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Flashcards in Cancer Deck (42):
1

What is the progression of cancer?

Normal
Hyperplasia
Dysplasia
Carcinoma in situ
Invasive carcinoma (E-cadherin inactivated, no cell-cell adhesion)
Metastasis

2

What are the features of anaplasia?

clumping nuclear chromatin
high N/C ratio
mitotic figures
prominent nucleoli
more primitive/less mature
may see giant cells

3

T/F Neoplasia means malignancy.

F. may be benign or malignant

4

What is desmoplasia?

fibrous tissue after a neoplasm

5

Describe grading and staging a tumor.

grade: 1-4. 1: well differentiated. 4: poorly differentiated.
stage: TNM
tumor size
nodal involvement
metastasis

6

Which cancers metastasize to the liver?

Cancer Sometimes Penetrates Benign Liver
Colon
Stomach
Pancreas
Breast
Lung

7

What is the origin, stain, and spread of carcinoma and sarcoma?

carcinoma--epithelial, spread by lymph, cytokeratin stain
sarcoma-mesenchymal, spread by blood

8

What are the benign and malignant forms of the following?
blood vessels
smooth muscle
striated muscle
CT

blood vessels:
benign: hemangioma; malignant: angiosarcoma

smooth muscle:
benign: leiomyoma; malignant: leiomyosarcoma

striated muscle:
benign: rhabdomyoma; malignant: rhabdomyosarcoma

CT
benign: fibroma; malignant: fibrosarcoma

9

What is cachexia?

weight loss and loss of fat and lean muscle
b/c of increased basal metabolic rate from release of TNFalpha, IFNgamma, IL-1, IL-6 from chronic disease

10

What are the paraneoplastic syndromes created by small cell lung cancer?

ACTH-Cushing's
ADH-SIADH
Lambert Eaton--muscle weakness better w/ use, antibodies to presynaptic Ca++ channels at NMJ
PTHrP

11

What are the paraneoplastic syndromes created by renal cell carcinoma?

ACTH
PTHrP
EPO

12

Which cancers can cause increased EPO release and polycythemia?

Potentially Really High HCT
Pheochromocytoma
Renal Cell Carcinoma
Hemangioblastoma
Hepatocellular carcinoma
leimyomas (fibroids that bleed may not cause anemia b/c also secrete EPO)

13

When do you see PSaMMOma bodies?

papillary carcinoma thyroid
serous papillary cystadenocarcinoma of ovary
meningioma
malignant mesothelioma

14

Which tumors give mets to the brain?

Lots of Bad Stuff Kills Glia
Lung
Breast
Skin (melanoma)
Kidney (RCC)
GI (colon)

15

Which tumors give mets to the bone?

Permanently Relocated Tumors Like Bone

**genitourinary:
Prostate (blastic)
RCC (lytic)

Thyroid (lytic)
lung (mixed)
Breast (mixed)

16

What are the following associated w/?
BCR-ABL
BCL-2

BCR-ABL; oncogene
a part of the PHiladelphia chromosome t(9;22) CML, ALL
tyrosine kinase intracellular

BCL-2; oncogene
antiapoptotic
follicular lymphoma

17

What are the following associated w/?
c-myc
L-myc
N-myc

all oncogenes
c-myc: burkitt lymphoma, transcription factor
L-myc: lung tumor, transcription factor
N-myc: neuroblastoma, transcription factor

18

What are the following related to?
DCC
DPC4/SMAD4

NF1
NF1

all tumor suppressor genes
DCC: colon cancer
DPC4: pancreatic cancer

NF1: chromosome 17; neurofibromatosis type 1
NF2; chromosome 22; NF2, related to acoustic schwannomas

19

Describe what Rb does.

Rb regulates transition from G1-->S
binds E2F
released when it is phosphorylated by cyclin-dependent kinase4-cyclin D

when it is mutated, can't regulate & can predispose to retinoblastoma and osteosarcoma

20

How many mutant alleles does it take to produce cancer w/ oncogenes? tumor suppressor genes?

Oncogenes-1
tumor suppressor genes-2

21

What does p53 do?

responsible for half of all cancers
w/ p21 can arrest cell cycle
at G1/S and G2/M checkpoints
if it chooses can upregulat BAX for apoptosis

22

How does RAS work?

GPCR-->MAP kinase-->cell proliferation
oncogene

23

Which cancers with these mutations:
K-RAS
H-RAS
N-RAS?

K-RAS: Kolon, lung, pankreatic tumors
H-RAS: hematuria: bladder and kidney tumors
N-RAS: melanoma, hematologic malignancies, follicular thyroid cancer

24

What is the most common oncogene? Tumor suppressor gene?

oncogene-RAS
tumor suppressor gene--p53

25

Which cancers are caused by ionizing radiation?

myeloid leukemias: AML, CML
thyroid cancer

26

Which type of ultraviolet radiation causes skin cancer?

UVB--forms pyrimidine dimers

27

What is used to treat actinic keratoses so that they don't transition into squamous cell carcinoma?

5-FU

28

What are the important features of tuberous sclerosis?

ash leaf spots
SIA
seizures
ID
angiofibromas

3 cancers:
1. cardiac rhabdomyoma
2. renal angiomyolipoma
3. astrocytoma

29

What is a weird thing that HCV can cause?

papillary thyroid cancer

30

What are the cancers w/ highest incidence and mortality in US among men and women?

Men:
Incidence
1. Prostate
2. Lung
3. Colon
Mortality:
1. Lung
2. Prostate
3. Colon

Women:
Incidence
1. Breast
2. Lung
3. Colon/Uterine

Mortality:
1. Lung
2. Breast
3. Colon

31

What type of cancer do aromatic amines--such as benzidine and 2-naphthylamine cause?

transitional cell carcinoma
naphthalene found in moth balls

32

What type of cancer does arsenic cause?

Angiosarcoma-liver
Lung cancer
Squamous cell carcinoma

33

What type of cancer does carbon tetrachloride cause?

centrilobular necrosis, fatty change of the liver

34

Nitrosamines (smoked foods) like hotdogs cause what types of cancer?

squamous cell carcinoma of esophagus
gastric cancer

35

Vinyl chloride, found in refrigeration can cause what type of cancer?

angiosarcoma-liver

36

Screening for breast cancer, cervical cancer?

Breast: mammogram 50-75 1/2 yrs
Cervical: pap smear 1/3yrs 21-65

37

Screening for prostate, colon, lung cancer?

prostate: no recommendations
colon: colonscopy 1/10 yrs 50-75
flex sigmoidoscopy 1/5 yrs, fecal occult blood 1/1yr
Lung: annual CT lung 55-80 if 30 pack year hx of smoking and still smoking or quit

38

Which cancers are patients who are obese at increased risk for?

esophageal adenocarcinoma
renal cell carcinoma
Women: gallbladder, endometrial
men: thyroid, colon

39

When you have a high fat diet, what are you at increased risk for in terms of cancer?

Butter, Chips, Pringles, stEak
Breast, Colon, Prostate, Endometrial

40

What are you at increased risk for w/ inactivity?

breast, colon

41

What do you the following tumor markers correspond to?
Alk Phosph
AFT
CA15-3/CA27-29
CA19-9
CA125
CEA
S-100
TRAP

Alk Phosph: bone or liver
AFT: hepatocellular carcinoma
CA15-3/CA27-29: breast
CA19-9: pancreatic
CA125: ovarian
CEA: pancreatic, colorectal
S-100: melanoma, schwannoma
TRAP: hairy cell leukemia (CLL)

42

Which 2 tumor markers are elevated in pancreatic canceR?

CA19-9
CEA