cancer basics

Question 1

normal cell type replaced by another

Answer 1

metaplasia

Question 2

barrett’s esophagus

Answer 2

metaplasia:

squamous epithelium → columnar epithelium (intestinal)

Question 3

abnormal growth

loss of normal size, shape, orientation

Answer 3

dysplasia

Question 4

REVERISBLE changes in histoogy

Answer 4

hyperplasia
metaplasia
dysplasia

Question 5

cells regressing
less differentiated
less like mature cells, more like primitive cells

Answer 5

anaplasia

Question 6

high nucleus to cytoplasmic ratio
prominent nucleoli
clumping of nuclear chromatin
mitotic figures

Answer 6

anaplastic characteristics

Question 7

cells growing in uncontrolled fashion

benign OR malignant

Answer 7

neoplasia

Question 8

IRREVERISBLE changes in histology

Answer 8

anaplasia

neoplasia

Question 9

adenoma: glandular architecture (colon polyp)
papilloma: finger-like architecture

Answer 9

benign tumor arising from epithelium

Question 10

carcinoma:
adenocarcinoma
papillary carcinoma
use cytokeratin stain

Answer 10

malignant tumor arising from epithelium

Question 11

tumors that spread via lymphatics

Answer 11

epithelial tumors

Question 12

tumors that spread hematogenously

Answer 12

mesenchymal tumors

Question 13

malignant blood cell tumors

Answer 13

leukemia
lymphoma
multiple myeloma

Question 14

hemangioma (cherry)

Answer 14

benign blood vessel tumor

Question 15

angiosarcoma (usually liver)

Answer 15

malignant blood vessel tumor

Question 16

osteoma

Answer 16

benign bone tumor

Question 17

osteosarcoma

Answer 17

malignant bone tumor

Question 18

lipoma

Answer 18

benign fat tumor

Question 19

liposarcoma

Answer 19

malignant fat tumor

Question 20

benign mesynchymal tumors rarely progress to

Answer 20

sarcoma (vs epithelial tumors: adenoma → carcinoma)

Question 21

sarcomas (mesenchymal) are more aggressive than

Answer 21

carcinomas

Question 22

rhabdomyoma

Answer 22

benign skeletal muscle tumor

Question 23

rhabdomyosarcoma

Answer 23

malignant skeletal muscle tumor

Question 24

leiomyoma

Answer 24

benign smooth muscle tumor

Question 25

leiomyosarcoma

Answer 25

malignant smooth muscle tumor

Question 26

tumor with more than 1 cell type mature: mature tissues, no anaplastic cells (ovarian tumor) immature: MALIGNANT

Answer 26

teratoma

Question 27

how much cellular differentiation and mitotic activity the tumor cells show

Answer 27

grade low grade: well-differentiated, cells resemble normal cells high grade: less differentiated

Question 28

size of tumor | how much it has spread

Answer 28

stage

Question 29

TNM staging system

Answer 29

Tumor size Nodal involvement Metastasis

Question 30

prognostic value + treatment options depends on

Answer 30

stage

Question 31

neoplastic progressoin

Answer 31

normal → hyperplasia → dysplasia (lose normal size, shape, orientation) → carcinoma in situ (malignant cells haven't invaded BM yet) → invasive carcinoma (malignant cells break thru BM: locally invasive)→ metastasis (invade lymphatic or blood vessel)

Question 32

liver metastasis (more common than 1° liver cancer)

Answer 32

``` Cancer Sometimes Penetrates Benign Liver: Colon (drains to liver) Stomach (drains to liver) Pancreas Breast Lung ```

Question 33

``` ↑ LFTs: ↑ alk phos liver tenderness ab pain hepatomegaly hepatic dysfunction: ascites, jaundice ```

Answer 33

liver mets S/S

Question 34

brain metastasis (50% brain tumors are mets = most common brain tumor is mets)

Answer 34

``` Lots of Bad Stuff Kills Glia: Lung Breast Skin (melanoma) Kidney (renal cell carcinoma) GI tract (colon cancer) ```

Question 35

headache - 50% cases focal neuro dysfunction: hemiparesis cognitive dysfunction: memory loss, personality changes seizures

Answer 35

brain mets S/S

Question 36

bone metastasis (more common than 1° bone tumors)

Answer 36

``` Permanently Relocated Tumors Like Bone Prostate Renal cell cancer Thyroid Lung Breast ```

Question 37

lytic: break down bone (lung, multiple myeloma, breast) blastic: build new bone - but disordered and weak (prostate, breast)

Answer 37

bone mets S/S

Question 38

profound weight loss fat + lean muscle loss cause: tumor produces cytokines (TNF α) that raise BMR main cause of cancer death + disability

Answer 38

cachexia

Question 39

``` histological finding in: papillary thyroid cancer Serous papillary cystadenocarcinoma of ovary Meningioma Malignant mesothelioma ```

Answer 39

psammoma body

Question 40

laminated, concentric, calcified spherules

Answer 40

psammoma body

Question 41

malignant tumors arise from clonal expansion of

Answer 41

single precursor cell daughter cells pass on mutated DNA

Question 42

4 main targets of genetic damage:

Answer 42

proto-oncogenes tumor suppressor gene genes that regulate apoptosis DNA repair genes (susceptible to ionizing radiation, chemical carcinogens)

Question 43

malignant transformation is due to

Answer 43

nonlethal genetic damage (no trigger for apoptosis) | multistep: multiple mutations (protooncogene + dna repair gene, etc)

Question 44

normal genes that regulate cell proliferation and differentiation (code for GF, GF R, tyrosine kinase) but when mutated become called

Answer 44

proto-oncogenes: normal | oncogenes: mutated

Question 45

regulate cell cycle

Answer 45

tumor suppressor genes: G1→ S: DNA repair, if can't repair: p53, Rb (stays bound to E2F TF) G2 →M: p53

Question 46

cyclin D activates CDK4

Answer 46

cyclin D-CDK 4 phosphorylates Rb → Rb unbinds from E2F TF → allow G1 to S

Question 47

how many mutations in tumor suppressor alleles to get cancer

Answer 47

two: | TWOmor suppressor alleles

Question 48

p53

Answer 48

acts through p21 to cause cell cycle arrest works at G1/S and G2/M checkpoints causes apoptosis by inducing TF of pro-apoptotic genes (BAX) p53 binds to damaged DNA → stop cell cycle → either repair DNA or trigger apoptosis

Question 49

mutation in Rb

Answer 49

not bound to E2F: G1→S

Question 50

mutation in p53

Answer 50

progress through cell cycle despite presence of DNA damage/mutations

Question 51

cell growth in absence of normal mitotic signals

Answer 51

oncogenes: oncoproteins are missing important regulatory elements GOF mutation

Question 52

how many mutations in proto-oncogene alleles to get cancer

Answer 52

ONE mutation

Question 53

most common oncogene abnormality in human tumors: | 15% all human tumors have mutated RAS proteins

Answer 53

ras oncogene

Question 54

most common mutations that cause cancer

Answer 54

``` p53 (50% human cancers) ras oncogene (20% human cancers) ```

Question 55

RAS proto-oncogene protein product

Answer 55

part of G protein in GF receptor → when GF + RAS protein bind to GF R → activate MAP kinase → stimulate cell proliferation