Oncology 1 Section 3 Exam

phases of mitosis

• interphase - DNA replicates, cell prepares for division

• prophase - centrioles move to opposite poles of the cell and ch romatin granules organize into chromatids

• metaphase - chromatin granules align and attach to centrosomes

• anaphase - chromosomes formed

• telophase - division of the cytoplasm, two new nuclear membranes appear to enclose each new set of chromosomes

first step in healing process

inflammation

cardinal signs of inflammation (first person)

• tumor - swelling

• dolar/dolor - pain

• calor - heat

• rubor - redness

• functio laeso/laesa - loss of function

• first described by Celsus/Celsius

pus

result of the death of millions of leukocytes

embolus

circulating blood clot that has become detached or particle

types of anoxia

• stagnant anoxia - due to ischemia

• anoxic anoxia - insufficient pulmonary oxygenation

• anemic anoxia - reduced hemoglobin

• histotoxic anoxia - inability of cells to utilize oxygen effectively

round cells

• characteristically found in chronic inflammation

  • “constant warriors”

• monocytes

• macrophages

• lymphocytes

• plasma cells

common tumor markers

• carcinogenic embryonic antigen (CEA)

  • most commonly used

  • normal range: 0-3.0

  • non-specific

    • recurrent colorectal disease

    • breast, lung, ovarian, and pancreatic cancer

    • may be elevated in patients who smoke or have malignant liver disease

• prostate specific antigen (PSA)

  • normal range: 1-4

  • helpful but not diagnostic (DRE)

• alpha-fetoprotein (AFP)

• monitor some liver and some testicular cancers

• beta human chorionic Gonadotropin (b-HCG)

  • very specific and very sensitive for choriocarcinoma (aggressive form of testicular cancer)

• Ca 15-3

  • breast cancer antigen test

  • relatively new for monitoring breast cancer

• Ca 19-9

  • primarily used for colorectal cancer

  • also can be used for pancreatic and stomach cancer

• Ca 125

  • helpful for monitoring ovarian cancer

• alkaline phosphatase/acid phosphatase

  • indicative of bone metastases

lysosomes

digestive system of the cell

nitrogenous bases of DNA

Adenine attached to Thymine

Cytosine attached to Guanine

types of muscle cells

• smooth - one oval nucleus

• skeletal - multi-nucleated and contain a large number of mitochondria which supply energy for contraction

• cardiac

chemotaxis

direct migration of inflammatory cells toward an inured area

leukocytosis

increase in the number of circulating leukocytes (white blood cells) associated with the inflammatory reaction

anergy

a condition in which a proper inflammatory response does not or cannot occur

necrosis

irreversible change resulting in local death of the cell

histotoxic anoxia

anoxia caused by an inability of the cells to utilize oxygen

B-cell vs T-cell lymphocytes

• B-cells

  • responsible for the humoral response

  • derived from the bone marrow

  • protect against bacteria

• T-cell

  • responsible for the cellular mediated response

  • derived from thymus

  • protect against tumors, bacteria, viruses, and transplant rejection

antigen

any substance that is capable of triggering an immune response

ribosomes

synthesize proteins

infarct

complete blockage of blood to an area

hematoma

hemorrhage involving an accumulated swelling of blood such as a blood blister

acquisition of immunity

• active natural - acquired when body is exposed to a pathogen/antigen like a virus or bacteria and immune system creates antibodies

• active artificial - e.g., inoculation or vaccinations, on every subsequent occasion that a person is exposed to the disease, immunologic memory mobilizes a response so fast that the toxin is neutralized before it produces the disease (amnestic response) which generally diminishes as times goes by but boosters can re-awaken the waning immunity

• passive natural - transfer of antibodies from mother to fetus or infant through the placenta or breast milk

• passive artificial - transfer of antibodies from a previously immune person, e.g., bone marrow transplant

macrophage

cell type responsible for recognizing, phatocytosing, and transporting antigenic material to the lymph nodes

antigens

• substance that, when introduced into the body, initiates an immune response

• usually foreign to the host

  • infectious agents

  • foreign proteins

  • tissue grafts

opportunistic infections

infections that occur during times of low resistance

causes of inflammation

• microbes - most common

• hypoxia

• ionizing radiation

• chemicals

• allergic or immune reactions

• cancer

endoplasmic reticulum

• circulatory system of the cell

• principle component of cytoplasm

mitochondria

• “power plant” of the cell

• produces energy (ATP) for the cell from sugars and other organic fuels

keloid treatment

• resections and steroid injections

• resection followed by low dose radiation (900-1200 cGy in 3 fractions) if not successful

prognostic factors for breast cancer

• S-phase index - number of cells that activiely dividing

• ploidy - amount of DNA that each cell contains

• estrogen receptor

• progesterone receptor

• Cathepsin D - relatively new prognostic marker that measures an enzyme present in cells which is directly related to aggressiveness of tumor

cancers associated with Epstein-Barr Virus (EBV)

• Hodgkin’s disease

• Nasopharyngeal cancer

• Burkitt’s lymphoma

• immunoblastic lymphoma

petechiae

very small “pin point” hemorrhage

composition of “ingredients” in cells

• 80% water

• 15% protein

• 3% lipids

• 1$ carbohydrates

• 1% nucleic acid

superficial lymph node groups

• cervical

• axillary

• inguinal

collateral circulation

developing new pathways to lymph vessells

methods by which lymph is circulated through the body

• skeletal muscle contractions

• respiratory movements

organ that assumes the function of the spleen if removed

liver

size of a typical normal lymph node

1-25 mm in length (kidney bean)

afferent vessels vs efferent vessels vs lymph sinuses

• afferent vessels - lead into node

• efferent vessels - lead away from the node

• lymph sinuses - maze inside node

first part of maze in lymph sinuses

corridor

spinal cord compression (treatment, symptoms, diagnosis)

• treatment

  • surgery = laminectomy + placement of stabilizing rods

  • RTT - higher doses for first few days than normal 300 cGy/day for 10 days

    • PA single 6cm wide field only

  • steroids - relieve pain and improve symptoms

  • analgesics/narcotics - control pain

  • chemotherapy - may help if primary is chemosensitive

• symptoms

  • back pain

  • paresthesia

  • coldness, especially in extremities

  • incontinence (urgency)

• diagnosis

  • MRI is best practical since patient would have to lie for long periods

  • myelogram

trabeculae

supporting structure or “skeleton” of a node

common presentation for SVC

upper thoracic and/or facial swelling (upper edema)

cancer patients that have some sort of pericardial involvement

20%

thymus gland

• somewhat obscure function but has some role in immunity

• can secrete hormones that regulate growth and development in small amounts

  • considered an endocrine gland by some

• larger in children thatn in adults

• located in upper thoracic cavity

chyle

lymph from digestive tract that is milky in appearance due to presence of fats

thoracic (left) lymphatic duct

• begins at the cisterna chyli and empties into left subclavian vein

• drains all lymph from every part of the body except the upper right quadrant

largest mass of lymphatic tissue in the body

spleen

primary functions of spleen

• to phagocyte bacteria and worn out blood elements

• produce lymphocytes

• store and release blood

effusion

escape of fluid into a part

tamponade

excess fluid in the pericardium

standard dose/fractionation for treating SVC

400 cGy/day for 3 days, then resume normal 180 cGy/day

paresthesia

numbness or tingling in extremities

cisterna chyli

dilated sac that serves as a reservoir for lymph from the intestines (chyle)

traditional RTT oncologic emergencies

• superior vena cava syndrome (SVC)

• spinal cord compression

• hemorrhages (usually from gynecological cancers)

spinal level of cisterna chyli

second lumbar vertebra (L2)

The microscope was introduced in the early part of what century?

17th century

clinical disease has its inception with some kind of cellular injury or malfunction that is ultimately expressed at what level of function

molecular/cellular

homeostatic state

a set of circumstances in which cellular processes associated with life proceed normally and in accordance with the function genetically assigned to that cell

hallmark of reversible damage

cellular swelling

most common cause of tissue damage

hypoxia

6 important causes of cell damage and common pathway

• radiation

• hypoxia

• chemicals

• microorganisms

• immunologic reactions

• neoplasms

common pathway to causing damage - free radicals

chromosomes

specific positions (or loci) on protein structures that genes are assigned to

cytosol

semi-liquid material that make up cytoplasm

golgi apparatus

• important in the storage and management of intracellular chemical substances

• synthesizes carbohydrates

• storehouse of the cell

ATP

adenosine triphosphate

phase of the cell cycle in which living cells are fully functional but not programmed for mitosis and will not divide

G0 or G1

shortest phase of the cell cycle

M or mitosis phase

phase of the cell cycle where in nuclear DNA is synthesized

S or synthesis phase

chemical components of nucleotides

• phosphate

• sugar (S. carbon)

• nitrogenous bases

nitrogenous base that substitutes for thymine in RNA

uracil

“building blocks of life”

proteins

body areas that do not typically have any access to lymph

• brain (due to CSF)

• spinal cord

• cornea

• epidermis (skin, hair, nails)

• very little in skeletal muscles