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| a complex of diseases which occurr when normal cells mutate into abnormal cells that take over normal tissue, eventually harming and destroying the host. |
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1. uncontrolled growth and spread of abnormal cells.
2. proliferation
3. metastasis |
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uncontrolled growth of abnormal cells.
can be benign, malignant, or borderline. |
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well differentiated
slow growing
encapsulated
non-invasive
does not metastasize |
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undifferentiated
erratic and uncontrolled growth
expansive and invasive
secretes abnormal proteins
METASTESIZES |
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| nomenclature of neoplasia |
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tumor is named according to:
1. parenchyma/organ/cell
2. pattern and structure (gross or microscopic)
3. embryonic origin |
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malignant tumor
glandular or epithelial cell origin |
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malignant tumor
connective tissue origin |
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1. chemicals
2. viruses/bacteria
3. radiation
4. heredity
5. diet
6. hormones |
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radiation/sunlight
chemical/food irritants
altitude/humidity |
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smoking
dietary--preservative and additives
drugs |
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high fat
processed foods
alcohol |
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| viral/bacterial carcinogens |
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hep b/herpes/ebv/papilloma
HIV
h. pylori causes stomach cancer |
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DES
OCP especially estrogen |
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| kaposi's sarcoma- associated herpesvirus |
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| depressed immune system due to HIV infection leads to kaposi's sarcoma |
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benign grows locally and cannot spread or metastasize.
malignant invades neighboring tissues, enters blood vessels, and metastasizes. |
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tissue growth based on excessive cell division.
potentially reversible.
can be normal response to irritant, i.e. callus. |
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| cell growth differing in size, shape, arrangement. |
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severe dysplasia
some cancer cells |
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1. invasion--cells from primary tumor invade surrounding tissues.
2. spread--tumor cells spread though lymph or blood, or direct expansion
3. establishment and growth--cells are established and grow in secondary site: lymph nodes or organs |
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| blood-borne, commonly to liver and lungs |
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| tumor pieces break off and "seed" in new areas |
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cellular immunity
cytotoxic t cells kill tumor cells directly |
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humoral immunity
b cells produce antibody |
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| macrophages engulf cancer cell debris |
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| due to direct obstruction or pressure by tumor |
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impaired function of blood cells
decrease in cell production
impaired bone marrow
impaired platelet production |
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tumor erodes blood vessels
bleeding and severe anemia |
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| anorexia-cachexia syndrome |
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causes wasted appearance of client
pt does not feel like eating/has difficulty eating/cannot process food |
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ectopic sites with excess hormone production stimulated by tumor cells
-parathyroid hormone, insulin, ADH. |
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change in bladder/bowel
a sore that does not heal
unusual bleeding/discharge
thickenings or lumps
indigestion/difficulty swallowing
obvious change in wart or more
nagging cough/hoarseness
unexplained anemia
sudden weight loss |
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skin and mucous membranes for lesions, bleeding, petechia.
assess stool, urine, sputum, vomitus for bleeding
hair texture/loss |
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abdomen for masses, bulges, abnormalities
lymph nodes for enlargement |
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| lung, heart, bowel sounds |
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CBC
tumor markers-proteins in blood that are made by tumors. PSA and CEA
alkaline phosphatase-bone mets
biopsy |
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xrays-hard tissue
CT/MRI-soft tissue
US-no radiation
from biopsies, PAP smears |
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scope in colon
need bowel prep |
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| scope in urethra to view urinary bladder |
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staging determines size and mets
grading classifies by tissue type |
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T-extent of tumor
N-extent of spread to lymph nodes
M-presence of metastasis |
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tx-cannot be evaluated
t0-no evidence of primary
tis-in situ
T1-T4- size/extent |
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regional lymph nodes
nx-cannot be evaluated
n0-no involvement
n1-3-number and extent of spread |
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distant metastasis
mx-cannot be evaluated
m0-no mets
m1-distant mets |
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acute/chronic pain
impaired skin integrity
impaired oral mucous membrane
risk for injury/infection
fatigue
imbalanced nutrition: less than body requirements |
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