Nursing BS 231 Pathophysiology Exam 2 Questions and Answers- Portage Learning, Exams of Nursing

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Exam 2:

1. Blood tests for tumor markers are the single best screening tool for cancer. Why or why not? 1. False, they are elevated in benign conditions, most are not elevated in the early stages of malignancy. b. What is the most important procedure in diagnosing the correct cancer and histology? 1. Tissue Biopsy b. List two signs or symptoms a patient may present with that might indicate a cancer diagnosis: 1. Bleeding; sore that doesn’t heal; fluid in the pleural, pericardial, or peritoneal spaces; chest pain, shortness of breath, cough, abdominal discomfort or swelling. Other possible answers can include a mass or lump, pain (need to be specific), fatigue, fevers, weight loss 2. What are two systemic manifestations of cancer exhibited by cancer patients? Weight loss, wasting of body fat and muscle tissue, weakness, anorexia, and anemia, fatigue, sleep disturbances b. Explain the TNM system:
   1. T is the size and local spread of the primary tumor.
   2. N is the involvement of the regional lymph nodes.
   3. M is the extent of the metastatic involvement. b. 1. What are the three possible goals of cancer treatment?
   4. Curative, control, palliative 2.How does radiation kill cancer cells? a. Radiation therapy uses high-energy particles or waves to destroy or damage cancer cells. This leads to the creation of free radicals, which damage cell structures. Radiation can interrupt the cell cycle process, kill cells, or damage DNA in the cells.
2. Cell proliferation is the process in which proliferating cells become more specialized cell types. a. False, cell differentiation
3. Cell differentiation is the process of increasing cell numbers by mitotic cell division. False, cell proliferation
4. What are two important properties that stem cells possess? Potency and self- renewal
5. These are cells of the same lineage that have not yet differentiated to the extent that they have lost their ability to divide: progenitor or parent cells
6. Define polyp. Are they benign or malignant? a. A polyp is a growth that projects from a mucosal surface, such as the intestine. A polyp can be benign or malignant
7. How do cancer cells achieve immortality? a. Cancer cells keep high levels of telomerase, an enzyme that prevents telomere shortening. This gives the ability of the chromosomes to continue to replicate forever.

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6. What is a tumor suppressor gene? Give one example. a. Tumor suppressor genes are associated with gene underactivity. These genes slow down cell division, repair DNA mistakes, or tell cells when to die. BRCA1 or 2, TP

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6. A 40-year-old woman has experienced heavy menstrual bleeding. She was told she has a uterine tumor called a leiomyoma. She is worried she has cancer. What do you tell her? Explain at least 2 differences between a benign and malignant tumor. a. Leiomyoma is a benign tumor. (Leiomyosarcoma is malignant) Student can add any of the following: Benign tumors are well-differentiated cells, resemble the cells of tissues of origin, and have a slow, progressive rate of growth. They grow by expansion and remain localized to their site of origin, not capable of metastasizing. They develop a rim of connective tissue around the tumor called a fibrous capsule, which aids in surgical removal. Benign tumors are less of a threat unless they interfere with vital functions b. Malignant neoplasms invade and destroy tissue. They grow rapidly, spread to other parts of the body, and lack well-defined margins. They can compress blood vessels and outgrow their blood supply, causing ischemia and tissue injury. Surgery can be more difficult if it has spread.
7. A 62-year-old man with a 30-pack year smoking history is diagnosed with small cell lung cancer with metastasis to the bone. (1) Explain the process of how cancer spreads metastatically. (2) What symptoms might he have presented with? (3) Which screening test would he have benefited from? a. (1) Metastasis- a cancer cell must break loose from the primary tumor, invade the surrounding extracellular matrix, gain access to a blood vessel, survive its passage in the bloodstream, emerge at a favorable location, invade the surrounding tissue, begin to grow, and establish a blood supply. b. (2) Chest pain, shortness of breath, cough, bone pain. c. (3) Yearly low-dose chest CT.
8. Benign tumors have which of the following characteristics? Select all that apply. a. Undifferentiated cells b. Grows by expansion c. Gains access to blood and lymph channels d. Growth may stop or regress
9. What are the genetic events that can lead to cancer? Select all that apply. a. Gene amplification b. Pleomorphism c. Point mutation d. Seeding e. Chromosomal translocation
10. List 4 of the 7 risk factors linked to cancer as stated in the module. a. obesity b. 2. life style c. 3. herderity d. 4. UV radiation
11. List three characteristics of cancer cells and briefly explain what it means: a. 1. Rapid cell division - they lose the regulation process that inhibits growth of the cell and will keep dividing b. 2. Evade Apoptosis - They are immortal and the apoptosis feature is turned off due to the loss of cellular function and regulation. c. 3. Undifferentiated - Cancer cells do not differentiate
12. Which of the following is not a risk factor for developing cancer? Sunscreen
13. All of the following viral agents are correctly paired with the associated lesion

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except: a. Human papillomavirus (HPV): genital warts b. Epstein-Barr virus: carcinoma of the cervix c. Hepatitis B virus: hepatocellular carcinoma

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d. Human herpes virus-8: Kaposi sarcoma

6. List one example of screening for each method: observation, palpation, and lab test/procedure: a. Observation: skin, mouth, external genitalia b. Palpation: breast, thyroid, rectum and anus, prostate, lymph nodes c. Laboratory tests and procedures: Pap smear, colonoscopy, mammography