45. Molecular Pathogenesis and Precision Medicine Flashcards

1
Q

What are the risk factors for bowel cancer?

A

Age, poor diet, obesity
Smoking, excess alcohol
Family history (FAP, HNPCC)

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2
Q

What are the symptoms of bowel cancer?

A
Changes in bowel movements
Abdominal discomfort/bloating
Loss of apetite/weight loss
Blood in stool
Unexplained anaemia/fatigue
'Pencil stools'
Pelvic pain
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3
Q

What is Vogelstein’s theory of colonic carcinogenesis?

A

Different genetic changes are associated with progression of benign tumours to malignant ones
More than one somatic mutation is needed to produce a full cancer cell

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4
Q

What 3 things are used to stage bowel cancer?

A

Size of tumour
Lymph nodes
Metastases

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5
Q

What is stage 1 of bowel cancer?

A

Tumour is in inner wall of colon or rectum only

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6
Q

What is stage 2 of bowel cancer?

A

Tumour is in muscle layer of colon or rectum

May have spread to other tissues

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7
Q

What is stage 3 of bowel cancer?

A

Tumour spread to nearby lymph nodes

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8
Q

What is stage 4 of bowel cancer?

A

Tumour has spread to other parts of the body

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9
Q

What is the difference between a colonoscopy and a sigmoidoscopy?

A

Colonoscopy examines entire length

Sigmoidoscopy examines only the lower third

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10
Q

What does it mean if a tumour is sessile?

A

No stalk present

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11
Q

What does it mean if a tumour is pedunculated?

A

Attached to the surface by a stalk

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12
Q

What is the difference between familial and hereditary colon cancer occurance?

A

Familial: occurs in more than one family member could be genetic, non-genetic or multifactorial
Hereditary: exact gene defect is known

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13
Q

What is APC?

A

Tumour suppressor gene
Mutated in large number of sporadic and inherited colon cancers
Normally decreases beta-catenin

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14
Q

What is the inheritance of a mutated APC allele called?

A

Familial adenomatous polyposis

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15
Q

What is HNPCC?

A

Hereditary Nonpolyposis Colorectal Cancer
Only small number or no polyps present
Inherited mutation in a DNA mismatch repair gene

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16
Q

What tumour suppressor mutation is associated with breast and ovarian cancer?

A

BRCA1

BRCA2

17
Q

What tumour suppressor mutation is associated with retinoblastoma?

A

Rb

18
Q

What tumour suppressor mutation is associated with renal cell carcinoma?

A

VHL

19
Q

What tumour suppressor mutation is associated with familial melanoma?

A

CDKN2A

20
Q

How can precision medicine be applied to cancer?

A

Screening programmes
Monitoring of high risk populations
Molecular diagnostics
Monitoring response to treatment biomarkers
Targeted therapy based on molecular features of the tumour

21
Q

What growth receptor is overexpressed in colorectal cancers?

A

EGFR

22
Q

What drug is an EGFR inhibitor?

A

Cetuximab

23
Q

In what case will cetuximab not work?

A

If the KRAS gene is mutated

24
Q

What is companion diagnostics?

A

Test designed to be paired with a specific drug

Shows which patient could be helped by a drug