Intro Path Flashcards Preview

USMLE Step 1. > Intro Path > Flashcards

Flashcards in Intro Path Deck (91):
1

Acanthosis nigricans

Rare neoplastic indicator of visceral malignancy (more commonly associated with insulin resistance)

2

Barrett esophagus

Precursor to esophageal adenocarcinoma

3

Chronic atrophic gastritis, postsurgical gastric remnants

Predispose to gastric adenocarcinoma

4

Cirrhosis

Predisposes to hepatocellular carcinoma

5

Ulcerative colitis

Predisposes to colon adenocarcinoma

6

Actinic keratosis

Precursor to SCC of the skin

7

Dermato- and polymyositis

Predispose to visceral malignancies, particularly GU

8

Dysplastic nevus

Precursor to malignant melanoma

9

Multiple seborrheic keratoses

GI, breast, lung, and lymphoid malignancies

10

Paget disease of the bone

Predisposes to secondary osteosarcoma and fibrosarcoma

11

Plummer-Vinson Syndrome

Predisposes to SCC of the esophagus

12

Tuberous sclerosis

Often manifests with multiple hamartomatous (benign) tumors including giant cell astrocytomas, renal angiomyolipomas, cardiac rhabdomyomas; tumors may become malignant

13

Xeroderma pigmentosum, albinism

Predispose to SCC, basal cell carcinoma, melanoma

14

AIDS

Predisposes to aggressive lymphoma (non-Hodgkin) and Kaposi Sarcoma

15

Autoimmune diseases (like Hashimoto thyroiditis, SLE)

Predispose to lymphoma

16

Down Syndrome

Predisposes to acute lymphocytic leukemia

17

Immunodeficiency

Predisposes to lymphoma, melanoma, renal cell carcinoma

18

Li-Fraumeni syndrome

p53 mutation predisposes to various cancer types at a young age (sarcoma, breast, leukemia, adrenal gland)

19

Radiation exposure

High risk of developing leukemia, sarcoma, papillary thyroid cancer, breast cancer

20

Oncogenes

Gain of function leading to increased cancer risk. Need damage to only 1 allele.

21

Tumor suppressor gene

Loss of function leading to increased cancer risk. Both alleles must be lost for expression of disease

22

BCR-ABL

Oncogene

Gene product = tyrosine kinase

Tumor = CML, ALL

23

BCL-2

Oncogene

Gene product = Antiapoptotic molecule (inhibits apoptosis)

Tumor = Follicular and undifferentiated lymphomas

24

BRAF

Oncogene

Gene product = Serine/Threonine kinase

Tumor = Melanoma, non-Hodgkin lymphoma

25

c-kit

oncogene

Gene product = Cytokine receptor

Tumor = Gastrointestinal stromal tumor (GIST)

26

c-myc

Oncogene

Gene product = Transcription factor

Tumor = Burkitt lymphoma

27

HER2/neu (c-erbB2)

Oncogene

Gene product = Tyrosine kinase

Tumor = Breast, ovarian, and gastric carcinomas

28

L-myc

Oncogene

Gene product = Transcription factor

Tumor = Lung tumor

L = Lung

29

N-myc

Oncogene

Gene product = Transcription factor

Tumor = Neuroblastoma

N = Neuroblastoma

30

RAS

Oncogene

Gene product = GTPase

Tumor = Colon cancer, lung cancer, pancreatic cancer

31

RET

Oncogene

Gene product = Tyrosine kinase

Tumor = MEN2A and 2B, medullary thyroid cancer

32

APC

Tumor Supressor Gene

Gene product = -

Tumor = Colorectal cancer (associated with FAP)

33

BRCA1/BRCA2

Tumor Supressor Gene

Gene product = DNA repair protein

Tumor = Breast and ovarian cancer

34

DCC

Tumor Supressor Gene

Gene product = DCC (Deleted in Colon Cancer)

Tumor = Colon cancer

35

DPC4/SMAD4

Tumor Supressor Gene

Gene product = DPC (Deleted in Pancreatic Cancer)

Tumor = Pancreatic cancer

36

MEN1

Tumor Supressor Gene

Gene product = Menin

Tumor = MEN1

37

NF1

Tumor Supressor Gene

Gene product = Ras GTPase activating protein (neurofibromin)

Tumor = Neurofibromatosis type 1

38

NF2

Tumor Supressor Gene

Gene product = Merlin (Schwannomin) protein

Tumor = Neurofibromatosis type 2

39

p16

Tumor Supressor Gene

Gene product = Cyclin-dependent kinase inhibitor 2A

Tumor = Melanoma

40

p53

Tumor Supressor Gene

Gene product = Transcription factor for p21, blocks G1 to S phase transition.

Tumor = Most human cancers, Li-Fraumeni syndrome

41

PTEN

Tumor Supressor Gene

Tumor = Breast cancer, prostate cancer, endometrial cancer

42

Rb

Tumor Supressor Gene

Gene product = Inhibits E2F; blocks G1 to S phase transition

Tumor = RetinoBlastoma, osteosarcoma

43

TSC1

Tumor Supressor Gene

Gene product = Hamartin protein

Tumor = Tuberous sclerosis

44

TSC2

Tumor Supressor Gene

Gene product = Tuberin protein

Tumor = Tuberous sclerosis

45

VHL

Tumor Supressor Gene

Gene product = Inhibits hypoxia inducible factor 1a

Tumor = von Hippel-Lindau disease, renal cell carcinoma

46

WT1/WT2

Tumor Supressor Gene

Tumor = Wilms Tumor (nephroblastoma)

47

Tumor markers

should not be used as primary screening tool for cancer diagnosis or screening.

They may be used to monitor tumor recurrence and response to therapy, but definitive diagnosis is usually made via biopsy

48

Alkaline phosphatase (ALP)

tumor marker

Metastases to bone or liver, Paget disease of bone, seminoma (placental ALP)

49

Alpha fetoprotein (AFP)

tumor marker

Hepatocellular carcinoma, hepatoblastoma, yolk sac (endodermal sinus) tumor, mixed germ cell tumor

Normally made by fetus. Transiently elevated in pregnancy; high levels associated with neural tube and abdominal wall defects, lower levels associated with Down Syndrome

50

B-hCG

Tumor marker

Hydatidiform moles and Choriocarcinomas (Gestational trophoblastic disease), testicular cancer, mixed germ cell tumor.

Produced by syncytiotrophoblasts of the placenta

51

CA 15-3/CA 27-29

Tumor marker

Breast cancer

52

CA 19-9

Tumor marker

Pancreatic adenocarcinoma

53

CA 125

Tumor marker

Ovarian cancer

54

Calcitonin

Tumor marker

Medullary thyroid carcinoma

55

CEA

Tumor marker

CarcinoEmbryonic Antigen. Very nonspecific but produced by about 70% of colorectal and pancreatic cancers; also produced by gastric, breast, and medullary thyroid carcinomas

56

Chromogranin

Tumor marker

Neuroendocrine tumors/carcinoid

57

PSA

Tumor marker

Prostate-specific antigen. Prostate cancer.

Can also be elevated in BPH and prostatitis. Questionable risk/benefit for screening.

58

EBV

Associated with:

Burkitt lymphoma
Hodgkin lymphoma
Nasopharyngeal carcinoma
Primary CNS lymphoma (in immunocompromised)

59

HBV, HCV

Associated with:

Hepatocellular carcinoma

60

HHV-8

Associated with:

Kaposi Sarcoma

61

HPV

Associated with:

Cervical and penile/anal carcinoma (types 16, 18)
Head and neck cancer

62

H. pylori

Associated with:

Gastric adenocarcinoma
MALT lymphoma

63

HTLV-1

Associated with:

Adult T cell leukemia/lymphoma

64

Liver fluke

Associated with:

Cholangeiocarcinoma

65

Schistosoma haematobium

Associated with:

Bladder cancer (squamous cell)

66

Aflatoxins (Aspergillus)

Carcinogen

Liver

Impact = Hepatocellular carcinoma

67

Alkylating agents

Carcinogens

Blood

Impact = Leukemia/lymphoma

68

Aromatic amines (benzidine, 2-naphthylamine)

Carcinogens

Bladder

Impact = Transitional cell carcinoma

69

Arsenic

Carcinogen

Liver - Angiosarcoma
Lung - Lung cancer
Skin - SCC

70

Asbestos

Carcinogen

Lung

Impact = Bronchogenic carcinoma > mesothelioma

71

Carbon tetrachloride

Carcinogen

Liver

Impact = Centrilobular necrosis, fatty change

72

Cigarette smoke

Carcinogen

Bladder - transitional cell carcinoma
Cervix - Cervical carcinoma
Esophagus - SCC/adenocarcinoma
Kidney - RCC
Larynx - SCC
Lung - Squamous cell and small cell carcinoma
Pancreas - Pancreatic adenocarcinoma

73

Ethanol

Carcinogen

Esophagus - SCC
Liver - HCC

74

Ionizing radiation

Carcinogen

Thyroid - Papillary thyroid carcinoma

75

Nitrosamines (smoked foods)

Carcinogen

Stomach - gastric cancer

76

Radon

Carcinogen

Lung - Lung cancer (2nd leading cause after cigarette smoke)

77

Vinyl chloride

Carcinogen

Liver - Angiosarcoma

78

Psammoma bodies

Laminated, concentric spherules with dystrophic calcifications. PSaMMoma bodies are seen in:

Papillary carcinoma of thryoid
Serous papillary cystadenocarcinoma of ovary
Meningioma
Malignant mesothelioma

79

1,25-(OH)2D3 (Calcitriol)

Linked to paraneoplastic syndrome

Effect = hypercalcemia

Neoplasm = Hodgkin lymphoma, NH-Lymphoma

80

ACTH

Linked to paraneoplastic syndrome

Effect = Cushing syndrome

Neoplasm = Small cell lung carcinoma, renal cell carcinoma

81

ADH

Linked to paraneoplastic syndrome

Effect = SIADH

Neoplasm = Small cell lung carcinoma, intracranial neoplasms

82

Antibodies against presynaptic Ca channels at NMJ

Linked to paraneoplastic syndrome

Effect = Lamber-Eaton myasthenic syndrome (muscle weakness)

Neoplasm = Small cell lung carcinoma

83

Erythropoietin

Linked to paraneoplastic syndrome

Effect = Polycythemia

Neoplasm = Renal cell carcinoma, hemangioblastoma, hepatocellular carcinoma, leiomyoma, pheochromocytoma

84

PTHrP

Linked to paraneoplastic syndrome

Effect = Hypercalcemia

Neoplasm = Squamous cell lung carcinoma, renal cell carcinoma, breast cancer

85

Cancer incidence - Men

1) Prostate

2) Lung

3) Colon/rectum

Lung cancer incidence has dropped in men, but has not changed in women.

86

Cancer incidence - Women

1) Breast

2) Lung

3) Colon/rectum

87

Cancer mortality - Men

1) Lung

2) Prostate

3) Colon/rectum

Cancer is the second leading cause of death in the US (heart disease number 1)

88

Cancer mortality - Women

1) Lung

2) Breast

3) Colon/rectum

89

brain metastasis

Lung > breast > prostate > melanoma > GI

50% of brain tumors are from metastases. Commonly seen as multiple well-circumscribed tumors at gray/white matter junction

90

Liver metastasis

Colon >> stomach > pancreas

Liver and lung are the most common sites of metastasis after the regional lymph nodes

91

Bone metastasis

Prostate, breast > lung, thyroid, kidney

Bone mets >> primary bone tumors (multiple myeloma, lytic). Common mets to bone: breast (mixed), lung (mixed), thyroid (lytic), kidney (lytic), prostate (blastic).

Predilection for axial skeleton