Microbiology 160 exam 2 – Flashcards
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How many annual deaths in the US each year from cigarettes?
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480,000
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how many percent of all deaths in the US was due to cigarette smoking?
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20%
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Tobacco Facts
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tobacco products are the only legal consumer products that can be lethal when used exactly as the manufacturer intends
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Teenagers and smoking in the US
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current cigarette smoking among US high school students lowest in 24 years
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smoking and your pets
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-secondhand smoke has been associated with oral cancer and lymphoma in cats, lung and nasal cancer in dogs, as well as lung cancer in birds -higher incidence of nasal tumors in long nosed breed of dogs -shorter or medium nosed dogs showed higher rates of lung cancer
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Additives in cigarettes
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-more than 600 legally added -cocoa: produces bromine gas that dilutes airways -menthol: enables smoker to inhale more easily by numbing throat -ammonia: compounds speed the delivery of nicotine -acetaldehyde and pyridine: strengthen nicotine's impact on brain and nervous system -sweeteners: more appealing
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Smoking and pregnancy: effects on women
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-difficulty getting pregnant -placenta separates from the womb early causing bleeding -placenta covers cervix causing complications -pregnancy occurs outside of the womb
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Smoking and pregnancy: effects on babies
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-baby born too small -baby born too early -sudden infant death syndrome -stillbirth -infant death -cleft lip/palate
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E-cigarette concentrations
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range from zero nicotine, low (6-8mg/ml) and midrange doses (10-14mg/ml), to high (16-18mg/ml) and extra high (54mg/ml)
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Top five consumers in % of cigarettes smoked
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1. China 2. Russia 3. US 4. Indonesia 5. Japan
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Health risks from smoking
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-smoking can damage every part of the body -causes cancers and chronic diseases to every part of body -spouses have an approx. 30% increased risk of lung cancer
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Facts about addition to nicotine
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-average amount of nicotine in cigarette smoke has increased 10% since 1998 -nicotine is tobacco plant's natural protection from being eaten by insects -within 8 seconds of first-ever puff, nicotine arrives at brain's reward pathways -in brain nicotine gains control over flow of 200+ neurochemicals -men who don't quit smoking lose an average of 13.2yrs of life; women lose av. of 14.5yrs
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Drug with highest % of people who get addicted after trying
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tobacco
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Lung cancer facts
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-1.1 billion (15%) people are smokers globally -smoking is estimated to account for 80-90% of all lung cancer cases -lung cancer is the leading cause of cancer related deaths worldwide (1.6 mill a year)
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Main types of lung cancer
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-non-small cell carcinoma (85%) may be treated surgically -small cell carcinoma (15%) characterized by rapid growth and dissemination; treated with chemo and radiation
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types of non-small lung cancer
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-adenocarcinoma -squamous cell carcinoma -large cell carcinoma
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Adenocarcinoma
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-type of non-small lung cancer that develops on outer boundaries of lungs -more common in women -cause 40% of lung cancers in US
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Squamous cell carcinoma
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-type of non-small lung cancer that starts in bronchi -may not spread as rapidly as other lung cancers -cause 30% of all lunger cancers in US
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Large cell carcinoma
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-type of non-small lung cancer that is any large tumor that cannot be classified -cause 15% of all lung cancer in US
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Small cell carcinoma of the lung
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-also called oat cell carcinoma, can create its own hormones -without treatment is the most aggressive of any type of pulmonary tumor, median surveil 2-4 months -has greater tendency to be widely disseminated -more responsive to chemo
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Cigarette tar
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-sticky brown substance which causes yellow-brown stains -mixture of substances that together form a sticky mass in lungs -paralyses the cilia (small hairs which protect lungs)
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Progression of colon cancer
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-begins with development of polyps in the epithelium of the colon -2 gene mutations involved
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2 gene mutations involved colon cancer
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-deletion of a healthy copy of the APC tumor suppressor gene on chromosome 5, or p53 -a mutant proto-oncogene
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colon cancer stage 0
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cancer has not grown beyond inner layer of colon wall
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colon cancer stage 1
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cancer is grown to outer layer of wall
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colon cancer stage 2
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tumor is through colon wall, not yet spread to lymph nodes
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colon cancer stage 3
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cancer has spread to lymph nodes
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colon cancer stage 4
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cancer spreads to distant sites in body, such as liver or lung
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Risk factors for colorectal cancer
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-polyps -family history -age -having long term inflammation of the colon -eating a diet high in fat and low in fiber -physical inactivity
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Polyps
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non-cancerous growths that can become cancerous over time; most colon cancers develop from polyps
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Signs and symptoms of colorectal cancer
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-change in bowel habits for 2 or more weeks -frequent gas pains, cramps, bloating, or feelings of fullness in abdomen -red or dark blood in or on the stool or rectal bleeding -fatigue and/or iron deficiency anemia in men and older women -pencil thin stools -feeling that the bowel does not empty completely -weight loss for no known reason -abnormal pain
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colon cancer screening tests
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-stool tests -flexible sigmoidoscopy -colonoscopy -virtual colonoscopy
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Flexible Sigmoidoscopy
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-used to screen for colorectal cancer -a flexible fiberoptic tube is introduced through the rectum and slowly advanced toward the splenic flexure -physician may inspect the bowel for polyps from anus to colon
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Colonoscopy
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-most widely used diagnostic method to study the colon and has the highest diagnostic sensitivity of all tests -90-95% of colon can be examined in most studies -test takes 60 min or less -offers the flexibility of performing biopsy of suspicious regions and the ability to perform endoscopic polypectomy -"gold standard" for the diagnosis of colorectal neoplasms
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colorectal cancer treatment options
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-surgery -chemotherapy -radiotherapy -monoclonal antibody therapy (drugs Avastin and Erbitux)
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Heredity and Cancer Risks
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family history that might indicate an inherited gene mutation would include: -cancer in several closely related people on same side in several generations -cancer at younger ages than usual -more than one diagnosis of cancer in same person -specific types of cancer that are linked to specific genes
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% of cancers related to an inherited gene mutation
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5-10%
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Inherited cancer facts
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-inheriting gene mutation does not mean that child is born with cancer, only that child inherits a higher risk of developing cancer sometime during lifetime
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Cowden Disease
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-inherited mutations in the PTEN gene have been found in 80% of people with Cowden syndrome -usually present by the late 20s -increased risk of breast, thyroid, endmeyrial and uterine cancer -multiple lesions
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Inherited Polyposis Syndromes
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are inherited colorectal cancer syndromes that are associated with multiple precancerous polyps in the colon
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Familial Retinoblastoma (type of cancer in the eye)
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-normal child has 1 in 20,000 chance of developing disease -in families of retinoblastoma survivors, 50% of children develop the disease -40% of cases are familial, rest are sporadic -children with familiar form develop multiple tumors, sporadic cases have single tumor
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Li-Fraumeni syndrome
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-cancer predisposition syndrome associated with soft-tissue sarcoma, breast cancer, leukemia, osteosarcoma, melanoma, and cancer of colon, pancreas, adrenal cortex, lung and brain -extremely rare -p53 or CHECK2 gene mutation
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Xeroderma Pigmentosum
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-2 copies of the same gene inherited from each parent -patients are sensitive to UV; sunlight could be fatal -sunlight exposure leads to skin cancer
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Breast Cancer Inheritance
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-families with breast cancer mutations are rare and account for only 4% of all breast cancer cases -risk results from interaction of several mutated genes
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Prostate Cancer Inheritance
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-hereditary prostate cancer accounts for 5-10% of all prostate cancers -men who inherit prostate cancer tend to get the disease at a younger age
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Possible benefits of gene testing
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-allow for more accurate assessment of cancer risk -if positive doctors can screen earlier for cancers -if results are negative, invididuals may not have to screen as aggressively -early cancer screening can be offered to other at risk family members if mutation is identified -no physical risks involved
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Possible risk gene testing
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-can be emotionally difficult -emotional stress on relatives who have not had genetic testing -health insurance coverage for cancer screening -possibility of employers or insurance provider discrimination based on genetic test results
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Similarities and differences compared to adult cancers
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-cancer is common in adults; rare in children -cancer in adults is mostly attributed to environmental factors; no clear causation in children -biggest difference: childhood cancer is much more curable
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Cancers of central nervous system
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-brain tumors -primary brain cancer -metastatic brain cancer
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brain tumors
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many types; most common called gliomas
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primary brain cancer
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rarely spreads beyond central nervous system, death results from uncontrolled tumor growth within limited space of skull
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metastatic brain cancer
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indicates advanced disease and has a poor prognosis
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signs and symptoms brain tumors
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-change in pattern of headaches; worse headaches -unexplained nausea or vomiting -vision problems -gradual loss of sensation or movement in arm or leg -difficulty with balance -speech difficulties -confusion in everyday matters -personality or behavior changes -seizures -hearing problems -hormonal disorders
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What is leukemia?
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-cancer found in blood and bone marrow caused by too many white blood cells in body -affects the organs that manufacture blood cells
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4 types of leukemia
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1. acute lymphoblastic leukemia (most common) 2. acute myelogenous leukemia 3. chronic lymphoblastic leukemia 4. chronic myelogenous leukemia
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Hodgkin's lymphoma
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affects lymph nodes nearer to the body's surface, such as in the neck armpit, and groin area
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Non-Hodgkin Lymphomas
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affect lymph nodes found deep within the body; include Burkitt's, non-Burkitt's and lymphoblastic lymphoma
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How does childhood cancer affect the family?
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-one of most devastating challenges for a family -parents are traumatized--did their actions play a role in their child's cancer? -other siblings often neglected -siblings traumatized at thought that a brother or sister might die -siblings traumatized at thought that they too will develop cancer
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Risk factors for breast cancer
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-older age -breast density -genetic factors -family history -long menstrual history -ionizing radiation -use of combined postmenopausal hormone replacement therapy -alcohol consumption -having no children -older that 30 years of age at first full term pregnancy -postmenopausal obesity
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Breast cancer screening recommendations
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-age 40: women should have the opportunity to begin screening -age 45: yearly mammograms -age 55: mammograms every other year -age 55+: continue to have regular mammograms
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Invasive Ductal Carcinoma (IDC)
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an invasive breast cancer that penetrates the wall of a duct; comprises between 70-80% of all breast cancer cases
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Invasive Lobular Carcinoma (ILC)
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accounts for 10-15% of all breast cancers
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Lumpectomy (open biopsy)
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a surgical procedure in which all or part of a lump is removed and tested for malignancy
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What are hormones?
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a hormone is a chemical messenger from one cell to another; function as a signal to the target cells
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beneficial effects of estrogen
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-programs breast milk production -controls cholesterol -prepares for fetus -preserves bone strength
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harmful effects of estrogen
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increases cancer risk in breast and uterus
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Hormone Replacement Therapy
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aims to boost hormone levels to reduce symptoms (hot flashes, mood swings, loss of libido) that come with reduced levels of sex hormones
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HER-2 Receptor
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-Human epidermal growth factor receptor-2 -HER-2 + breast cancer is aggressive -higher risk of recurrence
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HER-2 positive breast cancer
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-tumors are less responsive to hormone treatment -over expression is also observed in tumors
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Ways to detect and diagnose breast cancer
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-mammography -biopsy -ultrasonography
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breast cancer treatment options
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depend on stage of cancer -local tumor: surgery, radiation or chemo -whole body/metastasized cancer: systemic treatments -complementary and holistic therapies
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Risk factors of cervical cancer
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-HPV infection -multiple sex partners -started having sex before 18 -other STIs -smoking -multiple pregnancies -oral contraceptives -diet family history -low socioeconomic status -molecular genetic factors: p53
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history of cervical cancer
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-was common in female sex workers -rare in nuns -more common in second wives of men whose first wives had died from cervical cancer -rare in jewish women
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types of cancers associated with HPV
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-cervical cancer: most common HPV associated cancer -vulvar cancer: 40% linked to HPV -vaginal cancer: 70% linked to HPV -penile cancer: 40% linked to HPV -anal cancer: 85% linked to HPV -cancers of head and neck
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5 most common HPV types
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1. HPV 16 2. HPV 18 3. HPV 45 4. HPV 31 5. HPV 33
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skin cancer risk factors
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-hereditary -environment: level of UV light -multiple nevi (moles) -occupational exposure -elevation: UV stronger as elevation increases -latitude -cloud cover: may reduce UV
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Most common type of cancer in the US
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skin cancer
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how sunburn causes skin cancer
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1. UV radiation from sunlight causes DNA mutations 2. cells with damaged DNA destroyed by apoptosis 3. cell with mutant p53 gene evades apoptosis and continues proliferating
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Effects of UV radiation
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-UVB is main cause of skin cancer -damages DNA -oxidize lipids and produces harmful free radicals -causes inflammation -disrupts cell communication and causes expression of stress response genes -weakens the immune responses of the skin
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2 major types of non-melanoma skin cancers
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1. basal cell carcinoma (80%) 2. squamous cell carcinoma (16%)
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2 main types of skin cancer
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1. melanoma: higher mortality rate 2. keratinocyte/non-melanoma: higher number of cancer cases
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squamous cell carcinoma appearance
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-appears as a scaly, reddish, dome shaped fleshy nodule, often with a central ulcer -5mm to few cm in size -mostly appears on sun exposed areas of the skin or lips
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basal cell carcinoma appearance
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-pear like grayish nodule, -few mm in size -appears on sun exposed areas of face, scalp, neck, upper area of chest and back -several nodules may merge
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How melanomas arise
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melanomas arise from melanocytes and are more dangerous; metastasize before tumor is noticed
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characteristics of melanoma
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-can develop anywhere on body -most develop in areas that have had exposure to sun -can occur in areas that don't receive much sun exposure
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melanoma of the eye
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-rare -usually in patients over age 45/adults -if untreated can cause cataract and glaucoma
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The ABCD Rule
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used to distinguish benign moles from melanoma -A: asymmetry; one half not like other -B: border irregular -C: color varied from one area to another -D: diameter larger than 6mm
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Skin cancer treatments
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-cryosurgery (freezing) -surgery -immunotherapy -chemotherapy -radiation therapy -photodynamic therapy
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Yervoy
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blocks CTLA-4 in melanoma
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BioVex Vaccine for advanced melanoma
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Causes immune system to expose anti-tumor cells
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Pap test
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-developed in 1943 by Dr. George Papanicolaou -This is the most successful screening test, reducing cervical cancer mortality by 70% in the United States -
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pap smear morphology
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-dysplasia: nucleus is larger than it should be -mild dysplasia: nucleus is 3-4 times larger than it should be -moderate dysplasia: nucleus is 5-6 times larger than it should be -severe dysplasia: nucleus taking up most of the cell
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3 FDA approved HPV vaccines
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-Cervarix -Gardasil -Gardasil 9
