Physical agents- mechanical forces, temperature, electrical

Radiation injury- UV, ionizing radiation

Chemical injury- drugs, lead, mercury

Biologic agents- viruses, parasites, bacteria

Nutritional inbalance- excess or deficiencies of nutrients

1. Free radical formation

2. Hypoxic and ATP depletion

3. Disrupiton of intracellular calcium homeostatis

1. Coagulative- protein denaturation

2. Liquefaction- digestive hydrolytic enzymes

3. Caseous- debris deposits

4. Fat- lipases break down triglycerides

5. Gengrenous- dry (line of demarcation), wet, or gas

Programmed cell death

No inflammation

Reduced cell size

Plasma membrane intact

Pathologic cell death

Inflammation

Increased cell size

Distrubed cell membrane

Base pair substitution- missense or nonsense

Frameshift mutations

Syphilis

Toxoplasmosis

Other

Rubella

Cytomegalovirus

Herpes

-Deletions

-Duplications

-Inversions: missing fragment reinserted backwards

-Translocations: exchange of material between nonhomologous chromosomes

Mitosis:

-Asexual

-Two identical 2n daughter cells

Meiosis:

-Sexual

-Four nonidentical n daughter cells

Genotype: set of genes

Phenotype: observable expression of genes

Percent of individuals with a specific genotype who express the expected phenotype

Assume 100% penetrance, but varying degrees of expression of the phenotype

Abnormal # of chromosomes (monosomy, trisomy)

Trisomy 21

Mental retardation

Sterility

Menstrual irregularity

45, X

Missing all or part of an X chromosome

Females only

Short stature

Neck webbing

Sterility

XXY

Only in males

Mental retardation

Sterility

Types of cellular adaptation

-Atrophy: get smaller

-Hypertrophy: get bigger

-Hyperplasia: increased # of cells

-Metaplasia: one type of adult cell type is replaced by a different type

-Dysplasia: "deranged cell growth", cells vary in size, shape, and organization

-Destroys pathogens directly

-Opsonization (cell lysis)

-Chemotactic factors (attract phagocytic cells)

-Rapid release of histamine (vasodilation and increased permeability)

-Extrinsic and intrinsic

-Forms fibrin mesh

-Stops bleeding

-Increased permeability

-Chemotaxis/leukocyte migration

-Increased permeability due to bradykinin

-Pain stimulated by bradykinin

Change in genetic expression (phenotype) without DNA mutation

-Slow growing

-Well defined capsule

-Not invasive

-Well differentiated

-Low mitotic index

-Do no metastasize

-Grows rapidly

-Not encapsulated (has appendages)

-Invasive

-Poorly differentiated

-High mitotic index

-Can metastisize

Benign- end in "-oma"

Malignant-

      Epithelial end in "-carcinoma"

      Connective tissue end in "-sarcoma"

      Lymphatic tissue = "lymphomas"

      Blood forming cells = "leukemias"

      Glandular or ductal epithelium= "adenocarcinomas"

Preinvasive epithelial malignant tumors of glandular or epithelial origin that have not broken through the basement membrane or invaded the surrounding stroma

• Do not exhibit contact inhibition (keep multiplying when cells come in contact with eachother
• Anchorage independent (can proliferate while suspended)

Normal genes that direct protein synthesis and cellular growth

Mutant genes that can allow the uncontrolled growth of cancer

-AKA anti-oncogenes

-Genes the prodcue proteins that inhibit cellular division

• Point mutations
• Chromosome translocation
• Mutation of tumor-suppresor genes
• Gene amplification (duplication of portion of chromosome)
• Loss of heterozygosity (both chromosome copies of a gene are inactivated)
• Gene silencing
• Chromosome instability

1. Transformation
2. Angiogenesis
3. Motility and invasion
4. Embolism and circulation
5. Invasion into different organ
6. Tumor cell proliferation and angiogenesis (in new organ)

• Stage I: No metastasis
• Stage II: Local invasion
• Stage III: Spread to regional structures
• Stage IV: Distant metastasis

TNM system

• T for tumor spread
• N for node involvement
• M for the presence of distant metastasis

• C- Change in bowel or bladder habits
• A- A sore throat that does not heal
• U- Unusual bleeding or discharge
• T- Thickening of lump in breast or elsewhere
• I- Indigestion
• O- Obvious change in wart or mole
• N- Nagging cough or hoarseness

• C- Continued, unexplained weight loss
• H- Headache with vomiting in the morning
• I- Swelling or persistent pain in bonesor joints
• L- Lump or mass in abdomen, neck, elsewhere
• D- Development of whitish pupil of the eye
• R- Recurrent fevers not caused by infection
• E- Excessive bleeding or bruising
• N- Noticeable paleness or prolonged tiredness

Deficiency of circulating white blood cells

Deficiency of circulating platelets

• Pain
• Cachexia (weight loss, anorexia, muscle loss)
• Anemia
• Thrombocytopenia
• Infection
• Hair loss
• Mucositis
• Hypercalcemia
• Hyponatremia