Applied Pathophysiology: Altered Cell Growth

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Questions and Answers

What characteristic is typically associated with a benign tumor?

Minimal anaplasia (correct)

Poor prognosis

Significant anaplasia

Rapid metastasis

Which of the following describes the process of cancer cells moving into adjacent tissues and organs?

Metastasis

Seeding

Local spread

Direct extension (correct)

What is the main mechanism by which metastasis occurs?

Iatrogenic spread

Direct extension

Seeding via body cavities

Embolism via blood vessels (correct)

Which factor does NOT contribute to the preferential location of metastasis?

Random chance of cell landing at a specific site Signup and view all the answers

Which of these is generally considered an exception to standard cancer nomenclature?

Lymphoma Signup and view all the answers

What is the term for the unregulated cellular proliferation observed in neoplastic cells?

Autonomy Signup and view all the answers

Which of the following best describes anaplasia in the context of cancer?

Loss of cellular differentiation and function Signup and view all the answers

A malignant tumor's increased motility and loss of cohesion typically lead to which of the following outcomes?

Movement to other locations Signup and view all the answers

How does increased energy expenditure by tumor cells affect surrounding tissues?

It deprives unaffected cells of nutrients. Signup and view all the answers

What is the primary role of rapid angiogenesis in tumor growth?

Providing an extensive blood flow to tumor cells Signup and view all the answers

Which of the following is NOT a typical characteristic of a benign tumor?

Rapid proliferation Signup and view all the answers

What is a key difference in tissue structure between benign and malignant tumors?

Benign tumors display orderly tissue structure while malignant tumors exhibit a disordered structure Signup and view all the answers

Which process is typically associated with malignant tumors but not with benign tumors?

Metastasis Signup and view all the answers

What is the primary use of tumor markers in cancer management?

To monitor the clinical course of cancer after diagnosis and treatment effectiveness Signup and view all the answers

Which of the following best describes paraneoplastic syndromes?

Hormonal, neurologic, hematologic, or chemical disturbances not directly related to tumor invasion Signup and view all the answers

A definitive cancer diagnosis is typically achieved through:

Microscopic examination of tumor cells Signup and view all the answers

What is the defining characteristic of carcinoma in situ?

Confined to the epithelium without basement membrane invasion Signup and view all the answers

Which of these is NOT a main goal of cancer treatment?

Genetically modify the cancer cells to promote apoptosis Signup and view all the answers

What is the main focus of palliative care in cancer treatment?

Treating symptoms without curing the cancer Signup and view all the answers

In the TNM staging system, what does 'N' represent?

Nodal involvement Signup and view all the answers

Which diagnostic method involves the direct visualization of a tumor mass?

Imaging studies with X-rays, CTs or ultrasounds Signup and view all the answers

A tumor is classified as T3N2M1. What does this indicate about the tumor's extent?

Large tumor, extensive regional nodal involvement, distant metastasis Signup and view all the answers

Which approach involves addressing the patient and their family's emotional needs alongside physical treatment?

A holistic approach Signup and view all the answers

What does a higher numerical grade in cancer staging indicate?

Cells are highly undifferentiated Signup and view all the answers

Which of these is NOT a factor that affects the prognosis of cancer?

Dietary habits Signup and view all the answers

What is a common characteristic of neoplasms that cause paraneoplastic syndromes?

Their production and secretion of ectopic hormones Signup and view all the answers

What is a 5-year survival rate?

Percentage of people who are alive 5 years after diagnosis, regardless of their cancer status Signup and view all the answers

Which of the following is a systemic manifestation of cancer?

Lymphadenopathy and unexplained fever Signup and view all the answers

What factor of cancer contributes to an increased metabolic rate in the body?

The tumor itself Signup and view all the answers

Study Notes

Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease

The lecture material is adapted from 2022 Wolters Kluwer Health, Lippincott Williams & Wilkins.
The book is titled "Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease".
The fourth edition of the book is mentioned.
The lecture series is MPAT12001 Medical Pathophysiology Lecture Series.
The lecture is given by Dr. Romeo Batacan Jr.

Altered Cell Proliferation and Differentiation

Normal cell proliferation and differentiation are controlled by genes.
Neoplastic cells ignore genetic controls, leading to:
- Autonomy: Unregulated cellular proliferation
- Anaplasia: Loss of cellular differentiation, resulting in loss of cell function.
- The degree of anaplasia correlates with the aggressiveness or malignancy of the tumor.

Altered Cell Proliferation and Differentiation: Further details

Loss of cell-to-cell communication leads to unrestricted tumor growth.
Increased energy expenditure by tumor cells deprives unaffected cells of nutrients.
Increased motility and loss of cohesion/adhesion promote tumor movement to other locations.
Rapid angiogenesis provides extensive blood flow to the tumor.
Substance secretion alters metabolism and degrades surrounding unaffected cells.
Foreign antigens presented on the cancer cell surface trigger an immune response.

Benign versus Malignant Tumors

Benign tumors remain localized and resemble the tissue of origin.
While benign tumors overproliferate, they are differentiated. They can be dangerous if they impact nearby structures or obstruct vital functions.
Malignant tumors are invasive, destructive, and rapidly proliferate. They promote ischemia and necrosis.
Cancer is malignant neoplasm.
Benign tumors are characterized by:
- Near normal cell structure
- Orderly tissue structure
- Growth rate usually above normal
- Invasive growth is uncommon
- Metastasis is absent
- Typical capsule
- Minimal anaplasia
- Good prognosis
Malignant tumors are characterized by:
- Abnormal shapes and larger cells/nucleolus
- Disordered/irregular tissue structure
- Rapid growth rate
- Typical invasive growth
- Typical metastasis
- Rare/incomplete capsule
- Typical anaplasia
- Poor prognosis

Cancer Spread

Local spread: proliferation within the original tissue of origin.
Direct extension: tumor cells move into adjacent tissues and organs.
Seeding: direct extension, with tumor cell implantation in body cavities.
Metastasis: spread to distant sites
- Main mechanism is metastasis via embolism.
- Metastasis can also occur via body cavities.
- Iatrogenic metastasis is due to medical intervention.
- Neoplasms tend to have predictable tropism (a preferred location) due to environmental suitability, adherence molecule compatibility, and location relative to blood flow paths.

Cancer Classification: TNM Staging

This system classifies the extent and spread of the neoplasm.
Usually for solid tumors.
Includes tumor size, lymph node involvement, and location of metastasis.
Higher numbers indicate more extensive tumor size and involvement.

Cancer Classifications: Grading

Grading refers to the degree of anaplasia (loss of cell differentiation) in the tumor.
Staging (numeric) indicates a higher number indicates a greater tumor size and invasion (local to distant).
Grade I tumors are well-differentiated, resembling the original tissue.
Grade IV tumors are highly undifferentiated.

Cancer Prognosis

Many factors affect cancer outcome and course, including type of cancer, location, stage, patient age, and overall health.
Some factors that influence prognosis are the response to treatment, a 5-year survival rate (rate if people are living after 5 years with cancer, and cancer-free), remission, and living with cancer.

Clinical Manifestations of Cancer

Early general symptoms can be vague.
Major manifestations are related to:
- Systemic inflammatory and immune responses.
- Increased metabolic rate induced by tumors.
- Systemic effects of neoplasm, including paraneoplastic syndromes.
- Local effects of tumor encroachment.
- Effects on blood.

Paraneoplastic Syndromes

These are hormonal, neurologic, hematologic, or chemical disturbances unrelated to the primary tumor's invasion.
They cause a wide range of clinical manifestations and are common characteristics of neoplasms.
These neoplasms have the ability to produce and secrete ectopic (or inappropriate) hormones.
These neoplasm mimic hormone functions, which leads to clinical manifestations.
These neoplasms may also disturb neurologic function.

Diagnostic Tests

History taking and physical examination
Imaging studies (X-rays, endoscopy, CT, MRI, ultrasound)
Direct visualization of masses.
Biopsy and cytology studies
Tumor markers: used to observe cancer course, screen for cancer risk, and aid in diagnosis. (Most cancer is only diagnosed by microscopic tumor cell examination)

Cancer Treatment

Treatment strategies include:
- Completely eradicating neoplasms.
- Controlling continued growth.
- Reducing symptoms without curing the cancer using surgery, chemo, radiation, hormones, or immunotherapy.
Treatment of cancer frequently involves comprehensive care including psychsocial aspects of treatment and care.

Adverse Effects of Cancer Treatment

Adverse effects can include surgery-related issues, chemotherapy side effects, radiation-related side effects, biologic response modifier side effects, and/or hormonal side effects.

Cancer Prevention

Awareness of known carcinogens (the "hateful 13").
Avoiding known risk factors can sometimes help prevent some types of cancer
Awareness of factors that increase risk .

Cancer Screening

Regular screening can lead to early detection, which reduces cancer incidence.
- Breast cancer (mammography)
- Cervical cancer (Pap smear)
- Colorectal cancer (rectal examination, fecal occult blood test, colonoscopy)
- Prostate cancer (PSA testing, transrectal ultrasonography)
- Melanoma (self-examination)

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Description

Explore the concepts of altered cell proliferation and differentiation as introduced in the fourth edition of 'Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease.' This quiz focuses on how neoplastic cells bypass genetic controls, leading to autonomy and anaplasia, and the implications on tumor aggressiveness.