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Cancer > Cancer > Flashcards

Cancer Flashcards

1
Q

What is a carcinoma

A

Derived from epithelial cells. Most common cancers

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2
Q

What is a sarcoma

A

Cancers arising from connective tissue (e.g. bone, cartilage, fat, nerve)

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3
Q

What are lymphoma and leukemia

A

Arise from cell that make blood

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4
Q

What is a germ cell tumour

A

Cancers derived from pluripotent cells, most often presenting in the testicle or ovary (seminoma and dysgerminoma)

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5
Q

What is a blastoma

A

Cancers derived from immature precursor cells or embryonic tissue. More common in adults

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6
Q

What are the 3 types of lung non small cell carcinomas

A

Squamous cell, adeno, large cell undifferentiated

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7
Q

What are lung squamous cell carcinomas

A

Smokers (98%)
Often arises centrally/proximally in large bronchi more than peripheral lung
Occurs in bronchi more than larynx and trachea because flow more turbulent (where toxins deposit)

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8
Q

What can lung squamous cell carincomas cause

A

Can cause obstruction airway, atelectasis, collapse of lung
Can invade lymphatics
Can cause clubbing
PTH secretion, clubbing, hypertrophic pulmonary osteoarthropathy, hyperthyroidism due to ectopic TSH

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9
Q

What are lung adenocarcinomas

A

Most common lung cancer in non-smokers
More likely to be peripheral than central
Might see glands and/or mucin production
Triad: clubbing, long bone swelling, and arthritis

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10
Q

What are lung adenocarcinomas in situ

A

: Lepidic growth pattern (gentle) - replaces T1 pneumocytes, but no invasion of interstitium. Can be solitary nodule or multiple nodules. Presents as cough and dyspnea, with or without mucus

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11
Q

What are the paraneoplastic features of lung adenocarcinoma in situ

A

gynaecomastia, hypertrophic pulmonary osteoarthropathy

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12
Q

What are lung large cell undifferentiated carcinomas

A

Miscellaneous category.
Large cells with prominent nuclei, no desmosomes, no keratin, no mucin staining
Expression analysis on cDNA microarray

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13
Q

What are lung small cell carcinomas

A

Exclusively smokers
Paraneoplastic syndromes: related to cancer but not affected by size of tumour
Secretes hormones: ACTH ( can cause Cushing’s), ADH (low Na abnormality)
Eaton Lambert - like myasthenia gravis
Fast-growing, rapid progression, early metastases, often high stage at presentation
High nuclei to cytoplasm ratios, frequent mitotic figures, high percentage of cells in division, salt and pepper chromatin, cells aren’t that small

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14
Q

What is prostate cancer

A

Early prostate cancers have few symptoms
Metastatic disease may present as bone pain
Local advanced: pelvic pain or with urinary symptoms

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15
Q

What is normal PSA

A

under 4ng/ml

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16
Q

What are most prostate cancers

A

95% adenocarcinoma
Often multifocal - 70% lie in the peripheral zone
Graded using the Gleason grading system (2 is best prognosis and 10 is worst)
Lymphatic spread occurs first to the obturator nodes and local extra prostatic spread to seminal vesicles associated with distant disease

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17
Q

How can prostate cancer be treated

A

Radiotherapy: radiation proctitis and rectal malignancy are late problem
Surgery: radical prostatectomy - standard treatment for localised disease. Causes erectile dysfunction
Hormonal therapy: testosterone stimulates prostate tissue and prostatic cancers show some degree of testosterone dependence. Bilateral orchidectomy may be used

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18
Q

What can increase PSA levels

A 
BPH
Prostatitis and UTI
Ejaculation
Vigorous exercise
Urinary retention
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19
Q

What are oncogenes

A

cancer promoting genes. Only one mutate gene is needed for cancer to occur

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20
Q

What is ABL

A

Oncogene -cytoplasmic tyrosine kinase - chronic myeloid leukaemia

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21
Q

What is c-MYC

A

Oncogene -transcription - Burkitt’s lymphoma

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22
Q

What is BLC-2

A

Oncogene -apoptosis regulator protein - follicular lymphoma

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23
Q

What is RET

A

Oncogene -tyrosine kinase receptor - multiple endocrine neoplasia

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24
Q

What is RAS

A

Oncogene -g protein - pancreatic

25
Q

What is Erb-B2

A

Oncogene -tyrosine kinase receptor - breast and ovarian

26
Q

What are tumour suppressor genes

A

loss of function results in an increased risk of cancer

27
Q

What is P53

A

Li-Fraumeni syndrome (autosomal dominant) = breast, sarcomas brain, adrenals

28
Q

What is APC

A

Tumour suppressor gene - colorectal cancer

29
Q

What are BRCA1/2

A

Tumour suppressor gene - breast and ovarai

30
Q

What is NF1

A

Tumour suppressor gene - neruofibromatosis

31
Q

What is Rb

A

Tumour suppressor gene - reinoblastoma

32
Q

What is WT1

A

Tumour suppressor gene - Wilm’s tumour

33
Q

What is multple tumour suppressor 1

A

Tumour suppressor gene - MTS1

34
Q

What are the risk factors for breast cancer

A

female sex, older age, personal or family hx, nulliparity, obesity, hypertension and diabetes, chronic stress

35
Q

What are suspicious findings indicative of breast cancer

A

Ill-defined mass, fixed mass (especially if attached to the chest wall, overlying skin changes (orange peeling - associated with inflammatory breast cancer, dimpling, erythema), nipple retraction, axillary lymphadenopathy

36
Q

What are the types fo DCIS

A

comedo, cribriform, micropapillary and solid

37
Q

What is comedo DCIS

A

form micro-calcifications
Confined to ductal tissue without invasion of basement membrane
Tx: lumpectomy with/out radiation (breast conservation)
Modified radical mastectomy: removal of all breast tissue, removal of nipple/areolar complex, reconstruction
Chemo not necessary

38
Q

What is lobular carcinoma in situ

A

Carcinoma confined to lobular tissue without invasion of basement membrane
No micro calcifications
Associated with axillary nodal metastasises
Usually single growth pattern
Very likely to be bilateral

39
Q

What are breast infiltrating ductal carcinomas

A

Carcinoma of the duct cell with invasion of base membrane
Most common breast cancer
Can give liver and lung metastasises. CXR, CT liver, LFTs, bone scan

40
Q

What are breast infiltrating lobular carcinomas

A

Carcinoma of the duct cell with invasion of the BM.
Strong tendency towards bilateralality
If cancer is confined to breast, chemo not needed

41
Q

What are the changes seen with invasive breast cancer

A 
Nuclear pleomorphism
Coarse chromatin
Angiogenesis
Invasion of the BM
Dystrophic calcification
Abnormal mitoses
Vascular invasion
Lymph node metastasis
42
Q

What is inflam breast ancer

A

Aggressive breast cancer. Includep eau d;orange, dimpling, metastasis. Surgery contraindicated. Tx is chemo

43
Q

What is Paget’s disease of the reast

A

Chief symptom is eczematous dermatitis of the nipple. Usually signals an underlying breast cancer.

44
Q

What is ovarian ancer

A

90% epithelial in origin, most serous carcinomas

RF: BRCA1/2, early menarche, late menopause, nulliparity

45
Q

What are clinical features

A 
Abdo distension and bloating
Abdo and pelvic pain
urinary symptoms
Early satiety
Diarrhoea
46
Q

What investigations need to be undertake for ovarian cancer

A

CA125 (endometriosis, menstruation, benign ovarian cysts may also raise CA125)

47
Q

What is thyroid papillary carcinoma

A

Mixture of papillary and colloidal filled follicles
Papillary projections and pale empty nuclei
Seldom encapsulates
Haematogenous metastasis rare
Lymph node metastasis predominate
Often young female

48
Q

What is thyroid follicular adenoma

A

Usually present as solitary thyroid nodule

49
Q

What is thyroid follicular carcinoma

A

Macroscopically encapsulate, microscopically capsular invasion is seen. Without this, follicular adenoma
Vascular invasion predominates

50
Q

What is thyroid medullary carcinoma

A

C cell derived from neural crest and not thyroid tissue
Serum calcitonin levels often raised
Both lymphatic and haematogenous metastasis are recognised, nodal disease associated with a very poor prognosis
MEN-2

51
Q

What is thyroid anaplastic carcinoma

A

Most common in elderly female

Local invasion is a common feature

52
Q

What is Hodgkin’s Lymphoma

A

Asymptomatic lymphadenopathy
Cough, Pel Ebstein fever, haemoptysis, dyspnoea
Reed Sternbeg cell may be identified histologically
Infection with EBV linked to this

53
Q

What is cervical cancer

A

Squamous cell (80%) and adenocarcinoma (20%)
HPV 16, 18, 33 most important factor
HPV 16 and 18 produces the oncogenes E6 and £7
E6 inhabits the p53
E7 inhibits RB

54
Q

What is Burkitt’s lymphoma

A

High grade B cell lymphoma
African form: involve maxilla or mandible, associated with EBV
Sporadic form: abdominal (e.g. ileo-caecal) tumours are the most common form. More common in px with HIV
Associated with c-myc gene translation
Starry sky appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells

55
Q

What is multiple myeloma

A

Malignancy of plasma cells (blood cells that produce antibodies)

56
Q

What are the signs of multiple myeloma

A

Monoclonal production of Ig - precipitate and deposit in kidney (kidney failure), increased thirst
Increased bone turnover - lytic bone lesions (predisposition to fractures - esp spinal column) - low back pain
Hypercalcaemia - constipation, nausea and poor appetite. Due to osteoclastic bone resorption caused by local cytokines.
Crowding of bone marrow (where blood cells are produced) - anaemia and thrombocytopenia - fatigue and pallor
Decreased production of normal Ig - immunocompromised

57
Q

What is Reidel’s thyroditis

A

rare cause of hypothyroidism characterised by dense fibrous tissue replacing the normal thyroid parenchyma. On examination a hard, fixed, painless goitre is noted. It is usually seen in middle-aged women. It is associated with retroperitoneal fibrosis.

58
Q

What is subacute thyroiditis

A

Subacute thyroiditis (also known as De Quervain’s thyroiditis and subacute granulomatous thyroiditis) is thought to occur following viral infection and typically presents with hyperthyroidism

Cancer (1 decks)

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