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Pathology final > Cancer > Flashcards

Cancer Flashcards

1
Q

What are mitotic bodies/figures, and what do they tell you about a cancer?

A

More mitotic bodies mean more rapidly dividing cancer

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2
Q

In What types of tissues do sarcomas arise, and how do they prefer to spread?

A

Muscles and connective tissue - spread in blood stream

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3
Q

In what types of tissued do carcinomas arise, and how do they prefer to spread?

A

Epithelium; spread though lymphatic system

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4
Q

What are adenocarcinomas?

A

Glandular cancers

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5
Q

Which tissues are most sensitive to ionizing radiation and why?

A

Cells in mitosis or the G2 phase because the genome is all unraveled and exposed

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6
Q

Does the ending “-oma” always mean the cancer in benign

A

NO! - oma means tumor

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7
Q

How does the Ames Test work, and for what reasons might it be misleading?

A

It works by detecting mutagenic effects of potential carcinogens via inducing frameshift mutations. Mutated salmonella cannot produce its own histamine. The bacteria will dies without histamine. You place these bacteria in a how-histadine medium (plate) with a potentially mutagenic chemical. If it is mutagenic then the Salmonella can revert back. This will not show epigenetic changes. Misleading also because it doesn’t take into account the possibility the substance will be modified in the liver via conjugation pathway. aka indirect carcinogen. Lastly, it can raise false concerns because a mutagen isn’t necessarily a carcinogen in minute amounts, but this cannot be tested in the Ames test.

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8
Q

Worldwide, which cancer kills the most females, and which kills the most men?

A

Men: colorectal and lung cancer
Women: Breast and colorectal

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9
Q

In the first world, at what age range does cancer incidence peak?

A

80-84

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10
Q

Know you MEN syndromes

A

MEN 1: PPP - pituitary adenoma, parathyroid hyperplasia, pancreatic tumors
MEN 2a: PMP - parathyroid hyperplasia, medullary thyroid carcinoma, pheochromocytoma
MEN2b: MMMP: Medullary thyroid carcinoma, pheopchromocytoma, marfanoid body habitus, mucosal neuromas,

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11
Q

What is the difference between a preneoplastic disorder, and a paraneoplastic syndrome?

A

Preneoplastic syndromes occurs when a neoplasm elaborates a substance that results in an effect that is not directly related in an effect that is not directly related to growth, invasion, or metastasis of the tumor itself (hormone-like substances, etc.) The syndrome may precede the neoplastic diagnosis and may serve as a signal.

Preneoplastic disorders may be acquired and are issues that increase the likelihood of reaching a cancerous stage and are correlated directly with the cancer (i.e. HepB and liver cancer)

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12
Q

What is an initiator, and what is the difference between direct-acting and indirect-acting chemical carcinogens? What are pro carcinogens?

A

Initiators: direct-acting chemical carcinogen modify DNA to cause cancer; indirect-acting chemical carcinogens (procarcinogens) get altered metabolically within us to form active carcinogens

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13
Q

What is the difference between a genotoxic and non-genotoxic mechanism?

A

Genotoxic mechanisms employ DNA damage, chromosomal misentegration, etc.

Nongenotoxic mechanism employ chronic irritation/cell death, ROS, epigenetic silencing, immunosuppression, etc.

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14
Q

What do geneticists look for when they are trying to find promotor regions on genes, and why do you increase the risk of malignancy as you increase the number of methylations at these sites?

A

Promotor region alterations are looked at because the mutations are found in all cancers ever studied. Methylation at the CpG island ends with complete silencing of a gene.

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15
Q

What type of solar radiation is the most carcinogenic?

A

UVB

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16
Q

How does UVB cause cancer?

A

It produces pyrimidine dimers in DNA leading to transcriptional errors and mutations of pro to-oncogenes and tumor suppressor genes.

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17
Q

What type of radiation is the hospital’s friend? ie. The radiation oncologist’s friend? The friend of the sterilization?

A

Ionizing radiation (higher-energy radiation)

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18
Q

Why is neutrons radiation not used?

A

Neuron radiation doesn’t interact as well and penetrates deeper in the body, only ionizing indirectly.

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19
Q

What 3 essential activities are pro to-oncogenes involved in?

A

Synthesis of receptors
Synthesis of messenger systems
Involved in nuclear transcription

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20
Q

Know what is meant by gain-of-function and loss-of-function mutations and how many “hits” to the alleles are needed to produce each.

A

Gain of function = Oncogenes: stimulate cell cycle, ONE HIT PROCESS,

Loss of function = Tumor Suppressors: inhibit cell cycle, TWO HIT PROCESS

21
Q

Why was Mrs. Rous upset with Dr. Rous? In his garage, what did he find out that would eventually lead to the understanding that 20% of human cancers come from?

A

Funny story!: Mrs. Rous was upset because Dr. Rous used her blender in his tumor experiments. He took tumor cells from a chicken, blended them up in her blender (ewww gross!) and strained the liquid over a filter. In doing so, he strained out the viruses from the tumor. He then fed these viruses to another healthy chicken, and that chicken ended up getting cancer as well!!

This experiment lead to the understanding that 20% of all cancers are cause by viruses and the inducing factor.

22
Q

How to viruses cause cancer? What is an acutely transforming retrovirus and how does the process work?

A

The viruses that have been most useful to research are the retroviruses. Unlike most organisms , whose genetic information is contained in molecules of DNA, the genes of retroviruses are encoded by molecules of RNA (ribonucleic acid). When retroviruses infect a cell, a viral enzyme called reverse transcriptase copies the RNA into DNA. The DNA molecule then integrates into the genome of the host cell to be replicated so that new viral progeny can be made.
Two types of cancer-causing, or transforming, retroviruses can be distinguished on the basis of the time interval between infection and tumour development: acutely transforming retroviruses, which produce tumours within weeks of infection, and slowly transforming retroviruses, which require months to elicit tumour growth. When acutely transforming retroviruses infect a cell, they are able to incorporate some of the host cell’s genetic material into their own genome. Then, when the retrovirus infects another cell, it carries this new genetic material with it and integrates this tagalong material along with its own genome into the genome of the next cell. It was the discovery of this ability that led to the discovery of oncogenes.

23
Q

Fred and Freda both have grade II Stage IIa adenocarcinoma of the distal esophagus. What is it about the same type of tumor at the same stage, that still may make the prognosis in these two individuals different? (hint: think about how clonal expansion of surviving cell variants work)

A

Hormone receptivity/sensitivity. (Estrogen-sensitive cancers may grow more rapidly, but also show a greater sensitivity to radiation therapies)

24
Q
  1. What are the 7 fundamental changes in cell physiology that are needed for the tumor to behave in a malignant fashion?
A 
Self-sufficiency in growth signals
Insensitivity to growth-inhibitory signals
Evasion of apoptosis
Limitless replicative potential
Sustained angiogenesis
Ability to invade and metastasize
Defects in DNA repair
25
Q

What is the guardian of the genome, and what phase does it normally stop the cell from entering if the cell has damaged DNA?

A

p53 is the guardian of the genome. It prevents a cell with damaged DNA from entering S-phase.

26
Q
  1. What is Li-Fraumeni syndrome, and what does it cause? What year was it described first in?
A

One of many examples of an inherited germ-line mutation:

Li-Fraumeni syndrome:

  • germ-line rotation of p53 on chromosome 17
  • high rate of many types of tumors
  • patients get childhood sarcomas, breast cancer, brain tumors, leukemia, adrenal cancers
27
Q

Apoptosis is regulated by which two genes?

A

bcl-2 (inhibits apaptosis)

a. prevents release of cytochrome c from mitochondria
b. binds pro-apoptotic protease activating factor (Apaf-1)

p-53 (stimulate apoptosis)

a. elevated by DNA injury and arrests the cell cycle
b. if DNA repair is impossible, p53 stimulate apoptosis

28
Q

What is FNA (fine needle aspiration), and what does it not give the pathologist?

A

FNA is a diagnostic procedure used to investigate superficial (just under the skin) lumps or masses. In this technique, a thin, hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope. Fine-needle aspiration biopsies are very safe, minor surgical procedures. A needle aspiration biopsy is safer and less traumatic than an open surgical biopsy.
(I think this is what the second half of the question is getting at?) There is a risk, because the biopsy is very small (only a few cells), that the problematic cells will be missed, resulting in a false negative result. There is also a risk that the cells taken will not enable a definitive diagnosis.

allows the pathologist to determine metastatic qualities of the cells, but not the morphologic qualities

29
Q
  1. How, on an angiogram, can you tell if vessel growth is normal, or has been caused by angiogenesis resulting from a neoplasm?
A

In angiogenesis, tumor-derived vessels are:

- tortuous
- irregularly shaped
- “leaky”
- May grow continuously
- tumor cells may line structures that look like capillaries (vasculogenic mimicry)
30
Q
  1. Why are mice, and not horses or rabbits, sometimes chosen to produce monoclonal antibodies to human cancers in?
A

Use mouse because human immune system hates mouse.

31
Q

What do monoclonal antibodies specifically target in human cancers? (hint: CA-125, CA-19-9 {what are these})

A

The mouse antibodies target tumor markers, and then the human makes antibodies against the mouse antibodies. Thereby the human indirectly makes antibodies for the tumor cells and destroys the tumor by destroying the monoclonal antibodies.

32
Q
  1. What is the difference between tumor grading and staging?
A

Tumor grading:

a. A histologic estimate of the malignancy of a tumor
b. Grading is specific for each type of tissue and cancer within it

Tumor Staging
a.Clinical estimate of the extent of tumor spread

33
Q
  1. What is Grade 4 cancer, and what is Stage 4 cancer?
A

Grade 4 Cancer: glands are fused; no intervening stroma

Stage 4 Cancer: METASTASIS

34
Q

In tumor progression, what does genetic instability mean? What does this translate to, for people that have a cancer recurrence, and need chemotherapy again? Is this analogous to antibiotic resistance in bacteria?

A

Genetic instability: malignant cells are more prone to mutate and accumulate additional defects (and survive!). For those who have cancer recurrence, this would mean that the selective growth advantage of the continued cell lines would give way to malignancy. This would – in part – be analogous to antibiotic resistance in bacteria.

35
Q

What would a grade 4, stage 4 cancer indicate? (in terms of prognosis)

A

Metastatic and not a good prognosis.

36
Q

What is the difference between seeding and transplantation as it relates to metastasis?

A

Seeding is when tumor cells slough off the tumor and grow little tumors in the same tissue or against a body cavity wall. Transplantation is when a tumor cell travels through lymph or blood to a new location. Local vs distant metastasis

37
Q

Who was Sister May Joseph, and what principle of metastasis did she discover?

A

Sister Mary Joseph was a nurse who discovered periumbilical nodes correlated to pancreatic cancers

38
Q

What 3 cancers like to metastasize to the brain, and what 3 to the bone?

A

Brain: skin, breast, lung
Bone: breast, lung, prostate (kidney, thyroid)

39
Q
  1. On x-ray, what cancers produce osteoblastic vs. osteolytic lesions?
A

Osteoblastic lesions: prostate cancer

Osteolytic lesions: renal and breast cancers

40
Q
  1. What test can you use on physical exam to test for possible bony metastasis to the spine?
A

Tuning fork exam. Place the base of a vibrating fork on a vertebra. If it hurts, that is a positive sign. Commonly used to test for fracture too!

41
Q
  1. Know the definitions for induction, Neoadjuvant, andjuvant, and salvage treatments
A

Induction: sole treatment; used for advanced diseases or when no other treatment exists

Neoadjuvant: chemotherapy is given first, followed by a secondary treatment

Adjuvant: combination with another modality; given after other treatments are used

Salvage: for tumors that fail to respond to initial chemotherapy

42
Q
  1. Which two types of tumors are very radiosensitive to XRT? – WHY?
A

Seminomas and lymphomas because their cells are always replicating (M-phase)

43
Q
  1. Which two types of tumors are very radioresistant? – why?
A

Epithelial and sarcomas: They don’t spend much in M phase because they are not replicating very quickly

44
Q
  1. What is the NCCN? – Why might you want to sign up for an account? How do you use it?
A

National Comprehensive Cancer Network. Use it to identify different cancer stages and stuff.

45
Q

What are odors that suggest a diagnosis?

A

Bitter almonds - cyanide
Fruity - Diabetic keroacidosis, isopropanol
Garlic - Organophosphates, arsenic, DMSO, Se
Mothballs - Napthalene, camphor

46
Q

How often to patents with carbon monoxide poisoning turn cherry red?

A

Rarely

47
Q

What poisoning often accompanies carbon monoxide poisoning in residential fires, yet was no even known of until very recently> How are each treated?

A

Cyanide poisoning is clinically indistinguishable from carbon monoxide poisoning in the field.

Carbon monoxide poisoning can be determines through a pulse oximeter

48
Q

What is generally meant by the heavy metals, and what 2 ways are their exposures described in?

A

Heavy metals or metalloids of environmental concern; can be Pb, Hg, Cd (all denser than Fe) or thallium,

Acute and chronic exposures are seen

49
Q

Do radioisotopes bioconcentrate? How do they get into the air? (hint: no water…fuel rods get hot… they melt together…they start a fire…smoke is released into the air containing_____)

A

RADIOACTIVE MATIERIAL! Yes, I believe they do

biomagnification/bioconcentration is the process of the concentration of toxic substances in living organism as they move up each step of the food chain.

Pathology final (7 decks)

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