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KMMS > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

A disease caused by normal cells changing so that they grow in an uncontrolled way, invade surrounding tissue, and travel to other parts of the body.

A

Cancer

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2
Q

A swelling; commonly a synonym for ‘neoplasm’

A

Tumour

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3
Q

A new growth of abnormal cells

A

Neoplasia

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4
Q

Mitotic figures, or number of dividing cells, in a benign neoplasm is

A

rare, or low

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5
Q

Histological resemblance to normal tissue in malignant cells is

A

often poor (poorly differentiated)

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6
Q

The border of a malignant neoplasm is described as

A

Poorly defined and irregular

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7
Q

The border of a benign neoplasm is described as

A

well-defined or encapsulated

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8
Q

True or false: Necrosis is common in malignant neoplasms

A

True

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9
Q

Classification based on the tissue type or cell of origin is known as

A

histogenetic classification

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10
Q

Malignant neoplasms of epithelial cells are known as

A

Carcinomas

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11
Q

Malignant neoplasms of connective tissue or mesenchymal tissue are known as

A

Sarcomas

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12
Q

Malignancies of the haematopoietic system are known as

A

Leukemias

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13
Q

Malignancies of the lymphatic system are known as

A

Lymphomas

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14
Q

A benign tumour of non-glandular or non-secretory epithelium is known as a

A

Papilloma

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15
Q

A benign tumour of glandular or secretory epithelium is known as an

A

Adenoma

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16
Q

List the three key features assessed in the tumour grading system

A
  1. Mitotic activity
  2. Cellular & nuclear features (size & shape)
  3. Degree of resemblance to normal tissue (ie differentiation)
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17
Q

A low grade tumour corresponds with what type of cell/tissue differentiation?

A

Cells are well differentiated (ie closely resemble normal tissue)

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18
Q

Name two qualities of a medium grade tumour

A
  1. Cells have some loss of differentiation
  2. Cells exhibit some abnormalities (abnormal shape, nuclei)
  3. Growing more rapidly than normal cells
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19
Q

A high grade tumour corresponds with what type of cell/tissue differentiation?

A

Cells/tissue is poorly differentiated

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20
Q

This is the system commonly used that describes the anatomical extent of spread of the cancer

A

Tumour staging

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21
Q

What does tumour staging of “N2” signify?

A

Many lymph nodes involved

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22
Q

What does tumour staging of “M2” signify?

A

Metastases to multiple organs

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23
Q

What is the numerical range of tumour sizes in the TNM tumour staging system?

A

1 - 4. Number varies depending on tissue type, rather than by size alone.

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24
Q

According to Duke’s classification system for colorectal cancer stages, a tumour confined to the submucosa is considered grade:

A

A

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25
Q

According to Duke’s classification system for colorectal cancer stages, a tumour that has spread through the muscularis propria layer, but does not yet involve the lymph nodes is considered grade:

A

B

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26
Q

According to Duke’s classification system for colorectal cancer stages, a tumour that has spread to at least one lymph node is considered grade:

A

C

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27
Q

According to Duke’s classification system for colorectal cancer stages, a tumour that has spread to another part of the body is considered grade:

A

D

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28
Q

What types of changes to DNA can cause cancer (3)

A

Mutations, deletions, translocations

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29
Q

Changes in organisms caused by modification of gene expression

A

Epigenetics

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30
Q

Promoter methylation is an example of

A

an epigenetic change

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31
Q

A mutation in this type of gene results in a gain of function, where the protein product is produced in higher quantities

A

Oncogene

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32
Q

Oncogenes need a mutation in how many alleles in order to result in abnormal cell growth?

A

One

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33
Q

A mutation in this type of gene causes a loss of function

A

Tumour suppressor gene

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34
Q

Tumour suppressor genes need a mutation in how many alleles to result in abnormal cell growth?

A

Generally two (recessive), though haploinsufficiency can occur in some cases of one mutated allele

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35
Q

Abnormal cell growth resulting from one mutated allele in a tumour suppressor gene is known as

A

Haploinsufficiency

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36
Q

Name two examples of oncogenes

A

K-Ras (or H-Ras, N-Ras), or Myc

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37
Q

K-Ras encodes for a protein expressed in the Ras/MAP __________ pathway.

A

kinase

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38
Q

What type of mutation is prevalent in lung, colorectal, and pancreatic cancers?

A

K-Ras (oncogene) mutation

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39
Q

Physiologic regulators of cell proliferation and differentiation are known as

A

Proto-oncogenes

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40
Q

These types of genes are characterised by the ability to promote cell growth in the absence of normal mitogenic signals

A

Oncogenes

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41
Q

This type of oncogene encodes for a transcription factor protein, and promotes proliferation by controlling the expression of target genes, including N-Ras and p53. This leads to processes like immortalisation, proliferation, and apoptosis.

A

Myc

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42
Q

List some examples of tumour suppressor genes

A
  1. BRCA 1 & BRCA 2
  2. TP53, which codes for p53
  3. Rb1
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43
Q

Rb1 is associated with what type of cancer?

A

Retinoblastoma

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44
Q

Name the six hallmark features of cancer: (remember I’m PEARR)

A
  1. Proliferative signalling
  2. Evading growth suppressors
  3. Invasion & metastases
  4. Replicative immortality
  5. Angiogenesis
  6. Resisting cell death
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45
Q

Cancer cells don’t rely on external signals in order to divide. They have acquired a number of mutations that short circuit growth factor pathways, leading to unregulated growth. This describes which hallmark feature of cancer?

A
  1. Sustaining proliferative signalling
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46
Q

Cancer cells don’t respond to growth inhibitory signals becuase of mutations they’ve obtained, or gene silencing (epigenetics). This describes which hallmark of cancer?

A
  1. Evading growth suppressors
47
Q

When cancer cells spread around the body and cause malignant disease, invading organs and compromises the function of the body. This corresponds with which hallmark of cancer?

A
  1. Activating invasion and metastasis
48
Q

Unlimited replicative potential due to long telomeres corresponds with which hallmark of cancer?

A
  1. Enabling replicative immortality
49
Q

Cancer cells form new blood vessels that the tumour relies on for survival and expansion. This corresponds with which hallmark of cancer?

A
  1. Inducing angiogenesis
50
Q

Cancer cells can evade apoptotic signals. This corresponds with which hallmark of cancer?

A
  1. Resisting cell death
51
Q

Name the two emerging hallmarks of cancer

A
  1. Deregulating cellular energetics

8. Avoiding immune desctruction

52
Q

Cancer cells demand an increase of fuel via synthetic prescursors. This corresponds with which emerging hallmark of cancer?

A
  1. Deregulating cellular energetics
53
Q

Cancer cells interfere with the body’s immune response to avoid destruction. This corresponds with which emerging hallmark of cancer?

A
  1. Avoiding immune destruction
54
Q

List the two enabling characteristics that go along with the hallmarks of cancer

A
  1. Tumour promoting inflammation

2. Genome instability and mutation

55
Q

What is “the key to all of the other hallmarks (of cancer), and to cancer taking hold?

A

Genome instability and mutation

56
Q

Inflammatory cells provide _________ and _________ that promote angiogenesis and invasion

A

growth factors and enzymes

57
Q

What type of drugs act on the pathway of cancer cells sustaining proliferative signalling?

A
  1. EGFR inhibitors
58
Q

What type of drugs act on the pathway of cancer cells enabling replicative immortality?

A
  1. Telomerase inhibitors
59
Q

What type of drugs act on the pathway of cancer cells inducing angiogenesis?

A
  1. Inhibitors of VEGF signaling
60
Q

Tumours can either be classified based on their ________ or by their __________

A

behaviour (benign or malignant, grade/stage), or by their histogenic classification

61
Q

Histogenetic classification refers to the

A

cell or tissue of origin

62
Q

What two things determine whether treatment will be curative or palliative?

A

Diagnosis and prognosis

63
Q

The anticipated course of the disease in terms of cure, remission, or fate of the patient

A

Prognosis

64
Q

What types of interventions can influence a cancer prognosis? (2)

A

Medical or surgical interventions

65
Q

Name 5 things that determine the cancer prognosis for a patient

A
  1. Tumour classification
  2. Grade
  3. Stage
  4. Age and general health of pt
  5. How the tumour is predicted to respond to a tx
66
Q

Treatment given, in the absence of macroscopic evidence of metastasis, to patients at risk of recurrence from micrometasteses, following treatment given for the primary lesion. This describes what type of treatment therapy?

A

Adjuvant

67
Q

Treatment is given before primary surgery, both to shrink the tumour in order to improve local excision, and to treat any micrometastases as soon as possible. This describes what type of therapy?

A

Neo-adjuvant

68
Q

Priorities of this type of treatment provide relief of tumour symptoms, preservation of quality of life, and prolongation of life

A

Palliative

69
Q

Name the original “Three pillars of cancer treatment”

A
  1. Surgery
  2. Radiotherapy
  3. Chemotherapy
70
Q

Name the three additional types of systemic drug therapies (other than chemotherapy)

A

Endocrine therapies
Targeted therapies
Immunotherapy

71
Q

What is one benefit of robot-assisted keyhole surgery?

A

Less invasive that traditional surgical techniques

72
Q

True or false: surgical resection of a tumour can be curative as long as the cancer is contained in that one area and hasn’t spread.

A

True

73
Q

This type of radiotherapy aims to deliver a treatment dose to a well-defined target volume with curative intent.

A

Radical radiotherapy

74
Q

This type of radiotherapy is used to reduce the risk of tumour recurrence after primary surgery. The aim of treatment is to eradicate occult (hidden) micrometastatic disease that cannot be demonstrated on imaging.

A

Adjuvant radiotherapy

75
Q

This type of radiotherapy is used to alleiviate symptoms of local disease (such as haematuria) or distant metastases (such as bone pain.

A

Palliative radiotherapy

76
Q

What are the three types of external radiotherapy?

A
  1. Fractionated external beam
  2. Stereostatic radiotherapy/radiosurgery
  3. Proton beam therapy
77
Q

This type of radiotherapy delivers radiation doses in increments separated by at least 4-6 hours. It aims to exploit any advantage in DNA repair between normal and malignant cells.

A

Fractionated external beam

78
Q

This type of radiotherapy can concentrate XRays or gamma radiation from multiple sources onto a small volume

A

Stereostatic radiosurgery/ radiotherapy

79
Q

This type of radiotherapy uses charged proton particules with little side scatter, has a focused beam, and provides less of a dose to the surrounding tissue

A

Proton beam therapy

80
Q

Which of the external types of radiotherapies are recommended for use in children?

A

Proton beam therapy

81
Q

Name the two types of internal radiotherapy

A

Bracytherapy and systemic radionuclides

82
Q

This type of radiotherapy uses a radiation source that is placed in close contact with the tissue to provide intense exposure over a short distance to a restricted volume

A

Brachytherapy

83
Q

This type of radiotherapy is delivered intravenously or as a drink

A

Systemic radionuclides

84
Q

Systemic radionuclides such as 131-iodine are used in the treatment of what type of cancer?

A

Thyroid cancer

85
Q

Which type of cells exhibit better repair after sub-lethal doses or radiation damage- cancer cells or normal cells?

A

Normal cells

86
Q

Which cell type proliferates more rapidly- cancer cells or normal cells?

A

Cancer cells

87
Q

Explain the basis of giving radiotherapy in incremental doses

A

Normal cells proliferate more slowly than cancer cells, therefore they have more time to repair damage before replication.

88
Q

List the common side effects with chemotherapy

A
  1. Nausea & vomiting
  2. Hair loss
  3. Myelosuppression
  4. Mucositis
  5. Fatigue
89
Q

Name two examples of cytotoxic chemotherapy drugs

A

Cisplatin and Paclitaxel

90
Q

“Small molecule” cancer drugs include:

A
  1. Cytotoxic chemotherapy drugs
  2. Targeted therapies
  3. Immunotherapies
91
Q

The “biologic” cancer drugs include:

A
  1. Antibodies (targeted therapies and immunotherapy)
  2. Oncolytic viruses
  3. Vaccines (immunotherapy)
92
Q

These types of cancer drugs interfere with specific molecular targets involved in growth, progression, and spread of cancer. Can be small molecule drugs OR biologics.

A

Targeted therapies

93
Q

Name an example of a small molecule targeted therapy drug

A

Vemurafenib (Zelboraf)

94
Q

The mechanism of action for this drug is to block activity of V600E BRAF

A

Vemurafenib (Zelboraf)

95
Q

What type of cancer does Vemurafenib (Zelboraf) treat?

A

Malignant melanoma

96
Q

What is the effect of blocking V600E BRAF?

A

Decrease in excess melanocyte proliferation

97
Q

Name two examples of drugs that are antibodies (discussed in lecture)

A

Trastuzumab (Herceptin) and Nivolumab (Opdivo)

98
Q

This drug binds to and blocks the HER2 protein receptor, affecting the signalling of tyrosine kinase

A

Trastuzumab (Herceptin)

99
Q

This drug blocks PD1/PDL-1 interaction, which relieves the suppression of T cell activity. An immune checkpoint inhibitor

A

Nivolumab (Opdivo)

100
Q

What type of cancer is Nivolumab (Opdivo) used to treat?

A

Malignant melanoma

101
Q

What type of cancer is Trastuzumab (Herceptin) used to treat?

A

Breast cancer

102
Q

What is the effect of PD1/PDL-1 interaction in a cancer cell?

A

Leads to suppression of T cell activity

103
Q

This type of therapy treats cancers that are hormone sensitive

A

Endocrine therapies

104
Q

Which endocrine therapy is used in the treatment of breast cancer?

A

Tamoxifen

105
Q

What is the mechanism of action for Tamoxifen?

A

Blocks estrogen receptors

106
Q

What type of drugs are endocrine drugs? Small molecule or biologics?

A

Small molecule

107
Q

Which types of cancers are hormone sensitive?

A

Breast, ovarian, womb, and prostate

108
Q

Examples of immunotherapy type cancer drugs include:

A

Vaccines
Immune system modulators
Checkpoint inhibitor therapies

109
Q

Cancer drug resistance can be either __________ or _________.

A

Intrinsic or acquired

110
Q

In this type of drug resistance, treatment naive patients show no response to a cancer therapy.

A

Intrinsic

111
Q

In this type of drug resistance, patients show initial response to therapy, but subsequently relapse and progress

A

Acquired

112
Q

What are the mechanisms of cancer drug resistance?

  1. Altered ________ transport
  2. Enhanced ___ repair
  3. __________ pathway defects
  4. Alteration of _________ molecules
A
  1. Altered membrane transport
  2. Enhanced DNA repair
  3. Apoptotic pathway defects
  4. Alteration of target molecules
113
Q

What is the biomarker associated with malignant melanoma (immune checkpoint that suppresses T cell tumour death activity?)

A

PD-L1

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