Exam 3: Section 5 Remaining Material Flashcards
1
Q
What is Mets
A
Metastasis
2
Q
Which form of cancer is most likely to travel via lymphatics
A
Carcinoma
3
Q
Tumors with anaplasia are most likely to be
A
Invasive malignant tumor
4
Q
Tumors with fairly well differentiated cells are more likely to be
A
Slowly growing benign tumors
5
Q
Most cancer related deaths occur between
A
55-70 years old
6
Q
Most common cause of cancer related deaths in males
A
Prostate CA
7
Q
____ correlation between rate of growth and differentiation in cancer cells
A
Inverse
8
Q
____ tumors are less likely to be encapsulated
A
Malignant
9
Q
MC breast cancer
A
Invasive ductal carcinoma
10
Q
MC breast tumor
A
Fibroadenoma
11
Q
Osteosarcomas travel ____ primarily
A
Lungs
12
Q
Colorectal CA travels to ____ primarily
A
Liver
13
Q
Most reliable indicator for malignancy
A
Metastasis
14
Q
Most people from cancer die from ____ as a result of Mets
A
Organ failure
15
Q
3 types of Mets
A
- Seeding
- Lymphatic
- Hematogenous
16
Q
Seeding Mets
A
Invasion of natural body cavities
17
Q
2 types of body cavities primary associated with seeding Mets
A
Ovaries
CNS
18
Q
Lymphatic Mets are MC form of Mets for
A
Carcinomas
19
Q
Lymphatic Mets are determined by
A
Site and tumor parenchyma
20
Q
Lymphatic Mets usually involved a ___ node
A
Sentinel lymph node
21
Q
Hematogenous Mets is MC Mets for
A
Sarcoma
22
Q
Type of Mets that is very rapid
A
Hematogenous
23
Q
Hematogenous Mets are most likely to spread to
A
First capillary bed
24
Q
GI cancer using hematogenous Mets go to
A
Liver
25
Systemic circulation cancers using hematogenous Mets go to
Lungs
26
Ultimate cause of CA is
Genetic alterations
27
Common CA in US
Breast
Colorectal
Esophageal
28
Common CA in Africa
Liver
29
Common CA in Japan
Stomach
30
Cancer diagnosis is ___, but cancer related deaths are ___
Increasing
Decreasing
31
CA deaths in men is decreasing by
20%
32
CA deaths in women is decreasing by
10%
33
Cancer related deaths are decreasing due to
1. Reduced tobacco
2. Improved treatment
3. Improved screening
34
Pediatric CA results in ___ of childhood deaths
10%
35
2 reasons CA affects older adults
1. Acquired more somatic mutations
| 2. Less active immune system
36
Sporadic CA develops in the absence of
Family history
37
Sporadic CA is primary result of
Harmful environmental exposures and damage to genetic material
38
Examples of preneoplastic lesions
Metaplasia
| Dysplasia
39
Proto-oncogene
Normal gene that promotes cellular growth by encoding for transcription factors
40
Oncogene
Altered proto-oncogene that now promotes excessive cellular growth
41
Only ___ allele is needed to be mutated to change a proto-oncogene to an oncogene
1
42
Tumor suppressor gene
Normal genes that slow down cellular growth
43
If TSGs are altered, they can contribute to
Uncontrolled/ dysregulated cell growth
44
___ alleles must be altered for a TSG to contribute to carcinogenesis
Both
45
Apoptosis Genes normally ___ cells that have genetic alterations
Kill
46
CA cells ____ pathways that enact apoptosis for altered cells
Deactivate
47
DNA repair genes
Gene abnormalities go uncorrected and may contribute to carcinogenesis
48
Karyotype
Number and appearance of chromosomes
49
Aneuploidy
Abnormal number of chromosomes
50
Balanced translocation
Large genetic change on chromosome level
51
Balanced translocations can result in
Overexpression of proto-oncogenes
52
Deletions can deactivate
TSGs by losing genes
53
Gene amplifications can overexpress
Proto-oncogenes
54
Structural abnormalities
1. Balanced translocations
2. Deletions
3. Gene amplifications
55
Example of gene amplification
Breast CA over expressing HER2
56
Indications of gene amplification
Homogeneously stained region
Double minutes
57
Epigenetic modifications are ____ changes in gene expression
Heritable
58
Epigenetics impacts function, but not
Genotype
59
Epigenetic modifications are
Reversible
60
Epigenetic modifications silences genes via
DNA methylation
Histone modification
61
Epigenetics impacts carcinogenesis when ___ are silenced
TSGs or DNS repair genes
62
Sub clones ____ malignant potential
Increase
63
8 hallmarks of cancer
1. Evade apoptosis
2. Self sufficiency in growth signals
3. Insensitivity to anti-growth signals
4. Tissue invasion and metastasis
5. Limitless replicative potential
6. Sustained angiogenesis
7. Evasion of immune system
8. Altered cellular metabolism
64
Driver mutations
Directly contribute to development and progression of CA
65
Passenger mutations
Produce genetic variants that may give tumor selective advantage
66
Mutations inherited via the germline affect
Entire body
67
Mutation in RB gene
Retinoblastoma
68
TP53 gene mutation
LI-Fraumeni Syndrome
69
APC gene mutations
Colorectal CA
70
NF1 gene mutations
Neurofibromatosis
71
BRCA 1 and BRCA 2 gene mutations
Breast and ovarian CA
72
Philadelphia chromosome
Abnormality in chromosome 22 in which part of chromosome 9 is transferred to it
73
Bone marrow cells that contain Philadelphia chromosome are often found in
Chronic myelogenous leukemia
74
Burkitt Lymphoma involved balance translocation between chromosome __ and __
8
| 14
75
Warburg Effect
Change in CA cell metabolism
Aerobic glycolysis
76
Governor of cell cycle
RB gene
77
RB plays role at ___ checkpoint
G1 to S
78
This infection may inactivate Rb
HPV
79
Guardian of genome
TP53 gene
80
MC mutated gene in all CA
TP53 gene
| >70%
81
P53 monitors for cellular stressors such as
Anoxia
Activation of oncogenes
Genetic alterations
82
3 controls mechanisms involving TP53 gene
1. Quiescence
2. Senescence
3. Apoptosis
83
Quiescence causes ___ cell cycle arrest in response to ___
Reversible
Minor DNA damage
84
Senescence results in ___ cell cycle arrest in response to ___
Permanent
Major DNA damage
85
Apoptosis results in ____ in response to irreversible genetic damage
Programmed cell death
86
4 most common cancers associated with Li-Fraumeni Syndrome
SBLA
1. Sarcomas
2. Breast
3. Leukemia / lymphomas
4. Adrenal gland
87
Hay flick limit
40-70 divisions
88
Why is there a hay flick limit?
Telomeres shorten —activates TSGs—senescence
89
Limitless replication in CA results from non-homologous end-joining between haphazard chromosomes, which can rarely cause
Telomerase re-activation
90
Telomerase
Repairs and maintains telomeres
91
The normal result from non-homologous end-joining
Mitotic catastrophe
92
Reactivation of telomerase is observed in ___ of all cancers
90%
93
Pro-angiogenic Factors can be from
Tumor cells
Macrophages
Stromal cells
94
Angiogenesis is in response to
Tissue hypoxia
95
The new vessels from angiogenesis are dilated, ___, and ____, and can be a route for
Tortuous, leaky
Metastasis
96
Invasion occurs on a ___ level
Local
97
Metastasis occurs on a __ level
Distant
98
Invasion metastasis cascade
1. Invasion of ECM
2. Vascular spread
3. Micrometastases grow and invade
99
Intravasation
Process of tumor cells metastasizing and entering the blood vessels
100
Sites of blood stasis
Lungs
| Bone marrow
101
Once in blood vessels, tumor cells can be vulnerable to attach from these lymphocytes
NK
CD8+ T cells
102
___ can aggregate and provide some protection to CA cells from an immune attack
Platelets
103
Genomic instability
High frequency of mutations within an individual’s genome
104
Types of DNA repair
1. Mismatch repair
2. Nucleotide excision repair (NER)
3. Homologous recombination
105
Pathology caused by dysfunction in DNA mismatch repair
Hereditary Nonpolyposis Colorectal CA (HNPCC)
Aka lynch syndrome
106
Pathology caused by dysfunction in NER
Xeroderma Pigmentosum
107
Pathology caused by dysfunction in homologous recombination
Breast cancer
108
Xeroderma pigmentosum is a ____ defect in NER
Congenital
109
TP53 gene can by deactivated by __ or ___
HPV or Hep B
110
CA cells loosen surrounding intercellular connections by deactivation
E-Cadherin genes
111
CA degrade ECM via
Proteolytic enzymes
112
Once a CA cells invades the basement membrane, it is no longer considered “____”, but rather ____
In situ
Stage 1 “invasive” CA
113
3 features of inflammation that increase CA risk
1. Release of growth factors
2. Angiogenesis
3. Local invasion
114
Acute radiation syndrome can cause these cancers
```
Leukemia
Thyroid
Breast
Colon
Lung
```
115
Most common cancer, that exceeds breast, prostate, lung and colorectal ca combined
Skin
116
MC skin cancer
Basal cell carcinoma
117
Most lethal and rare skin cancer
Melanoma
118
Melanoma is due to
Intense UV exposure
119
3 types of skin cancer
1. Basal cell carcinoma
2. Squamous cell carcinoma
3. Melanoma
120
H. Pylori is associated with 90% of
Peptic ulcer disease
121
H. Pylori can cause these 2 cancers
Gastric adenocarcinoma
| MALT lymphoma
122
Only ___ of H.pylori transitions to CA
3%
123
Retroviruses are ___ viruses that use ____
RNA viruses
Reverse transcriptase
124
Human T cell Lymphotropic virus-1 (HTLV-1) infects
CD4+ T cells
125
HTLV-1 uses the ___ gene
TAX
126
TAX gene activates ____ and suppresses ____
Cyclins (cyclin D)
TP53
127
HTLV-1 is more common in
Japan
Africa
S. America
128
How is HTLV-1 transmitted
Sexual contact
Infected blood
Breastfeeding
129
Strains of HPV making genital warts
HPV-6
| HPV-11
130
Strains of HPV responsible for squamous cell carcinoma
HPV-16
HPV-18
131
HPV promotes cellular growth by activating ____ and deactivating ____
Cyclins
TSGs
132
HPV gene ___ deactivates p53
E6
133
HPV gene ___ inactivates Rb
E7
134
Epstein-Barr virus is responsible for __ and infects ___
Mono
B cells and epithelial cells
135
EBV predisposes you for risk of
Burkitt lymphoma
Lymphomas
Hodgkin lymphoma
Nasopharyngeal CA
136
Responsible for 80% liver CA
Hep b and c
137
Hep B and C are MC in
Africa
| SE Asia
138
Cancer cachexia is associated with ___ cancer
Advanced
139
Cachexia
Wasting away of body fat and lean muscles due to widespread CA causing hypermetabolic state on body
140
Anorexia can be observed in cachexia due to
Cytokine TNF
141
Not due to local destruction of tumor or tumor putting pressure on surrounding tissues
Paraneoplastic syndromes
142
Paraneoplastic syndromes can be due to
Immune activation or hormone production
143
Paraneoplastic syndromes occur in
15% of all CA
144
Hypercalcemia is an example of
Paraneoplastic syndromes
145
Hypercalcemia can be caused by
Breast CA stimulates PTH levels, increasing osteoclasts activity
146
Cushing syndrome is an ____ disorder
Endocrine
147
Cushing syndrome aka
Hypercorticoid
148
Cushing syndrome can be due to
1. Exogenous corticosteroid therapy
2. Pituitary adenoma (Cushing disease)
3. Adrenal adenoma
149
Characteristics of Cushing syndrome
1. Weight gain
2. Hirsutism
3. Purple striae
4. Hypertension
5. Muscle atrophy and weakness
6. Menstrual abnormalities
150
Suspected antigen Cushing syndrome
ACTH
151
Suspected antigen hypercalcemia
PTH
152
Suspected antigen polycythemia
EPO
153
Suspected antigen anemia
Immune activation
154
Suspected antigen thrombotic endocarditis
Inflammation
| Hypercoagulability
155
Suspected antigen acanthosis nigricans
Epidermal GFs
156
Type of CA with Cushing syndrome
Lung
Pancreas
Neuronal
157
Type of CA with hypercalcemia
```
Lung
Breast
Kidney
Leukemia
Lymphoma
```
158
Type of CA with polycythemia
Liver
Kidney
Cerebellar
Hemangioma
159
Type of CA with anemia
Thymus gland
160
Type of CA with hypertrophic osteoarthropathy
Lung
161
Type of CA with thrombotic endocarditis
Any advanced CA
162
Type of CA with acanthosis nigricans
Gastric
Lung
Uterine
163
Grading
Degree of cellular differentiation
164
Staging measures
Extent of spread
165
Staging uses
Multiple sources
166
Excision
Partial removal of organ or tissue from body
167
Biopsy
Removal of smaller sample of cell
168
Colposcopy
Imaging procedure to view magnified image of cervix
169
Colposcopy is an example of a
Biopsy
170
Fine needle aspiration
Removal of cells via aspiration with a needle
171
Fine needle aspiration is used with
Superficial tumor that is easily palpated
172
Examples of tissues that can have fine needle aspiration
Breast
Thyroid
Lymph nodes
Salivary glands
173
Cytological smear aka
Papanicolaou smear
174
Pap smear
Sampling sheet cells off the surface of an organ
175
Organs that can have a Pap smear
```
Cervix
Endometrium
Meninges
Bronchi
Bladder
Prostate
Stomach
```
176
___ may be sample for biochemical abnormalities or irregular enzyme levels
Body fluids
177
Tumor makers are _____ for presence of cancer
Non-diagnostic
178
Prostate specific antigen (PSA) elevated levels can be due to
Benign prostatic hyperplasia
Recent ejaculation
Prostate cancer
