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MCC > Quiz 3 > Flashcards

Quiz 3 Flashcards

1
Q

What are the four general steps of tumor progression?

A
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2
Q

What is the common initial site of spread for a carcinoma?

A

regional lymphatics, to the regional lymph nodes

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3
Q

Hematogenous spread is more characteristic of what type of cancer?

A

sarcomas (some carcinomas also)

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4
Q

Which 4 carcinomas prefer hematogenous spread?

A
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5
Q

What type of metastisis is characteristic of ovarian carcinoma?

A

seeding of the body cavities “omental caking”

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6
Q

What is required for a dx of cancer?

A

biopsy or excision

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7
Q

Do benign or malignant tumors have a low nuclear to cytoplasmic ratio?

A

benign tumors

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8
Q

Do benign tumors ever metastasize?

A

Benign tumors never metastasize

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9
Q

What test is preferred to characterize malignant tumors that are difficult to classify on histology?

A

Immunohistochemistry

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10
Q

What are serum tumor markers?

A

Proteins released by tumors

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11
Q

What are three uses of measuring serum tumor markers?

A

-Screening (still requires tissue biopsy/excision for dx
-Monitoring reponse to treatment
-Monitoring recurrence

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12
Q

What is staging of cancer based on?

A

Size and spread

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13
Q

What is the key prognostic factor of cancer?

A

staging (NOT grade)

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14
Q

What does the TNM staging acronym stand for?

A

T- tumor size or DOI
N- spread to regional lympoh nodes (2nd most important)
M- metastasis (most important)

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15
Q

Define neoplasia:

A

uncontrolled autonomous growth of cells

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16
Q

Define anaplasia:

A

loss of differentiation

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17
Q

Define pleomorphism:

A

cells that look different from each other

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18
Q

What is the most common primary bone tumor?

A

Osteosarcoma

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19
Q

What is the most common soft tissue sarcoma in children?

A

Rhabdomyosarcoma

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20
Q

What are the two major groups of lung cancer?

A

Small cell (SCLC)
Non-small cell (NSCLC)

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21
Q

What is the difference between a neoplasm and a tumor?

A

a neoplasm is a new growth, and a tumor is a mass

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22
Q

What are the two histological components of a tumor?

A

parenchyma (malignant cells) and stroma (CT between cells)

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23
Q

How is a carcinoma defined?

A

A cancer arising from epithelial tissue

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24
Q

How is a sarcoma defined?

A

A cancer arising from solid tissue

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25
Q

How is a leukemia/lymphoma defined?

A

A cancer arising from the blood

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26
Q

What is the difference between liposarcoma and lipoma?

A

Liposarcoma- maligant tumor of fat
Lipoma- benign tumor of fat

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27
Q

What is melanoma?

A

A malignant tumor of melanocytes

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28
Q

What is a seminoma?

A

A tumor of germ cells (in testis)

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29
Q

What are the three most important carcinogens?

A

Chemicals, oncogenic viruses, and radiation

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30
Q

What is HTLV-1? With what kind of cancer is it associated?

A

It is a retrovirus endemic to Japan, the Caribbean, Africa, and South America

It causes adult T-cell leukemia/lymphoma

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31
Q

What pathologies are caused by HPV? What is its basic MoA?

A

Benign warts, cervical cancer, and oropharyngeal cancer

Viral oncoproteins E6 and E7 bind to p53 and Rb and neutralize their function

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32
Q

What what general areas is EBV implicated in respect to cancer?

A

EBV is a ubiquitous herpes virus implicated in develop of Burkitt lymphomas, B-cell lymphomas in patients with T-cell immunosuppression, and several other cancers

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33
Q

What two viruses are responsible for 70 to 85% of hepatocellular carcinomas worldwide?

A

HBV and HCV

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34
Q

What is being shown in this tumor sample?

A

a Homer-Wright rosette

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35
Q

What translocation is associated with 90% of Ewing sarcomas?

A

t(11;22) FLI1-EWSR1

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36
Q

What type of neuroblastic tumor is visible here? What histological features are notable?

A

a neuroblastoma

neuropil
small primitive cells

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37
Q

What type of neuroblastic tumor is visible here? What histological features are notable?

A

a ganglioneuroblastoma

neuropil
small primitive cells
schwannian stroma
maturing ganglion cells

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38
Q

What type of neuroblastic tumor is visible here? What histological features are notable?

A

a ganglioneuroma

ganglion cells
schwannian stroma

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39
Q

What are the key risk factors of lung cancer?

A

cigarette smoke, radon, and asbestos

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40
Q

What are the two most common benign lesions that can explain a solitary nodule in the lungs?

A

granuloma
bronchial hamartoma (lung tissue + cartilage)

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41
Q

What percent of lung carcinomas are non-small cell?

A

85%

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42
Q

Why is the percentage of small-cell vs. non-small cell lung carcinomas significant?

A

small-cell: poor response to surgery, good response to chemotherapy
non-small cell: good response to surgery; poor response to chemotherapy

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43
Q

What are the two most common types of non-small cell lung carcinoma?

A

Adenocarcinoma (40%)
Squamous cell carcinoma (30%)

44
Q

What two factors define squamous cell carcinoma of the lungs?

A

keratin pearls
intercellular bridges

45
Q

What type of neoplasm is especially associated with occupational exposure to asbestos?

A

mesothelioma

46
Q

What is the only modaility recommended in high risk colon cancer patients (family history of CRC)?

A

Sigmoidoscopy/colonoscopy

47
Q

For what groups would an autologous HCT be indicated?

A

several solid cancers
HL/NHL

48
Q

For what groups would an allogeneic HCT be indicated?

A

several leukemias, as well as myeloproliferative neoplasms

49
Q

What is an example of a go-to drug to treat CRS (cytokine release syndrome) as an effect of CAR T therapy?

A

Tocilizumab

50
Q

A cancer involving high PD-L1 expression with no driver mutation would merit what first line treatment? (not chemotherapy)

A

Immunotherapy

51
Q

EGFR mutations are more commonly seen in what three demographics?

A

women
Asian ancestry
non-smokers

52
Q

What is the first line treatment for a stage IV NSCLC with an activating EGFR mutation?

A

EGFR inhibitors

53
Q

What are the 5 stages of metastases?

A
  1. Invasion- MMPs play important role
    2.Intravasation
  2. Circulation
  3. Extravasation
  4. Colonization- rate-limiting step
54
Q

What type of paraneoplastic syndrome is most commonly caused by a carcinoid?

A

carincoid syndrome (caused by secretion of serotonin, histamine, kallikrein, prostaglandins)

55
Q

What type of paraneoplastic syndrome is most commonly caused by small cell carcinoma?

A

cushing syndrome (caused by secretion of ACTH)

56
Q

What type of paraneoplastic syndrome is most commonly caused by squamous cell carcinoma?

A

Hypercalcemia (caused by secretion of PTHRP)

57
Q

What testing would be done in a suspected case of HNPCC or Lynch syndrome?

A

IHC and microsatellite instability (MSI on PCR)

58
Q

Where do hyperplastic polyps most commonly present?

A

the left colon

59
Q

Where do juvenile polyps most commonly present?

A

the rectum

60
Q

What type of cancer is the second most common in both men and women?

A

lung cancer

61
Q

What is the most common type of cancer in men?

A

prostate cancer

62
Q

What is the most common type of cancer in women?

A

breast cancer

63
Q

What type of cancer is the leading cause of cancer deaths in men and women?

A

lung cancer

64
Q

What is the 5 year survival for a lung cancer diagnosed with distant metastases?

A

4.7%

65
Q

What are the two possible stages of Small cell lung cancer?

A

Limited- tumor is confined to ipsilateral hemithorax and regional nodes.
Extensive- tumor beyond the boundaries of limited disease

66
Q

What complications from lung cancer are indicatd by the acronym SPHERE?

A

S- SVC syndrome
P- Pancoast Tumor
H- Horner’s syndrome (PAM)
E- Endocrine abnormalities
R- Recurrent laryngeal nerve dysfunciton
E- effusions

67
Q

What type of polyp matches this etiology? What is most significant?

A

Hyperplastic polyp;

serrated crypts (part-way)

commonly in left colon

No malignant potential

68
Q

What type of polyp matches this etiology? What is most significant?

A

Juvenile polyp;

generally harmless

bleeding from protrusion through anal sphinctre

with dysplasia poses cancer risk

69
Q

What type of polyp best matches this etiology?

A

Hamartamous polyp

70
Q

What is the cancer risk in a carcinoma of 2cm or greater?

A

5-15%

71
Q

What is the cancer risk of a pedunculated polyp? a sessile polyp?

A

P: 1-15%
S: 5-50%

72
Q

What is the cancer risk of a tubular polyp? A villous polyp?

A

T: 1-15%
V: 5-50%

73
Q

What is the cancer risk of a polyp with high-grade dysplasia?

A

5-50%

74
Q

What type of APC mutations are most common?

A

Nonsense (truncating mutations)

75
Q

What are microsatellites?

A

repeating sequences of noncoding DNA

76
Q

Why is microsatellite instability important to recognize?

A

instability in microsatellites indicates ineffective DNA copy mechanisms, i.e. defective MMR enzyme

77
Q

What disease matches this etiology?

A

Familial adenomatous polyposis

78
Q

What treatment is typical for a dx of FAP?

A
79
Q

What disease matches this etiology?

A

Hereditary nonpolyposis colorectal carcinoma (Lynch syndrome)

80
Q

What disease matches this etiology?

A

HNPCC/Lynch syndrome

81
Q

What disase matches these descriptors?

A

Colorectal cancer

82
Q

What disase matches this etiology?

A

Colorectal cancer

83
Q

What are the preferred methods of screening for colorectal cancer?

A
84
Q

What are the treatments for colorectal cancer at stages I-IV?

A
85
Q

In what demographics is prostate cancer most common? What is the largest risk factor?

A
86
Q

Is a high PSA always indicated of prostate cancer? What level is worrisome?

A
87
Q

What two approaches are most common for tx of low risk prostate cancer?

A
88
Q

What is an ideal treatment for localized prostate cancer of medium/high risk?

A
89
Q

What options are available for tx of advanced prostate cancer?

A
90
Q

Using the colon crypt as an example, what key molecules are needed for stem cell maintenance?

A

Wnt and B-catenin

91
Q

Using the colon crypt as an example, what key molecules are needed for the proliferation of amplifying cells?

A

Ephrin

92
Q

Using the colon crypt as an example, what key molecules are needed for the differentiation of crypt cells?

A

TGF-B, Hh, BMP, and others

93
Q

What type of tumors tend to favor lymphatic spread?

A

carcinomas

94
Q

What type of tumors favor hematogenous spread?

A

sarcomas

95
Q

What treatments are favored for CRS (cytokine release syndrome) induced by CAR T cell therapy?

A

Tocilizumab

dexamethasone/methylprednisone

96
Q

What type of lung cancer may be indicated by the following histology slide?

A

Small-cell lung cancer

97
Q

What type of lung cancer may be indicated by the following histology slide?

A

carcinoid

98
Q

What type of lung cancer may be indicated by the following histology slide?

A

Adenocarcinoma of the lung

99
Q

What type of lung cancer may be indicated by the following histology slide?

A

Squamous cell carcinoma of the lung

100
Q

What is the standard of treatment for local (stage 1 or II) NSCLC?

A

surgery, possibly with adjuvant chemotherapy or IT

101
Q

What is the standard of treatment for a regional NSCLC (stage III)?

A

chemotherapy and radiation therapy

102
Q

What is the standard of treatment for distant NSCLC (stage IV)

A

Multiple lines of chemo and radiation therapy depending on tumor type

103
Q

What drug family is the standard chemotherapy for lung cancers?

A

platinum-based drugs

104
Q

What testing could be done in suspected cases of Lynch syndrome or HNPCC?

A

IHC and microsatellite instability (PCR)

105
Q

MSH2 and MLH1 mutations are involved in mutations in what process?

A

mismatch repair (MMR)

106
Q

What clinical triad might suggest an inflammatory polyp?

A

rectal bleeding, mucus discharge, and an inflammatory lesion of anterior rectal wall

MCC (10 decks)

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