Neoplasm

Question 1

A ____ refers to a mass. This mass can be ___ meaning it is localized to an area or _____ meaning it have the potential to metastasize and spread.

Answer 1

Tumor
Benign
Malignant

Question 2

____ means new tissue growth that is unregulated, irreversible, and derived from a single (monoclonal) cell

Answer 2

Neoplasia

Question 3

____ is also monoclonal but may not have achieved unregulated cell growth potential and is often reversible (pre-malignant)

Answer 3

Dysplasia

Question 4

Tumor nomenclature:

Answer 4

Question 5

The exceptions of nomenclature:
If the tumor ends in -oma it doesn’t always mean that it is benign. If it end in -blastoma it almost always means malignant

Answer 5

Question 6

Cancer is the ____ leading cause of death in adults and children

Answer 6

Second

Question 7

Cancer screening is effective because cancer usually begins as a ___ ___ cell. The goal of screening is to catch ____ before it becomes metastatic cancer.

Answer 7

Single mutated
Dysplasia

Question 8

Carcinogenesis:
Cancer formation is initiated by DNA damage of ___ ___ which evade’s DNA repair mechanisms and is not lethal to the cell. _____ are agents that damage DNA and include chemicals, viruses and radiation

Answer 8

Stem cell
Carcinogens

Question 9

Some DNA mutations will disrupt ___ ___, allowing for tumor growth and progression. Disrupted systems include ____, ___ ___ genes, and regulators of ___.

Answer 9

Regulatory systems
Proto oncogenes
Tumor suppressor
Apoptosis

Question 10

Schematic of carcinogenesis:

Answer 10

Question 11

The first step of carcinogenesis is called the ___ step. Initiators are agents that can cause DNA damage, but are not by themselves sufficient to cause a tumor. The second step: _____ are agents that can induce tumor formation from initiated cells, but do not damage DNA directly such as ____, ___, and ____.

Answer 11

Initiation
Promoters
Hormones, drugs, and phenols

Question 12

Picture of initiation and promotion:

Answer 12

Question 13

____ is an example of a virus that causes cervical cancer

Answer 13

HPV

Question 14

Hallmarks of cancer cells:

Answer 14

Question 15

Four classes of normal regulatory genes are primary targets of genetic damage in neoplastic transformation:

Answer 15

Question 16

Proto-oncogenes are genes that if ____ form oncogenes that lead to unregulated cellular growth. These are genes that encode ___ ___, ___ __ receptors, signal transducers, ___ ___ regulators

Answer 16

Upregulated
Growth factors
Growth factor
Cell cycle

Question 17

Table of proto-oncogenes:

Answer 17

Question 18

Tumor suppressor genes regulate cell growth and decrease the risk of tumor formation. ____ and ____ are classic examples

Answer 18

p53
Rb (retinoblastoma)

Question 19

p53 will stop the cell cycle in response to DNA damage. If repair is not possible, p53 upregulates ____, disrupting ___, and inducing apoptosis

Answer 19

Bax
Bcl2

Question 20

Both ____ of the p53 gene must be knocked out for tumor formation (Knudson two hit hypothesis).

Answer 20

Copies

Question 21

Rb regulates progression from __ to __ phase, same as p53. It holds the ___ transcription factor. When Rb is ____ it releases ____. When both copies of Rb are knocked out, ____ is uninhibited allowing for progression through the cell cycle.

Answer 21

G to S
E2F
Phosphorylated
E2F
E2F

Question 22

Table of tumor suppressor genes:

Answer 22

Question 23

____ is a regulator of apoptosis. It prevents apoptosis is normal cells and promotes apoptosis in mutated cells. ____ is over expressed in follicular lymphoma and ignores the usual signals for apoptosis and continues to ___.

Answer 23

Bcl2
Bcl2
Proliferate

Question 24

Other things necessary for tumor development:
____ is necessary for cell immortality. ____ (create their own blood supply) is necessary for tumor survival and growth.

Answer 24

Telomerase
Angiogenesis

Question 25

Cancer also must avoid ___ ___. Mutations often result in production of abnormal proteins, which are typically expressed on MHC class one and destroyed. But tumor cells evade immune surveillance by ____ ____ ___.

Answer 25

Immune surveillance Downregulating MHC class I

Question 26

Tumor progression, and cancer growth is important but the __/___ is more closely related to severe cancer

Answer 26

Morbidity/mortality

Question 27

Accumulation of mutations eventually results in tumor ability to ____ into surrounding tissues and spread

Answer 27

Invade

Question 28

Epithelial tumor cells often down regulate _____, which normally attaches epithelial cells to each other. Down regulation leads to ____ of cells

Answer 28

E-cadherin Dissociation

Question 29

____ destroys collagen type IV in the basement membrane. Cancer cells attached to ____ in the extra cellular matrix and spread locally. Entrance into ___ or ___ spaces allows for metastasis.

Answer 29

Collagenase Fibronectin Vascular Lymphatic

Question 30

____ is distant spread of tumor cells. Lymphatic spread is characteristic of ____. Hematogenous spread is characteristic of ___ and some ___, typically spreads to lungs.

Answer 30

Metastasis Carcinomas Sarcomas, carcinomas

Question 31

Seeding of body cavities is characteristic of ___ ___, which often involves the peritoneum

Answer 31

Ovarian carcinoma

Question 32

___ tumors tend to be slow growing, well circumscribed, distant, and mobile. ___ tumors are usually rapid growing, poorly circumscribed, infiltrative, and affixed to surrounding tissues and local structures

Answer 32

Benign Malignant

Question 33

___ is generally required before a tumor can be classified as benign or malignant with certainty.

Answer 33

Biopsy

Question 34

Histology basics:

Answer 34

Question 35

____ and ____ testing is used to characterized tumors that are difficult to classify on histology

Answer 35

Immunohistochemistry Molecular

Question 36

Picture of benign tumor- follicular adenoma of the thyroid: Notice the organized growth and uniform nuclei

Answer 36

Question 37

Picture of malignant tumor- squamous cell carcinoma of the lung: Notice poorly defined edges , disorganized growth, high nuclear to cytoplasmic ratio

Answer 37

Question 38

Specific markers for specific tissues, that help define the origin tissue of the tumor

Answer 38

Question 39

Elevated levels of tumor markers still require a ___ for diagnosis of carcinoma

Answer 39

Biopsy

Question 40

____ ____: production of substances, by a tumor that are not expected based on the cell or tissue of origin. Example: lung cancer is producing ___ or ___ and presenting with Cushing’s syndrome or hypercalcemia

Answer 40

Paraneoplastic syndromes ACTH PTH

Question 41

Cancer gradings of malignant types: Microscopic assessment of differentiation. Well differentiated is ___ ___ and resembles normal parent tissue. Poorly differentiated is ___ ___ and does not resemble the original tissue type. Moderately differentiated is somewhere in between.

Answer 41

Low-grade Hi grade

Question 42

Grading of tumors is important for determining the ___.

Answer 42

Prognosis

Question 43

Cancer ____ is assessing how far the tumor has spread. This is the key prognostic factors typically more important than grading. It requires full removal of the tumor. Uses ___ staging system. T: N: M:

Answer 43

Staging TNM Tumor size Spread to regional lymph nodes Metastasis

Question 44

Review

Answer 44

Question 45

Review

Answer 45

Question 46

Cancer drugs

Answer 46