neoplasia

Question 1

what is a neoplasm

Answer 1

new growth
abnormal mass of tissue
unco-ordinated growth, exceed that of normal tissues
persists after removal of stimuli that initiated the change

Question 2

what are the differences in growth pattern in benign vs malignant?

Answer 2

benign-
expansion, encapsulated, localised
malignant-
invasion, no capsule, metastasis

Question 3

what is the difference in growth rate between benign and malignant?

Answer 3

benign=slow

malignant= rapid, variable

Question 4

what are the differences in histology in benign vs malignant?

Answer 4

benign- resemble origin, uniform, few mitoses

malignant- not resemble, pleomorphism, many mitoses

Question 5

what are the clinical effects of a benign tumour?

Answer 5

lump/pressure/obstruction
+/- hormone secretion
tx local excision

Question 6

what are the clinical effects of a malignant tumour?

Answer 6

local pressure, infiltration and destruction, distant metastases
+/- hormone secretion
tx local excision + chemo/radiation

Question 7

what are the names for a squamous epithelial tumour?

Answer 7

benign-papilloma

malignant- squamous cell carcinoma

Question 8

what are the names for a glandular epithelium tumour?

Answer 8

benign-adenoma

malignant-adenocarcinoma

Question 9

what are the suffixes for a CT tumour?

Answer 9

benign- oma

malignant- sarcoma

Question 10

what tumours cant be benign?

Answer 10

lymphoid-lymphoma and haemopoietic - leukaemia

Question 11

what are the names for melanocyte tumours?

Answer 11

benign - melanoma

malignant - melanoma

Question 12

what are the names for germ cell tumours?

Answer 12

benign teratoma

malignant teratoma

Question 13

describe chemical carcinogens

Answer 13

smoking polycyclic hydrocarbons including tars, diet drugs, alcohol, asbestos

Question 14

what are the stages of carcinogenesis?

Answer 14

initiation- carcinogen induces genetic change
promotion- another factor stimulates cell for division
progression- additional mutations resulting in malignancy

Question 15

what is the latency period?

Answer 15

time from promotion to clinical tumour

Question 16

describe physical carcinogenesis

Answer 16

ionising radiation
damages DNA, causing mutation
radium-> bone + marrow tumour
UV light
damages DNA - skin cancer

Question 17

what is radiation sensitivity?

Answer 17

the most sensitive tissues are those where the cells are rapidly removed, eg, embryonic, haematopoietic organs, gonads

Question 18

what is viral carcinogenesis?

Answer 18

DNA viruses
common, viral DNA inserted into host DNA
RNA viruses
reverse transcribes then inserted

Question 19

give examples of viruses and their tumours

Answer 19

Epstein-Barr = Burkitt’s lymphoma, nasopharyngeal cancinoma
hep B/C - hepatocellular carcinoma
HPV- cervical + oropharyngeal carcinoma

Question 20

give some factors of oral cancer (aetiology)

Answer 20

tobacco- smoking/chewing
alcohol
diet/nutrition
oral hygiene
viruses
immunodeficiency
socioeconomic factors
GORD

Question 21

what is a potentially malignant disorder?

Answer 21

indicators of the risk of future malignancies occurring in oral mucosa

Question 22

what is leukoplakia?

Answer 22

white patch that cannot be rubbed off or attributed to any other cause-potentially malignant lesion - biopsy

Question 23

what is dysplasia?

Answer 23

abnormality confines to epithelium, underlying tissue not affected
potentially malignant
can affect various epithelial tissues
squamous (oral/cervical)
glandular
transitional eg bladder

Question 24

what are proto-oncogenes?

Answer 24

proto-oncogenes are normal genes which regulate cell division, 
growth factors
gf receptors
signal transducers
control of gene expression

Question 25

what are oncogenes?

Answer 25

oncogenes are abnormal variants which produce oncoproteins tight regulation lost mutation - increases activity of product excess normal product- duplication of gene enhanced transcription -translocation chromosome rearrangement

Question 26

what are tumour suppressor genes?

Answer 26

act to inhibit cell division and suppress growth anti-oncogenes require both alleles to mutate for malignancy rb onle one allele needed

Question 27

what are inherited factors?

Answer 27

genetic susceptibility to cancer inherited cancer syndromes familial cancer defective DNA repair

Question 28

what is p53?

Answer 28

guardian of the genome acts just before the restriction pont stops cycle to allow DNA repair/ apoptosis often inactivated in cancer (mutation/deletion/viral)

Question 29

what are the hallmarks of cancer?

Answer 29

``` growth rate/potential differentiation invasion/destruction avoid apoptosis angiogenesis evasion of host defences cell surface changes ```

Question 30

what are the modes of malignant tumour spread?

Answer 30

local spread, lymphatic spread, blood spread, transcoelomic spread, intraepithelial spread

Question 31

what are patterns of metastases?

Answer 31

carcomas- lymphatic/blood | sarcomas-blopd

Question 32

what are some predictable metastases?

Answer 32

lung->local nodes, liver, bone ,brain | tongue -> neck nodes, lung, spine

Question 33

how do tumour cells interact with cells and molecules in the local environment?

Answer 33

alter adhesion membrane make poor basement membrane increase protease prod or reduce inhibitors alter extracellular matrix

Question 34

what is tumour grading?

Answer 34

``` biological nature of the tumour assessment of: invasion into underlying tissue cellular atypia eg numberical, low etc, degree of differentiation ```

Question 35

what are some characteristics of a cells of a malignant tumour?

Answer 35

pleomorphism- cell and nucleus numerous mitoses abnormal mitoses variable differentiation

Question 36

what is cancer staging?

Answer 36

describes the extent of severity of a persons cancer | done by physical exams, imaging, lab tests, pathology and surgical reports

Question 37

what is the TNM staging ?system

Answer 37

T tumour size N lymph node involvement M presence of metastases

Question 38

what are the clinical effects of lung cancer?

Answer 38

cough, haemoptysis, chest pain, pneumonia

Question 39

what are systemic effects of cancer caused by?

Answer 39

often caused by cytokines/hormones released by tumour/ organ dysfunction

Question 40

give examples of systemic effects of cancer

Answer 40

fever, anorexia, weight loss, neurological problems, endocrine syndromes, metabolic effects

Question 41

what is tumour immunology?

Answer 41

immune surveillance | can suppress of enhance cancinogenesis

Question 42

how does the immune system recognize tumour cells?

Answer 42

``` tumour associated antigens(TAAS) products of mutated genes overexpressed proteings viral proteins oncofetal antigens ```

Question 43

what is elimination?

Answer 43

cell mediated immune response cytotoxic T-lymphocytes NKCs - 1st line defence macrophages

Question 44

what is escape? (evade immune response)

Answer 44

cells may acquire molecular changes: alter tumour antigen expression-lack T recognition activation of immunoregulatory pathways leading to T unresponsiveness immunosuppressive factors eg cytokines

Question 45

what is immunotherapy?

Answer 45

``` using px own immunes response to control and destroy malignant cells: active immunization reversal of immunosuppression adopted cell transfer strengthening natural immune responses ```