HS/PHS 203 EXAM 2 STUDY GUIDE

Abnormal pap smear

Slides of abnormal cells shed from the surfaces of tumors

Grading and staging of tumors

TNM system

T

Size of the primary tumor

T0

In situ

T1-T4

Increasing size

N

Spread of tumor to regional lymph nodes

N0

No spread

N1-N3

Progressive lymph node spread

M

Distant metastasis

M0

No spread

M1-M2

Extensive metastasis

Stage 1/Early Stage

A small, invasive mass or tumor has been found; no spread to lymph nodes or other tissues; sometimes called early-stage or 'localized' cancer

Stage 2/Localized

Cancer has started to affect nearby tissue; mass may have grown in size; spread to lymph nodes near the mass

Stage 3/Regional Spread

Cancer affects more surrounding tissue; mass may have grown in size; spread to distant lymph nodes away from the mass

Stage 4/Distant Spread

Cancer has spread to other tissues or organs beyond the region where it originated; sometimes called advanced or 'metastatic' cancer

Malignant tumor blood supply

Derives blood supply from tissues they invade; malignant tumors outgrow blood supply; new blood vessels multiply in adjacent normal tissues

Retinoblastoma

Malignant tumor of primitive retinal cells; loss of function of tumor suppressor gene - RB which controls cell growth in the retina; can be inherited or sporadic

Characteristics of a malignant tumor

Rapid, uncontrollable growth, the ability to invade and destroy surrounding tissues, and the capacity to metastasize to distant sites in the body

Carcinoma

Involves epithelial tissue; most common: 85% of all tumors found in skin, large intestine, glands, stomach, lungs, prostate; metastasis principally through lymph vessels

Sarcoma

Arising from connective tissues, such as fat, bone, cartilage, muscle; less common, but spreads more rapidly; little differentiation; anaplasia (lack of form); metastasis through bloodstream

Etiologic Factors

Chemical carcinogens, gene and chromosomal abnormalities, failure of immunologic defenses, heredity, viruses that cause some cancers in humans

Leukemia

Neoplasm of blood cells; usually does not form solid tumors; proliferates within bone marrow, crowds out blood-forming cells; neoplastic cells spill over into the bloodstream

Neoplasm development

Many neoplasms take years to spread; neoplasms derive from a single cell (stem cell); tumor heterogeneity; cells within the tumor are very diverse; tumor grows and mutates

Chemotherapy

Eliminates cells that divide frequently; used to destroy subclinical metastases that have spread from the primary tumor; normal cells recover quickly, side effects disappear gradually

Apoptosis

Role in cancer prevention

Indirect transmission

transmission through an intermediary

Contaminated food or water

source of indirect transmission

Chlorination of water supplies

method to control the spread of infection

Effective sewage treatment facilities

method to control the spread of infection

Standards for handling, manufacturing, and distributing commercially prepared foods

method to control the spread of infection

Eradication and/or control of animal sources and vectors

method to control the spread of infection

Insect vector

organism that can transmit disease

Reverse transcriptase

enzyme that makes a DNA copy of RNA genetic material in HIV

HIV integrase

enzyme that inserts DNA copy into cell's genetic material

Syphilis

caused by Treponema pallidum; can cause severe damage to almost any organ in the body

Primary syphilis

penetrates mucous membranes and forms a chancre

Secondary syphilis

systemic infection with skin rash and enlarged lymph nodes

Tertiary/Latent Phase syphilis

late destructive lesions in internal organs, may appear 20 years after initial infection

Congenital Syphilis

transmission of disease from mother to child, may cause death of fetus or infant

Gonorrhea

primarily infects mucosal surfaces such as urethra and genital tract

Chlamydia

most commonly reported STD; clinical manifestations similar to gonorrhea

Retrovirus

type of virus that uses RNA as its genetic material and replicates by converting RNA to DNA

Clinical manifestations of HIV

symptoms and effects of HIV infection

Early stage of HIV

Large amount of virus detected in blood and body fluids.

Infected lymphocytes

Large numbers of infected lymphocytes in lymph nodes.

Mild febrile illness

Early symptom of HIV infection.

Anti-HIV antibodies

Body responds by forming anti-HIV antibodies (in 1 to 6 months after initial infection) and cytotoxic T cells.

Virus amount decline

Amount of virus declines, but body's defenses cannot eliminate virus.

Continuous virus production

Large numbers of virus produced continuously that infect and destroy CD4 cells and circulate in bloodstream.

Virus amount correlation

Amount of virus correlates with magnitude of infection.

Chronic stage of HIV

Eventually, rate at which CD4 cells are replaced cannot keep up with rate of destruction.

Antiviral drugs

Antiviral drugs can suppress proliferation and damage but cannot eliminate virus.

AIDS cure

There is no cure for AIDS.

Primary therapy for HIV

Primary therapy includes use of various combinations of three different types of antiretroviral.

Goal of HIV treatment

Maximally inhibit HIV viral replication with fewer adverse reactions.

Highly Active Antiretroviral Therapy (HAART)

Treatment regimen for HIV; drugs given in combination to target different phases of the virus life cycle.

Ulcerative Colitis

Inflammation is limited to mucosa, bowel not thickened; frequently begins in rectal mucosa and spreads until entire colon is involved.

Ulcerative Colitis complications

Bleeding; bloody diarrhea; perforation; long-standing disease may develop cancer of colon and/or rectum.

Crohn's Disease

Chronic inflammation and ulceration of bowel mucosa; thickening and scarring of the entire thickness of the bowel wall.

Skip lesions

Affects scattered areas of the distal ileum.

NSAIDs

Nonsteroidal anti-inflammatory drugs; can cause acute gastritis when inhibiting cyclooxygenase (COX) enzyme.

Obesity

Any caloric intake that exceeds requirements is stored as adipose tissue and weight is gained.

Obesity consequences

Diabetes, hypertension, cardiovascular disease, musculoskeletal disabilities.

Intussusception of the colon

Telescoping of a segment of bowel into the adjacent segment; common cause of intestinal obstruction in children.

Lactose intolerance

Unable to digest lactose into glucose and galactose for absorption due to lactase deficiency.

Inguinal Hernia

Common in men; loop of small bowel protrudes through a weak area in inguinal ring and descends downward into scrotum.

Umbilical Hernia

Loop of bowel protrudes into umbilicus through defect in the abdominal wall.

Femoral Hernia

Loop of intestine extends under inguinal ligament into the groin.

Reducible Hernia

Herniated loop of bowel can be pushed back into abdominal cavity.

Incarcerated Hernia

Cannot be pushed back.

Strangulated Hernia

Loop of bowel is tightly constricted, obstructing the blood supply to the herniated bowel; requires prompt surgical intervention.

Volvulus Hernia

Rotary twisting of bowel impairing blood supply; common site is sigmoid colon.

Fistula

An abnormal connection between two body parts, such as an organ or blood vessel and another structure; usually the result of an injury or surgery.

Achalasia

Sphincter fails to open properly due to malfunction of nerve plexus; esophagus becomes dilated from food restriction.

Incompetent esophageal cardiac sphincter

Sphincter remains open & gastric juices leak back into esophagus.

Reflux esophagitis

Complications include inflammation, ulceration, and scarring of squamous mucosal lining.

Barrett's esophagus

Cellular change from squamous to columnar epithelium; increases risk for cancer.

Symptoms of esophageal diseases

Difficulty swallowing (dysphagia), substernal discomfort or pain, inability to swallow (complete obstruction), regurgitation of food into trachea, choking and coughing.

Risk factors for esophageal carcinoma

Related to alcohol intake, smoking, consumption of near boiling beverages, and possibly HPV.

Helicobacter pylori

Small, curved, gram-negative organisms that colonize the surface of gastric mucosa; produce urease that decomposes urea into ammonia, increasing risk of gastric acid and duodenal ulcers.

Dental plaque

Sticky film on teeth formed by aerobic and anaerobic bacteria mixing with saliva.

Dental cavity

Loss of tooth structure from bacterial action.

Gingivitis

Inflammation of the gums due to masses of bacteria and debris accumulating around base of teeth.

Periodontal disease

Inflammation extends to tissues that support teeth; forms small pockets of infection between teeth and gums.

Pyorrhea

Pus discharged from the gums.

Stomatitis

Inflammation of the oral cavity caused by irritants or infectious agents.

Trench mouth/Vincent angina

Two bacteria that cause necrotizing gingivitis.

Carcinoma of the Oral cavity

Arises from squamous epithelium (lips, cheek, tongue, palate, back of throat); frequently metastasizes.

Bioprosthetic

Two types: Porcine (pig) and Bovine (cow). Aortic valves inserted with a catheter or surgically.

TAVR

Transcatheter Aortic Valve Replacement. Does not require anticoagulation. Not as durable as mechanical valves (10-15 years).

Mechanical

Three types: Caged-ball, Tilting circular disk, Bi-leaflet. More durable, lasts longer (20 years). Requires lifetime of anticoagulation.

Impact of cocaine on cardiovascular system

Prolongs and intensifies effects of sympathetic nervous system. Increases heart rate: increased oxygen demand. Increased muscle irritability: predisposes to arrhythmias. Increased peripheral vasoconstriction and coronary artery spasm: high blood pressure. Fatal arrhythmias and MI can occur even among those with normal coronary arteries.

Function of the heart

Muscular pump; propels blood through the lungs to the tissues.

Location of the heart

Located within the mediastinum (approx. from the 2nd intercostal space to the 5th). Rests on the diaphragm. Anterior to vertebral column and posterior to sternum.

Chambers of the heart

Right atrium (RA) and Right ventricle (RV): Pulmonary pump, circulates blood into pulmonary artery, lungs. Left atrium (LA) and Left ventricle (LV): Systemic pump, circulates blood into aorta, organs and tissues.

Fastest way to diagnose a heart attack

ECG. Measures electrical activity of the heart.

P wave

Atrial depolarization, atrial systole.

QRS complex

Ventricular depolarization, ventricular systole.

T wave

Ventricular diastole.

PR interval

Time for depolarization to pass from atria to ventricles via AV bundle.