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Flashcards in Neoplasia 3 Deck (45):
1

in Dx: If malignant, think

primary? metastatic?

2

What causes weight loss and anorexia in tumours?

late stage make TNF-A and IL-1, increases metabolism

3

clinical presentation of lung tumour

cough
haemoptysis
wheeze
dyspnoa
pneumonia
Pancoast syndrome

4

What are paraneoplastic effects?

side effects of cancers such as endocrine, immunological (rashes), clubbing, vascular

5

What kinds of paraneoplastic effects in lung cancer?

hypercalcemia
cushings, inapropriate ADH, ACTH

6

Are tumour markers used in dx?

not really, more in follow up because it's not specific or elevated in every case

7

Why do x-rays and CTs besides for Dx?

staging and follow-up

8

Another way to investigate lung tumours besides radiology?

bronchoscopy

9

Tissue sampling cytology is what?

fine need aspiration, only look at cells

10

Histopathology in tissue sampling is:

H&E, stains, immunohistochemistry

11

What kind of sample needed for histopathology of neoplasia?

full piece of tissue

12

Why do immunohistochemistry anyways?

helps distinguish primary from metastatic lesions

13

Once diagnosis of malignancy is made, what other info?

tumour type/subtype
grade
stage
lymph invasion?
other

14

Want to gather lots of info on tumours for what?

Prognosis
management
comparing treatments

15

4 main types of lung carcinomas:

squamous cell carcinoma
adenocarcinoma
large cell
small cell

16

lung cancer is one of most common in the world: Incidence?

13%

17

More males of females lung cancer?

2.7:1 males

18

average age of lung cancer Dx?

60

19

3 big predisposing factors for lung cancer

tobacco
asbestos
arsenic

20

a non smoker is most likely to get which cancer?
squamous cell carcinoma
adenocarcinoma
large cell
small cell

adenocarcinoma

21

What pathogenesis are the following part of?
Goblet Cell hyperplasia
reserve cell hyperplasia
squamous metaplasia
squamous dysplasi
carcinoma in situ
invasive carcinoma

Pathogenesis of Small cell carcinoma in lung

22

Does SCC form cavities?

yes, has necrotic core

23

What paraneoplastic effects does SCC predispose you to?

pneumonia
bronchiectasis
recurrent infections

24

Adenocarcinomas are more proximal or peripheral?

peripheral

25

SCC are more proximal or peripheral bronchi?

proximal

26

What is you can't determine tumour type on H&E?

other stains available
S100
LCA
CAM5.2 (liver cells stain, but not the tumour)

27

Which are more aggressive? poorly differentiated or well differentiated?

poorly differentiated ones will mess you up

28

What the gleason score for?

prostate cancer grading

29

what is the modified bloom and richarson for?

breast ca grading

30

what is stage of a cancer?

progression of malignancy

31

What is TMN system? what is the acronym stand for?

For staging tumours
T= primary tumour
N= lymph node involvement
M= distant metastases

32

What does 'X' mean in staging?

unknown or cannot be assessed

33

TNM is universal for all organs?

Nope. Different parameters for different organs!

34

eg. of predictive factors in breast cancer?

HER2 amplification
oestrogen and progesterone receptors

35

5 main treatments for cancer

surgery
radiotherapy
chemotherapy
targeted therapy
other(immuno, bone marrow)

36

targeted therapy is different how for cancer?

less harmful to normal cells, more specific for tumour oncoproteins

37

Two main categories for cancer targeted therapy:

1. small molecules (inhibit growth factors/tyrosine kinase)
2. monoclonal antibodies that target proteins/receptors

38

2 most important mutations in lung carcinoma?

EGFR
ALK

39

What's so significant about EGFR?

significant rate of mutations in young non/light smoking female asians with low-stage disease

40

What does EGFR tyrosine kinase doman increase downstream?

hyperactivation of signaling pathways leading to abnormal proliferation

41

How to treat EGFR mutations?

target therapies like Gefitinib and Erlotinib inhibit EGFR

42

Can all lung carcinomas be treated with targeted therapies?

No, tumour need to be tested, could be resistant

43

What is cachexia

wasting syndrome due to loss of appetite and the body just not processing nutrition appropriately

44

3 ways to die from cancer

1. cachexia
2. secondary infection
3. damage to vital organ by primary/secondary tumours

45

Prevention of cancer? 4 things

public education
lifestyle
screening program
laws for workplace exposure