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Applied Pathophysiology for the Advanced Practice Nurse 2nd Edition by Lucie Dlugasch Lachel Story|

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Applied Pathophysiology for the Advanced Practice Nurse 2nd Edition by Lucie Dlugasch Lachel Story|

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Test bank For Applied Pathophysiology for the Advanced
Practice Nurse 2nd Edition by Lucie Dlugasch Lachel Story|
9781284255614 | All Chapters with Answers and Rationals

Why does cancer occur? - ANSWER: malfunction of genes that control cell reproduction, growth,
differentiation, and/or apoptosis

what is proliferation? - ANSWER: generation of new cells

what is differentiation? - ANSWER: the orderly process of cellular maturation to achieve a specific
function
*stem cells are highly UNdifferentiated

what does neoplasm mean? - ANSWER: irreversible deviant cell clusters (essentially,
cancer)....literally, "new growth"

Which cell types are most prone to cancer? Which are not? - ANSWER: epithelial and blood cells (cells
that rapidly divide)
- cardiac myocytes, mature neurons, and lens of the eye do not divide

What are the two major types of mutations that can affect cell growth and division? - ANSWER: -
Inherited (5% of cancers): present in egg or sperm as they form zygote; hereditary

- Acquired (95% of cancers): occur after conception; either from environmental conditions or
idiopathic

What must happen to a chromosome/gene for cancer to arise? - ANSWER: BOTH copies of genes (one
from each chromosome pair) must mutate

What are two categories of genes that, when mutated, lead to cancerous transformations? -
ANSWER: 1. Oncogenes (promote unregulated cell growth and development)

2. Tumor Suppressing Genes (prohibit over-proliferation of cells; regulate apoptosis)

What are proto-oncogenes and how do they become oncogenes? - ANSWER: they are "normal" genes
that regulate cell function and have the potential to become oncogenes through...
1. point mutation
2. translocation
3. gene amplification (altering chromosome by accelerating gene replication)

How do radiation, hormones, chemicals, tobacco, and microbes promote carcinogenesis? - ANSWER:
Radiation--producing reactive oxygen species (type of free radical), damaging cell membrane and
allowing radiation to interrupt cell DNA

Hormones--some tumor cells depend on hormones for growth

Chemicals--producing reactive species/free radicals that alter cell proteins or induce mutation

Tobacco--hurts respiratory mucosa

Microbes--viruses (e.g. HIV); alter genes or proteins that regulate oncogenes

what are reactive oxygen species? - ANSWER: a type of free radical that contains oxygen and easily
reacts with other molecules in a cell

, Differentiate autonomy and anaplasia. What are other distinct characteristics of neoplasms? -
ANSWER: autonomy: unregulated neoplasm proliferation
anaplasia: loss of cell differentiation and loss of cell function (degree of anaplasia determines
malignancy)

- loss of cell-cell communication
- increased energy expenditure
- increased motility
- rapid angiogenesis
- substance secretion
- presence of foreign antigens

*Autonomy leads to unregulated cell generation while anaplasia leads to loss of cell function
*Think: metaplasia and dysplasia refer to the changing of cell shape/size/etc.

Differentiate benign and malignant. - ANSWER: Benign: tumors that remain localized and closely
resemble tissue of origin; typically cells that over-proliferate but don't have much differentiation

Malignant: invasive, destructive, metastasize, and do not resemble tissue of origin; typically cells that
over-proliferate and differentiate

Differentiate local spread, direct extension, seeding, and metastases. - ANSWER: local spread--
proliferation within tissue of origin
direct extension--proliferation into adjacent tissues and organs
metastases--proliferation to distant sites by way of lymphatic vessels or blood vessels

*seeding is a type of direct extension that involves proliferation within peritoneal and pleural cavities
surrounding the affected tissue/organ

Define carcinoma in situ. - ANSWER: describe carcinomas confined to the epithelium that have not yet
penetrated the basement membrane

- this is a good prognosis!!! It means it has not spread to neighboring tissue

carcinoma, sarcoma, and blast-oma refer to (benign/malignant) tumors - ANSWER: malignant

What does T-N-M stand for with tumor staging? - ANSWER: T = tumor size
N = node (lymph) involvement
M = metasteses

How are tumors graded? - ANSWER: I-IV

I & II: differentiated; resemble tissue of origin
III & IV: undifferentiated; do not resemble tissue of origin

What are general manifestations of cancer? - ANSWER: inflammatory and immune processes,
including lymphadenopathy (enlarged lymph nodes), fever, and anorexia

*anorexia in this sense means loss of appetite, not anorexia nervosa

What is cachexia and why does it occur? - ANSWER: "feeling full" syndrome/loss of appetite caused by
release of

1. tumor necrosis factor
2. chemical mediators

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