Oncology

Question 1

Lymphoma that is equivalent of chronic lymphocytic leukemia

Answer 1

Small lymphocytic lymphoma

Question 2

Presents with skin lesions that show cerebriform nuclei, can spill into blood and cause leukemia

Answer 2

Mycosis fungoides, in the blood its called Sezary syndrome

Question 3

What disease is associated with adult T-cell lymphoma?

Answer 3

HTLV infection, seen in IV drug abusers or populations from Japan, West Africa, Caribbean

Question 4

What diseases are associated with Marginal cell MALT lymphoma?

Answer 4

Sjogren syndrome, Hashimoto’s thyroiditis, H. pylori

Question 5

Mantle cell lymphoma translocation

Answer 5

t(11;14) - cyclin D1 and heavy-chain Ig

Question 6

Lymphomas associated with t(14;18)

Answer 6

Diffuse large B-cell lymphoma and Follicular lymphoma

-translocation of Bcl-2 and heavy-chain Ig

Question 7

Translocation in Burkitt

Answer 7

t(8;14) - transforms c-myc oncogene to heavy-chain Ig location

Question 8

Difference in sporadic and endemic Burkitt lymphoma

Answer 8

endemic - jaw lesion, seen in Africa

sporadic - pelvis or abdomen lesion

Question 9

Starry sky appearance of lymphocytes with interspersed tingible body macrophages, endemic and sporadic form, associated with EBV

Answer 9

Burkitt lymphoma

Question 10

Most common non-Hodgkin lymphoma in kids

Answer 10

Lymphoblastic lyphoma

Question 11

Most common non-Hodgkin lymphoma in adults

Answer 11

Diffuse large B cell lymphoma

Question 12

Localized, single group of enlarged non-tender lymph nodes, B-symptoms, good prognosis

Answer 12

Hodgkin lymphoma

Question 13

Ages affected by Hodgkin lymphoma

Answer 13

20s and around 65

Question 14

Characteristic cells seen on histology of Hodgkin lymphoma

Answer 14

Reed-sternberg - binucleated giant cells that look like owl’s eyes, CD15 and CD30+
-amount determines prognosis (fewer Reed-sternberg is a better prognosis)

Question 15

B symptoms of Hodgkin lymphoma

Answer 15

fever, night sweats, weight loss

Question 16

Most common leukemia in kids, tons of lymphoblasts, bone pain is common, associated with Down syndrome

Answer 16

ALL

Question 17

Marker that is present in ALL

Answer 17

+ Tdt

Question 18

Smudge cells, CD20+, CD19+, CD5+, associated with AI hemolytic anemia, seen in older adults >60, most common leukemia in adults

Answer 18

CLL (smudge cells = crushed little lymphs)

Question 19

Seen in middle aged adults (around 60), Auer rods, tons of myeloblasts, + myeloperoxidase
associated with prior radiation, benzene, alkylating agents, myeloproliferative dz, Down syndrome

Answer 19

AML

Question 20

Translocation present in some AML forms and the treatment

Answer 20

t(15;17) - tx with all-trans retinoic acid (ATRA)

Question 21

Always have Philadelphia chromosome, dysregulated production of mature and maturing granulocytes, splenomegaly, fatigue, abdominal pain, can accelerate to blast crisis, negative for leukocyte alkaline phosphatase

Answer 21

CML

blast crisis - transforms to AML or ALL

Question 22

What is the Philadelphia chromosome?

Answer 22

t(9;22) - BCR-ABL hybrid that encodes a constitutively active tyrosine kinase
-tx CML with imatinib (anti-tyrosine kinase)

Question 23

Characteristic auer rods

Answer 23

AML-M3 subtype

Question 24

What type of leukemia do myeloproliferative disorders progress to?

Answer 24

AML

Question 25

Classic symptoms of Multiple Myeloma

Answer 25

Jerry is a CRAB - Calcium is high, Renal involvement, Anemia, Bone lytic lesions/back pain

Question 26

What is seen on UA with MM?

Answer 26

nothing - have to do electrophoresis to see Ig light chains, called Bence Jones proteins (IgG)

Question 27

Most common tumor arising from bone in adults

Answer 27

Multiple Myeloma

Question 28

M spike associated with high IgM, hyperviscous blood, no bone lesions

Answer 28

Waldenstrom-Macroglobulinemia

Question 29

Tear-drop red cells associated with fibrosis on bone marrow bx

Answer 29

Myelofibrosis

Question 30

Headache + pruritis + plethora (red hands and feet)

Answer 30

Polycythemia

Question 31

Cancers that metastasize to brain

Answer 31

"Lots of Bad Stuff Kills Glia" - Lung, Breast, Skin (melanoma), Kidney, GI (colon)

Question 32

Cancers that metastasize to bone

Answer 32

"Permanently Relocated Tumors Like Bone" - Prostate, Renal Cell carcinoma, Thyroid, Lung, Breast

Question 33

Cancers that metastasize to liver

Answer 33

"Cancer Sometimes Penetrates Benign Liver" - Colon, Stomach, Pancreas, Breast, Lung

Question 34

Cancers that show psammoma bodies

Answer 34

PSaMMoma - Pheocromocytoma, Serous papillary cystadenocaricnoma of ovary, Meningioma, Malignant mesothelioma

Question 35

Cancer that causes Cushing syndrome (increased ACTH)

Answer 35

Small cell lung cancer

Question 36

Cancer that causes SIADH

Answer 36

Small cell lung cancer

Question 37

Cancers that cause Hypercalcemia

Answer 37

Squamous cell lung cancer (releases PTHrP), Multiple Myeloma, Hodgkin lymphoma (increases Vit D), Other carcinomas (renal, head and neck cancers, bladder, breast)

Question 38

Cancers that cause Polycythemia (increase EPO)

Answer 38

"Potentially Really High Hematocrit" - Pheocromocytomas, Renal Cell Carcinoma, Hepatocellular carcinoma, Hemangioblastoma

Question 39

Cancer that causes muscle weakness that improves with use

Answer 39

Small cell lung cancer - makes abs to Ca2+ channels at NMJ, called Lambert-Eaton syndrome

Question 40

Cancer associated with Hashimoto's thyroiditis

Answer 40

marginal cell lymphoma

Question 41

Most common tumor suppressor gene that is mutated

Answer 41

p53

Question 42

What does p53 normally do?

Answer 42

acts as a check point for G1 --> S phase, G2 --> M phase; normally activates p21

Question 43

What cancers is Rb associated with?

Answer 43

osteosarcoma, retinoblastoma

Question 44

Most common oncogene

Answer 44

RAS - colon cancer, lung cancer, pancreatic cancer

Question 45

What occurs when RAS is mutated?

Answer 45

constitutively active GTPase that doesn't require receptor binding

Question 46

What disease and gene are associated with bilateral acoustic schwannomas?

Answer 46

Neurofibromatosis 2 - NF2 tumor suppressor is mutated

Question 47

What is normal function of most tumor suppressor genes?

Answer 47

control cell cycle progression

Question 48

What protein is normally bound by Rb?

Answer 48

E2F transcription factor

Question 49

What is normal function of many proto-oncogenes?

Answer 49

regulate cell proliferation and differentiation | -kinases, receptors

Question 50

Top cancers for incidence and mortality in men

Answer 50

Incidence - Prostate > lung > colon | Mortality - Lung > prostate > colon

Question 51

Top cancers for incidence and mortality in women

Answer 51

Incidence - Breast > lung > colon (uterine) | Mortality - Lung > breast > colon

Question 52

What cancer is associated with benzene and naphthylamine exposure?

Answer 52

transitional cell carcinoma (bladder)

Question 53

What cancers are associated with radiation?

Answer 53

papillary thyroid carcinoma, CML, AML

Question 54

What cancers is EBV associated with?

Answer 54

Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma

Question 55

What type of bladder cancer is smoking associated with?

Answer 55

Transitional cell carcinoma

Question 56

What type of cancer is schistosoma haematobium associated with?

Answer 56

Squamous cell carcinoma (think S for schistosoma and squamous cell)

Question 57

What cancer can acanthosis nigricans be a sign for?

Answer 57

gastric adenocarcinoma (usually associated with obesity and diabetes)

Question 58

What cancer is associated with Aspergillosis?

Answer 58

aflatoxins - hepatocellular carcinoma

Question 59

What cancers are associated with alcohol use?

Answer 59

squamous cell carcinoma (esophagus), hepatocellular carcinoma

Question 60

Tumor marker for hepatocellular carcinoma and testicular tumors

Answer 60

alpha-fetoprotein

Question 61

Tumor marker for ovarian cancer

Answer 61

CA 125

Question 62

Tumor marker for pancreatic and colon cancer

Answer 62

CEA

Question 63

Tumor marker for pancreatic cancer

Answer 63

CA 19-9 (and CEA)

Question 64

Tumor associated with alkaline phosphatase tumor marker

Answer 64

mets to bone, Paget dz of bone