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Neoplasia

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					      Neoplasia

And Inherited and Congenital
         Diseases
Abnormalities of Cell
     Growth
              Hyperplasia – number
               of cells increases
              Hypertrophy – size of
               cells increases
              Metaplasia – size and
               numbers stay the same
               but the cell morphology
               changes (may be a
               pre-cancerous sign )
              Neoplasia – a new
               type of cellular growth
               in a tissue, ie tumor
    Neoplasia may be:
 Benign = relatively harmless unless a
  vital area is involved
 Malignant – cancerous ! They grow
  and then spread throughout the body
   Benign vs Malignant
Benign                  Malignant (Cancer)
                         Very invasive with
 Well defined; often
                          vague borders
  encapsulated
                         Dedifferentiated –
 Appear similar to       appear to be very
  cell of origin          immature version of
 Does not spread to      cell of origin
  other tissues          Metastasis – spreads
                          via blood or lymph to
 Slow growth             other tissues/organs
 Usually not fatal      Rapid growth

                         High fatality rate
               Benign




                                     Malignant
Note: Death is usually due to complications caused by cancer
         Neoplasm
        Nomenclature
Benign – tissue of origin + suffix –oma
 Benign tumor in glandular tissue =

adenoma
 Benign tumor in bone =

 osteoma
 Benign tumor in fatty tissue =

lipoma
      Neoplasm
  Nomenclature (cont.)
Malignant:
 If tissue of origin is epithelial, than add suffix
  –carcinoma
   – Malignancy in glandular tissue =
Adenocarcinoma
 If tissue of origin is bone, muscle, cartilage,
  or connective tissue, add suffix –sarcoma
   – Malignancy in bone =
Osteosarcoma
        Nomenclature
         Exceptions
 Melanoma or Lymphoma –usually
  malignant! Need to see adjective in
  front of term (benign or malignant)
 Glioma – highly fatal malignancy of
  glial cells in the CNS
Etiology of Malignant
 Neoplasia (Cancer)
    Neoplasia Treatment
 Benign – surgical resection
 Malignant:

Surgery: to remove all of tumor if feasible and
  if the tumor has not metastasized
    – Palliative surgery made be done for symptom
      relief
Radiation Therapy – kills rapidly dividing cells
    – Can be done by penetration or implantation
     Neoplasia Treatment
           (cont.)
Malignant (cont.):
Chemotherapy (often done in conjunction with
  radiation therapy)
 Alkylating agents: inhibit tumor growth by by
  reacting with DNA
    – Nitrogen mustard, Cytoxan
   Antimetabolites: compete with tumor
    metabolites in producing nucleic acid
    – Methotrexate
   Plant alkaloids: alter protein synthesis and
    nucleic acids
    – Vincristine
Chemotherapy has
many side effects!

    Some patients find
chemotherapy worse than the
         cancer!
  Neoplasia Treatment
        (cont.)
Malignant:
 Hormone therapy – some hormones
  inhibit malignant neoplasia while
  others stimulate it
  – Hormone therapy may involve removing
    stimulating hormones or adding inhibiting
    hormones
Diseases Present
    at Birth

Chromosomal aberrations
    Genetic defects
   Congenital defects
Chromosomes
Down’s Syndrome
  (Trisomy-21)
           Slanted eyes with
            round face
           Short, stocky stature
           Learning deficiency yet
            extremely good
            disposition
           Sub-par immune
            system so tend to be
            “sickly”
           Usually develop
            Alzheimer’s if survive
            to age 60
Klinefelter’s Syndrome
 (Trisomy-23 = XXY )
              Male genitalia at
               birth
              Secondary female
               traits during puberty
               – Gynecomastia
               – Pelvic girdle widens
              Some learning
               impairment
              Usually are sterile
 Turner’s Syndrome
(Monosomy-23 = Xo)
            Female genitalia at
             birth
            Minimal changes at
             puberty
             – Lack of breast
               development
             – Pelvis does not widen
             – Sterile
            Very bright!
            Turner’s responds to
             hormone therapy if
             diagnosed early
             enough!
    Autosomal Recessive
     Genetic Diseases
   Genes line up in pairs in chromosomes
    – Each gene of the pair is referred to as an
      allele
   Alleles may be dominant or recessive
    – Dominant = always manifests no matter
      what other allele it is paired with
    – Recessive = has to be paired with
      another recessive allele to manifest
Possible Gene Pairings:
   Homozygous Dominant
    – Both alleles are the same and dominant
    – The dominant trait is expressed
   Homozygous Recessive
    – Both alleles are the same and recessive
    – The recessive trait is expressed
   Heterozygote
    – A dominant allele and a recessive allele are
      paired on a chromosome
    – The dominant trait is expressed but the
      recessive allele is still carried
  Most autosomal
recessive diseases

 Occur when heterozygotes
     (“carriers”) mate
    Autosomal Recessive
         Diseases
   Cystic Fibrosis
    – Recessive gene causes thick exocrine
      secretions which impair lung and pancreatic
      function
   Sickle Cell Anemia
    – Hemolytic anemia caused by fragile and
      abnormally shaped RBCs
   Phenylketonuria (PKU)
    – Missing enzyme prevents metabolization
      phenylalanine
    – Causes CNS damage to the newborn
PKU
      Sex-Linked
      Inheritance

 Usually the defective allele is
transmitted from mother to son
     on the X of the 23rd
         chromosome
Example: Hemophilia
Congenital Defects

Disease/defect present at birth
   but NOT due to genetics
    Congenital defects are
     caused by anything
     that interferes with
         intrauterine
        development
 Poor blood flow and oxygen delivery
 Maternal viral infection

 Drugs taken by the mother
Thalidomide Baby
A child born with a
congenital defect…

Does NOT pass the defect on to
       his/her children
An increase in the number of cells of a
  particular tissue producing an increase
  in the size of that tissue best defines:
A. Metaplasia
B. Hyperplasia
C. Hypertrophy
D. Neoplasia
E. Atrophy
Hemophilia occurs when:
A. Heterozygous parents produce
     homozygous offspring
B. A homozygous recessive parent
     and a heterozygous parent produce
     homozygous recessive male or
     female offspring
C. Several homozygous recessive genes
   occur in the offspring
D. A heterozygous mother passes on the
   recessive trait via an X chromosome to a
   male offspring
E. An abnormal division of chromosomes
   produces a male with XXY chromosome
       How does chronic
      inflammation differ
          from acute?
A.   I and IV             I.     Fibrous tissue is
B.   II and III                  present along
                                 with the exudate
C.   I, III, and IV
                          II.    Eosinophils are
D.   II, III, and IV             present instead
E.   I, II, III, and IV          of neutrophils
                          III.   Primary cells
                                 present are
                                 monocytes
                          IV.    Less exudate is
                                 present
What is the expected action of
   corticosteroids when they are used to
   treat inflammation?
A. Reduce edema caused by exudation

B. Block histamine release

C. Relieve pain

D. Promote blood clotting at the injury

E. Vasoconstriction to prevent bleeding
     Which of the following
        are malignant?
A.   V only              I.     Myosarcoma
B.   II and III          II.    Chondroma
C.   I, IV, and V        III.   Glioma
D.   II, III, and IV     IV.    Osteosarcoma
E.   I, III, IV, and V   V.     Bronchogenic
                                carcinoma
What abnormality occurs to cause Down’s
   Syndrome?
A. A male receives a recessive gene on the X
   chromosome
B. The cell fails to divide properly producing
   an extra chromosome on an autosomal
   pair
C. The cell fails to divide properly producing
   an extra X chromosome
D. The offspring receives two recessive
   genes from the parents
E. Damage to the embryo occurs during
   intra-uterine development
Treatment that is palliative :
A. Cures the disease

B. Treats the symptoms and makes the
   patient comfortable
C. Prevents disease

D. Prevents complications and helps to
   cure the disease
E. Uses drastic measures as a last
   resort in an attempt to cure a disease
Metastasis, the formation of secondary
   tumors in organs other than that in
   which the tumor originated, is a
   characteristic of:
A. Metaplasia

B. Benign neoplasia

C. Hyperplasia

D. Malignant neoplasia

E. Anaplasia
When a person is stung by a bee, and
   there is a reaction where blood
   vessels dilate, blood pressure falls,
   and there is decreased blood flow to
   vital organs, what type of allergic
   reaction has occurred?
A. Anaphylactic

B. Delayed

C. Cytotoxic

D. Cell – mediated

E. Immune complex hypersensitivity
Following the initial injury that triggers
    inflammation, what is the first stage of the
    inflammatory response?
A.  An increased number of monocytes and
    lymphocytes are produced and mobilized
    to the site of injury
B.  Blood vessels in the area dilate to
    increase blood flow and their permeability
    increases
C.  Eosinophils converge at the injury site and
    release histamine
D.  Fibroblasts appear at the site and start
    laying down collagen
E.  Macrophages appear and begin
    phagocytosis

				
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posted:9/13/2012
language:English
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