Neoplasia

Question 1

Tumor grade vs. stage

Answer 1

Grade - degree of cellular differentiation and mitotic activity

Stage - TNM

Question 2

Hamartoma vs choristoma

Answer 2

Hamartoma = Disorganized overgrowth of tissue in its native location

Choristoma = normal tissue in abnormal location

Question 3

Cachexia mediators

Answer 3

TNF-alpha, IFN-gamma, IL-1, IL-6

Question 4

Actinic keratosis = precursor to __

Answer 4

SCCA of the skin

Question 5

Dermato- and polymyositis = precursors to ___

Answer 5

Visceral malig (esp GU)

Question 6

Multiple seborrheic keratoses = precursor to

Answer 6

GI, breast, lung, and lymphoid malig

Question 7

Paget dz of bone is a precursor to ___

Answer 7

2ary osteosarcoma and fibrosarcoma

Question 8

Plummer-Vinson syndrome predisposes to ___

Answer 8

SCCA of esophagus

Question 9

Tuberous sclerosis predisposes to ___

Answer 9

Hamartomatous tumors (benign but may become malignant)

Question 10

Autoimmune dz predisposes to ___

Answer 10

Lymphoma

Question 11

Down syndrome predisposes to

Answer 11

ALL

Question 12

Immunodeficiency predisposes to ___

Answer 12

lymphoma, melanoma, RCCA

Question 13

Tumor markers

Answer 13

Alk phos - mets to bone or liver, Paget’s dz of bone, seminoma

alpha-fetoprotein - made by fetus (high levels - neural tube/ab wall defects; low levels - Down synd), assoc with hepatocellular ca, hepatoblastoma, yolk sac, mixed germ cell

beta-hCG (made by syncytiotrophoblasts) - hydatidiform moles, choriocarcinomas (gestational trophoblastic dz), testicular ca, mixed germ cell tumor

CA15-3/CA27-29 (breast cancer)

CA19-9 (pancreatic adenocarcinoma)

CA125 (ovarian cancer)

Calcitonin (medullary thyroid carcinoma)

Carcinoembryonic antigen (nonspec)

Chromogranin (neuroendocrine tumors/carcinoid)

PSA (prostate cancer)

Question 14

Carcinogens

Answer 14

• Aflatoxins (aspergillus) - hepatocellular carcinoma
• Aromatic amines (transitional cell carcinoma in bladder)
• Alkylating agents (leukemia/lymphoma)
• Asbestos (bronchogenic carcinoma, mesothelioma)
• Carbon tetrachloride (centrilobular necrosis, fatty change in liver)
• Nitrosamines (smoked foods) - gastric cancer
• Vinyl chloride (Angiosarcoma in liver)

Question 15

HL/NHL Paraneoplastic syndromes

Answer 15

Hypercalcemia via 1,25-OHD3

Question 16

SCLC carcinoma paraneoplastic syndromes

Answer 16

Cushing syndrome (ACTH)

SIADH (ADH)

Lambert-Eaton myasthenic syndrome (antibodies against presynaptic Ca channels at NMJ)

Question 17

Cancers that cause polycythemia

Answer 17

RCCA, hemangioblastoma, hepatocellular carcinoma, leiomyoma, pheo

Via Epo

Question 18

Cancers that cause hypercalcemia

Answer 18

Squamous cell lung carcinoma, RCCA, breast cancer

Via PTHrP

Question 19

Psammoma bodies caused by ____ (cancers)

Answer 19

PSaMMoma

Papillary carcinoma of thyroid

Serous papillary cystadenocarcinoma of ovary

Meningioma

Malignant mesothelioma

Question 20

Most common cancers (men vs. women)

Answer 20

Men: prostate, lung, CRC

Women: Breast, lung, CRC

Question 21

Highest mortality cancer

Answer 21

Men: lung, prostate, CRC

Women: lung, breast, CRC

Question 22

P-glycoprotein, aka

Answer 22

Multidrug resistance protein 1 (MDR1)

Adrenal cell ca and other cancers - pump out toxins, including chemo drugs