Cancer Biology Quiz
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Questions and Answers

What is the main characteristic of leukemia when compared to other types of cancer?

  • It is a result of chronic infections
  • It is caused by environmental factors
  • It is widely spread in the bloodstream and bone marrow (correct)
  • It forms a tumor
  • What is the role of genes that are mutated in cancer development?

  • They promote cell growth
  • They inhibit cell apoptosis
  • They are responsible for the formation of tumors
  • They decrease malignant cell growth (correct)
  • Which of the following is an example of a chemical carcinogen?

  • Ionizing radiation
  • HIV
  • Hepatitis B virus
  • Tobacco smoke (correct)
  • What is the result of retroviruses transforming bcl-2 into an oncogene?

    <p>Uncontrolled cell growth and inhibition of cell apoptosis</p> Signup and view all the answers

    What is the definition of a neoplasm or tumor?

    <p>An abnormal mass of tissue due to abnormal growth of cells</p> Signup and view all the answers

    What is the reason behind higher distribution of highly water-soluble drugs in premature neonates?

    <p>Higher total body water</p> Signup and view all the answers

    Why do neonates have a higher risk of CNS adverse effects from phenytoin?

    <p>Reduced plasma protein binding</p> Signup and view all the answers

    What is the consequence of reduced CYP2D6 activity in children with ADHD treated with atomoxetine?

    <p>Greater increases in heart rate and blood pressure</p> Signup and view all the answers

    Why is the weight-based dose of gentamicin often higher in premature neonates than in adults?

    <p>Higher volume of distribution</p> Signup and view all the answers

    What is the reason behind the increased risk of kernicterus and jaundice in neonates?

    <p>Displacement of bilirubin from albumin binding</p> Signup and view all the answers

    What is the characteristic of CYP1A2 activity in fetal liver tissue and newborns not exposed to caffeine in utero?

    <p>Negligible activity</p> Signup and view all the answers

    Why do antibiotics have improved distribution into the CNS in premature neonates?

    <p>Functionally immature blood-brain barrier</p> Signup and view all the answers

    What is the consequence of lower CYP3A4 activity in premature neonates?

    <p>Slower metabolism rate</p> Signup and view all the answers

    Why do infants require larger doses of anti-epileptic medications like midazolam?

    <p>Due to the abnormal function of GABA receptors in early life</p> Signup and view all the answers

    What is the characteristic of GABA receptors in early infancy?

    <p>Excitatory function</p> Signup and view all the answers

    What is the reason for reduced clearance of aminoglycosides like gentamicin in newborns?

    <p>Immature tubular secretion and lower GFR</p> Signup and view all the answers

    Why do newborns exposed to caffeine during gestation have a shorter caffeine half-life?

    <p>Due to the higher levels of CYP1A2 activity at birth</p> Signup and view all the answers

    What is the effect of dopamine on heart rate in premature neonates?

    <p>No effect on heart rate</p> Signup and view all the answers

    What is the reason for the concomitant use of dexamethasone and indomethacin altering the normal progress of renal maturation in the neonate?

    <p>Due to the pharmacodynamic changes in infancy</p> Signup and view all the answers

    What is the effect of glucuronidation on the elimination of certain drugs in newborns?

    <p>Decrease in the elimination of certain drugs</p> Signup and view all the answers

    Why do newborns require more frequent dosing of caffeine compared to older infants?

    <p>Due to the shorter caffeine half-life</p> Signup and view all the answers

    What is a disadvantage of intramuscular drug administration in neonates?

    <p>Reduced absorption due to reduced skeletal muscle blood flow</p> Signup and view all the answers

    Why is subcutaneous drug absorption delayed in neonates?

    <p>Lower percentage of body fat</p> Signup and view all the answers

    What is a characteristic of transdermal drug absorption in neonates?

    <p>Enhanced skin absorption due to thinner epidermis and greater perfusion</p> Signup and view all the answers

    What is a risk associated with using iodine as a topical disinfectant before surgery in neonates?

    <p>Thyroid dysfunction</p> Signup and view all the answers

    What is a characteristic of rectal drug absorption in neonates?

    <p>Rapid absorption due to high rectal contractions</p> Signup and view all the answers

    Why is rectal acetaminophen suppository rapidly absorbed in neonates?

    <p>High contractions in the rectum</p> Signup and view all the answers

    What is a characteristic of blood flow in neonates?

    <p>Greater blood flow reaches the cerebral vasculature</p> Signup and view all the answers

    Why is diazepam gel rapidly absorbed in neonates?

    <p>High contractions in the rectum</p> Signup and view all the answers

    Study Notes

    Cancer Definition and Types

    • Cancer is a defect in mechanisms controlling cell survival, proliferation, and death.

    Neoplasms (Tumors)

    • Abnormal mass of tissue due to abnormal cell growth.

    Leukemia

    • A blood cancer that doesn't form a tumor.
    • Widely spread in the bloodstream and bone marrow.

    Causes of Cancer

    • Environmental Factors
      • Ionizing radiation
      • Chemical carcinogens (e.g., tobacco smoke, alcohols, and asbestos)
    • Chronic Infections (Viruses)
      • Hepatitis B and C are associated with Hepatocellular Carcinoma (HCC)
      • HIV is associated with certain types of lymphomas
      • Retroviruses (e.g., HIV) can transform bcl-2 → oncogene → uncontrolled cell growth and inhibition of cell apoptosis
    • Genetic Factors
      • Mutation in tumor suppressor genes
      • Genes that suppress malignant cell growth (e.g., p53 gene mutation associated with various solid tumors)
    • Lifestyle Factors
      • Unbalanced diet
      • Hormones

    Pharmacology in Neonates

    • Newborns exposed to caffeine during gestation have higher levels of CYP1A2 activity at birth, resulting in a shorter caffeine half-life of 4-5 hours, necessitating more frequent dosing.

    Drug Metabolism

    • Phase II: Lower UDP-glucuronosyl transferase (UGT) activity affects the metabolism of morphine, chloramphenicol, and acetaminophen.
    • Phase I: Lower CYP3A4 activity leads to a slower rate of erythromycin metabolism, increasing the risk of adverse effects.
    • Phase I: Genetic polymorphisms of CYP2D6 result in lower activity, affecting the metabolism of atomoxetine, leading to increased heart rate, blood pressure, and impaired weight gain in children with ADHD.
    • Phase I: CYP1A2 activity is negligible in fetal liver tissue and in newborns not exposed to caffeine in utero.

    Drug Elimination

    • Kidneys are not fully developed at birth, resulting in lower GFR, immature tubular secretion, and decreased clearance of aminoglycosides and digoxin.
    • Concomitant use of dexamethasone and indomethacin may alter the normal progress of renal maturation in neonates.

    Pharmacodynamic Changes

    • Reduction in adrenergic receptor density or downregulation of receptors in the myocardium of premature neonates, making them resistant to the effects of β-adrenergic agonists.
    • GABA receptors are abnormal in infancy and develop with age, explaining why infants require relatively larger doses of anti-epileptic medications.

    Drug Distribution

    • Functionally immature blood-brain barrier, resulting in higher drug distribution into the CNS, making antibiotic therapy for sepsis and meningitis more effective.
    • Higher total body water, leading to greater distribution of highly water-soluble drugs like linezolid and gentamicin.
    • Plasma protein binding is reduced in neonates due to decreased circulating levels of albumin and decreased binding affinity, affecting the distribution of phenytoin and sulfonamides.

    Drug Absorption

    • Intramuscular & Subcutaneous Absorption:
      • Reduced muscle size, weaker muscle contractions, immature vasculature, and reduced skeletal muscle blood flow, leading to reduced absorption of I.M administered drugs in neonates.
      • Lower percentage of body fat in neonates, delaying subcutaneous drug absorption (e.g., insulin).
    • Transdermal Absorption:
      • Greater skin to body surface area ratio, thinner epidermis, better hydration, and greater perfusion, enhancing skin absorption and increasing the risk of significant toxicity.
    • Rectal Absorption:
      • High contractions in the rectum causing premature expulsion of solid rectal drug formulations (suppositories).
      • Rapid absorption of rectal solutions of drugs like diazepam gel.
      • Rapid absorption of rectal acetaminophen suppositories.

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    Test your knowledge of cancer definition, types, and causes, including environmental factors and chronic infections.

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