Cancer

Define Etiology:

Cause or reason for phenomena

Define idiopathic:

cause unknown

Define iatrogenic:

a cause that results from unintended or unwanted medical treatment.

What is a risk factor?

the probability of developing a disease when a particular factor is present.

Define Pathophysiology:

the study of abnormalities of physiologic functioning of living beings.

Define Clinical Manifestations:

signs and symptoms of a pathophysiologic process.

Define Symptom:

subjective → reported by the individual (what someone tells me)

Define Signs:

objective → found through clinical examination, labs, or X-rays/imaging (what I can see)

Define Latent:

the time between exposure and when the host became infectious to others

Define Incubation:

the time between initial exposure to a pathogen and the first appearance of symptoms

What is the difference between latent and incubation?

The incubation period tracks the time from infection until symptoms appear, whereas the latent period tracks the time from infection until the host becomes infectious.

Define Prodromal period:

Beginning signs and symptoms

Define Acute phase:

rapid onset and short duration (hours, days, weeks)

Define Chronic Phase:

refers to a condition that develops slowly and persists over a long period

Define subclinical phase:

the stage of of a disease where microscopic or functional changes are occurring in the body, but no clinical signs or symptoms are yet visible or felt by the patient.

Define Exacerbations:

a sudden worsening or flare up of the symptoms of a chronic disease

Define Remissions:

a period during a chronic disease where symptoms temporarily decrease, disappear, or become inactive.

Define Convalescence:

Means the patient is getting better

Define Sequela:

a chronic, long term condition or complication that results directly from a previous acute illness or injury

What are some factors affecting disease?

• Age

• Gender

• Genetic and Ethnic Background

• Geographic Area

What are the three levels of prevention?

Primary Prevention, Secondary Prevention, Tertiary Prevention

Define Primary Prevention and list an example.

Prevent the disease ( keep the person from getting the disease process)

Examples:

• Improved nutrition, housing, and sanitation

• Immunizations

• Education

• Safety precautions-seat belts, speed limits, chemicals

Define Secondary Prevention and list an example.

Early detection treatment and prevent

Examples:

• Physical examinations and routine screening

• Self breast exams

• Amniocentesis: a medical procedure where a small amount of amniotic fluid is removed from the uterus for testing during pregnancy.

Define Tertiary Prevention and list an example.

Reduce. Complications of established disease (helping someone who is already sick live the best life possible and keeping their illness from getting worse.

Examples:

• Once a disease is established, medical and surgical treatment(advanced disease and disability)

• Rehabilitation

What is the function of the plasma membrane?

• Act as a barrier from the external environment

• Separate intracellular fluid (ICF) from extracellular fluid (ECF)

• Protect internal organelles

• Control what enters and leaves the cell because it is semipermeable

• Membrane proteins transport charged ions in and out of the cell

• Membrane proteins also perform most of the membrane’s functions

What happens when the plasma membrane is injured?

• The guardian of the internal organelles is damaged.

• Injurious agents can affect any organelle.

• Water can enter the cell → causing swelling.

• Mitochondria can become damaged → energy production stops.

• Organelles swell and deteriorate.

• The nucleus is also vulnerable to injury

____________ provide most of the membrane function.

Membrane Proteins

How do large molecules cross the plasma membrane?

Endocytosis and exocytosis

• Endocytosis = the cell takes in large molecules from outside the cell.

  • Pinocytosis = “cellular drinking”

  • Phagocytosis = “cellular eating”

• Exocytosis = the cell secretes/releases large molecules outside the cell.

Explain the Sodium-Potassium pump

a. Function

b. Does it need energy (ATP)?

c. Maintains LOW___concentrations in the cell and HIGH____.

a. Function: Maintains low sodium (Na⁺) and high potassium (K⁺) concentrations in the cell and maintains cell volume.

b. Does it need energy (ATP)? Yes.

c. Maintains LOW sodium (Na⁺) concentrations in the cell and HIGH potassium (K⁺) concentrations in the cell.

What is the function of the mitochondria?

The mitochondria are the energy producers of the cell.

• They convert organic nutrients into ATP.

• ATP is the principal source of cellular energy.

• Aerobic metabolism occurs inside the mitochondria and requires oxygen

Describe Aerobic metabolism and Anaerobic metabolism.

• Aerobic metabolism= happens inside the mitochondria and requires oxygen.

• Anaerobic metabolism= happens outside of the mitochondria and is also called glycolysis.

AEROBIC = AIR → oxygen → mitochondria

ANAEROBIC = without oxygen → outside mitochondria (makes lactic acid)

Which is more efficient aerobic metabolism or anaerobic metabolism?

AEROBIC = AIR → oxygen → mitochondria (gives 34 ATP molecules)

Describe the functions of lysosomes.

• Contain digestive enzymes.

• Digest particles brought into the cell by endocytosis, pinocytosis, or phagocytosis.

• Digest worn-out cell parts.

• When a cell dies, lysosomes can rupture and release enzymes that digest the whole cell → autolysis.

lysosomes = “clean-up crew” → they break down things the cell needs to get rid of.

Ribosomes manufacture _______________.

Proteins

The ______________houses the DNA of the cell.

nucleus

Homeostasis is the attempt by the body to maintain internal conditions to a “set point” in response to ______________

stressors

Cells adapt to stress. The adaptation can be adaptive or maladaptive---reversible or irreversible. Describe these cellular adaptations and give an example of WHY it would happen.

a. Atrophy = cells get smaller
👉 Happens when the cell isn’t being used much.
Example: muscle gets smaller from disuse.

b. Hypertrophy = cells get bigger
👉 Happens when the cell has to work harder.
Example: heart gets bigger from hypertension.

c. Hyperplasia = more cells
👉 Happens when the body needs more cells.
Example: pregnancy → more breast cells for milk production.

d. Metaplasia = one cell type changes into another
👉 Happens because the environment is irritating the cells, usually with chronic inflammation.
Example: esophagus cells change because of constant stomach acid irritation.

e. Dysplasia = abnormal/deranged cell growth
👉 Cells become different in size, shape, and organization.
Example: can become precancerous.

f. Neoplasia = new, uncontrolled growth
👉 Cells grow uncontrollably and disorganized; usually refers to cancerous growth.

What happens when the sodium-potassium pump fails? Why?

If it fails:
→ Na⁺ builds up inside the cell
→ Water follows Na⁺ into the cell
→ Cell swells
→ If severe, the cell can burst.

Why? The pump normally keeps Na⁺ low inside the cell and helps maintain cell volume.

What happens with loss of plasma membrane integrity?

Loss of plasma membrane integrity = the cell’s protective barrier is damaged.

→ Water can enter the cell → swelling
→ Mitochondria can be damaged → energy production stops
→ Organelles swell and deteriorate
→ The nucleus can also be injured.

What happens when proteins are not synthesized?

→ ATP (the cell’s main source of energy) is low
→ Protein production begins to fail
→ Cell degeneration (the cell is becoming damaged and losing its normal structure and function) can begin
→ Cell death can occur.

What happens with genetic damage? Example?

Genetic damage = damage to the cell’s DNA.

→ DNA is injured → mutations occur → cell structure and function can change → abnormal proteins may be produced → changes may be incompatible with life.

Example: exposure to high doses of radiation can trigger cancerous cell changes.

Cells can be damaged by too much of a substance accumulating within the cell.

Give an example of this. Could it be reversible?

Example: jaundice — abnormal substances can accumulate within cells.

Yes, it could be reversible if the accumulation is brought under control.

What cases injury to cells?

a. Define hypoxia. What causes hypoxia?

b. How do free radicals injury a cell? How can we counteract free radical

injury?

c. What is am example of a physical agent of injury?

d. What is an example of chemical injury?

e. What types of microorganisms cause cellular injury?

f. What does it mean to have immunological reaction?

g. Genetic disorders can mutate and damage cellular ________.

h. What types of nutrients to cells need to function?

a. Hypoxia = not enough oxygen getting to the cell.

Causes:
→ Ischemia
→ Anemia
→ Low oxygen in the environment
→ Inadequate oxygen diffusion
→ Suffocation
→ Airway obstruction

b. Free radicals = harmful molecules that damage the cell.

→ They damage organelles and the nucleus.
→ Antioxidants (vitamins A, E, C, and beta-carotene) help fight them.

c. Physical injury example:
→ Mechanical trauma, such as a fall, laceration, or gunshot wound.

d. Chemical injury example:
→ Drugs, pollution, poison, or high blood glucose from diabetes.

e. Microorganisms:
→ Bacteria
→ Viruses
→ Fungi
→ Parasites

f. Immunological reaction = the immune system overreacts and attacks the body's own cells/tissues.

Example: autoimmune diseases like rheumatoid arthritis.

g. Genetic disorders can mutate and damage cellular ________.
→ DNA

h. Nutrients cells need:
→ Amino acids
→ Glucose
→ Fats
→ Minerals
→ Carbohydrates
→ Proteins

What is endothelium?

a thin layer of cells that lines the inside of arteries.

What causes endothelial cell injury and WHY?

a. Hypertension

b. Free radicals

c. High glucose

d. Hyperlipidemia

a. Hypertension → high pressure creates a strong shearing force against the artery wall → damages the endothelium.

b. Free radicals → attack the endothelium → disrupt its integrity.

c. High glucose → glucose attaches to endothelial cells → disrupts their integrity → can lead to arteriosclerosis.

d. Hyperlipidemia → low density lipoproteins combine with WBCs in the artery wall → starts the process of atherosclerosis.

2 types of irreversible cellular injury:

a. Describe necrosis

b. Describe apoptosis

a. Necrosis = cell/tissue death because the injury is too severe or prolonged. The cell’s contents are released into the bloodstream.

Example: myocardial infarction → ischemic necrosis.

b. Apoptosis = programmed cell death that happens naturally over a specific time. It normally has no harmful effects on the body.

Example: WBCs die by apoptosis after an inflammatory reaction.

What types of interventions by the health care team can help reverse cell injury?

• Remove the thing causing the injury.

• Restore circulation or nerve stimulation.

Is all stress negative? Explain

No. Stress can be positive or negative.

• Eustress = positive stress → motivates you.

• Distress = negative stress → negatively affects your well-being.

What happens in the stress response? Explain each

• Neurological → the nervous system becomes activated.

• Endocrine → hormones are released/activated.

• Immune → the immune system is suppressed.

a. ALARM = Fight or Flight 🚨

Your body is saying: “Something is wrong! Get ready!”

• SNS → releases norepinephrine (a catecholamine)

• Adrenal medulla → releases epinephrine (catecholamine)

• Adrenal cortex → releases cortisol

• Your notes list aldosterone under the adrenal medulla, but they don't explain its effect.

• Overall → your body becomes more alert and ready to respond to the stressor.

b. RESISTANCE = Body tries to cope

• The body keeps releasing hormones/catecholamines to fight the effects of stress.

• This stage is time-limited.

• When the stress goes away → SNS/adrenal stimulation decreases → PSNS takes over → body relaxes.

Easy way:

Alarm = GO! 🚨 → Resistance = KEEP FIGHTING → PSNS = RELAX 😌

c. EXHAUSTION = Body runs out of resources

If the stress lasts too long:

→ Hormone/catecholamine levels can't stay high

→ Body's resources become depleted

→ Body starts showing dysfunction

→ Person may feel run-down, depressed, anxious, or physically sick.

🧠 Remember: Alarm → Resistance → Exhaustion.

a. ALARM = Fight or Flight 🚨

Your body is saying: “Something is wrong! Get ready!”

• Sympathetic Nervous System → releases norepinephrine (a catecholamine)

• Adrenal medulla → releases epinephrine (a catecholamine)

• Adrenal cortex → releases cortisol

• Your notes list aldosterone under the adrenal medulla, but they do not explain its effect.

• Overall → your body becomes more alert and ready to respond to the stressor.

b. RESISTANCE = Body tries to cope

• The body keeps releasing hormones and catecholamines to fight the effects of stress.

• This stage is time-limited.

• When the stress goes away → sympathetic nervous system and adrenal stimulation decrease → parasympathetic nervous system takes over → body relaxes.

Easy way:

Alarm = GO! 🚨 → Resistance = KEEP FIGHTING → Parasympathetic Nervous System = RELAX 😌

c. EXHAUSTION = Body runs out of resources

If the stress lasts too long:

→ Hormone and catecholamine levels cannot stay high
→ Body’s resources become depleted
→ Body starts showing dysfunction
→ Person may feel run-down, depressed, anxious, or physically sick.

🧠 Remember: Alarm → Resistance → Exhaustion.

What is allostatic load? What happens with allostasis overload?

Allostatic load = the “wear and tear” on the body caused by stress reactions.

Think: repeated or long-term stress → body keeps working hard → wear and tear builds up.

Allostatic overload = stress becomes greater than the body’s ability to adapt.

→ The body can no longer handle the stress → pathophysiological disorders can develop.

What are some interventions helpful in the treatment of stress?

• Reduce caffeine

• Yoga

• Exercise

• Get enough sleep

• Proper nutrition

• Stress management programs

• Psychotherapy

• Alternative medicine

• Pharmacology

Why is exercise beneficial?

• Increases metabolism

• Prevents obesity

• Lowers blood pressure and pulse rate

• Improves blood flow

• Helps the body use glucose

• Improves digestion

• Strengthens bones and muscles

• Increases oxygen/ventilation capacity

• Increases high density lipoprotein

• Helps prevent blood clots

• Raises endorphins → can improve how you feel

What is lipoprotein?

a substance that carries fats through the blood.

What are the harmful effects of inactivity and immobility

• Blood clots → venous stasis

• Low blood pressure when standing → orthostatic hypotension

• Heart becomes weaker/deconditioned

• Trouble taking a full breath

• Increased risk of aspiration and pneumonia

• Muscle shrinking → muscle atrophy

• Muscle tightening → contractures

• Bone breakdown → osteoporosis and fractures

• Urinary stasis → kidney stones

• Constipation

• Skin breakdown → pressure injuries

• Infection

• Isolation, depression, delirium, and cognitive impairment

🧠 Simple idea: less movement → problems with the heart, lungs, muscles, bones, digestion, urination, skin, and mental function.

What can the health care team to do counteract immobility?

• Active range of motion

• Passive range of motion

• Isometric exercise

• Aerobic exercise

• Change positions at least every 2 hours

• Use a special mattress

• Use anti-thromboembolic stockings

Where are pressure injuries likely to develop?

Pressure injuries are likely to develop over bony prominences.