MCB Lecture 64 Neoplasia I Flashcards Preview

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Flashcards in MCB Lecture 64 Neoplasia I Deck (36)
0

Describe pathological and physiologic causes of hypertrophy

Pathological: hypertension, leading to increased heart cell size and stenosis
Physiological: athletes heart, lifting weights: increased muscle size

1

Describe pathological and physiologic causes of hyperplasia

Pathological: too many growth factors, hormones
Physiological: growth of the uterus during pregnancy

2

Describe two causes of metaplasia

Smoking: ciliated columnar epithelium replaced with stratified squamous
Barrett oesophagus: simple squamous replaced with columnar in response to gastric acid reflux

3

What is dysplasia?

Pre malignant condition of proliferation

4

What are the features of cells that have undergone dysplasia?

Loss of cell polarity
Loss of tissue architecture
Atypical mitoses
Proliferation

5

What is the outcome of dysplasia?

Expected progression on to cancer

6

What is neoplasia?

New growth of cells

7

What is the name for the study of cancer?

Oncology

8

What suffix is used to denote benign neoplasms?

-oma

9

What are the features of benign neoplasms?

Well differentiated
Discrete location
Can not invade and replace healthy tissues
Can't metastasise

10

What is cystic teratoma?

This is an example of a benign neoplasm
It arises from stem cells, so many different tissue types are see that produce hair, teeth and secrete stuff

11

What are the features of malignant neoplasms?

They can metastasise and invade and replace healthy tissues
They are no longer well differentiated
They are not localised to a discrete area
Much dysplasia
Less differentiated

12

What are the most common cancers?

The gender specific cancers such as breast and prostate are the most common

13

Which cancers contribute to the most deaths?

Lung, colorectal, breast and prostate

14

What is an individual's lifetime risk of cancer?

1/3

15

What are the two broad categories of aetiology of cancer?

Environmental and hereditary

16

What are some environmental causes of cancer?

What are the common features of the mode of action of these things?

Smoking, industrial, dietary

They all contain highly reactive oxygen species that make the genome unstable

17

All cancer, hereditary or otherwise, is due to ...

Genomic instability

18

Why are double stranded breaks dangerous?

When the cell tries to repair this, mistakes are often made, leading to mutations

19

What does non-ionising radiation do?

Makes thiamine dimers

20

What does ionising radiation do?

Causes double and single stranded breaks

21

Describe how oncogenic viruses cause cancer
eg?

They insert genes into the host genome. This may disrupt tumour suppressor genes

HPV, EDV

22

Describe how immunodeficiency leads to cancer

Eg. ?

When an individual is immunosupressed, they can not kill neoplastic cells and many tumours result

E. HIV

23

How can chronic inflammation lead to cancer?

The cytokines and other inflammatory substances are highly reactive

24

How can genetics play a role in cancer?

Gene mutation of an oncogene or tumour suppressor gene

Eg. BRCA-1, Rb gene, APC

25

What are the 5 methods of detection of cancer?

Physical examination
Histology / cytology
Tumour markers
Imaging
Molecular diagnosis

26

Describe how physical examination is used to detect cancer

This is no longer sufficient

27

Describe how cytology and histology is used to detect cancer

Looking at biopsies under the microscope: cell numbers and tissue structure etc.

28

Describe how tumour markers are used to detect cancer

What are the two main ways this is done?

Immunohistochemistry: using MHC that is specific for antigens involved with cancer
Eg. EGF receptor is the antigen. MHC binds, and is seen because it is marked

Biochemical assay: same thing, done in the blood

29

Describe how imaging is used to detect cancer

Inject isotopically marked glucose and then use PET scanning to see where is highly metabolically active

30

How can cancers be diagnosed molecularly:
- What are we looking for?
- How can we find it?

PCR: eg. Of BCR-abl to detect residual leukaemia cells in CML

Genome wide profiling: microarrays, RNA-seq

31

Describe the difference in survival rate when breast cancer is detected early

Early detection: 98% survival over next 5 years

32

What are the two modes of staging of cancer?
Which is the most useful?

Grading
Staging

Staging is more useful

33

Describe how grading of cancer is done

Look at the cells and grade them based on:
Level of differentiation
Mitoses
Architecture

Give it a grade from low to high

34

Describe how staging of cancer is done

Stage it based on: size of primary lesion T
Presence of metastasis M
Extent of spread to region lymph nodes N

35

Describe the TNM system of cancer staging

T: size of primary tumour
M: presence of metastasis
N: extent of spread to the regional lymph nodes

Eg T1-T4

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