patho exam 2

Exam Structure

• Total Questions: 50 Multiple Choice Questions

  • Content covers weeks four, five, and six

  • Topics:

    • Cellular proliferation and cancer

    • Cardiovascular and lymphatic systems

    • Digestive systems

  • Question Distribution:

  • Approximately 16-18 per topic

  • Review Time: 10 minutes at the end of the exam

Cellular Proliferation and Cancer

• Terminology Overview:

  • Important to understand new terms related to cancer.

  • Tumor Suppressor Gene:

  • Definition: A normal or non-mutated gene that regulates cell growth, ensuring controlled cell division.

  • Function: Encodes proteins that prevent unregulated cell growth.

  • Mutations can lead to increased cancer risk.

  • Key examples:

  • p53 gene: Important for regulating cell cycle.

  • BRCA1 and BRCA2 genes: Inherited genes with potential mutations affecting cancer risk (e.g., breast and ovarian cancers).

    • Everyone has these genes; however, it’s crucial to distinguish between normal and mutated copies.

  • Apoptotic Gene:

  • Definition: Regulates cellular apoptosis (programmed cell death).

  • Importance: Marks the end of a cell's lifespan and initiates self-destruction.

  • Tumor Markers:

  • Definition: Biomarkers indicative of cellular activity, particularly in cancers.

  • Role: Help assess cancer progression or treatment efficacy.

  • Increased levels, such as CA19.9, indicate worse cancer.

Cancer Imaging and Radiation

• Medical Imaging:

  • CT Scans: Commonly ordered for cancer assessment.

  • Risks associated with cumulative radiation exposure during repeated scans.

Benign vs. Malignant Cells

• Key Differences:

  • Review charts contrasting benign and malignant cell characteristics.

  • Hallmarks of Cancer Cells:

  • Recognize the 10 distinct characteristics of malignant cells, pivotal for exam questions.

  • Telomerase Role:

  • Cancer cells can produce telomerase to prolong telomeres, resisting apoptosis and enabling indefinite division.

  • Angiogenesis:

  • Definition: The process of forming new blood vessels.

  • Cancer cells induce angiogenesis for increased nutrient and oxygen supply.

  • Examples of angiogenic factors:

    • VEGF (Vascular Endothelial Growth Factor)

    • bFGF (Basic Fibroblast Growth Factor)

Proto-Oncogenes vs. Tumor Suppressor Genes

• Proto-Oncogenes:

  • Act as accelerators of cell division, regardless of quality.

• Tumor Suppressor Genes:

  • Function as brakes, correcting errors in division and preventing cancerous growth.

Cancer Risk Factors and TNM Staging

• Risk Factors:

  • Recall specific risk factors for various malignancies for exam preparation.

• TNM Staging System:

  • Knowledge of TNM is essential for interpretation:

  • T: Tumor size (T1 indicates degree of invasiveness)

  • N: Node involvement

  • M: Metastasis (M0 = no metastases, M1 = metastases present).

  • Understand what TNM stages indicate rather than performing staging.

Cellular Differentiation

• Anaplasia and Differentiation:

  • Anaplasia: Deterioration of cells to an earlier state.

  • Differentiation merely describes appearance, not behavior or metastatic potential.

  • Poor differentiation does not confirm metastasis; biopsy is needed.

Cancer Diagnostic Testing

• Role of Diagnostic Tests:

  • Best method for diagnosing cancer involves obtaining cellular samples through tissue biopsy or aspiration.

Cancer Treatment Terms

• Surgical Options:

  • Definitive Treatment: Aimed at curing cancer.

  • Palliative Surgery: Focused on symptom relief without curing.

• Chemotherapy Types:

  • Induction Chemotherapy: Initial treatment to induce remission.

  • Neoadjuvant Chemotherapy: Given before primary treatment to shrink tumors.

  • Adjuvant Chemotherapy: Post-surgery treatment to eliminate remaining cancer cells.

Paraneoplastic Syndrome

• Definition:

  • Paraneoplastic syndrome refers to a syndrome caused by cancer that produces symptoms not directly related to the local presence of cancer cells.

Cardiovascular System Overview

• System Function:

  • Responsible for fluid movement in the body, includes disturbances and predisposing factors for cardiovascular diseases.

• Infant Pathophysiology:

  • Questions primarily focus on transitional pathophysiology and congenital disorders; be able to identify based on classic clinical scenarios.

Types of Cardiomyopathy

• Cardiomyopathy Types to Identify:

  • Dilated Cardiomyopathy

  • Hypertrophic Cardiomyopathy

  • Restrictive Cardiomyopathy

Arterial Diseases

• Key Topics:

  • Atherosclerosis

  • Arterial thrombus formation

  • Embolism

• Key Understanding:

  • Recognize risk factors and classic presentations.

  • Understand atherosclerosis pathophysiology and how conditions like hypertension and diabetes accelerate it.

  • Virchow's Triad:

  • Factors:

  • Stasis

  • Vascular injury

  • Hypercoagulability

DVT Recognition

• Signs and Symptoms of DVT:

  • Recognize common presentations without pharmacological treatment knowledge.

Myocardial Ischemia and Infarction

• Key Differences:

  • Differences between angina and myocardial infarction based on symptoms, lab findings, and EKG results.

• Clinical Scenarios:

  • Ability to identify myocardial infarction or angina in patient scenarios based on diagnostic testing.

Valvular Heart Disease

• Rheumatic Fever:

  • Major cause; know the pathogen involved.

• Valvular Dysfunction and Pressure Changes:

  • Be prepared to identify pressure changes in the heart chambers due to stenosis or regurgitation.

  • Stenotic Conditions: Problems opening valves (Aortic stenosis and Mitral stenosis).

  • Regurgitant Conditions: Backflow of blood (Aortic regurgitation, Mitral regurgitation, and Tricuspid regurgitation).

Heart Failure

• Causes:

  • Left-sided Heart Failure:

  • Caused by hypertension and ischemic heart disease.

  • Right-sided Heart Failure:

  • Typically due to left-sided heart failure or primary pulmonary disorders.

Digestive System Overview

• Common Symptoms and Diseases to Recognize:

  • Intestinal Obstructions: Various causes, necessitate ability to identify based on clinical scenarios (e.g., volvulus due to previous surgeries).

  • GI Bleeding Terminology: Know terms such as hematemesis (bloody emesis).

  • Abdominal Pain Causes: Understand classical presentations for conditions like appendicitis.

• NSAIDs and GI Issues:

  • Review implications of long-term NSAID use, especially with duodenal ulcers.

Colon Cancer Progression

• Stage Progression Overview:

  • Understand how colon cancer progresses from stage one polyp through to stage four metastatic disease, including involvement of lymph nodes.

Acid-Base Imbalance

• Vomiting Effects:

  • Excessive vomiting leads to loss of hydrogen ions, resulting in metabolic alkalosis.

  • Requires understanding of acid-base balance principles from earlier weeks.

Closing Remarks

• Review all material carefully and let the instructor know if any questions arise.

• Prepare using examples, illustrations, and symptom recognitions to aid in exam success.