Neoplasia

Question 1

Non-Neoplastic Cell Growth

Answer 1

Hypertrophy, Hyperplasia, Metaplasia and Dysplasia

Question 2

Malignant Cell Growth

Answer 2

Anaplasia

Question 3

Hypertrophy examples

Answer 3

Phy: Uterine enlargement
Path: Cardiac enlargement with hypertension

Question 4

Hyperplasia examples

Answer 4

Phy: Gland epithelial proliferation of breast at puberty
Path: Endometrial hyperplasia with menorrhagia

Question 5

Metaplasia examples

Answer 5

Lung Cancer - Normal ciliated columnar replaced with squamos cells
Esophageal Adenocarcinoma - Normal stratified squamos of lower esophagus with columnar goblet cells

Question 6

Tumor Components

Answer 6

Parenchyma - Biologic behavior, Stroma - Support (Non-neoplastic, CT, Blood vessels and inflammatory cells)

Question 7

“-carcinoma”

Answer 7

Malignant, Older, Lymph

Question 8

“-sarcoma”

Answer 8

Malignant, Younger, Hematogenous

Question 9

Teratoma

Answer 9

Congenital, Multipotential cells, Hair, Teeth, Bone, Benign (more common) in women, Malignant in men

Question 10

Hamartoma

Answer 10

Disorganized tissue indigenous to site

Question 11

Choristoma

Answer 11

Congenital anomaly

Question 12

Cancer New Cases

Answer 12

Prostate/Breast
Lung&Bronchus
Colon&Rectum

Question 13

Cancer Deaths

Answer 13

Lung&Bronchus
Prostate/Breast
Colon&Rectum

Question 14

Genetic Predispositon

Answer 14

5-10%, BRCA 1 & 2 gene mutation, MEN, Familial adenomatous polyposia, Li-Fraumeni, Xeroderma pigmentosum, Familial retinoblastoma, Neurofibromatosis

Question 15

Environment/Lifestyle

Answer 15

75-80%,

Question 16

Greatest modifiable risk factor for cancer

Answer 16

Cigarette smoking

Question 17

Second most common cause of lung cancer

Answer 17

Radon - Decay of uranium, in quarries, mines, seeps into home basements

Question 18

Diet Carcinogens

Answer 18

Red meats, Beta carotene, Drinking water with arsenic, Grains, nuts or pulses harboring aflatoxins

Question 19

Oncogenic Viruses

Answer 19

RNA: HTLV -1
DNA: HPV, EBV, HEP B/C

Question 20

Precancers

Answer 20

Leukoplakia - Squamos cell carcinoma
Chronic atrophic gastritis - Gastric carcinoma in pernicious anemia
Chronic ulcerative colitis - Colorectal carcionoma
Villous adenoma of colon - Colorectal carcinoma

Question 21

Oral Precancer

Answer 21

Leukoplakia, Erythroplakia, Smokeless tobacco keratosis, Lichen planus, Reverse smokers palate, Oral submucous fibrosis, Actinic cheilosis

Question 22

Plummer-Vinson Syndrome

Answer 22

Smooth, red tongue, Sideropenic dysphagia due to iron deficiency anemia, Esophageal webs, Squamos cell carcinoma of esophagus and pharynx

Question 23

MYC

Answer 23

Proto-Oncogene
Nucleus of all cells
Over expressed - Increase CDK, Cycle to active phase (G1 to S)

Question 24

RAS

Answer 24

Proto-Oncogene
Common mutation
Overactive sign to uncontrolled proliferation

Question 25

TP53

Answer 25

``` p53 - Tumor Suppressor gene Anti-proliferative effects DNA Damage repair Apoptosis, Affect my stress MOST common mutation ```

Question 26

Gene Change in Cancer

Answer 26

Balanced translocation, Deletion, Gene amplification

Question 27

BCR-ABL

Answer 27

Chronic Myeloid Leukemia, Philadelphia Chromosome, Translocation 9 & 22

Question 28

EGFR

Answer 28

Activation to Cyclin activator to proliferation in OSCC

Question 29

HPV infection

Answer 29

Into host genome, Increase E6 and E7, E6 binds p53, E7 binds Rb

Question 30

Hallmarks of Cancer

Answer 30

``` Growth signals Bodys signals to stop Evade apoptosis Limitless replication Improved blood supply Invade and Metastasize Deregulate cell energetics Avoid Immune destruction Genome instability Tumor promoting inflammation ```

Question 31

Cancer elicit

Answer 31

CD8+ T cell response

Question 32

Marker of Prostatic Carcinoma

Answer 32

Acid Phosphatase | PSA

Question 33

Marker of Hepatocellular Carcinoma, Germ Cell tumors

Answer 33

Alpha Fetoprotein

Question 34

Marker of GI Carcinoma

Answer 34

Carcinoembryonic Antigen

Question 35

Paraneoplastic Pemphigus

Answer 35

Non-Hodgkin lymphoma, Chronic lymphocytic leukemia, Castlemann disease, Lung carcinoma, Malignant melanoma, Thymoma; Autoimmune disorder - Tumor antigens trigger immune response in skin blisters

Question 36

VEGF

Answer 36

Vascular Endothelial Growth Factor - Increased angiogenesis, Embryonic circulatory system, Lung, Breast and Colon cancer

Question 37

Common Sites of Metastasis

Answer 37

Bone, Liver, Lungs

Question 38

Oral Cancer Metastasis

Answer 38

Cervical nodes inlarge, Firm, Painless, Fixed (matted), May move sideways, Distant = "Below clavicle"

Question 39

Breast Cancer Metastasis

Answer 39

Axillary lymph nodes, Lymphedema

Question 40

Lung Cancer Metastasis

Answer 40

Bronchial lymph node

Question 41

Sarcoma Metastasis

Answer 41

Pulmonary metastases

Question 42

Grading Differentiation

Answer 42

Grade I: Well differentiated Grade II: Moderately differentiated Grade III and IV: Poorly differentiated

Question 43

Anaplasia

Answer 43

"Form backwards," Undifferentiated, Primitive cells - High malignancy, Stem cells of some undergo divergent differentiation, Epithelial and mesenchymal, Certain tumors induce stromal change or fibrosis

Question 44

TNM

Answer 44

Tumor size (0-3) Presence of tumor in local/regional lymph nodes (0-2) Presence of tumor at distant site (Beyond nodes; 0-X)

Question 45

Therapy

Answer 45

Surgery, Radiation, Chemotherapy | Hormone Therapy, Immune Therapy and Targeted Therapy

Question 46

Premalignant/Malignant Skin Lesion

Answer 46

Pre: Actinic Keratosis (Most common, Actinic cheillitis in lips) Malignant: Basal cell carcinoma, Squamos cell carcinoma, Melanoma

Question 47

Nevi VS Melanoma

Answer 47

``` Nevi = "Mole" Acquired, Benign neoplasm of melanocytic origin, Common, Intraoral - Palate, Muccobuccal fold and Gingiva; Junctional, Compound and Intradermal; Congenital; Melanoma = Malignant neoplasm of melanocytic origin, UV, Deaths ```

Question 48

Types of Melanomas

Answer 48

Superficial Spreading Melanoma: Most common Lentigo Maligna Melanoma: Elder, Sun exposed skin Acral Lentiginous melanoma: Palmes and Soles of feet, sugungal areas, Common in backs, Mucous membranes Nodular Melanoma: Amelanotic melanoma

Question 49

ABCDE of Melanoma

Answer 49

``` Asymmetry Border Color Diameter Evolution ```