Neoplasia complete Flashcards
(149 cards)
1
Q
Benign tumor origin
A
Epithelial or Connective tissue origin
2
Q
Benign tumors of epithelial origin
A
Ectoderm, endoderm
3
Q
Benign tumors of connective origin
A
mesoderm
4
Q
Teratomas origin
A
Derives from ectoderm, endoderm, mesoderm
5
Q
Origin of Carcinomas
A
Derive from squamous, glandular (adenocarcinoma), transitional epithelium
6
Q
Origin of Sarcomas
A
Derive from connective tissue
7
Q
Hamartoma
A
non-neoplastic overgrowth of tissue
8
Q
Choristoma
A
normal tissue where it should NOT be
9
Q
Neoplastic component of that determines the tumors biologic behavior
A
parenchyma (tissue that does the work)
10
Q
Grade of cancer asks…
A
does the cancer resemble its parent tissue or not?
11
Q
Features of Malignant tumors
A
↑ nuclear/cytoplasmic ratio; abnormal mitotic spindles
12
Q
How many doubling times (cell cycles) are required b4 a tumor can be clinically evident
A
30
13
Q
Benign and malignant tumors derive from a…
A
single precursor cell (monoclonality)
14
Q
Why dont malignant tumors lose genetic material after multiple cell divisions?
A
d/t upregulation of telomerase activity
15
Q
Feature of Basal cell carcinoma
A
invade tissue but do NOT metastasize
16
Q
2nd most important criterion for malignancy
A
Invasion
17
Q
Tissue resistant to invasion
A
Cartilage, elastic tissue
18
Q
Loss of intercellular adherence (E-cadherin)
A
→ cell invasion
19
Q
Extranodal metastasis (eg liver) has greater prognostic significance than…
A
nodal metastasis (TNM )
20
Q
Routes of metastasis
A
lymphatic (carcinomas), hematogenous (sarcomas), seeding body cavities
21
Q
Type of metastasis common w/ surface-derived ovarian cancers
A
Seeding
22
Q
Bone metastasis
A
Vertebra MC site; paravertebral venous plexus
23
Q
Feature of Osteoblastic metastasis
A
↑ serum alkaline phosphatase (dephosphorylates pyrophosphate which inhibits bone formation); seen in prostate cancer
24
Q
Consequences of Osteolytic metastasis
A
hypercalcemia, pathologic fxs
25
Bone metastasis on X-ray
Osteoblastic-radiodense; Osteolytic-radiolucent
26
MC tissue metastasize to
Lymph node
27
2nd MCC death in US
Cancer
28
Lifetime risk for cancer
Men 〉 Women
29
Population w/ greatest overall risk for cancer
Blacks
30
MC cancer in children
Acute lymphoblastic leukemia (ALL)
31
Cancer incidence in men
Prostate 〉 Lung 〉 Colorectal
32
Cancer incidence in women
Breast 〉 Lung 〉 Colorectal
33
Incidence of gynecologic cancer
Endometrial 〉 Ovarian 〉 Cervical (lowest d/t pap smears)
34
MCC of cancer death in adults
Lung cancer
35
Cancer-related deaths in men
Lung 〉 Prostate 〉 colorectal
36
Cancer-related deaths in women
Lung 〉 Breast 〉 Colorectal
37
Most rapidly ↑ing cancer worldwide
Malignant melanoma
38
Cancer in china
Nasopharyngeal carcinoma 2ndary to EBV
39
Cancer in Japan
Stomach adenocarcinoma d/t smoked foods
40
Cancer of SE Asia
Hepatocellular carcinoma d/t Hep B and aflotoxins (produced by Aspergillus) in food
41
Cancer of Africa
Burkitts lymphoma d/t EBV and Kaposis sarcoma d/t HHV 8
42
AD cancer syndromes
Retinoblastoma, Familial Adenomatous Polyposis, Li-Fraumeni syndrome, Hereditary nonpolyposis colon cancer (Lynch syndrome), BRCA1 and BRCA2 genes
43
Retinoblastoma
point mutation inactivates RB suppressor gene; predisposition for osteogenic sarcoma in adolescence
44
Familial Adenomatous Polyposis (FAP)
inactivation of APC suppressor gene → malignant transformation of of polyps by age 50
45
Li-Fraumeni syndrome
inactivation of TP53 suppressor gene → ↑ risk for sarcomas, leukemia, carcinomas
46
Hereditary nonpolyposis colon cancer (HNPCC) aka Lynch syndrome
inactivation of DNA mismatch repair genes → cannot correct errors in nucleotide pairing; ↑ risk colorectal cancer w/o previous polyps
47
BRCA1 and BRCA2 genes
inactivation of genes ↑ risk for breast and ovarian cancer; can also be involved in Familial cancer syndromes
48
Autodomal recessive syndromes w/ defects in DNA repair
Xeroderma pigmentosum, Chromosome instability syndromes
49
Xeroderma pigmentosum
UV light → cross links adjacent pyrimidines (C&T) producing pyrimidine dimers; ↑ risk of skin cancer like basal cell carcinoma, squamous cell carcinoma
50
Chromosome instability syndromes
Chromosomes susceptible to damage by ionizing radiation and drugs→to cancer
51
Examples of Chromosome instability syndromes
Fanconi anemia, ataxia telangiectasia, bloom syndrome
52
Precursor of squamous cell carcinoma
Actinic (solar) keratosis
53
Most important factor in ↓ risk for cancer
Cessation of smoking
54
Name something that ↓ risk for hepatocellular carcinoma
HBV immunization
55
Name something that ↓ risk for cervical cancer
Human papillomavirus immunization
56
Least common gynecologic cancer in US
Cervical cancer
57
Test most responsible for ↓ incidence/mortality rate for cervical cancer
Cervical pap smear
58
Prostate-specific antigen (PSA)
more sensitive (yes,yes) than specific (no,no)
59
Rx H. pylori infection
↓ risk for developing gastric lymphoma/adenocarcinoma
60
Rx GERD
↓ risk for distal adenocarcinoma of esophagus
61
MC type of mutation in cancer
Point mutations
62
Genes involved in normal growth and repair
Proto-oncogenes
63
Genes that protect against unregulated cell growth
Suppressor genes
64
Antiapoptosis genes (prolife)
BCL2 gene family
65
apoptosis gene
BAX gene; activated by TP53 if DNA damage is excessive; BAX gene inactivates BCL2 antiapoptosis gene
66
Proto-oncogenes
ABL, HER (ERBB₂), MYC, N-MYC, RAS, RET, SIS
67
ABL
Nonrecptor tyrosine kinase; t(9;22); CML, chr. 22 Philadelphia chr
68
HER (ERBB₂)
Receptor synthesis; amplification mutation; Breast carcinoma (marker of aggression)
69
MYC
Nuclear transcription; t(8;14); Burkitts lymphoma
70
N-MYC
Nuclear transcription; amplification mutation; Neuroblastoma
71
RAS
GTP signal transduction; Point mutation; leukemia; lung, colon, pancreatic cancer
72
RET
Receptor synthesis; Point mutation; Multiple Endocrine Neoplasia IIa/IIb (MEN) syndromes
73
SIS
Growth factor synthesis; Overexpression; Osteogenic sarcoma, astrocytoma
74
Tumor suppressor genes
APC, BRCA1/BRCA2, RB, TGF-β, TP53, VHL, WT₁
75
Mutation common to tumor suppressor genes
Point mutation
76
APC
prevents nuclear transcription; Famililal adenomatous polyposis
77
BRCA1/BRCA2
Regulated DNA repair; Breast ovary, prostate cancers
78
RB
Inhibits G₁ to S phase; Retinoblastoma, osteogenic sarcoma, breast carcinoma
79
TGF-β
Inhibits G₁ to S phase; pancreatic and colorectal carcinomas
80
TP53
Inhibits G₁ to S phase, Repairs DNA, activates BAX; Lung, colon, breast carcinomas; Li-Fraumeni syndrome: breast carcinoma, brain tumors, leukemia, sarcomas
81
VHL
Regulates nuclear transcription; Von Hippel-Lindau syndrome; cerebellar hemanioblastoma, retinal angioma, renal cell carcinoma (bilateral), pheochromocytoma (bilateral)
82
Pheochromocytoma
Neuroendocrine tumor of medulla of adrenal glands; secretes excessive catacholamines
83
WT₁
Regulates nuclear transcription; Wilms tumor
84
Fxn of DNA repair genes
correct errors in nucleotide pairing; excise pyrimidine dimers
85
Enzymes involved in dimer excision
endonuclease, exonuclease, polymerase, ligase
86
Agent most responsible for cancer and cancer deaths in the US
Tobacco
87
Sequence of chemical carcinogenesis
Initiaion → promotion→ progression
88
Aflatoxin (from aspergillus)
HCC in assoc. w/ Hep B
89
Alcohol
Squamous cell carcinoma or oropharynx and upper/middle esophagus; pancreatic and Hepatocellular carcinomas
90
Alkylating agents
Malignant lymphoma
91
Arsenic
Squamous cell carcinoma of skin, lung cancer, liver angiosarcoma
92
Asbestos
Bronchogenic carcinoma, pleural mesothelioma
93
Benzene
Acute Leukemia
94
Beryllium
Bronchogenic carcinoma
95
Chromium
Bronchogenic carcinoma
96
Cyclophosphamide
Transitional cell carcinoma of urinary bladder
97
Diethylstilbestrol (DES)
Clear cell carcinoma of vagina/cervix
98
β-Naphthylamine (aniline dyes)
Transitional cell carcinoma of urinary bladder
99
Nickel
Bronchogenic carcinoma
100
Oral Contraceptives
Breast, cervical carcinomas
101
Polycyclic hydrocarbons
Squamous cell carcinoma: oral cavity, midesophagus, larynx, lung; Adenocarcinoma: pancreas, kidney; Transitional cell carcinoma: urinary bladder, renal pelvis
102
Silica
Bronchogenic carcinoma
103
Oncogenic RNA viruses
HCV , HTLV-1 (human T-cell lymphotropic virus)
104
HCV
produces postnecrotic cirrhosis; HCC
105
HTVL-1 (Human T-cell lymphotropic Virus)
Activates TAX gene, stimulates polyclonal T-cell proliferation, inhibits P53; T-cell leukemia and lymphoma
106
Oncogenic DNA viruses
EBV, HBV, HHV-8, HPV 16 and 18
107
EBV
Promotes polyclonal B cell proliferation, which ↑ risk for t(8;14); Burkitts lymphoma, CNS lymphoma in AIDS, mixed cellularity Hodgkins lymphoma, nasopharyngeal carcinoma
108
HBV
activates proto-oncogenes, inactivates p53; HCC
109
HHV-8
acts via cytokine released from HIV and HSV; Kaposis sarcoma in AIDS
110
HPV 16 and 18
Type 16: E6 gene product inhibits P53, Type 18: E7 inhibits RB; squamous cell carcinoma of vulva, vagina, cervix, anus, larynx, oropharynx
111
Pathogens and cancer
Viruses 〉 bacteria 〉 parasites
112
MC cancer d/t ionizing radiation
AML (acute myeloblastic leukemia) or CML (chronic myeloblastic leukemia)
113
MC cancer d/t excessive UV light exposure
Basal cell carcinoma
114
Squamous cell carcinoma in physical injury
3rd degree burns; chronically draining sinuses (chronic osteomyelitis)
115
Most effective host defense against cancer
Cytotoxic CD8 T cells
116
Most important prognostic factor
Staging criteria; TNM system
117
Least to most important prognostic factor
T 〈 N 〈 M (most important)
118
Molecule involved in Cachexia
TNF-α secreted by macrophages and tumor cells→suppresses appetite in hypothalamus and stimulates apoptosis
119
MC anemia in cancer
Anemia of chronic dz; normocytic anemic w/ corrected reticulocyte count 〈 3 %
120
Hemostasis abnormality in malignancy
Thrombogenic
121
MCC of death in cancer
Gram - sepsis
122
Skin abnormality that may be assoc. w/ stomach cancer
Acanthosis nigricans; black, verrucoid-appearing lesion
123
Signs of ectopic hormone production
hypercalcemia, hyponatremia, hypoglycemia, hypercortisolism, polycythemia
124
Eaton-Lambert syndrome
Small cell carcinoma of lung; Myasthenia gravis-like Sxs (muscle weakness); Ab against Ca channel
125
Hypertrophic osteoarthropathy
Bronchogenic carcinoma; Periosteal rxn of distal phalanx (often assoc. w/ clubbing of nail)
126
Nonbacterial thrombotic endocarditis
Mucus-secreting pancreatic and colorectal carcinomas; sterile vegetations on mitral valve
127
Seborrheic keratosis
Stomach carcinoma; Sudden appearance of numerous pigmented seborrheic keratoses (leser-Trélat sign)
128
Superficial migratory thrombophlebitis
Pancreatic carcinoma; Release of procoagulants (Trousseaus sign: hypercoagulability)
129
Nephrotic syndrome
Lung, breast, stomach carcinomas; Diffuse membranous glomerulopathy
130
Cushing syndrome
ACTH; small cell carcinoma of lung, medullary carcinoma of thyroid
131
Gynecomastia
hCG; Choriocarcinoma (testis)
132
Hypercalcemia
PTH-related protein: Renal cell carcinoma, 1° squamous cell carcinoma of lung, breast carcinoma; Calcitriol (VitD): malignant lymphoma (contain α1-hydroxylase)
133
Hypocalcemia
Calcitonin; Medullary carcinoma of thyroid
134
Hypoglycemia
Insulin-like facter; HCC
135
Hyponatremia
ADH; small cell carcinoma of lung
136
2° Polycythemia
EPO; Renal cell and Hepatocellular carcinoma
137
α-fetoprotein (AFP)
HCC, yolk sac tumor of ovary or testis
138
Bence Jones Protein
Multiple myeloma, Waldenströms macroglobulinemia
139
CA 15-3
Breast cancer
140
CA 19-9
Pancreatic, colorectal carcinomas
141
CA 125
Surface-derived ovarian cancer (eg serous cystadenocarcinoma; helpful in distinguishing malignant from b9
142
Carcinoembryonic antigen (CEA)
Colorectal and pancreatic carcinomas
143
Lactate dehydrogenase
Malignant lymphoma
144
Cytokeratin
epithelial origin
145
Vimentin
Connective tissue origin
146
Desmin
Muscle
147
GFAP
Neuroglia
148
Neurofilaments
Neurons
149
CD45+
Malignant lymphoma
