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Jason's Respiratory Block > Neoplasia 3 > Flashcards

Neoplasia 3 Flashcards

1
Q

in Dx: If malignant, think

A

primary? metastatic?

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2
Q

What causes weight loss and anorexia in tumours?

A

late stage make TNF-A and IL-1, increases metabolism

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3
Q

clinical presentation of lung tumour

A 
cough
haemoptysis
wheeze
dyspnoa
pneumonia
Pancoast syndrome
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4
Q

What are paraneoplastic effects?

A

side effects of cancers such as endocrine, immunological (rashes), clubbing, vascular

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5
Q

What kinds of paraneoplastic effects in lung cancer?

A

hypercalcemia

cushings, inapropriate ADH, ACTH

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6
Q

Are tumour markers used in dx?

A

not really, more in follow up because it’s not specific or elevated in every case

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7
Q

Why do x-rays and CTs besides for Dx?

A

staging and follow-up

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8
Q

Another way to investigate lung tumours besides radiology?

A

bronchoscopy

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9
Q

Tissue sampling cytology is what?

A

fine need aspiration, only look at cells

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10
Q

Histopathology in tissue sampling is:

A

H&E, stains, immunohistochemistry

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11
Q

What kind of sample needed for histopathology of neoplasia?

A

full piece of tissue

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12
Q

Why do immunohistochemistry anyways?

A

helps distinguish primary from metastatic lesions

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13
Q

Once diagnosis of malignancy is made, what other info?

A 
tumour type/subtype
grade
stage
lymph invasion?
other
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14
Q

Want to gather lots of info on tumours for what?

A

Prognosis
management
comparing treatments

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15
Q

4 main types of lung carcinomas:

A

squamous cell carcinoma
adenocarcinoma
large cell
small cell

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16
Q

lung cancer is one of most common in the world: Incidence?

A

13%

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17
Q

More males of females lung cancer?

A

2.7:1 males

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18
Q

average age of lung cancer Dx?

A

60

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19
Q

3 big predisposing factors for lung cancer

A

tobacco
asbestos
arsenic

20
Q 
a non smoker is most likely to get which cancer?
squamous cell carcinoma
adenocarcinoma
large cell
small cell
A

adenocarcinoma

21
Q 
What pathogenesis are the following part of?
Goblet Cell hyperplasia
reserve cell hyperplasia
squamous metaplasia
squamous dysplasi
carcinoma in situ
invasive carcinoma
A

Pathogenesis of Small cell carcinoma in lung

22
Q

Does SCC form cavities?

A

yes, has necrotic core

23
Q

What paraneoplastic effects does SCC predispose you to?

A

pneumonia
bronchiectasis
recurrent infections

24
Q

Adenocarcinomas are more proximal or peripheral?

A

peripheral

25
Q

SCC are more proximal or peripheral bronchi?

A

proximal

26
Q

What is you can’t determine tumour type on H&E?

A

other stains available
S100
LCA
CAM5.2 (liver cells stain, but not the tumour)

27
Q

Which are more aggressive? poorly differentiated or well differentiated?

A

poorly differentiated ones will mess you up

28
Q

What the gleason score for?

A

prostate cancer grading

29
Q

what is the modified bloom and richarson for?

A

breast ca grading

30
Q

what is stage of a cancer?

A

progression of malignancy

31
Q

What is TMN system? what is the acronym stand for?

A

For staging tumours
T= primary tumour
N= lymph node involvement
M= distant metastases

32
Q

What does ‘X’ mean in staging?

A

unknown or cannot be assessed

33
Q

TNM is universal for all organs?

A

Nope. Different parameters for different organs!

34
Q

eg. of predictive factors in breast cancer?

A

HER2 amplification

oestrogen and progesterone receptors

35
Q

5 main treatments for cancer

A 
surgery
radiotherapy
chemotherapy
targeted therapy
other(immuno, bone marrow)
36
Q

targeted therapy is different how for cancer?

A

less harmful to normal cells, more specific for tumour oncoproteins

37
Q

Two main categories for cancer targeted therapy:

A
  1. small molecules (inhibit growth factors/tyrosine kinase)

2. monoclonal antibodies that target proteins/receptors

38
Q

2 most important mutations in lung carcinoma?

A

EGFR

ALK

39
Q

What’s so significant about EGFR?

A

significant rate of mutations in young non/light smoking female asians with low-stage disease

40
Q

What does EGFR tyrosine kinase doman increase downstream?

A

hyperactivation of signaling pathways leading to abnormal proliferation

41
Q

How to treat EGFR mutations?

A

target therapies like Gefitinib and Erlotinib inhibit EGFR

42
Q

Can all lung carcinomas be treated with targeted therapies?

A

No, tumour need to be tested, could be resistant

43
Q

What is cachexia

A

wasting syndrome due to loss of appetite and the body just not processing nutrition appropriately

44
Q

3 ways to die from cancer

A
  1. cachexia
  2. secondary infection
  3. damage to vital organ by primary/secondary tumours
45
Q

Prevention of cancer? 4 things

A

public education
lifestyle
screening program
laws for workplace exposure

Jason's Respiratory Block (20 decks)

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