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BFOM Exam 2 > Introduction to Neoplasia > Flashcards

Introduction to Neoplasia Flashcards

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1
Q

What is a tumor?

A

A swelling or morbid enlargement

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2
Q

What is cancer?

A

A neoplastic disease, the natural course of which is progressive and possibly fatal

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3
Q

What is malignancy?

A

To act maliciously; cancer with the potential to cause death

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4
Q

What is a neoplasm?

A

Any new, abnormal growth, specifically a new growth of tissue in which the growth is uncontrolled and progressive

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5
Q

What is oncology?

A

The sum of knowledge concerning tumors

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6
Q

What two criteria do neoplasms have to have met?

A

Escaped normal regulatory mechanisms (apoptosis, proliferation, differentiation) and Varying degrees of autonomy without regard for their cellular environment

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7
Q

What do neoplasms have in regard to function?

A

Abnormal function/activity which leads to abnormal structure (structure is how it is diagnosed)

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8
Q

Are all tumors comprised of cells/tissue neoplasms?

A

No

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9
Q

What are two types of non-neoplastic tumors?

A

Hamartoma and Choristoma

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10
Q

What is a hamartoma?

A

A mass of irregularly formed tissue at the site where such tissue is NORMALLY found; some are neoplastic

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11
Q

What is a choristoma?

A

A mass of irregularly formed tissue at the site where such tissue is normally NOT found; not neoplastic

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12
Q

How do neoplastic tumors arise?

A

A normal cellular process or processes that have gone awry

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13
Q

How do neoplastic tumors come to consist of multiple cell types?

A

The initial neoplastic cell will undergo clonal expansion and some of those clones may develop mutations and expand again; after a few clonal expansions you may have a mass that consists of multiple cells with different mutations

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14
Q

What are the four general categories of “cancer genes”?

A

1.) Proto-oncogenes 2.) Tumor suppressor genes 3.) Apoptosis genes 4.) DNA repair genes

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15
Q

What are proto-oncogenes?

A

Growth promoting genes

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16
Q

How can proto-oncogenes cause cancer?

A

If a mutation alters a proto-oncogene to stay on continuously they cause replication out of control (called oncogenes)

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17
Q

What are tumor suppressor genes?

A

Growth inhibiting genes

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18
Q

How can tumor suppressor genes cause cancer?

A

If a mutation occurs that causes loss of function in a tumor suppressor gene it can cause a cell with DNA mutations to go unchecked into replication (usually occurs with other mutations)

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19
Q

What are the 8 fundamental changes in cell physiology that are hallmarks of cancer?

A

Avoiding immune destruction, Evading growth suppressors, Enabling replicative immortality, Tumor-promoting inflammation, Activating invasion and metastasis, Genomic instability, Inducing angiogenesis, Resisting cell death, Deregulating cellular energetics, Sustaining proliferative signaling

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20
Q

What is a driver mutation?

A

A mutation responsible for the tumors irregular behavior and metastatic/persistent behavior

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21
Q

What is a passenger mutation?

A

A mutation that is not needed for the tumors irregular behavior but is a mutation nonetheless

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22
Q

What extracellular receptors do oncogenes increase the presence of?

A

Growth hormones: c-ret (MEN), c-kist (GIST), Her-2/neu (breast/lung)

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23
Q

What is the most common intracellular proto-oncogene abnormality?

A

Mutation is Ras

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24
Q

What are two important tumor suppressor genes?

A

Rb (retinoblastoma), p53 family

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25
How does HPV cause cancer?
Product E6 promotes degradation of p53
26
How does Li Fraumeni syndrome occur?
It is a germ line mutation in p53 so every cell in different tissues will have the mutation causing multiple cancers
27
Over expression of which gene can extend cell survival and permit proliferation?
BCLA2
28
What occurs in hereditary nonpolyposis colon cancer (HNPCC)?
MLH1, MSH2 are mutated to mismatch repair genes
29
What two care taker genes are mutated in the majority of breast and ovarian cancers?
BRCA-1 and BRCA-2
30
What are three common sources of cancer genes?
Inherited germ line, spontaneous somatic mutations, Viral
31
What is tumor invasion?
A tumor growing into a new part of the tissue or body
32
What is metastasis?
Spread of a tumor to a new tissue or body part that is not connected to the primary or initial tumor
33
What are routes of metastasis?
Lymphatics, Hematogenous, Body surface/Cavity spread, Iatrogenic (surgical)
34
How do invading cells make it through the basement membrane?
By degrading type IV collagen
35
What are the clinical presentations of cancer?
1.) Direct tumor effects 2.) Indirect tumor effects 3.) Screening 4.) Incidental findings
36
What are local/direct tumor effects?
Mass effect: visible/palpable Destructive effects: Bleeding, bone changes, pain Alterations in function: increased or decrease in function
37
What are paraneoplastic syndromes?
Distant or systemic effects of neoplasms
38
What are the four classifications of paraneoplastic syndromes?
Endocrinopathies, Nerve and muscle symptoms, Dermatologic, Vascular/Hematologic
39
What are examples of endocrinopathies?
Cushing syndrome: ACTH from small cell lung cancer; Hypercalcemia: PTHRP from squamous cell carcinoma of lung
40
How are paraneoplastic neoplasms typically found?
Based on their symptoms we infer there is a tumor because of their clinical manifestations
41
What are cancer screening examples?
Pap smear, PSA, mammography, colonoscopy
42
What are incidental findings?
Cancer findings by accident typically through imaging for another issue, typically how kidney cancers are found
43
How is cancer pathologically evaluated?
Histology: biopsy or surgical specimen Cytology: fluid, exfoliative (Pap smear) Chemistry or molecular diagnostics
44
What are the key elements of tumor diagnosis?
Tissue type (resemblance to normal tissue), Stage (function behavior), Grade (structure appearance)
45
What is angiogenesis?
Growth of new blood vessels to supply the tumor with nutrients
46
What happens if a malignant tumor grows too fast?
The center of the cell mass can become necrotic due to the slow process of angiogenesis and the lack of blood supply
47
What is the only classification of lymphoma?
Malignant lymphomas
48
What is pre-invasive epithelial neoplasm?
A neoplasm still contained within the epithelial layers and therefore is in situ
49
What is a DCIS and LCIS?
A tumor that has not breached the basement membrane in breast cancer (Ductal and lobular)
50
What are the following intraepithelial neoplasms PIN, PanIN, CIN?
Prostate, pancreas, cervix
51
What is an intraepithelial neoplasm?
A neoplasm that has broken through the basement membrane of the epithelium
52
What are the two criteria for degree of differentiation of malignant neoplasms?
Histologic (tissue architecture) and Cytologic (size, shape/contour of individual cells)
53
What are the four grade differentiations for neoplastic tumors?
Grade 1: Well differentiated (low grade) Grade 2: Moderately differentiated (low grade) Grade 3: Poorly differentiated (high grade) Grade 4: Undifferentiated (anaplastic)
54
What is the most common system for tumor staging?
TNM
55
What does TNM stand for?
Tumor, Nodal status, Metastasis
56
What is the classification system for T?
Tumor T1-T4: Size/extent of primary tumor
57
What is the classification system for N?
Nodal status N0-N3: Presence and extent of lymph node metastasis
58
What is the classification system for M?
Metastasis M0-M1: Presence of distant metastasis
59
What is important to consider in the prognosis of a tumor?
Type of tumor, extent of tumor growth/spread at the time of diagnosis, co-morbidities
60
What are the three most common cancers in men?
Prostate, lung, colorectal
61
What are the three most common cancers in women?
Breast, lung, colorectal
62
What cancers cause the most deaths in men? Test question
Lung, prostate, colorectal
63
What cancers cause the most deaths in women? Test question
Lung, breast, colorectal
64
What are the 5 primary treatments for cancer?
Surgery, Radiation, Thermal, Chemotherapy, Biologics

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