dr kahn quiz 3 (sickle cell, lupus, breast cancer)

What is sickle cell disease? (ON EXAM)

A group of inherited red blood cell disorders

How is sickle cell passed on? (ON EXAM)

It PASSED BY GENES FROM PARENTS TO THEIR CHILDREN

IN ORDER TO INHERIT SICKLE CELL ANEMIA, —- PARENTS MUST EITHER HAVE SICKLE CELL —- (- SICKLE CELL GENES) OR SICKLE CELL —-(- SICKLE CELL GENE) (ON EXAM)

IN ORDER TO INHERIT SICKLE CELL ANEMIA, BOTH PARENTS MUST EITHER HAVE SICKLE CELL ANEMIA OR SICKLE CELL TRAIT

What is sickle cell disease characterized by? (ON EXAM)

• IT IS CHARACTERTIZED BY ABNORMAL HEMOGLOBIN CALLED HEMOGLOBIN S OR SICKLE HEMOGLOBIN IN RED BLOOD CELLS

What is hemoglobin? (ON EXAM)

• HEMOGLOBIN IS A PROTEIN IN RED BLOOD CELLS THAT CARRIES OXYGEN THROUGHOUT THE BODY

RED BLOOD CELLS CONTAIN —- THAT TAKE UP —- IN THE LUNGS AND CARRY IT TO —- THROUGHOUT THE BODY (ON EXAM)

RED BLOOD CELLS CONTAIN HEMOGLOBIN THAT TAKE UP OXYGEN IN THE LUNGS AND CARRY IT TO TISSUES THROUGHOUT THE BODY

RED BLOOD CELLS WITH NORMAL HEMOGLOBIN ARE WHAT SHAPE? (ON EXAM)

DISC-SHAPED

What does being disc-shaped allow red blood vessels to do? (ON EXAM)

• THIS SHAPE ALLOWS CELLS TO BE FLEXIBLE AND ABLE TO MOVE THROUGH BOTH LARGE AND SMALL BLOOD VESSELS

RED BLOOD CELLS WITH ABNORMAL HEMOGLOBIN ARE —- OR —— SHAPE (ON EXAM)

RED BLOOD CELLS WITH ABNORMAL HEMOGLOBIN ARE CRESCENT OR SICKLE SHAPE

How does red blood cells having a crescent or sickle shape affect them? (2 POINTS) (ON EXAM)

THE SHAPE MAKES THE CELLS INFLEXIBLE AND STICK TO THE VESSSEL WALLS

The sickle-shaped cells can stick to —- walls causing a —- to blood flow.

This can result in a —- or complete —— of blood flow

When this occurs, — cannot reach nearby —

It can cause —, acute — —, — damage, other —, and —- —.

(ON EXAM , ISSUES WITH SICKLE RED CELLS)

The sickle-shaped cells can stick to VESSEL walls causing a BLOCKAGE to blood flow.

This can result in a SLOWING or complete STOPPAGE of blood flow

When this occurs, OXYGEN cannot reach nearby TISSUES.

It can cause STROKE, acute CHEST SYNDROME, ORGAN damage, other DISABILITIES, and PREMATURE DEATH.

• Approximately —- americans have sickle cell anemia (ON EXAM)

• Approximately 70,000-100,000 americans have sickle cell anemia

• About - in - AA babies are born with sickle cell trait (ON EXAM)

About 1 in 13 AA babies are born with sickle cell trait

• About - in every - Black children are born with sickle cell disease (ON EXAM)

• About 1 in every 365 Black children are born with sickle cell disease

Nigeria, with an estimated 1997 population of 90 million, —— to —— babies with sickle cell disease are born each year (ON EXAM)

Nigeria, with an estimated 1997 population of 90 million, 45,000—90,000 babies with sickle cell disease are born each year

SICKLE CELL IS FOUND MORE IN — —, — , —, AND — HERITAGE. THOSE REIGONS ARE PRONE TO —. (ON EXAM)

• SICKLE CELL IS FOUND MORE IN MIDDLE EASTERN, INDIAN, MEDIETERRANEAN, AND AFRICAN HERITAGE.

• THOSE REIGONS ARE PRONE TO —.

THE VARIANT GENE FOR SICKLE CELL IS RELATED TO —-, NOT — — (ON EXAM)

THE VARIANT GENE IS RELATED TO MALARIA, NOT SKIN COLOR.

• MALARIA IS A — —- — CAUSED BY A —. PEOPLE WITH MALARIA OFTEN EXPERIENCE —, — AND — — — (ON EXAM)

• MALARIA IS A MOQUITO BORN DISEASE CAUSED BY A PARASITE. PEOPLE WITH MALARIA OFTEN EXPERIENCE, FEVER, CHILLS, AND FLU LIKE ILLNESS

(ON EXAM)
Malaria is caused by parasites — —. Mosquito transmits the disease through its —.

— is able to infect — — due to their — and increased rates of —- of infected — —

Also, — of Sickle Cell —- —- into —- inhibits parasite — and contributes to malaria —.

Malaria is caused by parasites —PLASMODIUM FALCIPARUM. Mosquito transmits the disease through its SALIVA.

P. FALCIPARUM is able to infect SICKLED CELLS due to their SHAPES and increased rates of —- of infected SICKLE CELLS.

Also, translocation of Sickle Cell Erythocyte MicroRNAs into P. falciparum inhibits parasite translation and contributes to malaria resistance.

Sickle cell trait is an inherited blood disorder that affects approximately — percent of African-Americans

8%

(ON EXAM) What are the 3 risk factors of sickle cell anemia? Or, sickle cell anemia is more common in certain ethnic groups, including:

• people of African descent, including AA (among whom 1 in 12 carries a sickle cell gene)

• Hispanic-Americans from Central & South America

• People of middle eastern, asian, indian, and Mediterranean Descent

What are the 7 sign and symptoms of sickle cell anemia?

1. LOOKING PALE

2. DARK URINE

3. YELLOW EYES

4. PAINFUL SWELLING OF HANDS AND FEET

5. FREQUENT PAIN EPISODES

6. STUNTED GROWTH 

7. STROKE

(ON EXAM) To diagnose for sickle cell disease, a patient can ask a doctor for a:

Blood test

(ON EXAM) Because sickle cell anemia symptompts can begin at — months of age, early diagnosis is critical

4 months

— newborns in the United states are tested for sickle cell disease (ON EXAM)

All

(ON EXAM) Sickle cell anemia can be identified before birth by:

testing a sample of amniotic fluid or tissue from the placenta

(ON EXAM) There has been reported cases where stem cells from -- — donors have cured — sickle cell patients

There has been reported cases where stem cells from half-matched donors have cured 7 sickle cell patients

(ON EXAM) Stem cell — are available for people with — forms of sickle cell disease, but they are associated with — — and require a — —- donors

(ON EXAM) Stem cell transplants are available for people with severe forms of sickle cell disease, but they are associated with signifcant risks and require a close-matched donors

(ON EXAM) What two treatments can help people manage and live with sickle cell anemia?

• Medications — Hydroxyurea (Hydrea(

• Blood transfusions

Can sickle cell disease be cured?

There is no definitive cure for every single sickle cell patient, but the stem cell treatment has been proven to cure 7 patients in 2018

A child with sickle cell disease may need to to medicine by the mouth up to — years to prevent — —- —-.

10 years, to prevent life threatening infections

what are some lifestyle habits that can allow people to live well with sickle disease?

• find good medical care

• healthy habits

  • 8-10 glasses of water a day

  • healthy food

• Get regular checkups at least once every year

• prevent infections, especially flu

(ON EXAM) For sickle cell anemia, in 1973, the average life span was —

14

(ON EXAM) In modern days, people with sickLE CELL DISEASE CAN LIVE INTO THEIR — AND —, and in some cases, beyond —

40-50s, some case even 60s

(ON EXAM) In sickle cell disease, long term treatment with —- may prolong survival

Hydroxyurea

(ON EXAM) What are the 4 complications of sickle cell disease?

• stroke

• increased vulnerability to infection

• acute chest syndrome: where the lungs suddenly lose their ability to breath oxygen

• pulmonary hypertension — high blood pressure in blood vessels that connect to the heart & lungs

(ON EXAM) Anything that reduces the amount of oxygen in the blood (—-, — —, flying at — altitudes without sufficient oxygen, or an —) may bring on a sickle cell — (also called an ——)

Anything that reduces the amount of oxygen in the blood (vigorous excercise, mountain climbing, flying at high altitudes without sufficient oxygen, or an illness) may bring on a sickle cell crisis (also called an exacerbation)

(ON EXAM) In children, sickle cell crisis may take the form of:

a chest syndrome

What is lupus (ON EXAM)

a chronic inflammatory disease that occurs when the body’s immune system attacks its own tissues and organs —→ the body cannot tell the difference between foreign substances and the person’s own cells and tissues

(ON EXAM) Inflammation caused by lupus can affect:

• JOINTS

• SKIN

• HEART

• LUNGS

• KIDNEYS

• BRAINS

( ON EXAM) What are the causes/potential triggers of lupus?

• Causes are unknown

• Potential triggers:

  • sunlight

  • infection

  • medication

(ON EXAM) Approximately - to — million Americans have a form of lupus but the actual number may be higher.

1.5-2 million

( ON EXAM )More than —% of people with lupus are women

90%

(ON EXAM) Symptopms and diagnosis of lupus occur most often between the ages of — and —- years

15 to 45 years

(ON EXAM) Lupus is — times more common in black women than in white women

3 times

(ON EXAM) Lupus is also more common in women of —, —, and — descent

Hispanic, Asian, and Native American descent

When it comes to lupus, — and — women tend to develop symptoms at an —- age than other groups (ON EXAM)

Black and hispanic women , at an earlier age

What are all the symptoms of lupus? (ON EXAM)

• Fatigue and fever

• joint pain, stiffness and swelling

• butterfly shaped rash on the face that covers the cheeks and bridge of the nose

• skin lesions that appear or worsen with exposure

• fingers and toes that turn white or blue when exposed to cold or during stressful periods

• shortness of breath

• chest pain

• dry eyes

• headaches, confusion, and memory loss

What are the four types of lupus? (ON EXAM)

• discoud lupus

• systemic lupus

• drug induced lupus

• neonatal lupus

What is discoid lupus identified by?

Rash on the face, neck, and scalp

What can systemic lupus affect?

can affect joints, lungs, kidneys, blood, or other organ tissues

When does drug-induced lupus occur (mention specific medications)

occurs after the use of certain prescribed drugs especially hydralazine (used to treat high blood pressure) and procainamide (used to treat irregular heart rhythms)

What is neonatal lupus? (also how long)

Rare condition acquired from the passage of maternal autoantibodies, and it persists within the first several weeks of life and maybe about six months before disappearing

What are the 3 treatments for lupus?

• some medications reduce inflammation tha causes pain fever and swelling

• other medication ssuppress the overactive immune system

• and some medications are combined to control the disease

What is the most common cancer in women aside from skin cancer?

Breast Cancer

When does breast cancer start? And what is it usually in the form of?

• breast cancer starts when cells in the breast begin to grow out of control

• usually form a tumour that can be felt as a lump

Breast cancer in women can start from different parts of the breast. Where do most begin and what are these type of cancers referred to as?

Most begin in the ducts that carry milk to the nipple (ductal cancers),

What type of breast cancer starts in the glands that make breast milk?

Lobular cancers

Do all types of breast cancer cause a lump in the breast?

No

Until puberty (usually age - or -) young boys and girls have a — amount of — tissue consisting of a few ducts located under the - and -

• Until puberty (usually age 9 or 10) young boys and girls have a small amount of breast tissue consisting of a few ducts located under the nipple and areola

Men’s breast tissue has —, but only a —.

ducts, few

Why is breast cancer less common in men?

Their breast duct cells are less developed due to low level of female hormones that affect the growth of breast cells

The average of US women diagnosed with breast cancer is — years old

The average of US women diagnosed with breast cancer is 62 years old

• - in - women will be diagnosed with breast cancer duirng hteir lifetime

• 1 in 8 women will be diagnosed with breast cancer duirng hteir lifetime

• -% of diagnosed breast cancer cases in women younger than 45

9%

• Black women are -% more likely to die from breast cancer compared to white women

• Black women are 40% more likely to die from breast cancer compared to white women

- in - black women with breast cancer are diagnosed with aggressive cancers such as — — breast cancer (TNBC). This is — than any other racial group.

1 in 5 black women with breast cancer are diagnosed with aggressive cancers such as triple-negative breast cancer (TNBC). This is higher than any other racial group.

• African American women are — likely to be diagnosed with breast cancer, however, they are more — to be diagnosed with aggressive cancers and — likely to die than white women

• African American women are less likely to be diagnosed with breast cancer, however, they are more likely to be diagnosed with aggressive cancers and more likely to die than white women

• Despite having a —% lower incidence rate of the disease, Hispanic women are — likely to be diagnosed with breast cancer at — stages when it is more —- to treat than white women

• Despite having a 20% lower incidence rate of the disease, Hispanic women are more likely to be diagnosed with breast cancer at later stages when it is more difficult to treat than white women

What is the leading cause of death for Hispanic women?

Breast cancer

• Female breast cancer rates are —- in NJ than the US overall

Higher

• Approx —% of black women with breast cancer are diagnosed at the early stages vs —% of white women, which causes an increase in — in black women

• Approx 57% of black women with breast cancer are diagnosed at the early stages vs 67% of white women, which causes an increase in mortality in black women

Male breast cancer accounts for less than -% of the overall incidence and mortality of this disease.

Male breast cancer accounts for less than 1% of the overall incidence and mortality of this disease.

What are the 5 risk factors for breast cancer?

• Lack of awareness in the AA community to this life-threatening disease

• Poor, non-existent health care necessary for early detection

• SCIENTISTS BELIEVE THAT OTHER FACTORS ARE:

  • EARLY ONSENT MENUSTRATION

  • DELAYED CHILD BEARING.

• environmental, lifestyle, and diet

—factors alone are not sufficient to explain the dramatic effect of race on breast cancer stage; however, —- variables in conjuction with —- beliefs and — could largerly account for the observed effect

Socieconomic factors alone are not sufficient to explain the dramatic effect of race on breast cancer stage; however, socieconomic variables in conjuction with cultural beliefs and attitudes could largerly account for the observed effect

What is they “key” to the solution for breast cancer

EDUCATION is the KEY

• Women should see their doctors for a regular breast exam every trhee years btwn ages of #-#, and every year after the age of #

• Women should see their doctors for a regular breast exam every trhee years btwn ages of 20-40, and every year after the age of 40

• Every woman over the age of - should have a mammography

• Every woman over the age of 40 should have a mammography

What is a mmamography?

• A low-dose X-ray procedure that allows visualization of the internal structure of the breast & Can pick up changes in the breast that might signal cancer long before any lumps can be felt 

The — remains the only definitive method of the diagnosis of cancer.

Biopsy

What are the 5 biopsy techniques

• fine needle aspiration biopsy

• core needle biopsy

• vacuum assisted breast biopsy

• incisional biopsy

• excisional biopsy

What does surgery in breast cancer involve?

Removal of all the malignant cells

What is a mastectomy?

The complete removal of the entire breast

What is chemotherapy used for in breast cancer?

To treat tumors which have spread beyond the area of radiotherapy and surgery

Currently, breast cancer — be cured

cannot

Most breast cancer risk factors, since they are —, cannot be —, and we do not yet have the means to prevent the initial development of cancers in the breast.

Most breast cancer risk factors, since they are traits, cannot be modified, and we do not yet have the means to prevent the initial development of cancers in the breast.

What is tamoxifen?

A hormonal drug used for decades to treat breast cancer

Tamoxifen reduced the incidence of developing breast cancer by approx #-#% in women considered at high risk for the disease

Tamoxifen reduced the incidence of developing breast cancer by approx 40-50% in women considered at high risk for the disease

How does tamoxifen work to prevent breast cancer?

It binds to specific tumour cell sites to keep estrogen from attaching and directing the cells to multiply

Acromatase Inhibitors are — drugs that dramatically suppress —- production by blocking —- glands and other tissues by blocking the effects of enzyme —-. These are drugs that show important advantages over Tamoxifen.

Aromatase Inhibitors are hormonal drugs that dramatically suppress estrogen production by blocking adrenal glands and other tissues by blocking the effects of enzyme aromatase. These are drugs that show important advantages over Tamoxifen.

Exemestane is a aromatase inhibitor/hormonal drug with less serious side effects than —. Women taking this drug are —% — likely to get cancer in the —- breast and were — as likely to develop unrelated cancer in other body areas.

Exemestane is a aromatase inhibitor/hormonal drug with less serious side effects than Tamoxifen. Women taking this drug are 65% less likely to get cancer in the other breast and were ½ as likely to develop unrelated cancer in other body areas.

Dr.Jeff brams attested that aromatase inhibitiors may work on —- women or those with tough to treat breast cancer not driven by —, whereas tamoxifen — tackle

Dr.Jeff brams attested that aromatase inhibitiors may work on premenopausal women or those with tough to treat breast cancer not drive by estrogen, whereas tamoxifen cannot tackle

Overall, —% of women in the exemestante group were cancer free 3 years after switching drugs, compared with — for women who stayed on tamoxifen.

Overall, 91.5% of women in the exemestante group were cancer free 3 years after switching drugs, compared with 86.8% for women who stayed on tamoxifen.

— recently approved by the US Food and Drug Administration to prevent — — in —- women, reduces the incidence of overall invasive breast cancer by —%

Raloxifene recently approved by the US Food and Drug Administration to prevent bone loss in post-menopausal women, reduces the incidence of overall invasive breast cancer by 66%

What does it mean if a breast cancer is non-invasive?

It has not spread beyond the milk ducts to other parts of the breast, to the lymph nodes in the under arm, or to other part of the body

Explain this type of breast cancer: Ductal Carcinoma in SITU (DCIS). It is a late stage or early stage cancer? It is easy to cure or hard to cure? Is it invasive or non invasive?

• Earlly stage cancer

• highly curable

• noninvasive

What is the most common type of invasive breast cancer and type of breast cancer?

 INVASIVE DUCTAL CARCINOMA

What type of invasive breast cancer makes up 70-80% of all invasive breast cancer cases?

Invasive ductal carcinoma

Lobular Carcinoma in SITU (LCIS). Is it invasive or non-invasive?

Non-invasive growth limited to the milk lobules of the breast

Women with LCIS have about a -% risk of developing invasive breast cancer in either breasts per year

1