L36 Cancer

Question 1

hyperplasia

Answer 1

controlled cell proliferation

Question 2

neoplasia

Answer 2

uncontrolled cell proliferation

Question 3

hypertrophy

Answer 3

Increase in cell size in response to stimulus.

Weight lifters !

Question 4

neoplasm

Answer 4

Uncontrolled cell proliferation leading to a

mass or nodule

Question 5

classifications of neoplasms

Answer 5

benign
malignant - primary, secondary
primary malignancy - carcinoma(95%), lymphoma (3%), sarcoma (1%)

Question 6

clinical presentation of benign neoplasm

Answer 6

Lump
Bleeding
Mass Effect
- Git Obstruction
Pain
Incidentally

Question 7

Types of malignant neoplasm

Answer 7

Carcinoma
Lymphoma
Melanoma
Sarcoma
Others, e.g. Brain tumours

Question 8

aetiology of cancer

Answer 8

• Environmental factors

* Inherited factors

Question 9

environmental carcinogenesis/factors

Answer 9

• Infectious agents
• Smoking
• Alcohol
• Dietary factors
• Obesity
• Oestrogen exposure
• Carcinogens
• Occupational
• Ambient environment (UV radiation)

Question 10

inherited factors

Answer 10

germline mutations

Question 11

what percentage of cancers have no inherited familial bias/sporadic

Answer 11

95%

Question 12

genes in carcinogenesis

Answer 12

Protooncogenes 
Oncogenes
Tumour suppressor genes.
Repair genes 
Anti-apoptotic genes

Question 13

proto oncogenes

Answer 13

Are normal genes that produce proteins that regulate cell proliferation.

Question 14

oncogenes

Answer 14

genes that promote autonomous cell growth in cancer cells

• Mutated form of proto-oncogene

Question 15

Tumour suppressor genes.

Answer 15

Suppress cell proliferation

Question 16

repair genes

Answer 16

Repair genes during cell division

Question 17

how do carcinogens affect genes in carcinogenesis

Answer 17

alter the proto-oncogene and therefore alter its activity on cell proliferation and cause cancer inactivate tumour
suppressor genes thereby reducing their suppressive effects on cell growth and thereby allowing tumours to develop

Question 18

how do we diagnose malignant cancers

Answer 18

• History & physical examination
• Initial investigations
• Radiology
• Depending on symptoms
• Pathology
• Biopsy
• Fluid
• Fine Needle Aspiration
• Resection

Question 19

dysplasia

Answer 19

Abnormal cells not involving the entire thickness

Question 20

cancer in situ

Answer 20

Abnormal cells involving the entire thickness

Question 21

invasive cancer

Answer 21

Abnormal cells extending into surrounding tissue

Question 22

carcinoma

Answer 22

Malignant tumour of epithelium

Question 23

Carcinomas are divided into

Answer 23

• In situ (curable)

* Invasive

Question 24

classification of carcinoma

Answer 24

• Squamous Cell Carcinoma
• Adenocarcinoma
• Urothelial Carcinoma
• Basal Cell Carcinoma
• Undifferentiated Carcinoma

Question 25

classification of clinical presentation of malignant neoplasm

Answer 25

* Effect of primary * Effect of metastasis * Effect of hormone secretion

Question 26

primary effect clinical presentation of malignant neoplasm

Answer 26

1. Mass e.g. cancer of the breast 2. Bleeding - Hemoptysis - Haematemesis - Melena - P.V. Bleeding - P.R. Bleeding - Fe Deficiency/Anaemia 3. Loss of function e.g. fracture of bone

Question 27

microscopical features of neoplasia

Answer 27

Hyperchromasia Mitoses High N/C Ratio Pleomorphism

Question 28

prognosis of neoplasm depends on

Answer 28

``` Stage Grade Size Site Adequacy of treatment ```

Question 29

sites of metastasis

Answer 29

``` Lymph Nodes Lungs Bone Liver Brain ```

Question 30

common examples of metastatic effects of malignant neoplasm

Answer 30

``` Lymphadenopathy Jaundice Bone Pain Or Fracture Cerebral Stroke Pneumonia ```

Question 31

routes of tumour spread

Answer 31

Direct Lymphatic Blood vessel

Question 32

international TNM Classification - stage of cancer spread

Answer 32

T - Tumour Size/Spread N - Nodes no. M - Metastases no.

Question 33

treatment of malignant neoplasms

Answer 33

Surgery Radiotherapy Chemotherapy Immunotherapy Targeted therapy e.g. Herceptin

Question 34

sarcoma

Answer 34

Malignant tumour of connective tissue

Question 35

malignant melanoma attacks what cell

Answer 35

Melanocyte in dermis

Question 36

sites of malignant melanoma

Answer 36

Skin Anal margin Eye Others

Question 37

physiotherapy issues in malignancy

Answer 37

``` Pneumonia Mobility Issues Stroke Lymphoedema Limb amputation ```