Disturbances of Growth

Question 1

hamartoma

Answer 1

benign tumor-like mass = overgrowth of differentiated cells & tissues that are normally present in affected location
“development” NOT “neoplastic”

Question 2

characteristics of neoplasms

Answer 2

irreversible

1) tumor cells = increased capacity to survive & reproduce
- -preservation of telomeres

Question 3

malignant tumors

Answer 3

1) carinoma
- -epithelial & glandular tissue
2) sarcoma
- -mesenchymal
- -young age 90% =

Question 4

Teratoma

Answer 4

derived from germ cells & *totipotential cells*
**most arise in gonads
Ex: benign ovarian dermoid cyst
testicular teratocarcinoma
"parasitic twin"

Question 5

spread & metastatses of tumors

Answer 5

• -symptomatic metastases = 30%

- -occult metastases = 20%

Question 6

routes of spread –local tissue

easiest –> hardest to infiltrate

Answer 6

1) loose CT
2) dense CT
3) elastic
4) cartilage

Question 7

local conditions at secondary site

Answer 7

tumor cell “homing” & “favorable soil hypothesis”

1) adequacy of blood supply & nutrients
2) mutual compatibility btwn tumor surface & endothelium
3) microenvironmental factors fav tumor survival

Question 8

common locations for metastasis

Answer 8

1) lymph nodes
- -L supraclavicular node “virchow’s” = visceral cancer -> thoracic duct.
- -breast cancer –> axillary nodes
2) liver
- -enspec GI & pancreas
3) lung
4) bone
- -breast, prostate, bone spread to here
5) CNS
- -LEAST common

Question 9

uncommon sites for metastasis =

Answer 9

spleen & striated muscle

Question 10

bone metastases general features

Answer 10

1) cancer cells are carried by circulation
2) destroy and replace bone
3) likely to form multiple lesions
(contracts w/ primary cancer = unifocal)

4) COMMON SITES = vertebrae// ribs// pelvis// sternum// proximal ends of long bones

Question 11

one more time for fun…

what are the common sites for bone metastases

Answer 11

vertebrae
ribs
pelvis
sternum
proximal long bones
(**remember things like to come to the middle!!)

Question 12

types of osseous metastasis

Answer 12

osteolytics = typically degrade bone
(except multiple myeloma)
osteoplastics = increase bone

Question 13

osteoLYTICS

Answer 13

most common bone cancer (radio-lucent)

• -osteoclasts = degrade bone
• -except multiple myeloma = increase bone

Question 14

osteoPLASTICS

Answer 14

radio-dense
–prostate & breast cancer
clin features = hypercalcemia

Question 15

most common sites for cancer

Answer 15

M = prostate, lung, lower GI, urinary, leukemia
F = breast, lung, lower GI, uterus, leukemia

Question 16

site of mortality of cancer

Answer 16

M = lung, prostate, lower GI, leukemia, pancreas/urinary
F = lung, breast, lower GI, leukemia, ovary

Question 17

national incident of cancer =

Answer 17

combo of environmental, hereditary, and cultural factors

Question 18

which gender is more at risk for cancer?

Answer 18

males

Question 19

hereditary factors & cancer

Answer 19

inherited mutated genes = familial retinoblastoma & familial colon colyposis syndrom

• -familial “clustering” of certain tumors associated w/ less well-defined genetic transmission
• -defects in DNA repair = Xeroderma pigmentosum = skin cancer & familial non-polyposis colon carcinomes

Question 20

hormone abnormalities

Answer 20

increased estrogen = more likely for breast, and endometrium cancer
–hormone is not carcinogenic but is a promotor of growth

Question 21

leukoplakia =

Answer 21

white discoloration

–oral mucosa, female vulva

Question 22

keratosis =

Answer 22

scaly from too much sun

think keratinocytes are repopulating ;)

Question 23

atrophic gastritis

Answer 23

helicobacter pylori infection

Question 24

ulcerative colitis

Answer 24

increased risk of colon cancer

Question 25

cirrhosis contributes to

Answer 25

hepatic cancer

Question 26

alkylating agents

Answer 26

``` directly mutagenic (conversion independent) --destroy cancer cells by damaging DNA ```

Question 27

Human T-cell leukemia viruses

Answer 27

(HTLV-1 & HTLV-2) - -RNA virus - -common in japan and caribbean

Question 28

warning signs of cancer

Answer 28

1) change in bowel or bladder funx 2) sore that fails to heal 3) lump or thickening in breast 4) unusual bleeding 5) indigestion or difficulty swolling 6) obvious changes in wart or mole 7) nagging cough or hoarseness

Question 29

clinical manefestations of cancer

Answer 29

local & systemic | --systemic = ectopic hormone production in non-hormonal glands = paraneoplastic syndromes

Question 30

anti-tumor mech

Answer 30

1) cytotoxic T cells (require sensitization) 2) NK cells (do NOT require sensitization) - -1st line of defense. - -interleukins enhance NK & T cells 3) Activated macrophages - -kill using oxygen-derived free radicles & cytokines

Question 31

complete remission of glial cells

Answer 31

inject patient w/ own "crippled" cancer cells by an "anti-sense" gene against the tumor's growth factor

Question 32

staging (TMN)

Answer 32

``` T= tumor size, shape, local spread...etc. M= metastasis N= nodes ```

Question 33

lab diagnosis

Answer 33

Ig = light chains = elevated in multiple myeloma & B-cell tumors

Question 34

surgery

Answer 34

about 2/3rds of tumors qualify for surgery | --of those about 2/3rds are cured

Question 35

chemotherapy side affects

Answer 35

- -damaging marrow, GI mucosa | - -procarbazine: depolymerizes DNA