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Jason's GI Block > GI Neoplasia > Flashcards

GI Neoplasia Flashcards

(69 cards)

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1
Q

what is interchangeable with carcinoma in situ?

A

intraepithelial neoplasia

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2
Q

malignancy is defined by?

A

invasion/metastasis

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3
Q

aneuploidy?

A

more than 2 chromosomes, inappropriate numbers: chromosomal instability

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4
Q

proto-oncogenes need one or two hits?

A

one hit

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5
Q

how many hits for TSGs?

A

two hit

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6
Q

P53 active between which cell phases?

A

G1 and S

G2 and M

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7
Q

RBactive between which cell phases?

A

G1 and S

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8
Q

carcinoma is cancer of?

A

epithelium

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9
Q

sarcoma is cancer of?

A

mesenchymal

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10
Q

dysplasia signs? 3

A

disordered
premalignant lesion
mutations

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11
Q

cancer is defined by?

A

invasion and breach of basement membrane to stroma

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12
Q

bone is a common site for breast and prostate possibly due to?

A

similar micro environment

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13
Q

example of physiological metaplasia?

A

cervical transformation zone during menstrual cycle

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14
Q

pathological metaplasia in oesophagus?

A

barrett’s oesophagus due to chronic GORD

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15
Q

HPV is only on cervix?

A

ubiquitous: >150 serotypes

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16
Q

What are the high risk cancer HPVs?

A

16 and 18

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17
Q

What are the low risk cancer HPVs?

A

6 and 11

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18
Q

what part of HPV genes leads to cervical cancer?

A

E2 gene disruption during viral genome integration leads to too much E6, E7 then loss of p53 and Rb tumour suppressors

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19
Q

What does HPV E6 and E7 oncoproteins do?

A

inhibits tumour suppressor protein

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20
Q

cervix intraepithelial neoplasia increased risk are which 2 categories?

A

ClN2 and ClN3

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21
Q

diagnostic criteria for Barrett’s oesophagus?

A

endoscopic evidence of columnar

histo: metaplasia (goblet cells)

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22
Q

what gives you an increased 10% lifetime risk of oseophageal adenocarcinoma?

A

Barrett’s oesophagus

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23
Q

What is the most common familial colorectal cancer syndrome?

A

Lynch Syndrome

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24
Q

gland fusion or fusion with lamina propria is a feature of?

A

malignancy

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25
what happens to nucleus of dysplastic cells?
loss of polarity | nuclear atypia
26
dysplastic changes to basement membrane?
separation of basal cell layer
27
fused glands in mucosa indicates what?
lamina propria invasion
28
what is a pre-invasive term for severe dysplasia?
carcinoma in situ
29
is there metaplastic precursor in breast ductal carcinoma in situ?
Nope.
30
breach in what = invasive carcinoma for cervix?
basement membrane
31
breach in what = invasive carcinoma for prostate?
basal cell layer loss
32
breach in what = invasive carcinoma for breast?
myoepithelial cell layer loss
33
breach in what = invasive carcinoma for oesophagus?
basement membrane
34
breach in what = invasive carcinoma for colon?
muscularis mucosae
35
4 ways of carcinoma spread?
direct lymphatic vascular perineural
36
what are adenomatous dysplastic polyps?
precursor lesions
37
Are Tubular adenoma/villous adenoma invasive? what are their features
nope. precursor, no invasion Tubular: sessile/pedunculated Villous: large/sessile
38
if the polyp is >1cm and high grade dysplasia then what?
increased risk of malignancy
39
cancer risk if you have Familial adenomatous polyposis?
100%
40
cancer risk if you have lynch syndrome?
70-80%
41
Familial adenomatous polyposis recessive or dominant?
dominant
42
where are the lymphatics in the colon?
not in the lamina propria
43
how to treat adenomatous polyps?
complete excision
44
are adenomatous polyps invasive?
no invasion beyond muscularis mucosae
45
are hyperplastic polyps benign? or malignant?
benign
46
at what point do you get colorectal adenocarcinoma?
invasion beyond muscularis mucosae
47
what happens to stroma witth colorectal adenocarcinoma?
desmoplastic stromal reaction
48
3 colorectal cancer pathways
``` Chromosomal instability microsatellite instability (MSI) CpG island methylator phenotype (CIMP) ```
49
which TSGs are lost in carcinoma?
p53 | SMAD4/SMAD2
50
which proto-oncogenes are lost in carcinoma?
K-RAS
51
what is the most common familial colorectal cancer syndrome?
Lynch Syndrome
52
Lynch Syndrome dominant or recessive? onset of cancer?
dominant | mean age 45
53
extracolonic cancers in Lynch Syndrome?
yes endometrium renal pelvis
54
2 things in micro satellite instability pathway?
defective DNA mismatch repair | widespread mutations in DNA micro satellites
55
where do sessile serrated adenoma/polyps usually arise?
proximal colon
56
sessile serrated adenoma/polyps easy or heard to detect?
hard to detect at colonoscopy
57
what is serrated in sessile serrated adenoma/polyps ?
elongation and serration of crypts
58
How do colorectal cancers grow in: 1. proximal colon 2. distal colon why?
1. bulky, polypoid: due to more liquid stool | 2. annular, stenosing, ulcerated: due to more solid stool
59
invasion assessment of colon cancer. 4 things
muscularis muscosae lymph nodes infiltration of adjacent organs perforation into peritoneal cavity
60
``` Australian staging for colorectal cancer: ACPS A ACPS B ACPS C ACPS D ```
ACPS A: beyond muscularis mucosae ACPS B: beyond muscularis propria ACPS C: lymph node metastasis ACPS D: distant metastase
61
TMN staging is?
Tumour invasion Tis, T1,2,3,4 Node metastases: N0,1,2 M etastases: Mx, M0,1
62
what organ is common site of metastases for colorectal cancer?
liver cause of portal system
63
neoadjuvant therapy is? Grade 1 is best or worse?
pre-operative chemoradiotherapy | grade 1 is complete tumour destruction
64
early onset cancer should raise suspicion of?
underlying syndrome
65
2 things that dysplasia has histologically:
nuclear atypia | disordered growth
66
complete excision of dysplasia will cure?
yes
67
Cetuximab and panitumumab block what?
EGFR signalling
68
K-RAS and B-RAF mutation predicts what?
poor response to EGFR-targeted therapy so need to screen before targeted therapy
69
Colorectal sequence:
``` normal, then get first hit (APC) dysplastic early adenoma (K-RAS) intermediate adenoma (SMAD4) late adenoma (p53) carcinoma metastasis ```

Jason's GI Block (32 decks)

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