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Flashcards in FHDT Neoplasia Dr. Breaux Deck (40)
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1

An abundance of non-neoplastic connective tissue in association with neoplastic growth is called
Answer
anaplasia
dysplasia
desmoplasia
metaplasia
hyperplasia

desmoplasia

In medicine, desmoplasia is the growth of fibrous or connective tissue.[1] It is also called desmoplastic reaction to emphasize that it is secondary to an insult. Desmoplasia may occur around a neoplasm, causing dense fibrosis around the tumor,[1] or scar tissue (adhesions) within the abdomen after abdominal surgery.[1]
Desmoplasia is usually only associated with malignant neoplasms, which can evoke a fibrosis response by invading healthy tissue. Infiltrating metastatic ductal carcinomas of the breast often have a scirrhous, stellate appearance caused by desmoplastic formations.

2

The most reliable feature in determining the malignancy of a neoplasm is
Answer
invasion of surrounding tissues
anaplasia of the cells
necrosis of the neoplasm
metastasis
presence of atypical mitosis

metastasis

3

Of the following neoplasms in children which is the most common?
Answer
leukemia
leiomyoma
neuroblastoma
osteogenic sarcoma
neuroblastoma

leukemia

4

Which of the following epithelial changes is most likely to be associated with malignant changes?
Answer
acanthosis
hyperkeratosis
parakeratosis
dyskeratosis
acantholysis

dyskeratosis

Dyskeratosis is abnormal keratinization occurring prematurely within individual cells or groups of cells below the stratum granulosum.[1]
Dyskeratosis congenita is congenital disease characterized by reticular skin pigmentation, nail degeneration, and leukoplakia on themucous membranes associated with short telomeres.[2]

Acanthosis is diffuse epidermal hyperplasia (thickening of the skin).

Acantholysis is the loss of intercellular connections, such as desmosomes, resulting in loss of cohesion between keratinocytes,[1] seen in diseases such as pemphigus vulgaris.[2] It is absent in bullous pemphigoid, making it useful for differential diagnosis.

Parakeratosis is a mode of keratinization characterized by the retention of nuclei in the stratum corneum. In mucous membranes, parakeratosis is normal.[1] In the skin, this process leads to the abnormal replacement of annular squames with nucleated cells. Parakeratosis is associated with the thinning or loss of the granular layer and is usually seen in diseases of increased cell turnover, whether inflammatory or neoplastic. Parakeratosis is seen in the plaques of psoriasis and in dandruff.

Hyperkeratosis (from Ancient Greek: ὑπέρ (hyper, “over”); keratos - keratin) is thickening of the stratum corneum, often associated with a quantitative abnormality of the keratin,[1] and also usually accompanied by an increase in the granular layer. As the corneum layer normally varies greatly in thickness in different sites, some experience is needed to assess minor degrees of hyperkeratosis.

5

Of the factors listed below, the one most important in determining prognosis in a patient with a benign neoplasm is
Answer
the age of the patient
removal with the limiting capsule intact
rate of growth
site of the mass effect
likelihood of malignant transformation

site of the mass effect

6

A solitary remnant of immature neuroectoderm in the posterior mediastinum would be called a
Answer

teratoma

choristoma

hamartoma

desmoid

sarcoma

choristoma

Teratomas are tumors that contain all 3 germ layers.
Choristomas are masses of normal histological tissue in places where they should not be. Neuroectoderm is histologically normal, but in the wrong place.
Desmoid tumors are cytologically bland fibrous neoplasms originating from the musculoaponeurotic structures throughout the body.

7

Staging of malignant neoplasms is based upon
Answer

grade of the lesion

degree of anaplasia

size of the lesion

thickness of tumor capsule

extent of spread


extent of spread

8

The best method of screening for carcinoma of the cervix is
Answer

biopsy

cytological examination of the cervical smear

colposcopy

bimanual pelvic examinations

cytological examination of the cervical smear

9

Determination of serum carcinoembryonic antigen (CEA) levels would be most helpful in
Answer

early detection of colon cancer in the general population

detection of colon cancer in a group of patients with miscellaneous gastrointestinal disorders

monitoring the response to surgery in patients treated for colon cancer

confirming the diagnosis

none of the above would represent an appropriate use of this test

monitoring the response to surgery in patients treated for colon cancer


Serum from individuals with colorectal carcinoma often has higher levels of CEA than healthy individuals (above approximately 2.5 ng/mL).[6] CEA measurement is mainly used as a tumor marker to monitor colorectal carcinoma treatment, to identify recurrences after surgical resection, for staging or to localize cancer spread through measurement of biological fluids

10

Carcinoma of which of the following organs has the lowest survival rate?
Answer

breast

prostate

colon

stomach

endometrium

stomach

11

Malignant neoplasms originating in tissue derived from either ectoderm or endoderm are usually classified as
Answer

hamartomas

teratomas

choristomas

carcinomas

sarcomas

carcinomas

12

In contrast to leiomyosarcomas, leiomyomas of the uterus are more likely to be
Answer

highly cellular

irregular at their margins

multiple

spreading into surrounding tissue

necrotic

multiple

Leiomyosarcomas would be necrotic, spreading to surrounding tissue, and irregular at their margins.

13

Stratified squamous epithelium which lacks a normal pattern of maturation and contains atypical cells is referred to as
Answer

neoplastic

metaplastic

hypoplastic

dysplastic

anaplastic

dysplastic

14

Following an abnormal Pap smear, a 34 year-old woman has a cervical biopsy. This demonstrated marked hyperchromatism and increased nuclear/cytoplasmic ratio of the epithelial cells. These changes involved the lower third of the epithelium without involvement of the basement membrane. These changes are best described as
Answer

carcinoma in situ (CIN III)

desmoplasia

hyperplasia

metaplasia

mild dysplasia (CIN I)

carcinoma in situ (CIN III)

15


Dermoid cyst of the ovary represents a form of
Answer

anomaly

ectopia

hamartoma

metaplasia

teratoma

teratoma

16

Loss of orderly maturation of epithelium is by definition
Answer

hyperplasia

metaplasia

neoplasia

dysplasia

anaplasia

dysplasia

17

Metastatic carcinoma to a lymph node is first seen in the
Answer

follicles

hilus

medullary sinusoids

capsule

subcapsular sinus

subcapsular sinus

18

Which tumor is most often implicated in ectopic production of hormones?
Answer

retroperitoneal fibrosarcoma

carcinoma of the large bowel

hepatocarcinoma

oat cell carcinoma of the lung

mesothelioma

oat cell carcinoma of the lung

19

Multiple hematogenous metastases to the lung are most characteristic of
Answer

carcinoma of the cervix

glioblastoma multiforme

osteogenic sarcoma

histiocytic lymphoma

carcinoma of the endometrium

osteogenic sarcoma

Sarcomas are hematogenous
Carcinomas are lymphogenous

20

Which of the following neoplasms has been associated with vinyl chloride products in the plastics industry?
Answer

retroperitoneal sarcoma

angiosarcoma of liver

hemangioma of liver

carcinoma of pancreas

fibrosarcoma

angiosarcoma of liver

21

A lesion on an epithelial body surface characterized by hyperchromatism, disturbance of cell polarity and cellular invasion through the basement membrane is a(n)
Answer

carcinoma

carcinoma in situ

choristoma

hamartoma

papilloma

carcinoma

22

A 35-year-old woman had a firm nodule on the dome of the uterus four years ago. The nodule has slowly increased in size and is now about twice the size it was when first discovered. She is asymptomatic. The uterine nodule most likely represents
Answer

congenital malformation

inflammation

hyperplasia

benign neoplasm

malignant neoplasm

benign neoplasm

23

The most important criterion of malignancy in a rectal tubular adenoma is
Answer

excessive mitotic activity of epithelial components of the tumor

papillary overgrowth of epithelium, with loss of regular glandular pattern

anaplasia and disorientation of cells comprising the epithelial growth

invasion of the stalk or base of the polyp by the epithelial growth

the presence of multiple polypoid lesions

invasion of the stalk or base of the polyp by the epithelial growth

24

A 36-year-old woman noticed a lump in her left breast one month ago. The mass is hard and seems to be attached to the chest wall. Several 2-3 cm lumps are present in the left axilla. At the time of biopsy, the surgeon discovers a 4 cm hard, poorly defined mass in the breast. The most likely diagnosis is
Answer

carcinoma

dysplasia

hamartoma

hyperplasia

metaplasia

carcinoma

25

A 36-year-old rancher lacerated the skin of his upper arm while stringing barbed wire. Subsequent infection produced an area of subcutaneous suppuration. He then developed an enlarged, tender axillary lymph node. Microscopic examination of the lymph node would most likely reveal histologic features of
Answer

desmoplasia

dysplasia

neoplasia

hyperplasia

sarcoma

hyperplasia

26

The most characteristic feature of a neoplasm in contrast to a reactive or inflammatory overgrowth is the

Tendency to recur after surgical treatment
size of the growth
rapidity of the growth
autonomous growth
sensitivity to radiation

autonomous growth

27

which single manifestation of neoplastic growth is the most certain evidence that it is malignant?

cellular atypia and pleomorphism
compression of surrounding tissue
large size
necrosis
metastasis

metastasis

28

the undifferentiated, pleomorphic cells found in many malignant neoplasms are described by the word

hyperplastic
dysplastic
anaplastic
hypoplastic
aplastic

anaplastic

29

The most likely biologic course of an untreated benign neoplasm is

spontaneous resolution after a period of limited growth
necrosis and involution after a period of limited growth
slow progressive growth
progressive growth and spread to other body sites
transformation to malignant neoplasm

slow progressive growth

30

Which is a malignant neoplasm arising from smooth muscle?

leiomyoma
malignant melanoma
leiomyosarcoma
multiple myeloma

leiomyosarcoma

leiomyoma is benign