Clasp - Cancer

Question 1

Define hyperplasia

Answer 1

Increase in number of cells due to a stimulus

Question 2

Define hypertrophy

Answer 2

Increase in size of cells

Question 3

Define atrophy

Answer 3

Decrease in size AND/OR volume of cells

Question 4

Define metaplasia

Answer 4

Reversible change from one mature cell type to another

Question 5

Define neoplasia

Answer 5

Growth without stimulus - broad term

Question 6

What is the nomenclature for a smooth muscle tumour

Answer 6

leiomyoma/sarcoma

Question 7

What is the nomenclature for a skeletal muscle tumour

Answer 7

Rhabdomyoma/sarcoma

Question 8

What is the nomenclature for a adipose tissue tumour

Answer 8

Lipoma/Liposarcoma

Question 9

What is the nomenclature for a bone tumour

Answer 9

Osteoma/osteosarcoma

Question 10

What is the nomenclature for a cartilage tumour

Answer 10

Chondroma/chondrosarcoma

Question 11

What is the nomenclature for a blood vessel tumour

Answer 11

Haemangioma/angiosarcoma

Question 12

What is the nomenclature for a nerve tumour

Answer 12

neuroma/MPNST

Question 13

What does raised alkaline phosphatase suggest?

Answer 13

A problem with the liver or the bone

Question 14

What do raised alkaline phosphatase and raised gamma GT suggest?

Answer 14

A problem with the liver

Question 15

What is a cholestatic picture based on bloods?

Answer 15

Raised alkaline phosphatase, raised bilirubin, raised ALT

Question 16

What is SAAG?

Answer 16

Serum Ascites Albumin Gradient - difference in concentration of albumin in serum compared to in the ascites

Question 17

What does a wide SAAG suggest?

Answer 17

Pathology causing portal hypertension

Question 18

What is an exudate and what does it suggest?

Answer 18

Pleural effusion fluid contains ≥ 30g/L protein, suggesting local pathology

Question 19

What is a transudate and what does it suggest?

Answer 19

Pleural effusion fluid containing <30g/L protein, suggesting systemic pathology

Question 20

What is radical treatment intent?

Answer 20

Curative intent, often significant side effects

Question 21

What is palliative treatment intent?

Answer 21

Non-curative intent to reduce symptoms, no significant side effects

Question 22

What is adjuvant treatment intent?

Answer 22

After surgery to reduce remission risk

Question 23

What is neo-adjuvant treatment intent?

Answer 23

Before surgery, to shrink tumour before surgical removal

Question 24

What is overall survival time?

Answer 24

Time alive

Question 25

What is disease free survival time?

Answer 25

Time spent with no signs/symptoms of cancer

Question 26

What is progression free survival time?

Answer 26

Time spent with cancer but without cancer progression

Question 27

What is local control time?

Answer 27

Time without recurrence or progression at a specific tumour site

Question 28

What is the 'two hit hypothesis' in inherited cancer?

Answer 28

The inherited mutation is the 'first hit' and a somatic (acquired) second mutation is the 'second hit' that leads to cancer

Question 29

What are the 2 types of mutations in cancer relevant to NGS?

Answer 29

Driver mutations and passenger mutations

Question 30

Why do tumours continuously acquire more mutations?

Answer 30

They lose the ability to repair DNA giving them genomic instability

Question 31

What are the 3 mutation mechanisms from which cancers arise?

Answer 31

1. Mutations leading to inactivation of tumour suppressor genes 2. Activation of oncogenes 3. Mutations in DNA repair pathways

Question 32

What is multifactorial inheritence?

Answer 32

Multiple inherited polymorphisms that increase the likelihood of getting a certain cancer, but not as much as a single autosomal dominant mutation (mendelian disorders)

Question 33

Name the histological layers in the GI tract

Answer 33

Mucosa Submucosa Muscularis externa/propria Adventitia/serosa

Question 34

What defines a T1 tumour?

Answer 34

Tumour cells have breached the muscularis mucosa and are present in the submucosa

Question 35

What defines a T2 tumour?

Answer 35

Tumour cells have infiltrated the muscularis externa

Question 36

What defines a T3 tumour?

Answer 36

Tumour cells which are unbound by muscle are located beyond the muscularis externa

Question 37

What defines a T4 tumour?

Answer 37

Tumour cells are present in the adventitia/serosa