Test 4 bio

layers of the skin

epidermis, dermis (derma), subcutaneous (fat layer)

epidermis

made of keratinocytes (outermost layer is dead keratinocytes) and basal cells at the bottom and melanocytes

dermis

middle, has blood vessels

types of skin cancer

squamous cell carcinoma, basal cell carcinoma, melanoma

melanoma

deadliest and rarest; most likely to metastasize; develops from melanocytes in the dermis; 4%; most common in areas exposed to the sun (women-legs and men-trunk);

basal cell carcinoma

80%; most common; slow growing and less aggressive; least likely to metastasize; develops from basal cells deep in the epidermis

squamous cell carcinoma

16%; tend to form in areas exposed to the sun, scares, tissue damage, x-rays, or consistent exposure to harsh chemicals; will metastasize but normally just to the subcutaneous layer not the bloodstream; forms from top of epidermis

risk factors for skin cancer

over exposure to UVB; tanning beds, too much time in the sun, age, no sunscreen, family history, genetics

tanning

your cells are being exposed to more UV so melanocytes are making more melanin to protect against that UV

burning

cells have too much DNA damage that they can no longer survive so they die off; dead cells cause peeling (dead cells shedding) blisters (pus from dead cells) and redness (blood to the aera)

why does your sunburn turn white when you touch it

blood as rushed to the site of the burn to help with healing and when you press on the area you are moving the blood away (then it will come rushing back when you move your finger)

UVA

damage to subcutaneous layer, responsible for aging and wrinkles, longer wave lengths so they go deeper

UVB

breaks hydrogen bonds btw DNA strands and causes thymine dimers which cause changes in gene expression and protein structure; attacks top layer of skin; causes cancer

UVC

absorbed by the ozone layer

why is nucleotide exchange repair important in protection from skin cancer

it removes thymine dimers so that they do not cause changes in gene expression and protein production

melanin

protects against UVA and B; absorbs the UV light and prevents it from damaging the DNA

Can you still develop skin cancer if you tan easily

yes

biopsy

provides a diagnosis whether a lesion is malignant or not

excisional biopsy

remove lesion and tissue around the sus area

incisional biopsy

remove only part of the lesion

punch biopsy

epidermis, dermis, subcutaneous layers are removed ; take out whole lesion and probe is designed to kills the cells around; hole punch

nail bed biopsy

taking biopsy from the nail bed to test for cancer

treatment options for skin cancer

localized: cryosurgery, topical chemo, photodynamic therapy, immunotherapy metastatic: systemic chemo

cryosurgery

liquid nitrogen to kill cancer cells

topical chemo

form of cream applied to surface of the skin; 5-flurocil chemo

5-flurocil chemo

mimics a uracil, interferes with RNA function, and impacts protein function

photodynamic therapy

patient gets drug photosensitizer which the cancer absorbs in 24-72 hrs; cells that absorbed the drug are exposed to light which causes the drug to make a form of oxygen that kills cancer cells

immunotherapy

helping the immune system kill off the cancer cells bc cancer cells have learned to avoid it; PD-1 and PD-L1 inhibitors allow for cancer cells to be recognizable again

systemic chemo

given as a pill or injection (5-Flurocil)

lobules

milk producing glands

ducts

bring milk to nipple

areola

dark-pigmented area surrounding the nipple

nipple

projection from the breast; baby uses it to get milk

HER2 +

too many HER2 receptor proteins on the outside that send more signals, causing cells to grow too quickly; targeted by drug herceptin

ER+

estrogen receptor positive; too many estrogen receptors inside the cell, estrogen fuels the growth and division of breast cancer cells; targeted by tamoxifin

different types of breast cancer

ductal breast cancer, lobular breast cancer, mixed tumor breast cancer, inflammatory breast cancer, mucinous breast cancer

BRCA1 and BRCA2

BRCA1 and BRCA2 are tumor suppressors that encode for proteins that are responsible for fixing breaks in chromosomes. Without these proteins, there will be breaks in chromosomes that will go unfixed. Breaks in chromosomes that are not repaired-> changes in the proteins encoded-> affect cellular activities-> promote cancer; breast, ovarian, pancreatic, melanoma

treatment that helps mutations in BRCA1/2

PARP inhibitor

breast exam

1. look at yourself in a mirror with arms by your sides
2. feel your breasts while lying down
3. feel your breasts while standing up

mammogram

x-ray image of the breast to detect tumors

how cells metabolize and how that is different in tumor cells

cellular respiration- 1. glycolysis (makes NADH and ATP) 2. Krebs cycle (NADH and FADH2) 3. electron transport chain (converts NADH and FADH2 into ATP); but cancer uptake larger amounts of glucose and use fermentation rather than cellular respiration

PET imaging

labeled with F-18 fluoro-2-deoxyglucose (radioactively labeled sugar) that can be seen by a machine; because tumors uptake glucose compared to normal tissue the tumors light up

treatment of breast cancer

chemotherapy (paclitaxel), radiation, surgery, targeted therapy- Herceptin and tamoxifen

herceptin

inhibits HER2 receptors

tamoxifen

inhibits ER receptors

privilege can affect diagnosis and treatment of breast cancer

higher socioeconomic status is associated with breast cancer bc of things that they do like dink more, have few children, have kids later in life, use birth control, and use menopausal hormone therapy

lactation

1. sucking stimulates nerves in the nipple and areola that travel to hypothalamus
2. in response, the hypothalamus stimulates the posterior pituitary to release oxytocin and the anterior pituitary to release prolactin
3. oxytocin stimulates lobules in breast to let down milk; prolactin stimulates additional milk production

why mothers feel contractions during breast feeding

oxytocin also stimulates contractions during labor

pap test

doctor takes a sample from cervix and examines it for changes; results: something is wrong or everything is fine

cervix

donut-shaped organ that connects the uterus to the vagina; closed during pregnancy and becomes dilated during labor; protects baby from infection and helps keep baby in the womb

major risk factor for cervical cancer

HPV which is a tumor virus

tumor viruses

integrate into chromosomes by or in DNA, can convert a proto-oncogene to an oncogene

treatment for cervical cancer

laser therapy, if spread it may need chemo

is there a vaccine for cervical cancer

yes; vaccine HPV

other cancer that HPV can cause

mouth and throat

why everyone who has BRCA1 and BRCA2 mutations wont get cancer

risk doesn't mean that they are going to get cancer, just that it is easier

types of head and neck cancer

hypopharyngeal cancer, lip and oral cancer, oropharyngeal cancer, nasopharyngeal cancer, metastatic squamous neck cancer, esophageal cancer, salivary glad cancer

challenges with head and neck cancer

can mess with voice, chewing, swallowing, eating; can be caused from radiation to help thyroid cancer

diagnosis of head and neck cancer

identified through inspection and palpation of the area; endoscopy, biopsy, CT and MRI, PET scan, bone scan, laryngoscopy,

EBV

Epstein-Barr virus; infects epithelial cells then b cells; can lead to nasopharyngeal cancer, mono; no vaccine

HPV

human papillomavirus; can cause head and neck cancer specially lip and oral cancer and cervical cancer; cause cells to divide instead of killing them off; do have vaccines to help prevent cancers caused by HPV; sequences similar to oncogenes

how tumor viruses integrate

into chromosomes by or in DNA, can convert a proto-oncogene to an oncogene; Genetic information from tumor viruses can integrate near proto-oncogenes and tumor suppressors in cells impacting their expression

head and neck cancer treatment

surgery, radiation, photodynamic therapy, cetuximab

cetuximab

antibody that targets a HER protein called EGFR or HER 1; binds outside cell and prevents cell from doing things it needs to thrive

digestive system

ingestion (food in mouth), to pharynx, esophagus, stomach, pyloric sphincter, small intestine, large intestine, appendix, colon, rectum anus

digestive system: what happens?

ingestion, digestion, absorption, elimination

mouth

teeth are for mechanical breakdown which increases surface area for enzymatic activity and ease of swallowing; salivary glands secrete saliva to lubricate food (contains amylase which initiates breakdown of starch); tongue manipulates food

bolus

chewed and lubricated food, what you swallow

swallowing

bolus moves to pharynx (back of the mouth); epiglottis covers the glottis to prevent choking, and bolus moves down esophagus

esophagus

muscular tube that passes food from mouth to stomach with peristalsis (muscular contractions); no absorption or digestion)

stomach

large, muscular sac; contains gastric fluid (HIC and pepsin); digest protein; mucus to protect lining bc of acid

Chyme

Partially digested, semiliquid food mixed with digestive enzymes and acids in the stomach.

pyloric sphincter

regulates the passage of chyme into small intestine

small intestine

23ft long, primary site for chemical digestion and absorption of nutrients; releases enzymes; numerous folds with villi (finger like projections) to hold the food and help it break down

gall bladder and liver

releases stored bile which acts as a detergent to emulsify fat

pancreas

releases sodium bicarbonate and neutralizes the chyme; exocrine gland releases enzymes such as amylase lipase, proteases, nucleases which breakdown food molecules to monomers for absorption; location of insulin production; head is by the small intestine and the tail is by the spleen

type one diabetes

any age; caused by the immune system destroying beta cells that secrete insulin in pancreas; people with little to no insulin cannot transport glucose to cells

type two diabetes

cells are no longer sensitive to insulin and cannot take sugar u pinto their cells; any age but most common in people over 40

Whipple

disease in the head of the pancreas, part of pancreas and small intestine and reconstruction/reseal after

stages of pancreatic cancer

1, 2, 3: a tumor has formed at the pancreas (stage 2b and 3 tumors may have regional spread to lymph nodes); 4:once cancer has spread to distant organs

cancers that BRCA1/2 mutations can cause

pancreatic, breast, ovarian, melanoma

common symptoms of pancreatic cancer

diabetes, jaundice, abdominal and lower back pain; changes in pee color

treatments of pancreatic cancer

whipple, olaparib (PARP inhibitor if BRCA 1/2), combination therapy Folfirinox

why does a tumor at the head of the pancreas cause jaundice

with a tumor at the head of the pancreas it messes with how the bile duct functions

absorption

water soluable- monosaccharides, amino acids, nucleotides all go to the blood stream; non water soluable- lipids go to lacteals (lymphatic system)

risk factors for pancreatic cancer

pancreatitis, obesity, smoking, old age, diabetes, family history, mutations in BRCA1 and 2 genes

4 classifications that are used for diagnoses for treatment purposes of pancreatic caner

resectable pancreatic tumors, borderline resectable tumors, locally advanced tumors, metastatic tumors

resectable pancreatic tumors

tumors that often have not made their way to the circulatory system or lymphatics and will likely be able to be successfully surgically removed

locally advanced tumors

have involvement of the circulatory system and/or lymphatic system that has high involvement of other organs before treatment; Surgery is often not an option

metastatic tumors

have spread throughout the body and cancer cells are detected in distant organs

borderline resectable tumors

tumors that have moved into the circulatory system and/or lymphatics and involvement of other structures but may be operable and have success with surgery

risk factors of colorectal cancer

over 50, obesity, inactivity, increased consumption of processed or red meat, increase in diets high in fat, decrease in fruits and veggies, decrease in fiber

sections of the large intestine

appendix, cecum, colon (ascending, transverse, descending, sigmoid), rectum, anus

large intestine

Absorbs water and forms feces; lots of bacteria to break down protein and carbs and to produce vitamins

polyp

growths that extend from the surface of large intestine; most are benign but some can become malignant

detection of colorectal cancer

fecal immunochemical test, stool DNA test, CT or sigmoidoscopy, colonoscopy, fecal occult blood test

what age should you start screening for colon cancer

45

Fecal immunochemical test (FIT)

every year, tests for tumor biomarkers through ELISAs

fecal occult blood test (FOBT)

detects blood in stool from a polyp

colonoscopy

should have one every 10 years; b4 exam a patient is sent home with a prep kit which is made to clean out the colon; use a long flexible rod to image/take samples from the colon