? (4)
- 1. anemia
- 2. abnormal CBC
- 3. increase/decrease in WBC
- 4. blood in stool
What is CBC?
complete booold count (includes Hgb levels)
What are the tests to check for blood in stool? (2)
What does "Stool For OB" mean?
check stool samples for occult
What is occult?
microscopic traces of blood in stool.
The antigen specific tests look for specific antigens in blood that help diagnose cancer, what are these antigens? (3)
- 1. PSA- Prostate specific antigen
- 2. CEA -Carcinogenic Embryonic antigen
- 3. CA 125 -ovarian
What is U/A?
What are the other tests they may use to diagnose cancer? (4)
- 1. X-rays
- 2. CT scans
- 3. MRI's
- 4. US
What is a biopsy?
taking samples of cells and examaning in lab for final dx
What is the only certain way to dx cancer and determine best type of chemotx?
What is usually biopsied to check for metatases?
What results in staging of Ca?
lymph nodes biopsy
What is staging of cancer based primarily on? (3)
- 1. Size of tumor
- 2. Involvement of lymph nodes
- 3. presence of metatases
What is carcinogenesis?
The progressive development of a cell to cancer.
What are the 3 general concepts of carcinogenesis?
- 1. Ca develops over time
- 2. often requires a genetic predisposition
- 3. often requires multiple triggers for the cells DNA to become Ca
What is another name for chemotherapy?
What are some actions of the chemotherapy drugs? (3)
- 1. interfere with cell division
- 2. interfere with angiogenesis
- 3. interfere with hormones that "feed" the tumor
What is important to note about the medications for a specific tumor?
need multiple meds
Does chemotherpy kill both Ca and normal cells?
What are the side effects of chemotherapy? (5)
- 1. hair loss
- 2. mucosal damage
- 3. decrease in WBC
- 4. decrease in platelets
- 5. GI irritation
What is Radiation therapy (RT)?
beamed target radiation into sites
RT has similar side effects to?
chemotherapy, except for the "Burns" (red, leathery appearance of skin)
What is an alternative to radiation therpay?
If someone has RT beads, what should they be aware of?
What are the ways side effects of Ca tx are managed? (8)
- 1. anti-emetic drugs to reduce nausea/vomiting
- 2. pain control
- 3. avoid exposure to people with infections
- 4. do not get vaccines
- 5. good nutrition
- 6. increase protein meals
- 7. increase fluids
- 8. closely motitor CBC and platelets
What are 2 characteristics of erythrocytes?
- 1. lifespan of 120 days
- 2. biconcave disc shaped
New RBC's are made via?
How many RBc's are made per minute?
RBC production requires? (7)
- 1. erythropoietin from kidney
- 2. Fe
- 3. folic acid
- 4. Vit B12
- 5. Copper
- 6. protein
- 7. other nutrients
Fe is part of what molecule?
What times does the body secrete extra erythropoietin?
- 1. blood loss
- 2. anemia
- 3. hypoxia
What are the erythropoietin drugs? (2)
- 1. procrit
- 2. epogen drugs
What is the normal range for Hgb in males and females?
- MALES: 14-16 g %
- FEMALES: 12-14 g %
What is the normal range for RBC in males and females?
- MALES: 5.5 x 106
- FEMALES: 4.8 x 106
1. how many oxygen molecules can Hgb hold? 2. When Hgb is full of these oxygen atoms, what is it called?
What 2 events happen after O2 dissociates from Hgb at a cellular level in capillaries?
Oxygen enters cells for metabolism-> becomes deoxyhemoglobin
CO2 is not heavily bound to Hgb, mostly is carried in the form of?
HCO3 (bicarbonate ions)
What is anemia?
Low Hgb (due to decreasing number of RBC's)
Low RBC's and then low Hgb means there will be?
impaired O2 transport
What are the GENERAL S&S of all anemia's? (5)
- 1. pallor
- 2. easy fatigue
- 3. SOB (shortness of breath)
- 4. increase P
- 5. possible syncope
What is pernicious anemia?
due to lack of intrinsic factor is the stomach, which is needed for Vitamin B12 absorption.
What is Fe deficiency anemia?
due to nutritional/hemorrhagic loss of Fe in body.
What is aplastic anemia?
temporary or permanent shutdown of hematopoisis (blood cell production) in bone marrow.
What are the internal S&S of aplastic anemia? (5)
- 1. anemia
- 2. leukopenia
- 3. thrombocytopenia->ecchomyosis
- 4. petichiae
- 5. pancytopenia
What is leukopenia?
decrease in WBC
What is thrombocytopenia?
What is petichiae?
small, pinpoint hemmorhages in skin
What is pancytopenia?
decrease in all blood cell types
What is Thalassemia? (2)
- 1. GENETIC impairment in Hgb
- 2. type varies for different races
What is sickle cell anemia?
INHERITED HgbS form, which causes RBC to "sickle"->clogs blood vessels
What events trigger sickle cell anemia? (3)
- 1. stress
- 2. hypoxia
- 3. illness
What are the S&S of sickle cell anemia? (2)
- 1. severe pain
- 2. jaundice
What are the 5 anemia's?
- 1. pernicious anemia
- 2. Fe deficiency anemia
- 3. aplastic anemia
- 4. thalassemia
- 5. sickle cell anemia
What is the tx for pernicious anemia?
Vitamin B12 injection
What is the tx for Fe deficiency anemia? (2)
- 1. identify/treat underlying cause
- 2. iron supplements
What is the tx for aplastic anemia? (4)
- 1. Fast tx of underlyign cause
- 2. removal of any bone marrow suppresents
- 3. blood transfusion
- 4. bone marrow transplant
What is the tx for thalassemia?
What is the tx for sickle cell anemia? (3)
- 1. drugs that reduce sickling
- Avoidance of:
- 2. strenuous activity
- 3. high altitudes
What is carbon monoxide poisoning?
Due to CO having higher affinity to Hgb than O2
What does CO poisoning lead to? (2)
no O2 available to cells-> death
What are the 3 characteristics of thrombocytes?
- 1. like to stick to eachother:agglutination
- 2. lifespan of 1 week
- 3. main function is to coagulate blood-> "thrombus"
What is a "thrombus"?
A blood clot
1. Where are thrombocytes made? 2. They are made when stimulated by what hormone?
- 1. Red bone marrow
- 2. thrombopoietin from liver and kidney
What are the normal ranges for thrombocytes in males and females?
BOTH: 150,000-400,000 per ml of blood
What is hemostasis?
stopping of blood flow, not just by platelet aggregation
Hemostasis involves what 2 things at the site of the clog?
- 1. vasoconstriction
- 2. edema
What is "fibrinolysis"?
dissolution of a hemostasis clot
What triggers hemostasis? (5)
- 1. injury to vessel
- 2. plaques
- 3. slowed blood flow
- 4. venous stasis
- 5. SURGERY
What are the clotting disorders? (4)
- 1. DIC
- 2. thrombocytopenia
- 3. hemophilia
- 4. thrombi formation
What is DIC?
too much fibrin forms
What is DIC due to? (5)
- 1. infection
- 2. obstetric complications
- 3. burns
- 4. Ca
- 5. trauma
What is the result of DIC?
In DIC, too much fibrin forms causing what 3 things?
intravascular clots-> tissue hypoxia, organ failure->all clotting factors are used up
What is thrombocytopenia due to? (3)
- 1. chemotx
- 2. auto-immune
- 3. virus (esp. in kids)
What is hemophilia?
genetic disorder causing lack of clotting factor (Factor VIII)
What is the usual result of hemophilia? (2)
- 1. fatal hemmorhages
- 2. minor injuries
What is unusual about hemophilia?
platelet count is NORMAL
hemophilia is a sex linked disease in which?
femlaes carry the gene, but males get the disease.
What is thrombi formation?
When clots form and may be fatal(not really a clotting disorder)
What are the thrombi formation predisposes factors? (2)
- 1. atherosclerosis
- 2. venous stasis
What does atherosclerosis predispose to?
clot formation in blood vessels around damaged endothelium
What is the difference between thrombus and embolus?
- thrombus: a clot forms and STAYS in place
- embolus: a clot forms and TRAVELS elsewhere
What does venous stasis predispose to?
a clot formation in veins (blood pooling-bed rest)
What happens if a clot travels to the brain?
What happens if a clot travels to the heart?
What happens if a clot travels to the lungs?
What are the main characteristics of leukocytes(WBC's)? (2)
- 1. stain and grandular presence/absence help subcategorize into 5 types
- 2. life-span is about 8 hours
What is the main function of WBC's?
Where are WBC's made?(2)
- 1. red bone marrow
- 2. lymph tissue
What is the normal range of WBC's for males/females?
5.0 X 103 - 9.0 X 103
What are the WBC disorders? (2)
- 1. Leukopenia
- 2. Leukemias
What is Leukopenia due to? (4)
- 1. chemotx
- 2. drug reaction
- 3. RT
- 4. decrease in folic acid
What are the subtypes of leukopenia? (2)
- 1. neutropenia
- 2. lymphcytopenia
What is neutropenia?
Decrease of neutrophils in the blood
What is lymphcytopenia?
decrease lymphocytes in blood
What is the risk of leukopenia? What does it lead to?
Infection which leads to death
What is leukemias?
group of malignant disorders characterized by abnormal reproduction and maturation of one or more types of WBC's
Leukemias can be acute in which age group?
What is AML?
Acute myelocytic leukemia
What is ALL?
acute lymphocytic leukemia
What types of acute leukemia would be found on charts?(2)
Leukemia can be chronic in which age group?
What types of chronic leukemia would be found on charts? (2)
What is CML?
Chronic myelocytic leukemia
What is CLL?
chronic lymphocytic leukemia
What are the S&S's of leukemia?(13)
- 1. weigh loss
- 2. fatigue
- 3. anemia
- 4. thrombocytopenia
- 5. multiple infections
- 6. increased bleeding
- 7. severe hemorrhage
- 8. kidney stones
- 9. fever
- 10. lymphadenopathy
- 11. splenomegaly
- 12. hepatomegaly
- 13. bone pain
What are the Lymphatic disorders? (2)
- 1. Lymphomas
- 2. multiple myeloma
What is lymphoma?
too many lymphocytes
What does lymphoma cause?
enlarged, painless lymph nodes
What is required to determine the true DX of lymphomas?
What are the 2 types of lymphomas? (2)
- 1. Hodgkins
- 2. Non-Hodgkins
What is Hodgkins? (3)
- 1. nodes usually in same area of body
- 2. quite curable with chemotx or RT
- 3. Reed- Sterrnberg cells in biopsy
What is Non-Hodgkins? (4)
- 1. nodes usually throughout body
- 2. more difficult to cure
- 3. NO Reed- Sternberg cells in biopsy
- 4. sometimes associated with HIV
In lymphomas, abnormal lymphocytes lead to what?
increased risk of infection
What is splenomegaly?
enlarged spleen (usually filters blood)
What is hepatomegaly?
What has the similair S&S of leukemia?
what are the advance SS of lymphomas?(4)
- 1. decreased weight
- 2. low grade fevers
- 3. night sweats
- 4. pruritis
what is pruritis?
what is mutiple myeloma?
excessive, non stoppable production of B-Lymphocytes
what is B-lymphocytes function?
they are plasma cells which infiltrate into bone marrow
what does multiple myeloma usually result in?
pathological fractures (fracture in bone due to cancer)
what age group does multiple myeloma usually effect?
what are the internal SS of multiple myeloma?(6)
what is proteinuria?
protein in urine
what are not uncommon in multiple myleoma due to the high calcium levels?
what is the treatment for multiple myeloma?
chemotx(difficult to cure)
what are 2 facts about multiple myeloma?
- 1.metastases common
- 2. cause unknown (idiopathic disease)
What are the 4 steps to hemostasis?
- 1. vasoconstriction(limits flow of blood to injury site)
- 2. Platelets activated by thrombin and aggregrate at injury site (forming temporary, loose platelet plug-the protein Fibrinogen triggers platelet clumping)
- 3. Fibrin Mesh(the clot) forms & entraps the plug
- 4. clot must dissolve for normal blood flow to resume
The dissolution of the clot occurs through the action of what?(1A)- takes time but enhances with what kind of drugs?(1B)
- 1A. action of plamin (fibrinolysis)
- 1B."Clot buster" drugs
What are the 4 current relevant drug therapies for Lymphatic disorders?
- 1. anti platelet aggregation (plavix, ASA, NSAID's)
- 2. thrombolytics (streptokinase)
- 3. heparin (slows clot growth-no dissolve)
- 4. warfarin (slows clot formation)
YAYY now we're done :):)
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