Oncology Flashcards
(159 cards)
1
Q
Hyperplasia
A
increased number of cells
2
Q
Metaplasia
A
Normal cell type is replaced by another
3
Q
Dysplasia
A
abnormal growth, loss of normal size/shape/orientation
4
Q
Anaplasia
A
irreversible, regression, high N:C ration, prominent nucleoli, clumping of chromatin, & mitotic figures
5
Q
Neoplasia
A
growing cells in an uncontrolled fashion
6
Q
Adenoma nomenclature
A
Benign Tumor of Epithelium w/ glandular architecture
7
Q
Papilloma nomenclature
A
Benign Tumor of Epithelium w/ finger-like projections
8
Q
Carcinoma nomenclature
A
Malignant Tumor of Epithelium
-Adenoma or Papillary
9
Q
Stain for Carcinoma
A
Cytokeratin
10
Q
Epithelial tumors spread
A
via lymph
11
Q
Mesenchymal tumors spread
A
via blood
12
Q
Mesenchymal Tumors - Blood
A
Blood cell tumors (leukemia, lymphoma), Blood vessel tumor (hemangioma, angiosarcoma)
13
Q
Mesenchymal Tumors - Bone
A
Osteoma, Osteosarcoma
14
Q
Mesenchymal Tumors - Fat
A
Lipoma, Liposarcoma
15
Q
Mesenchymal Tumors - Skeletal mm
A
Rhabdomyoma, Rhabdomyosarcoma
16
Q
Mesenchymal Tumors - Smooth mm.
A
Leiomyoma
Leiomyosarcoma
17
Q
Teratoma
A
tumor w/ >1 cell type
18
Q
Mature teratoma
A
mature tissues, no anapestic cells (ovarian tumors)
19
Q
Grade
A
cellular differentiation & mitotic activity
20
Q
Low grade
A
resemble normal cell architecture & have few mitotic figures
21
Q
Staging
A
size, spread (nodal involvement, metastasis)
22
Q
Liver metastasis
A
Colon Stomach Pancreas Breast Lung
23
Q
Liver Metastasis Sx
A
high LFTs, tenderness/abd pain, hepatomegaly, hepatic dysfunction (ascites, jaundice)
24
Q
Brain Metastasis
A
Lung Breast Skin (Melanoma) Kidney GIT tumors
25
Brain Metastasis Sx
HA, Focal Neuro defects (Hemiparesis), Cognitive Dysfucntion (memory loss, personality change), Seizures
26
Bone Metastasis Sx
```
Prostate
Renal Cell Carcinoma
Thyroid
Lung
Breast
```
27
Lytic Bone Metastasis
break down bone (MM)
28
Blastic Bone Metastasis
builds bone (prostate)
29
Paraneoplastic Syndrome - Small Cell Lung Cancer
ACTH -> Cushing
ADH -> SIADH (hyponatremia)
Lambert-Eaton Syndrome
30
Lambert-Eaton Syndrome
Small Cell Lunch Cancer producing Ab against presynaptic Ca2+ channels at the NMJ
31
Testing for Lambert-Eaton Syndrome
Isometric mm. contraction (weakness that improves w/ use)
32
Paraneoplastic Syndrome - Squamous Cell Lung Cancer
Humoral hypercalcemia of malignancy
| secretes PTHrP
33
Multiple Myeloma
Anemia, hypercalcemia, back pain (lytic bone lesions d/t local osteolytic factors)
34
Cachexia
tumors produce cytokines -> increase metabolic rate -> loss of fat & lean mm.
35
Psammoma Bodies are seen w/
Papillary thyroid cancer
Serous Papillary cystadenocarcinoma of the ovary
Meningioma
Malignant Mesothelioma
36
Psammoma Bodies
laminated concentric calcific spherules
37
Most common cause of hypercalcemia?
Primary hyperparathyroidism
38
Oncogenes
Mutation -> growth w/o GF (uncouple growth & GFs)
39
Tumor suppressor genes
Mutations allow unregulated cell cycle
40
Apoptosis genes
mutation, disables apoptosis
41
DNA repair genes
mutation, cells are susceptible to DNA damage
42
Tumor suppressor gene examples
Rb, p53 (checkpoint b/w G1/S)
| p53 S/G2
43
Rb mutation
can't inhibit E2F (TF)
44
Double-hit hypothesis
tumor-suppressor genes require mutations in both alleles
45
Heritable Retinoblastoma
inherit 1 mutation + 1 sporadic mutation
46
Sporadic Retinoblastoma
2 sporadic mutations
47
p53 mutations are seen in
50% of human cancers
48
p53 function
causes apoptosis by inducing transcription of pro-apoptotic genes (BAX) via p21
49
p53 mutations allow
cell replication through checkpoints despite DNA damage
50
APC
Familiar adenomatous polyposis
51
BRCA
Breast & Ovarian Cancer
52
DPC
Deleted in pancreatic cancer
53
DCC
Deleted in colon cancer
54
NF1
Neurofibromatosis type 1
55
NF2
Neurofibromatosis type 2
56
B/L acoustic neuromas
Neurofibromatosis type 2
57
WT1 & WT2
Wilms Tumors
58
VHL
Von Hippel-Lindau
59
TSC
Tuberous Sclerosis
60
RAS oncogenes
most common oncogene abnormality in tumors
61
K-RAS mutation
colon, lung, pancreatic tumors
62
H-RAS mutation
Bladder, Kidney tumors
63
N-RAS
Melanomas, Hematologic malignancies, Follicular thyroud cancer
64
RAS pathway
G-protein -> MAPK -> activation of TF
65
RAS mutation
constitutive MAPK activation
66
BCR-ABL
t(9:22) CML constitutive tyrosine kinase activation
67
RET mutation
assoc w/ MEN 2A & 2B
Pheochromocytoma, Medullar thyroid cancer
Papillary Carcinoma of the thyroid
68
HER2/neu
Breast, Ovarian, Gastric cancer
69
Trastuzumab
blocks HER2
70
C-myc
Burkitt Lymphoma
71
L-myc
Lung cancer
72
N-myc
Neuroblastoma (adrenal medulla)
73
Rb mutations are seen in
Retinoblastoma & Osteosarcoma
74
What TF is normally bound by Rb
E2F
75
Cigarette smoke is assoc w/ an increased risk of what type of cancer
Small Cell & Squamous Cell Carcinoma of the Lung
| Oral Cancer, Squamous cell Laryngeal Cancer, Pancreatic Cancer, Transitional Cell Carcinoma, RCC
76
EtOH use is assoc w/ an increased risk of what type of cancer
Oral Cancer, Laryngeal cancers, Squamous Cell esophageal cancer, HCC
77
Aflatoxin is assoc w/ an increased risk of what type of cancer
```
Aspergillus molds (corn, soybeans)
p53 mutation -> food contamination -> HCC
```
78
Nitrosamine is assoc w/ an increased risk of what type of cancer
Gastric cancer, Squamous cell esophageal carcinoma
79
Arsenic is assoc w/ an increased risk of what type of cancer
Lung cancer, Squamous Cell skin cancer, Angiosarcoma
80
Vinyl Chloride is assoc w/ an increased risk of what type of cancer
Angiosarcoma
81
Alkylating Agent is assoc w/ an increased risk of what type of cancer
Leukemia, Lymphoma
82
Benzene is assoc w/ an increased risk of what type of cancer
Leukemia, Hodgkin Lymphoma
83
Napthalene is assoc w/ an increased risk of what type of cancer
Transitional cell bladder carcinoma
84
Asbestos is assoc w/ an increased risk of what type of cancer
Bronchogenic carcinoma of the lung
| Mesothelioma
85
Radon is assoc w/ an increased risk of what type of cancer
Lung Cancer
86
Ionizing radiation is assoc w/ an increased risk of what type of cancer
Myeloid cancer (AML, CML), thyroid cancer
87
UV radiation is assoc w/ an increased risk of what type of cancer
Squamous & Basal cell carcinoma of the skin, Melanoma
88
UVB radiation induces
pyrimidine dimers in DNA (high risk of skin cancer)
89
UVA
generation of free radicals (slight risk of skin cancer)
90
HBV is assoc w/ an increased risk of what type of cancer
Cirrhosis -> HCC
91
HCV is assoc w/ an increased risk of what type of cancer
Cirrhosis -> HCC
| Papillary Thyroid Carcinoma
92
HTLV-1 is assoc w/ an increased risk of what type of cancer
T-cell lymphoma
93
HHV-8 is assoc w/ an increased risk of what type of cancer
Kaposi Sarcoma
94
EBV is assoc w/ an increased risk of what type of cancer
Hodgkin & Burkitt Lymphoma
| Nasopharyngeal carcinoma
95
HPV-16, -18
Cervical, Vaginal, Vulvar, Anal, Penile, Throat cancer
96
H. pylori is assoc w/ an increased risk of what type of cancer
Gastric cancer
97
S. bovis is assoc w/ what type of cancer
Colon cancer (IE)
98
Schistosoma haematobiumis assoc w/ an increased risk of what type of cancer
Squamous cell cancer of the bladder
99
Pt w/ hematuria from the Middle East?
Schistosoma haematobium
100
Clonorchis sinensisis is assoc w/ an increased risk of what type of cancer
biliary cancer
101
Acanthosis nigricans is assoc w/
insulin-resistance or gastric carcinomas
102
Actinic keratosis may be a precursor to
Squamous cell skin cancer
103
Tx for Actinic keratosis
5-FU
104
Autoimmune & immunodeficient diseases are assoc w/ an increased risk of what type of cancer
Lymphoma
105
Tuberous sclerosis findings
Facial angiofibromas,
Seizures, low IQ
Ash-leaf spots
106
Tuberous sclerosis is related to what types of tumors/cancers
Cardiac rhabomyoma
Renal angiomyolipoma
Astrocytoma
107
Ulcerative colitis is assoc w/ an increased risk of what type of cancer
colon cancer
108
Most common cancers in men
prostate, lung, colon
109
Most common cancers in women
breast, lung, uterine
110
Which cancers cause the highest mortality rate in women
lung, breast, colon
111
Which cancers cause the highest mortality rate in men
lung, prostate, colon
112
Primary Prevention
Smoking, Obesity, Poor diet, Inactivity, Sun exposure
113
Smoking
#1 cause of preventable cancer
114
Obesity is assoc w/ an increased risk of which cancers
```
increased esophageal adenoma
renal cell carcinoma
Endometrial cancer
Gallbladder cancer
Thyroid cancer
```
115
High-fat diet is assoc w/ an increased risk of which cancers
Breast, Colon, Prostate, Endometrial cancers
116
High-fiber diet is assoc w/
lower risk of colon polyps & colon cancer
117
Sedentary lifestyle is assoc w/ an increased risk of which cancers
breast & colon cancer
118
Sun exposure is assoc w/ an increased risk of which cancers
Basal & Squamous Cell Carcinomas, Melanoma (sun burns)
119
Secondary Prevention
early detection to decrease mortality
120
Breast Cancer Screening
Self-exams unadvised
Clinical Breast Exam
Mammograms from 50-75 q 2y
121
Cervical Cancer Screening
pap: 21-65yo q 3yrs
122
Prostate Cancer Screening
PSA (against screening)
| Digital Rectal Exam (no rec)
123
Colon Cancer Screening
Colonoscopy: 50-75 q 10yrs
Flexible sigmoidoscopy: 50-75 q 5 yrs
FOBT: 50-75 annually
124
Lung Cancer Screening
Chest CT: 55-80yo smoker w/ hx of 30pack hx
125
HCC Tumor Marker
AFP
126
Prostate Tumor Marker
PSA (BPH, etc)
127
Ovarian Tumor Marker
CA-125 (high w/ any peritoneal irritation) - use for Tx efficacy
128
Bone Mets Tumor Marker
Alkaline Phosphatase
129
Biliary Tract Tumor Marker
Alkaline Phosphatase
130
Paget's Disease Tumor Marker
Alkaline Phosphatase
131
Pancreatic Cancer Tumor Marker
CA 19-9, CEA
132
Colon Tumor Marker
CEA
133
Melanoma Tumor Marker
S-100
134
Schwannoma Tumor Marker
S-100
135
Hairy Cell Leukemia Tumor Marker
TRAP (Tartrate-resistant acid phosphatase)
136
Methotrexate MOA
inhibits Dihydrofolate reductase
137
Which drug can reverse the myelosuppression seen w/ Methotrexate
Leucovorin
138
Cyclophosphamide S/E
hemorrhagic cysitis d/t toxic metabolite acrolein
139
Cyclophosphamide S/E of hemorrhagic cysts can be prevented w/ what drug
Mesna
140
MOA of Doxorubicin & Daunorubicin
Generates free radicals & intercalates DNA
141
MOA of 5-FU
inhibits thymidylate synthase
142
MOA of 6-MP
Inhibits PRPP amidotransferase
143
Cytarabine MOA
inhibits DNA polymerization
144
Dexrazoxane
given w/ Doxorubicin & Daunorubicin to prevent cardiotoxicity
145
Uridine
given w/ 5-FU to rescue from myelosuppression
146
MOA of Etoposide
Inhibits topoisomerase II
147
MOA of Hydroxyurea
inhibits ribonucleotide reductase
148
MOA of Paclitaxel
stabilizes MTs by binding to Tubulin
149
MOA of Topotecan
Inhibits topoisomerase I
150
MOA of Vincristine
Inhibits MT formation
151
S/E of Tamoxifen
endometrial cancer
152
S/E of Trastuzumab
Cardiotoxicity
153
S/E of Paclitaxel
HSN rxn
154
S/E of Cisplatin
nephrotoxicity & ototoxicity
155
S/E of Vincristine
peripheral neuropathy
156
Bevacizumab MOA
VEGF inhibitor
157
Bevacizumab Uses
Metastatic cancers
158
Bevacizumab S/E
impaired wound healing, severe hemorrhage
159
Imatinib
enzyme inhibitor mutant bcr-abl
