Cancer Flashcards
(226 cards)
1
Q
what is hyperplasia
A
increase in cell number occurring in response to stimulus
2
Q
what causes hyperplasia to stop
A
withdrawal of stimulus
3
Q
give two examples of hyperplasia
A
lining of the uterus, liver regeneration after resection
4
Q
give an example of hypertrophy
A
cardiac (LVH, HOCM, aortic stenosis) and skeletal muscle
5
Q
what is hypertrophy
A
increase in cell size (more organelles etc)
6
Q
what is a risk of LVH
A
arrhythmia and death
7
Q
what is atrophy
A
loss of tissue (size/number of cells)
8
Q
what causes atrophy
A
withdrawal of a stimulus (hormonal, damage to a nerve )
9
Q
what is metaplasia
A
reversible change of one mature cell type to another mature cell type
10
Q
metaplasia with what has a high risk of malignancy
A
dysplasia
11
Q
what usually lines the bronchi
A
respiratory epithelium
12
Q
what is respiration epithelium
A
cilliated pseudostratified columnar epithelium
13
Q
what type of epithelium is usually found in the lungs
A
columnar
14
Q
what are the commonest types of lung cancer
A
small cell, adeno, and squamous
15
Q
why do you get squamous cell carcinoma in the lung
A
metaplasia of the columnar epithelium
16
Q
what metaplasia occurs in barretts oesophagus
A
oesophageal squamous to intestinal type columnar
17
Q
what type of cancer do you get in barretts
A
adenocarcinoma
18
Q
what cell types overs any surface that is exposed to the external environment
A
squamous
19
Q
what cells secrete mucous
A
goblet cells
20
Q
how do you tell stratified squamous
A
has lots of layers
21
Q
what cell type is shiny and exposed to external environments (give examples of locations)
A
non keratonised stratified squamous epithelium
nose, mouth, vagina, oesophagus, lips
22
Q
what is neoplasia
A
new growth without stimulus- can be benign/ pre malignant
23
Q
what is dysplasia
A
disordered growth, pre malignant
24
Q
what is malignancy
A
autonomous growth that invades other tissue (passes basement membrane) or has metastatic potential
25
give examples of benign growths/ tumours
carcinoid tumour in the lung, squamous papilloma, squamous dysplasia, carcinoma in situ
26
what is carcinoma in situ
sever abnormality and is closest to becoming full blown malignancy, that has not spread yet- is pre malignant
27
what is caseating necrosis with granulomatous inflammation
TB
28
what does stellate mean
star like
29
what does opacity on an x ray mean
white- denser than air
30
what does haziness on an CXR mean
consolidation
31
what can cause the pancreas to become diffusely firm
inflammation, infection, deficiency in hormone/ vitamin
32
does cystic suggest benign or malignant
benign
33
what is a cyst
thin walled round structure lined by epithelium
34
what is a pseudocyst
fluid filled cavity that lacks wall/lining
35
what does 'pancreas with pseudo cysts, diffusely form and white spots' suggest
pancreatitis
36
what are the white spots in pancreatitis
necrosis of pancreas and surrounding tissue
37
what are the causes of chronic pancreatitis
alcohol, gall stones, idiopathic
38
what suggests a gastric malignancy
shallow ulcer with heaped up edges
39
where in stomach are you more likely to get a malignancy
in the lesser curvature
40
where are you more likely to get a gastric ulcer
in the greater curvature
41
what does a gastric ulcer look like
more punched out
42
what type of cancer produces intracellular mucin
adenocarcinoma
43
does malignancy have high/ low nuclear to cytoplasm ratio
high
44
what is pleomorphism and what is it suggestive of
differences in size and shape, malignancy
45
what are signet rings seen in
adenocarcinoma and bronchiectasis
46
what cells does a neuroectoderm tumour affect
melanocytes and glial cells of the central nervous system
47
where are epithelial cells found
lining all internal and external surfaces
48
what types of epithelium is exposed to external environments
squamous
49
what type of epithelium is the skin
keratinised with adnexal structures
50
where is non keratinising epithelium found
internal- mouth, oesophagus, ear canal, cervix, vagina, anus
51
what cells make up the glandular cells of the stomach and hat do they secrete
G cells (gastrin), parietal cells (HCL and intrinsic factor), chief cells (pepsinogen and chymosin)
52
what type of cells are cilliated
pseudostratified ciliated columnar
53
what type of endothelium is found in the bladder
transitional
54
what is a carcinoma
epithelial malignancy
55
why are epithelial malignancies very rare in children
as low exposure to environmental risk factors
56
what cancers are more common in children
blood, brain, and bone
57
where does a colorectal cancer usually spread
lymphatic spread to local lymph nodes in the mesentery
follow vasculature supply in blood
58
where do testicular tumour spread to
do not spread to the groin
because of embryological development of the testes act as intra abdominal organ and so will spread to para aortic nodes
59
what cancers spread to the groin
from leg, scrotum or vulva
60
where does a primary lung tumour usually metastasise to
bone, brain, adrenal and liver
61
where does a liver tumour metastasise to
liver (other sites too but rare)
62
what cancers commonly spread everywhere
melanoma, prostate and small cell
63
what is mesenchymal
connective tissue
64
what is a sarcoma
cancer of the mesenchymal
65
give examples of sarcomas
bone, cartilage, fibrous tissue, fat, smooth muscle, skeletal muscle, nerves, blood vessels
66
what is a smooth muscle cancer called (benign and malignant)
LEIO myoma/sarcoma
67
what is a skeletal muscle cancer called (benign and malignant)
RHABDO myoma/sarcoma
68
what is a fat caner called (benign and malignant)
LIPO ma/sarcoma
69
what is a bone cancer called (benign and malignant)
oesteo ma/sarcoma
70
what is a cartilage cancer called (benign and malignant)
chrondro ma/sarcoma
71
what are blood vessel cancers called (benign and malignant)
haemangio ma/ angiosarcoma
72
what are nerve cancers called (benign and malignant)
neuroma / MPNST
73
what is more common in children sarcomas or carcinomas
sarcomas- still q rare
74
how do sarcomas spread
mostly blood- can widely disseminate
75
what do cells in sarcomas look like
spindle cell lesions, very elongated tapered shaped to cell, solid
76
what mutations are associated with sarcomas
large translocations- Ewings carcinoma t(11;22)
77
what are the types of haematological cancers
myeloid, lymphoid
78
what is a myeloid cancer
cancer of red blood cells, platelets, granulocytes
79
what is a lymphoid cancer
B cells, T cells
80
why dont blood cancers metastasise
as already in the blood and lymphatics
81
what is leukaemia
circulating malignant in the blood and bone marrow
82
what is leukaemia
circulating malignant cells in the blood and bone marrow
83
what is lymphoma
tumour like masses in lymph nodes
84
what would suggest a blood cancer
strange distribution of lymph node involvement that doesn't fit with anatomical drainage, and may involve liver and spleen diffusely (organeomegaly)
85
what are the symptoms of bone marrow involvement
make less red cells, platelets, granulocytes, B cells- low blood cells
86
what can cause big liver and spleen (organomegaly)
alcohol or malignancy
87
what are the b-symptoms of blood cancers
sweating, night sweats, weight loss
88
what do lymphoma look like
solid white masses, cells often pleomorphic, monotomous and clonal
89
what is a melanoma
a malignant tumour of melanoctyes (neuroectoderm)
90
what are the most common type of brain tumours
carcinomas- gliomas (mets until proven otherwise)
91
do brain tumours spread
no, only really to spinal chord- primary cancers stay in the brain
92
are brain tumours mostly benign or malignant
NEITHER- get classifies on molecular abnormalities instead
93
what are weinberg hallmarks
```
1- self sufficiency in growth signals
2- insensitivity to anti growth signals
3- evade apoptosis
4- limitless replication potential
5- sustained angiogenesis (growth of blood vessels)
6- tissue evasion and metastases
```
94
what are the components of prostatism
urinary hesitation, difficulty in voiding, post micturation dribbling
95
what is sensitivity
% of people with disease who have a positive test result
96
what is specificity
the likelihood of someone without out the disease being identified by the test as healthy
97
what is the positive predictive value
likelihood of having the disease following a positive predictive value
98
what is the negative predictive value
likelihood of someone being healthy following a negative result
99
where is ALP found
bone, biliary tree, placenta, intestine
100
what makes bone
osteoblasts
101
what cell degrades bone
osteoclasts
102
what is the albumin of neonates
AFP
103
what are the germ cell tumours
AFP and HCG
104
what is the LDH requirement for exudate
fluid LDH >/= ULN (164U/L)
105
cancer causes hyper/ hypo calcaemia?
hyper- consider cancer is calcium >3 mmol/L
106
what are the symptoms of hypercalcaemia
stones (renal stones), moans (psyciatric overtones), bones (painful bones), groans (abdominal groans)
107
what can be used to treat hypercalcaemia
IV fluids and pamidronate
108
who do people with hypercalcaemia get dehydrated
as sodium and water reabsorption from tubules prevented
109
what controls serum calcium
parathyroid glands
110
what causes PTH secretion
low serum calcium
111
how does PTH secretion cause
bone re absorption (calcium from bones goes into blood- rickets), and more calcium reabsorped from renal tubules
112
what causes a low serum calcium
vit d deficiency
113
what does final activation of vit D cause
reabsorption of calcium in the gut
114
what is secreted in malignancy that causes hypercalcaemia
PTHrP
115
what does not pick up PTHrP
PTH assay
116
what secretes HCG
cholangiocarcinoma
117
what secrets CEA
colorectal
118
what secretes AFP
HCC
119
what cancer causes cushings and why
small cell cancer as secretes ACTH whuch stimulates adrenal glands
120
what usually secretes ACTH
the pitruatry
121
what is the aim of radical treatment
to eradicate the cancer often at the expense of treatment related side efffects
122
what is the aim of palliative treatment
non curative, aims to improve symptoms and quality of life or to prolong life
123
what is adjuvant therapy
after surgery, aims to reduce risk of recurrence
124
what is neo adjuvant surgery
aims to shrink tumour before surgery
125
what is systemic anticancer therapy
(all systemic cancer therapy) cytotoxic chemotherapy, targeted therapy, immunotherapy
126
what are the types of treatment for cancer
surgery, external beam radiotherapy, brachytherapy, radionucletide therapy, systemic anticancer therapy
127
what is brachytherapy
radioisotopes placed locally at site of tumour
128
what does chemotherapy treat cancer
damages cells as they divide and stops them reproducing
129
what are the chemotherpay toxicities
malaise, fatigue, lethargy, alopecia, gi (diarrhoea, nausea, mucocitis (mouth ulcers), altered taste), haemotological, peripheral neuropathy, renal/ liver failure, nail changes, fertility changes/ menopause
130
what are the radiotherapy toxicities
site specific, cause local side effects
131
what is radio sensitising
when chemotherapy enhances they effects of radiotherapy
132
what is more likely to be cure by radiotherapy- squamous or adeno
squamous
133
do different parts of the body have different/ the same tolerance to radiation
different- ovaries v sensitive
134
Which inherent feature of cancer cell is most important in facilitating the acquisition of new features of a tumour
genomic instability
135
what is the commonest pattern of inheritance for risk of cancer
multifactorial inheritance
136
what type of mutation is likely to activate an oncogene
missense- change in sequence of amino acids
137
what mutations will stop a gene from working
deletions, nonsense and splice site
138
who should you treat first in a family if you suspect a inherited condition
affected relatives
139
what is a synonymous mutation
change in sequence of DNA that doesn't change amino acid sequence
140
what causes somatic mosaicism
when cells proliferate the acquire somatic differences
141
what is the pathophysiology of cancer
mutation
proliferation
invasive
metastases
142
what allows cancers to evolve
genomic instability
143
what is drug metabolism in relation to cancer
drugs that metabolise carcinogens
144
what switches on for cell division
oncogenes
145
what do driver mutations do
drive carcinogenesis
146
what are passenger mutations
just there due to unstable genome
147
what are the chromosome mutations
duplications, translocations, multiple extra chromosomes
148
what determines the characteristic of cancer
the driver mutation
149
what determines the treatment of cancer and why
oncogene signature- as therapy targets pathways
150
can different cell types exist within each cancer
yes, in lots
151
what is knudsons 2 hit hypothesis
that cancer is the result of the accumulation of multiple mutations- e.g. two somatic or inherit one and acquire one
152
what activates the gene promoter
a change in amino acid sequence
153
a mutation in what is common in melanomas, leading to the activation of what pathway
mutation in BRAF
| activates the KRAS pathway
154
what is the philadelphia chromosome
translocation of chromosome 22 in leukaemia cancer cells
155
what gene is associated with hereditary bowel cancer
MHL1
156
what is multifactoral inheritance
mixture of genes and environment
157
how can you modify the risk of hereditary cancer
screening, hormonal manipulation, surgical intervention
158
what is seen histologically in cancer
loss of normal structure, pale disorganised nuclei, mitosis
159
when can you genetically test children
if they are competent or there is a clinical benefit
160
name cytotoxic therapies
taxane, alkylating agent
161
radiations interaction with what mainly kills cells
DNA
162
which of the following is a risk factor for oesophageal squamous cell carcinoma;
- plummer vinson syndrome
- hiatus hernia
- barretts oesophagus
- kartageners syndrome
- intestinal metaplasia
plummer vinson syndrome
163
what are the symptoms of plummer vison syndrome
dysphagia, iron-deficiency anaemia, glossitis, cheilosis and oesophageal webs
164
what is kartageners syndrome
rare autosomal recessive disorder that causes defects in the action of the cilia lining the reps tract
165
which of the following is the strongest risk for developing cholangiocarcinoma;
- autoimmune hepatitis
- hep c
- primary sclerosing cholangitis
- primary biliary cirrhosis
- haemachromatosis
primary sclerosing cholangitis
166
where does lung cancer not commonly metastasise to
spleen
167
what are common side effects of chemotherpay
diarrhoea, neutropenic fever, alopecia, altered taste
168
what does a chest x ray showing multiple ill defined round opacities throughout lung fields show
metastatic renal cell carcinoma
169
what are the common late side effects of radiography
bladder instability, menopause, faecal urgency, skin fibrosis
170
what is the type of asbestos fibre that is associated with mesothelioma
chrysolite
171
does a T1 colorectal adenocarcinoma have metastatic potential
yes
172
what is vasogenic oedema
accumulation of fluid in brain due to break down of BBB
173
carcinoma= cancer from what cells?
epithelium
174
which cancer is most associated with smoking
pulmonary small cell carcinoma
175
name the cancer: a well circumscribed tumour protruding into the bronchus with a yellow cut surface
carcinoid tumour
176
how does HPV promote carcinogenesis
degrading normally produced p53
177
what is a mutation in a promoter most likely to result in
absence of a protein
178
what does a small cell carcinoma of the lung usually produce in excess
anti diuretic hormone
179
what tumour markers are used to monitor germ cell cancer (testes)
human chorionic gonadotrophin (HCG) and alpha feto protein (AFP)
180
what are the recorded end points for cancer treatment
disease free survival, toxicity free survival, progression free survival, overall survival
181
what is lynch syndrome
autosomal dominant condition carrying high risk of colon cancer (and ovarian, kidney, stomach, small intestine, liver sweat glands) - no other symptoms , may have benign polyps in the colon
182
what does grading describe
the degree of cytological atypia
183
what is PSA used in prostate cancer in
diagnosis and monitoring
184
what is the best investigation for initial presentation of respiratory cancer red signs
contrast enhanced CT chest and abdomen
185
what is a PET-CT scan
nuclear imaging that shows metabolically active areas
186
for a potential tumour marker which of the following test characteristics is most important in the diagnosis of malignancy:
- PPV
- sensitivity
- efficiency
- NPV
- specificity
sensitivity
187
what radiological investigations should be undertaken to stage this cancer- 57 y/o w/ rectal bleeding and altered bowel habit. PR shows palpable rectal mass that is biopsied and malignant
contrast enhanced CT chest, abdomen and pelvis plus MRI rectu,
188
where are pulmonary squamous cell carcinomas most commonly located
centrally in the lung
189
what does the drug herceptin target
epidermal growth factor
190
what type of cancer is derived from smooth muscle
leiomyoma
191
abnormalities in mismatch repair proteins as seen in lynch can be identified by what
presence of microsatelitte instability
192
BcI2 refers to which weinberg hallmark
evasion of apoptosis
193
which one of these is a malignant lesion;
- hepatoma
- lipoma
- pleomorphic adenoma
- rhabdomyoma
- leiomyoma
hepatoma
194
what virus is hepatocellular carcinoma most strongly associated with
Hep c
195
what are gastric marginal lymphomas most associated with
H. pylori infection
196
what cancer is NOT associated with obesity
gastric cancer
197
where can p53 cause cell cycle arrest
between G1 and S phase
198
where are cancers in lynch syndrome most commonly found
in the transverse colon
199
what structures does the aorta sit directly infront of
the pancrease
200
why are metastases from colon cancer in the liver darker
as they are hypovascular
201
what does 'multiple round soft tissue' suggest
lung metastases
202
what can cause cavitating metastases and what else can cause look a likes
renel cell carcinoma
cavitating septic emboli/ TB
203
where do metastases in the lungs tend to e
basal
204
where do TB usually affect the lung
apices
205
what do primary lung neoplasms look like
in upper lobes and stellate in shape
206
what can cause you to see too many ribs on an xray
emphysema
207
what are paraneoplatic syndromes
rare disorders triggered by an altered immune response to a neoplasm
208
what cancer releases SiADH
small cell
209
what cancer releases PTHrP
squamous cell carcinoma
210
what cancer releases ACTH
neuroenodcrine tumours
211
what is lambert eaton myasthenic syndrome
rare autoimmune disorder that is characterised by muscle weakness of the lungs
212
what do melanocytes produce
brown pigments
213
how a metastases named
after site of origin
214
name two cancers that metastasise early
small cell and melanoma
215
is radiotherpay/ chemotherapy local/systemic treatment?
radiotherpay- local
| chemotherapy systemic
216
why do aggressive cancers respond better to treatment
as treatment targets dividing cells
217
is mesothelioma a lung cancer?
no- its a pleural malignancy
218
why is mesothelioma an endothelial injury/ cancer
as mesothelial cells rest on the basement membrane
219
what can asbestos exposure cause
asbestosis, pleural effusion, rounded atelectasis, pleural plaques, adencarcinoma (different from mesothelioma)
220
what is asbestosis
long term inflammation and scarring due to asbestos exposure- breathlessness, cough, wheezing, chest pain
221
how does HPV cause carcinogenesis
E6 targets p53
| E7 targets pRB
222
how does EBV cause cancer
latency, integration with DNA
223
what viruses are associated with cancer
HPV, EBV, polyomavirus, HHV-8, HIV, hep C
224
how does HIV cause cancer
malignancy associated with immunosuppression
225
what type of cancer does plummer vision increase the risk of
oesophageal SCC
226
what do you screen for in lynch sydnrome
micro satellite instability and DNA missmatch repair
