Disorders of Growth Flashcards
(178 cards)
0
Q
In terms of increases in size of tissue - what does auxetic mean?
A
Increased size of individual cells
1
Q
In terms of increase in the size of tissue - what does muliplicative mean?
A
Increased number of cells
2
Q
In terms of increase in size of a tissue - what does Accretionary mean?
A
Increased connective tissue
3
Q
What does the term atrophy mean?
A
Decreased number/size of cells
4
Q
What does the term hypoplasia mean?
A
Failure of organ development
5
Q
What are the three hormonally sensitive organs to hyperplasia?
A
Endometrium
Breast
Thyroid
6
Q
What is the term for an increase in cell size?
A
Hypertrophy
7
Q
Out of hyperplasia, hypertrophy, atrophy, hypoplasia and metaplasia - which one is irreversible?
A
Hypoplasia
8
Q
What is the term for an aquired form of altered differentiation?
A
Metaplasia
9
Q
What type of neoplasia occurs in Barrett’s oesophagus, cervix, bronchus and salivary ducts?
A
Metaplasia
10
Q
What are the Hayflick numver, Telomere erosion and Telomerase all related to?
A
Senescence
11
Q
What type of cells are continuosuly dividing and are present as surface epithelia and haematopoetic cells?
A
Labile cells
12
Q
What type of cells have a low level of replicative activity, may divide rapidly if stimulated, hepatocytes, fibroblasts and endothelium?
A
Stable cells
13
Q
What type of cells are non-dividing, not able to re-enter the cell cycle and are neurones, skeletal and cardiac muscle?
A
Permananet cells
14
Q
What is the key to regeneration of a cell population?
A
Control of the cell cycle
15
Q
In relation to the control of the cell cycle - what can growth result from?
A
Shortening cell cycle time
Recruiting cells from resting or quiescent population
16
Q
What four phases does the cell cycle consist of?
A
G1, S, G2, and M
17
Q
In what stage of the cell cycle are cells quiescent?
A
G0
18
Q
What is the term for an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues, and persists in the same excessive manner after cessation of stimuli that evoked the change?
A
Neoplasm
19
Q
What are the two major classifications of neoplasia?
A
Behavioural - benign or maligant
Histogenic
20
Q
What type of neoplasm has expansile growth and no invasion?
A
Benign neoplasm
21
Q
What type of neoplasm is encapsulated?
A
Bengin
22
Q
What is the N:C ration like in benign neoplasms?
A
Normal
23
Q
How much pleomorphims is present in benign neoplasms?
A
Minimal
24
What can be said about the mitotic figures in a benign neoplasm?
Few mitotic figures
| Normal mitotic figures
25
In a benign neoplasm, what are the nuclei not?
Hyperchromatic
26
Do benign neoplasms metastasise?
No
27
What type of neoplasm has an invasive growth pattern and is not encapsulated?
Malignant neoplasm
28
What type of neoplasm is necrosis common in?
Maliganant
29
What can be said about the N:C ratio in maligant neoplasms?
Increased
30
Are maligant neoplasms pleomorphic?
Yes
31
What can be said about the mitotic figures in a malignant neoplasm?
More frequent mitotic figures
| Abnormal mitotic figures
32
What can be said about the nuclei of a malignant neoplasm?
Hyperchromatic
33
Which neoplasm is diploid and which is aneuploid?
Diploid - benign
| Aneuploid - Malignant
34
What two classes of neoplasm can epithelial be divided into?
Squamous
| Glandular
35
What is a benign, squamous neoplasm called?
Squamous papilloma
36
What is a benign glandular neoplasm called?
Adenoma
37
What is a malignant squamous neoplasm called?
Squamous carcinoma
38
What is a malignant, glandular neoplasm called?
Adenocarcinoma
39
What 6 classes can mesenchymal neoplasms be split into?
```
Fat
Endothelium
Chondrocyte
Osteoblast
Smooth muscle
Skeletal muscle
```
40
What is a fat, benign neoplasm called?
Lipoma
41
What is a fat, maligant neoplasm called?
Liposarcoma
42
What is an endothelium, benign neoplasm called?
Ahgioma
43
What is an endothelium, malignant neoplasm called?
Angiosarcoma
44
What is a chondrocyte, benign neoplasm called?
Chondroma
45
What is a chondrocyte, malignant neoplasm called?
Chondrosarcoma
46
What is an osteoblast, benign neoplasm called?
Osteoma
47
What is a malignant, osteoblast neoplasm called?
Osteosarcoma
48
What is a smooth muscle, benign neoplasm called?
Leiomyoma
49
What is a smooth muscle, malignant neoplasm called?
Leiomyosarcoma
50
What is a skeletal muscle, benign neoplasm called?
Rhabdomyoma
51
What is a skeletal muscle, maligant neoplasm called?
Rhabdomyosarcoma
52
What type of neoplasm are glioma, lymphoma, melanoma, seminoma, mesothelioma all?
Malignant tumours
53
What are the three key elements in cancer development?
1. Tumour growth
2. Angiogenesis
3. Invasion and metastasis
54
What are the 4 cancerous factors of tumour growth?
1. Replication
2. Escape from senescence
3. Evasion of apoptosis
4. Limitless replicative potential
55
What are the 5 components of neoplasms?
```
Neoplastic cells
Blood vessels
Inflamamtory cells
Fibroblasts
Stroma
```
56
What three inflammatory cells are found in a neoplasm?
Macrophages, lymphocytes and polymorphs
57
In relation to tumour growth - what types of cells are monoclonal?
Neoplastic cells
58
What are all neoplastic cells in a lesion derived from?
A single common ancestor
59
What is a pre-maligant process?
Dysplasia
60
What is invasive growth?
The migration of cells that have detached from the primary tumour mass.
61
What are the two types of movement for invasive growth in single cells?
Mesenchymal migration - proteolysis/traction
| Amoeboid movement - propulsion/utilise defects
62
During groups of cells moving in invasive growth what are there high levels of?
Autocrine promigratory factors and of proteolytic enzymes
63
What is a tumour stroma?
Desmoplasia
64
What does angiogenesis involve the formation of?
New blood vessels
65
What are 4 key modulators for angiogenesis?
Hypoxia
VEGF
FGF
TNFalpha
66
Name an endogenous inhibitor for angiogenesis?
Thrombospondin-1
67
Do tumours require less oxygen and metabolites than normal cells?
Yes
68
What are tumour implants that are discontinuous with the primary lesion?
Metastasis
69
What are the 4 routes of metastasis?
1. Lymphatic
2. Haematogenous
3. Across body cavities
4. Direct implantation
70
If the route of metastasis has been lymphatic what will the tumours be called?
Carcinomas
71
If the route of metastasis is haematogenous what with the tumours be called?
Sarcomas
72
What type of patterns account for common metastatic profiles?
Circular patterns
73
How far can a primary CNS malignancy spread?
Not beyond the CNS
74
What two neoplasms are at risk of direct implantation?
Mesothelioma
| Chondrosarcoma
75
What two immunological cells are involved inthe regression of cancer i.e. melanoma?
Cytotoxic T lymphocytes and NK cells
76
What part of the immune system are NK cells a part of?
Innate
77
What part of genomic instability is key in cancer development?
Defective DNA repair mechanisms
78
What type of change - that is a key element in cancer development - is reversible, heritable altered gene expression without mutation?
Epigenetic changes
79
In relation to epigenetic changes what do cancer cells show?
Global hypomethylation
80
What can some tumour suppressors be silenced by?
Hypermethylation
81
What two metabolic alterations are key elements in cancer development?
1. Aerobic glycolysis
| 2. Switch from mitochondrial oxidative phosphorylation to glycolytic pathways
82
What cancer can be caused by hydrocarbons?
Scrotal cancer
83
What cancer can be caused by aniline dyes?
Bladder cancer
84
What cancer can be caused by smoking?
Lung cancer
85
What cancer can be caused by Ni, wood dust?
Cancer of nasal sinuses
86
What cancer can be caused by sunlight?
Melanoma
87
What cancer can be caused by ionising radiation?
Leukaemia
88
What type of cancer can be caused by hepatitis B?
Hepatoma
89
What type of cancer can be caused by EBV?
NPC, Hodgkin's
90
What type of cancer can be caused by HPV?
Cervical cancer, head and neck cancer
91
What type of cancer can be caused by H.pylori?
Gastric lymphoma
92
What type of cancer can be caused by dietary factors?
GI cancers
93
What two steps does development of a tumour require?
1. Initiation - electrophilic molecules, DNA damage
| 2. Promotion - stimulate proliferation
94
Name 3 chromosome breakage syndromes?
1. Fanconi's anaemia
2. Bloom's syndrome
3. Ataxia telangiectasia
95
Name 3 specific gene defects that can cause cancer?
APC
BRCA-1
p53
96
Name an RNA viral carcinoma?
Rous sarcoma virus
97
Name a DNA viral carcinoma?
SV40, HBV, HPV
98
Name 6 classical oncogenes?
```
PDGF
EGFR
ras
src
myc
Bcl2, Pim kinases
```
99
What are the 4 ways proto-oncogenes can be activated?
Amplification
Translocation
Point mutation
Insertional mutagenesis
100
What cancer is N-myc associated with?
Neuroblastoma
101
What cancer is erb-B2 associated with?
Breast cancer
102
What type of proto-oncogene activation are N-myc and erb-B2 involved in?
Amplification
103
What type of proto-oncogene activation do these have:
t(14;18) - IgH/Bcl-2 (follicular lymphoma)
t(8;14) - c-myc/IgH (Burkitt's lymphoma)
t(9;22) - c-abl-bcr fusion (CGL)
Translocation
104
What type of proto-oncogene activation does Ras have?
Point mutation
105
What type of activation of proto-oncogenes do slow transforming RNA viruses have?
Insertional mutagenesis
106
Say 4 things about K-ras-activating point mutation?
Activating point mutations
GTP binding pocket
GTP hydrolysis
Locked in GTP bound (active form)
107
Name a gene affected by inactivation of tumour suppressors?
p53
108
Name a gene that is involved in point mutation during inactivation of tumour suppressors?
p53
109
To inactivate tumour suppressor genes how many alleles must be lost?
Both
110
What two ways can tumour suppressors lose both alleles?
Deletion and point mutation
111
what is another way - other than losing alleles by mutation - to inactivate a tumour suppressor?
Degrade protein
112
What is HPV degraded to?
E6 protein (p53) and E7 protein (pRb)
113
What is mdm2 degraded to?
Cellular protein
114
Name the "guardian of the genome"
p53
115
What occurs when p53 is activated?
Regulation of transcription of down-stream target genes
116
What two things does regulation of transcription of down stream target genes - from activation of p53 lead to?
1. Cell cycle arrest
| 2. Cell death apoptosis
117
What is p53?
A tumour suppressor protein
118
What tumour suppressor protein is activated by cell stress?
p53
119
What tumour suppressor protein is a transcription factor?
p53
120
Which tumour suppressor protein binds DNA and regulates expression of many genes?
p53
121
What 4 things can inactivate p53?
1. Point mutation
2. Deletion
3. Degrredation
4. Structural changes
122
Name 6 tumour suppressor genes
1. p53
2. pRB
3. APC
4. BRCA-1
5. NF-1
6. WT-1
123
What type of oncogenes: stimulate cell proliferation, inhibit cell death and are dominant?
Classical oncogenes
124
What type of cancer genes inhibit cell proliferation, stimulate cell death and are recessive?
Tumour suppressors
125
What does molecular carcinogenesis involve?
Both classical oncogenes and tumour suppressors
126
What occurs in the conversion of normal mucosa to hyperplastic mucosa?
Abnormal methylation
127
What is the risk of breast cancer if a patients mother got it at 70?
Low risk
128
What is the patients risk of cancer if their mother and sister had breast cancer at 45?
Medium risk
129
What is the patients risk of breast cancer if they have a BRCA1 mutation?
High risk
130
What clinical finding can chronic blood loss as a result of cancer lead to?
Anaemia
131
What can acute blood loss as a result of cancer lead to in a clinical presentation of a patient?
Haematemesis and haemoptysis
132
What can stridor and dyspnoea, dysphagia, abdominal pain, renal failure, jaundice and infection behind obstructing lesion all be a result of?
Narrow lumen due to primary tumour
133
What can metastasis in bone cause a patient to prevent with?
Pain and pathological fracture
134
What can metastasis in the brain cause a patient to present with?
Raised intracranial pressure, epilepsy and CVA
135
What can a meatastasis in the liver cause a patient to present with?
Jaundice
136
What can a metastasis in the adrenal glands cause a patient to present with?
Addison's disease
137
What are paraneoplastic syndromes?
Symptoms/syndromes in cancer patients that cannot be explained by the effects of local or distant spread of tumours
138
What are the 6 clinical syndromes of paraneoplastic syndromes?
```
Endocrinopathy
Neuromuscular
Dermatologic
Osteoarticular
Vascular
Nephrotic syndrome
```
139
What are the 4 clinical syndromes that come under endocrinopathy?
Cushings syndrome
Innappropriate ADH
Hypercalcaemia
Polycytheamia
140
What is the underlying cancer if a patinet has cushings syndrome?
Small cell lung cancer (causal mechanism - secrete ACTH)
141
What is the underlying cancer present if a patient has innappropriate ADH?
Small cell lung cancer (causal mechanism - Secrete ADH or atrial natriuretic)
142
What is the underlying cancer present if a patient has hypercalcaemia?
Squamous carcinoma of lung, T-cell keukaemia/lymphoma, renal carcinoma (causal mechanism - erythropoitein)
143
What is a clinical syndromes under the heading of neuromuscular?
Myasthenia
144
What is the underlying cancer if a patient has myasthenia?
Bronchogenic carcinoma (causal mechanism - immunologic Eaton-lambart syndrome)
145
Name a clinical syndrome under the heading Dermatologic
Acanthosis nigricans
146
What is the underlying cancer if a patient has acanthosis nigricans?
Gastric carcinoma (causal mechanism - immunologic, secrete ECF)
147
What is a clinical syndrome under the heading of osteoarticular?
Hypertrophic osteoarthropathy
148
What is the underlying cancer if a patient has hypertrophic osteoarthropathy?
Bronchogenic carcinoma
149
What are two clinical syndromes that come under the heading Vascular?
```
Venous thrombosis (Trousseau)
Nonbacterial thrombotic endocarditis
```
150
What is the underlying cancer if a patient has Venous thrombosis?
Pancreatic cancer (causal mechanism - activate clotting by mucin)
151
What is the underlying cancer if a patient has Nonbacterial thrombotic endocarditis?
Advanced cancer (causal mechanism - hypercoaguability)
152
What two underlying cancers could a patinet with nephrotic syndrome have?
Colo-rectal carcinoma
| Hodgkin's disease
153
What is the causal mechanisms for colo-rectal carcinoma and Hodgkin's disease causing nephrotic syndrome?
Immune complexes, tumoiur antigens
154
What are the two tumour types of breast cancer?
Tubular vs. NST
155
What are the two tumour types of lymphoma?
B-NHL vs. T-NHL
156
What are the two tumour types of non-melanoma skin cancer?
Basal cell carcinoma
| Squamous carcinoms
157
What does Duke's stage A say about colo-rectal cancer?
Confined to wall, no lymph node metastasis
158
What does Duke's stage B say about colo-rectal cancer?
Penetrates wall, no lymph node metastasis
159
What does Duke's stage C say about colo-rectal cancer?
Lymph node metastasis
160
What does Duke's stage D say about colo-rectal cancer/
Metastatic disease
161
What is the T1 stage of cancer?
Invasion of submucosa
162
What is the T2 stage of cancer?
Invasion of muscularis propria
163
What is the T3 stage of cancer?
Invasion to subserosa and non-peritonealised pericolic and pararecal tissues
164
What is T4 stage of cancer?
Invasion of adjacent organs or perforation of visceral peritoneum
165
What does the N0 stage say about colorectal cancer?
No regional lymph node metastasis
166
What does N1 stage say about colorectal cancer?
1-3 regional nodes contain metastatic tumour
167
What does N2 stage say about colo-rectal cancer?
4 or more nodes contain metastatic tumour
168
What does M0 stage say about colo-rectal cancer?
No distant metastasis
169
What does M1 stage say about colorectal cancer?
Distant metastasis
170
What does clinical staging I mean?
T1/T2, NO, MO
171
What does clinical staging IIA mean?
T3, NO, MO
172
What does clinical staging IIB mean?
T4, NO, MO
173
What does clinical staging IIIA mean?
T1/T2, N1, MO
174
What does clinical staging IIIB mean?
T3/T4, N1, MO
175
What does clinical staging IIIC mean?
Any T, N2, M0
176
What does clinical staging IV mean?
Any T, any N, M1
177
Where can a prostatic carcinoma metatasise to?
Vetebrae
