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Drexel Nursing 221 Exam 1 QUESTIONS
WITH CORRECT ANSWERS
Neoplasia - CORRECT ANSWER_"New Growth" It implies an abnormality of cellular growth. Synonymous with "tumor". Anemia - CORRECT ANSWER_A deficiency in circulating red blood cells. Tumors Thrombocytopenia - CORRECT ANSWER_A deficiency in the number of circulating platelets. Decrease is aggregation and clotting of blood. Epistaxis, metorrhagia hematuria, and petechiae often occur. Increased risk of intracranial hemorrhaging. Leukopenia - CORRECT ANSWER_A decrease in the number of circulating white blood cells. This causes an increased risk of infection and is the most common cause of death in immunocomprimised patients. Causes weight loss, anorexia, lymphoadenophy, and CNS dysfunction. -penia - CORRECT ANSWER_Lack of; Deficiency; Decrease.
What are the effects of cancer on the body? - CORRECT ANSWER_1) Pain - the break down of cells release inflammatory mediators which cause pain.
- Cachexia - overall loss of weight and general weakness.
- Immunosuppression - cancer cells secrete immunosuppressents which reduce T and B cell populations.
- Bonemarrow Suppression - contributes to leucopenia, throbocytopenia and anemia due to destruction of blood forming cells, malnutrition and chemotherapy.
- Paraneoplastic Syndrome - symptoms that can't be explained by obvious tumor properties (Ex. FUO)
- Hair loss and sloughing of mucosal membranes due to radiation or chemotherapy. Cachexia - CORRECT ANSWER_Overall loss of weight and general weakness. Paraneoplastic Syndrome - CORRECT ANSWER_Symptoms that can't be explained by obvious tumor properties. Ex. Tumors produce/secrete hormones or generate fevers of unknown origins (FUO). Staging of Tumors - CORRECT ANSWER_Location and pattern of spread of a tumor within the host. Tumor size, extent of local growth, lymph node and organ involvement, and presence of distance of metastases. Grading of Tumors - CORRECT ANSWER_The histological characterization of tumor cells and the degree of anaplasia.
grow more than 2mm unless they grow blood vessels into the tumor to provide oxygen and nutrients. What are the most common cancers that effect men? - CORRECT ANSWER_1) Prostate 25%
- Lung and Bronchial 15%
- Colon and Rectum 10% What are the most common cancers that effect women? - CORRECT ANSWER_1) Breast 26%
- Lung and Bronchial 14%
- Colon and Rectum 10% How many different cancers are attributable to smoking? - CORRECT ANSWER_Lung; Oropharynx; Larynx; Esophagus; Stomach; Pancreas; Bladder; Kidney; Myeloid leukemia. Benign Tumor - CORRECT ANSWER_Benign growth is generally easily cured. Tumor cells are cells that are typical of the tissue of origin ( meaning they look similar to normal healthy cells). Typically do not metastasize. Benign tumors can still be a cause for concern depending on the location of the tumor. Malignant Tumor - CORRECT ANSWER_A severe tumor that becomes progressively worse. They are anaplastic, meaning that they have lack of differentiation of pluripotent stem cells. Invasive and infiltrative. High chance of metastasizing.
Benign - CORRECT ANSWER_Kindly; favorable; not cancerous Malignant - CORRECT ANSWER_Deadly, extremely harmful, evil; spiteful, malicious; cancerous Metastasis - CORRECT ANSWER_Cancer cells that invade other parts of the body through the blood, the lymphatic system or site specific metastasis. What are the characteristics of benign tumors? - CORRECT ANSWER_Histology - Typical of tissue origin; few mitoses. Growth Rate - Slow Localization/Metastasis - Strictly local, often encapsulated/no metastasis due to slow growth. Tumor Necrosis - Rare Recurrence after treatment - Rare Prognosis - Good unless in a critical area. What are the characteristics of malignant tumors? - CORRECT ANSWER_Histology - Anaplastic, with abnormal cell size and shape. Many mitoses. Growth Rate - Rapid Localization/Metastasis - Infiltrative and frequent. Tumor Necrosis - Common Recurrence after treatment - Common Prognosis - Poor if untreated. Necrosis - CORRECT ANSWER_Tissue and cell death.
Tumor Suppressor Genes (TSG) - CORRECT ANSWER_Normally inhibit cell proliferation. Under activity of these genes results in cancer. (Ex. P53) Typically both copies of a tumor suppressor gene must be mutated for cancerous growth to occur. P53 - CORRECT ANSWER_A tumor suppressor gene that stalls cell division to allow time for the cell to repair damaged DNA. P53 may initiate apoptosis if the cell is unfixable. Mutation or underactivity of P53 can result in malignant tumor growth. Proto-oncogenes - CORRECT ANSWER_Genes that normally code for components of the cellular growth-activating pathways. Overactivity of these genes can cause cancer. Proto-oncogenes control growth factors, receptors, cytoplasmic signaling molecules, and nuclear transcription factors. A change in any of these factors can lead to abnormal cell proliferation. Oncogenes - CORRECT ANSWER_Cancer-causing genes that are formed due to mutations in proto-oncogenes. What is the multistep nature of carcinogenesis? - CORRECT ANSWER_1) Initiation - The genetic mutations which inappropriately activate proto-oncogenes or inactivate tumor suppressor genes.
- Promotion - The stage during which the mutant cell proliferates. This may involve activation or another
oncogene or inactivation of a tumor suppressor gene. Growth at this stage is typically undetectable.
- Progression - The mutant, proliferating cells begin to exhibit malignant behavior. These cells begin to accumulate more and more mutations with each division. Carcinogenesis - Initiation - CORRECT ANSWER_The genetic mutations which inappropriately activate proto-oncogenes or inactivate tumor suppressor genes. Carcinogenesis - Promotion - CORRECT ANSWER_The stage during which the mutant cell proliferates. This may involve activation or another oncogene or inactivation of a tumor suppressor gene. Growth at this stage is typically undetectable. Carcinogenesis - Progression - CORRECT ANSWER_The mutant, proliferating cells begin to exhibit malignant behavior. These cells begin to accumulate more and more mutations with each division. Radiation Oncogenesis - CORRECT ANSWER_1) Ionizing Radiation - Exposure causes 33x more likely to develop leukemia. (Atomic Bomb)
- Ultraviolet Light - Melanoma caused by prolonged exposure to sunlight. Oncogenic Viruses - CORRECT ANSWER_Viruses capable of inducing tumors.
ANSWER_Men have a 1 in 2 chance. Women have a 1 in 3 chance. What percentage of all cancers are due to environmental factors? - CORRECT ANSWER_33% of all cancers are due to environmental factors. Tumor Marker - CORRECT ANSWER_Certain enzymes or proteins that are secreted by tumor cells that are detectable in the blood. Tumor markers are useful for identifying presence of cancerous cells. Increasing blood concentrations of specific tumor markers may indicate progression and proliferation of cancerous cells. Prostate Specific Antigen (PSA) - CORRECT ANSWER_Tumor marker for prostate cancer. The onset of prostate cancer is often determined by the RAPID ELEVATION of PSA and not the overall amount of PSA in the blood. Thyroglobulin - CORRECT ANSWER_A tumor marker secreted by thyroid carcinoma cells. Elevated concentrations are linked to the onset of cancer. Monoclonal IgG - CORRECT ANSWER_Tumor marker for multiple myeloma. Elevated concentrations are linked to developing cancer. Neuron-specific Enolase - CORRECT ANSWER_Tumor marker for neuroblastoma. (It's also a good biomarker for small
cell carcinoma of the lung) Elevated concentrations are linked to cancer. Small Cell Carcinoma of the Lung - CORRECT ANSWER_Most malignant type of carcinoma of the lung. Stem Cell Transplantation - CORRECT ANSWER_A form of cancer therapy. It is used when bone marrow function is impaired. Often the entire bone is irradiated then stem cells will be transplanted. Gene and Molecular Therapy - CORRECT ANSWER_A form of cancer therapy.
- Genetic alteration of tumor cells to make them more susceptible to cytotoxic treatment or immune recognition.
- Altering immune cells to make them more efficient tumor killers.
- Altering tumors to make them express easily identifiable markers.
- Insterting P53 into tumor genome. Immunotherapy - CORRECT ANSWER_A form of cancer therapy. Interferons; interleukins; monoclonal antibodies Interferons - CORRECT ANSWER_Inhibit cell proliferation and stimulate natural killer (NK), T-cells, and macrophages. Used in cancer immunotherapy. Interleukins - CORRECT ANSWER_Peptides made and secreted by white blood cells which stimulate the
differentiated cells increase the severity of cancer. The severity of cancer depends on how closely the cancerous cells resemble the surrounding tissue. Each generation of blast cells (daughter cells) lowers the severity of cancer. Describe how tumor cells have necrotic centers. - CORRECT ANSWER_Tumor cells grow so quickly that the surrounding blood vessels don't penetrate fast enough to supply oxygen and nutrients to the center of the tumor. This causes the cells at the center to die. The rapidly growing layer uses most of the energy to grow and divide leaving behind an ischemic layer of cells which eventually die. Acute Inflammation - CORRECT ANSWER_Essential for healing.
- Vascular Stage - Increased vascular permeability. Fenestrations in capillaries widen to allow white blood cells to move out of capillaries more easily.
- Cellular Stage - Emigration of leukocytes, specifically neutrophils. Neutrophils neutralize and destroy pathogens limiting the spread of harmful agents through phagocytosis. Chronic Inflammation - CORRECT ANSWER_Occurs when pathogens are extremely persistent. Cell populations shift from mostly neutrophils to mostly macrophages and lymphocytes. Granuloma - CORRECT ANSWER_Pathogens that do not possess the appropriate receptor to be phagocytized are
surrounded by macrophages to wall off the pathogen from surrounding tissue. These masses of macrophages are called granulomas. Granulomatous Inflammation - CORRECT ANSWER_An inflammation that forms granulomas (Ex. Mycobacterium tuberculosis). Neutrophils - CORRECT ANSWER_Are the first to appear after an injury and are responsible for phagocytizing pathogens and debris. Neutrophils make up 60-80% of the circulating leukocytes. Lymphocytes - CORRECT ANSWER_Are primarily found in the lymph and are responsible for creating the immune response to an infection or disease. There are three subtypes of lymphocytes: natruak killer cells (NK), T-cells, and B-cells. Lymphocytes make up 20-30% of the circulating leukocytes. Monocytes - CORRECT ANSWER_AKA macrophages. Responsible for phagocytosis of debris and pathogens. (Monocytes when in the blood; macrophages when in surrounding tissues) Monocytes make up 3-8% of circulating leukocytes. Cancerous mutations cause monocytic leukemia. Eosinophils - CORRECT ANSWER_Are responsible for battling parasitic infections. Also play a role in allergic reactions. Eosinophils make up 1-6% of circulating leukocytes.
Histamine - CORRECT ANSWER_Acts as an inflammatory mediator. It is a vascular dilater which increases vascular permeability. It interacts with receptors of the smooth muscle lining capillaries to cause them to relax. When interacting with smooth muscle in the bronchi, it causes the bronchus to contract. Histamine is primarily produced by basophils and mast cells. Bronchspasm - CORRECT ANSWER_A sudden involuntary contraction of the bronchi, such as in asthma attack. Bradykinin - CORRECT ANSWER_Acts as an inflammatory mediator. It is a plasma protein manufactured in the liver. It is a potent vasodilator that increases permeability while also causing bronchial constriction. Complement - CORRECT ANSWER_Acts as an inflammatory mediator. It is a plasma protein that is manufactured in the liver. It facilitates phagocytosis and enhances chemotaxis. In addition, when it coats a pathogen or cell, it can cause cell lysis. (Ex. Hemolytic disease of the newborn) Chemotaxis - CORRECT ANSWER_Chemical signal calling WBC's to the site. Lysosomal Proteases - CORRECT ANSWER_Act as an inflammatory mediator. It is secreted by neutrophils and macrophages. The enzyme is responsible for digesting pathogens or surrounding tissue. Neutrophils also secrete free radicals.
Arachidonic Acid Pathway - CORRECT ANSWER_The breaking down of cells and release of their phospholipids trigger the lipoxygenase pathway to create leukotrienes and the cyclooygenase pathway to create prostaglandins and thromboxane which ultimately cause increased peripheral vascular permeability and bronchial constriction. Lipoxygenase Pathway - CORRECT ANSWER_Converts arachidonic acid to leukotrienes. Leukotrienes - CORRECT ANSWER_Help mediate the inflammatory response by increasing vascular permeability and smooth muscle constriction in the bronchi. Cyclooygenase Pathway - CORRECT ANSWER_Converts arachidonic acid into prostaglandins and thromboxane. Taking aspirin and NSAIDs inhibit the cyclooxygenase pathway. Prostaglandin - CORRECT ANSWER_Induce vasodilation and bronchoconstriction. In addition, certain prostaglandins inhibit inflammatory cell functions to prevent over inflammatory stimulation. Thromboxane - CORRECT ANSWER_Induces vasodilation and bronchoconstriction while promoting platelet and clotting functions.
Serous Exudate - CORRECT ANSWER_Clear fluid that occurs in mild inflammation. (Ex. runny nose) Serosanguineous Exudate - CORRECT ANSWER_Discharge that is clear with some blood (pink) tinge. Fibrinous Exudate - CORRECT ANSWER_Thick and clotted fluid, indicates advanced inflammation and may impede the healing process. Occurs when fibrinogen leaks into tissues from blood vessels. Purulent Exudate - CORRECT ANSWER_AKA Pus. Occurs with severe inflammation with bacterial infection. Hemorrhagic Exudate - CORRECT ANSWER_Associated with the most severe inflammations. Fluid is mostly blood. Necrosis is often surrounding the injured tissue and capillaries. Wound Healing - CORRECT ANSWER_Fibroblasts are stimulated by growth factors to form a collagen fiber meshwork that acts as scaffolding for endothelial cells can grow into the new connective tissue. Neutrophilia - CORRECT ANSWER_An increase in neutrophils Systemic Inflammation - CORRECT ANSWER_Complications include fever, neutrophilia, and muscle breakdown. Most systemic inflammations are elicited by three cytokines (IL- 1, IL-6, and TNF-α) which are released by macrophages
and inflamed tissue. Acute phase proteins from the liver cause an increase in fibrinogen which coat RBCs and cause them to aggregate more readily. Erythrocyte Sedimentation Rate (ESR) - CORRECT ANSWER_During inflammation, acute phase proteins from the liver cause an increase in fibrinogen in the blood. Fibrinogen then coats RBCs and cause them to aggregate more readily. This increase in aggregation of RBCs is indicative of inflammation. Autoimmune Disease - CORRECT ANSWER_Occurs when self tolerance is lost and reactions between self antigens and the immune system occur due to change in receptors of T-cells. Autoimmunity - CORRECT ANSWER_Occurs when the immune system recognizes the person's own cells ("self") as foreign and mount an immune response that injures self tissues. Antigenic Mimicry - CORRECT ANSWER_Small alterations in self tissue may lead to immunogenic attack. In addition, pathogens' receptors that closely resemble the host's receptor structure may cause the host's white cells to attack their own healthy cells. (Ex. Rheumatic Fever) Sequestered Antigens - CORRECT ANSWER_Self-antigens not normally seen by the immune system. (Ex. Sperm).
