Patho cell adaptation

Many patients develop cancer due to the malignant transformation of proto-oncogenes to oncogenes and the deactivation of tumor suppressor genes.  Which of these are tumor suppressor genes?

Question 1 options:

	D. MYC
	B. Her2-neu
	A. p53
	C. Ras

p53

Your patient, Mrs. Rogers, tests positive for the Rb gene.  How would you explain what this means to her? 

Question 2 options:

	A. You still have one other functioning allele that can stop the cell cycle and uncontrolled cellular growth
	B. You have a genetic mutation that stimulates uncontrolled cellular growth
	C. You cannot produce regulatory proteins to stop the cell cycle
	D. Your proto-oncogenes have mutated into oncogenes

You still have one other functioning allele that can stop the cell cycle and uncontrolled cellular growth

Four years later, Mrs. Rogers is diagnosed with stage II breast cancer.  What does this mean? 

Question 3 options:

	C. Her cancer has spread to distant sites
	D. Her cancer has spread to local sites
	A. Her cancer has spread to regional structures
	B. Her cancer is only in the organ of origin

Her cancer has spread to local sites

For many patients with cancer, there is no identifiable genetic cause.  However, there are other things in a patient's history which put them at risk for oncogenesis (developing cancer).  Which of these are possible causes of cancer?

Question 4 options:

	A. Chronic hepatitis B infection
	B. Acute bacterial infection
	C. Ulcerative colitis
	D. Both A and C
	E. All of the above.

Both A and C

p53 definition

a critical tumor-suppressor gene often called the guardian of the genome

Stage 1

The cancer is confined to its organ of origin

Stage 2

The cancer has become locally invasive, meaning it has begun to grow into nearby tissues beyond the initial site

Stage 3

The cancer has advanced to regional structures, such as nearby lymph nodes

Stage IV

The cancer has spread to distant sites and other tissues in the body

Which of these could be a cause of the patient’s hypovolemia?

Question 4 options:

	A. Profuse vomiting and diarrhea
	B. Diabetes Insipidus
	Burns on greater than 50% of body surface area
	All of the above

All of the above

You would expect to see these clinical signs and symptoms in your patient who is severely dehydrated and hypovolemic.

Question 2 options:

	C. Decreased urine output
	Warm extremities
	B. Hypertension
	A. Normal capillary refill

Decreased urine output

A patient is severely dehydrated and hypovolemic. Given that the body needs blood volume to adequately perfuse its tissues, how could the body compensate for this loss of volume?

Question 1 options:

	C. Increasing urine output
	B. Increasing vasoconstriction
	D. Shunting blood away from core organs via peripheral vasodilation
	A. Decreasing heart rate

Increasing vasoconstriction

How will this mechanism by the cells affect the patient’s pH?

Question 4 options:

	This would further aggravate the alkalosis.
	The patient would become more acidotic.

This would further aggravate the alkalosis.

How do the cells compensate for this electrolyte imbalance?

Question 3 options:

Sodium will shift into the ICF compartment of the cell

Water will shift out of the cell and into the ECF compartment

There will be a transcellular shift of calcium into ICF compartment of the cell

The cells will shift potassium from the intracellular fluid (ICF) to the extracellular fluid (ECF) compartment

The cells will shift potassium from the intracellular fluid (ICF) to the extracellular fluid (ECF) compartment

What electrolyte imbalance would you expect to see with this patient?

Question 2 options:

Hyperkalemia

Hypernatremia

Hypokalemia

Hypocalcemia

Hypokalemia

A patient is admitted with an adrenal tumor that secretes too much aldosterone. Based upon this finding, what acid-base imbalance is this patient at risk for?

Question 1 options:

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

metabolic alkalosis