Check Your Understanding 1 (Ch. 1,2,4,7)

After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor

is Malignant Primary indicates that the cancer began in the lungs and did not metastasize from another site. Staging procedure is requires to determine if the cancer has spread.

Paraneoplastic syndromes in cancer involve excessive uptake of substances by multiple means. A common substance found in excessive amounts resulting from cancer paraneoplastic syndrome is

Calcium Common paraneoplastic syndromes include hypercalcemia associated with abnormal production of parathyroid hormone-related protein by tumor cells.

What cellular component is most susceptible to radiation injury?

DNA Cellular DNA is particularly susceptible from radiation via breakage of the bonds holding the linear DNA together.

In general, with aging, organ size and function ____________.

Decrease

Extreme cold injures cells by all of the following except? A. Rebound vasodilaltion B. Crystallization C. Initial vasoconstriction D. Decreased blood viscosity

Decreased blood viscosity. Hypothermia causes increased blood viscosity, which can result in ischemic injury. Initial vasoconstriction causes ischemic injury. Rebound vasodilation leads to intense swelling which damages peripheral nerves. Crystallization of cellular components leads to rupture of these components.

The primary effect of aging on all body systems is?

Decreased functional reserve. All body-systems show age-related changes that can be generally describes as a decrease in functional reserve; aging leads to inability to adapt to (internal and external) environmental changes.

The cellular change that is considered to be preneoplastic is

Dysplasia. Dysplastic cells have the potential to become cancerous and are therefore referred to as preneoplastic.

Disease that is native to a particular region

Endemic

Reperfusion injury to cells:

Involves the formation of free radicals. Free-radicals form when high-energy electrons partially reduce oxygen in reperfusion injury. Reperfusion injury usually causes more cell damage than the original hypoxia. It results in calcium overload in the cells. Reperfusion injury results from hypoxic injury.

Necrotic death of brain tissue usually produces _________ necrosis.

Liquefactive This necrosis is produced when brain tissue dies, as it is rich in enzymes and has little connective tissue.

What is the effect of stress on the immune system?

May involve enhancement or impairment of the immune system. Many studies demonstrate that long-term stress impairs the immune system, but many researchers identify that short-term stress may enhance the immune system.

Familial retinoblastoma involves the transmission of what from parent to offspring?

Mutant tumor-suppressor gene.

Which cellular response is not reversible?

Necrosis Necrosis refers to the death of cells/tissue and is not reversible.

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by:

Norepinephrine N.E. is secreted in response to activation of the sympathetic nervous system during stress by the adrenal medulla.

Proto-oncogenes are what?

Normal cellular genes that promote growth.

A patient with high BP who is otherwise healthy is counseled to restrict sodium intake. This is an example of?

Secondary prevention Secondary prevention is the early detection, screening, and management of the disease, such as by prescribing sodium restriction for high BP.

Your patient is scheduled for a staging procedure and she wants to know what that means. What do you tell her?

It is a procedure for determining the extent of tumor spread. Staging describes the location and pattern of spread of a tumor. CT, MRI, and PET imaging techniques have allowed for noninvasive cancer detection.

A patient has been exposed to meningoccocal meningitis, but is not yet demonstrating signs of this disease. This is called the _____ stage.

Latent

A patient with metastatic lung cancer want to know her chances for survival. Which response is correct?

Lung cancer has about a 15% survival rate.

Breast cancer in women who have the breast cancer gene _____________? A. Occurs at an earlier age. B. Is more common than non-inherited breast cancer. C. Unilateral D. Have a different response in treatment.

Occurs at an earlier age. The age of onset of inherited breast cancer is earlier than the onset of non-inherited forms and the prevalence of bilateral breast cancer is higher. Breast cancer in women who have the breast cancer gene is less common (only 5% to 10% of all cases) than non-inherited breast cancer and is more likely to be bilateral. Response to treatment is not affected by whether the cancer gene is present.

After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of?

Tertiary prevention Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate and restore effective functioning such as prescribing a cholesterol-lowering medication following a heart attack.

The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of?

Tumor necrosis factor. Production of tumor necrosis factor (TNF) and other immune cytokines is thought to be imporant in producing the hypermetabolic state leading to cachexia in cancer.

Which stress-inducing hormone does not increase blood glucose?

Aldosterone This affects water and sodium retention and potassium loss in the urine.

Your patient eats "lots of fat," leads a "stressful" life, and has smoked "about two packs a day for the last 40 years." Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is? A. High-fat diet B. Urban pollutants C. Cigarette smoking D. Stressful lifestyle

Cigarette smoking The most likely contributing factor for the development of lung cancer is cigarette smoking. Tobacco smoke contains hundreds of compounds, many of which have known genotoxicity and probably serve as initiators. Tobacco smoke also contains promoters, which spur the mutant cells to proliferate. Although a high-fat diet, urban pollutants, and a stressful lifestyle have been implicated in some types of cancer, they are not the likely contributing factor in your patient's lung cancer.

In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive.

False The degree of tissue-specific degeneration predicts malignant potential. A lack of differentiated features in a cancer cell is called anaplasia, and a greater degree of anaplasia is correlated with a more aggressive malignant tumor.

An increase in organ size and function caused by increased workload is termed ____________.

Hypertrophy Increased function of an organ such as the heart of skeletal muscle results in organ hypertrophy because of cellular enlargement.

The effects of excessive cortisol production

Immune Suppression Cortisol suppresses immune function and inflammation and stimulates appetite.

Coagulative necrosis is caused by?

Interrupted blood supply. This leads to ischemic injury.

The cellular response indicative of injury because of faulty metabolism is known as what? A. Intracellular accumulations B. Hydropic swelling C. Lactate production D. Metaplasia

Intracellular accumulations. Intracellular accumulations result from faulty metabolism of lipids, carbohydrates, glycogen, and proteins. Hydropic swelling results from malfunction of the sodium-potassium pump. Lactate production results from anaerobic glycolytic pathway. Metaplasia occurs from persistent cell injury.

What is disease prevention?

Involves management of the disease once it has developed.

A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of?

Primary prevention Prevention of disease by altering susceptibility or reducing exposure for susceptible individuals by providing vaccination.

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, what will happen?

Rapidly dividing cells will be killed.

C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinic examination reveals an oral temperature of 102.3, skin rash, dysphagia, and reddened throat musoca with multiple pustules. He complains of sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have been prescribed. The etiology of C.Q.'s disease is:

Streptococcal infection.

The stage during which the patient functions normally, although the disease processes are well-established, is referred to as:

Subclinical

Allostasis is best defined as

The overall process of adaptive change necessary to maintain survival and well-being.

Metaplasia is?

The replacement of one differentiated cell type with another.

What is not part of Selye's three phases of the stress response? A. Allostasis B. Alarm C. Resistance D. Exhausation

Allostasis Defined as the ability to successfully adapt to challenges.

Cancer grading is based on:

Cell Differentiation Grading refers to the histologic characterization of tumor cells and is basically a determination of the degree of anaplasia (lack of differentiation).

Persistence of the alarm stage will ultimately result in?

Permanent damage and death. If the alarm stage were to persist, the body would soon suffer undue wear and tear and become subject to permanent damage and even death. Actions taken by the individual during the resistance stage lead to stress reduction. The resistance stage may or may not occur following the alarm stage, based on resource availability. The sympathetic nervous system will continue to function, resulting in continued release of stress hormones.

What is not an indicator that an individual is experiencing high stress? A. Tachycardia B. Pupil constriction C. Diaphoresis (Sweat) D. Increased peripheral resistance

Pupil constriction. Pupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, and increased peripheral resistance are indicators of stress and also occur because of catecholamine release.

An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of:

Secondary prevention. This is the stage of early detection, screening, and management of the disease such as prescribing diet and exercise for an individual who has already developed obesity.