PATHOLOGY-Gen.Principles Flashcards
(159 cards)
1
Q
Key player in the intrinsic pathway of apoptosis?
What activates this pathway?
A
Key player= cyt c
Release of cytochrome c from the mitochondria means death (suicide) will occur.
Activated by: Signal comes from within the cell e.g toxin, radiation, hypoxia
2
Q
Name 2 pro-apoptotic proteins and 1 anti-apoptotic protein in the intrinsic pathway of apoptosis?
A
PRO: Bax
Bak
ANTI: Bcl2….which inhibits Apaf1 which would normally activate caspases
3
Q
In the extrinsic pathway, how does the binding of the Fas-Ligand to the Fas receptor lead to apoptosis?
A
Binding of ligand creades binding site for FADD…a death adaptor protein that then activates caspases…Caspases then activate proteases
4
Q
Major differences between Necrosis and Apoptosis?
-Name 2
A
Necrosis is murder and Apoptosis = suicide
After necrosis, Inflammatory ensues but there is no inflammation in this “organized” way of dying
5
Q
Difference in sequence of events between Coagulative Necrosis and Liquefactive Necrosis
A
COAG: proteins denature first, then enzymatic degradation occurs
LIQUI: Enzymatc degradation due to release of lysosomal enzymes occurs first.
6
Q
Three diseases or species associated with Caseous Necrosis?
A
- TB
- Systemic Fungi
- Nocadia (a Gram.P.Rod)
7
Q
Two pathways of activating the extrinsic pathway of apoptosis?
A
- Via the binding of a Fas ligand to a Fas receptor (CD95)
- Via cytotoxix release of
a. Granzymes
b. Perforin
by CD8+ cells
8
Q
Two organs/disease processes associated with Fatty Necrosis?
What causes the “chalky” appearance in Fatty necrosis?
A
Pancreatitis (enzymatic saponification)
Breast Trauma (non-enzymatic sapofication) Nb: Saponification = binding with resulting in chalky deposit
9
Q
What kind of damage is inflicted by “Fibrioid Necrosis”?
Name 2 classic diseases associated with this type of necrosis?
A
DEF: this is damage to a vessel wall
EXAMPLES:
- Henoch-Schonlein Pupura,
- Churg Strauss Syndrome
**Also see in malignant HTN
10
Q
What is the major difference between wet gangrenous necrosis and dry?
Which two parts of the body are most susceptible to gangrenous necrosis?
A
DRY: regular Ischemic coagulative necrosis
WET: Same as above, but with infection superimposed on top.
COMMON SITES:
-GI Tract and limbs (think diabetes)
11
Q
Which organs undergo coagulative necrosis?
A
Everything except the brain! Brain = liquefactive necrosis due to high fat content
12
Q
What is the hallmark of reversible cellular injury? i.e. reversible with re-oxygenation
-Name at least 3 other findings in reversible damage?
A
HALLMARK= cellular swelling
OTHER FINDINGS:
- low Na+/K+ activity due to low ATP
- Fatty changes
- low glycogen
- Membrane Blebbing
- Ribosomal Detachment and low protein synthesis
13
Q
What is the hallmark of Irreversible cellular injury?
-Name at least 3 other findings in irreversible damage?
A
HALLMARK: Membrane damage from degradation of phospholipid and increasing Calcium concentration
OTHER FINDINGS:
- Nuclear: Pyknosis, karyorrhexis, karyolysis
- Lysosomal rupture
- Mitochondrial permeability and vacuolization
14
Q
the following organs, which areas are more susceptible to hypoxia/ischemia and infarction:
a. Brain
b. Heart
c. Colon
A
BRAIN:
- ACA/MCA/PCA boundary areas
HEART:
-LV Subendocardium
COLON:
- Splenic Flexure
- Rectum
15
Q
In the following organs, which areas are more susceptible to hypoxia/ischemia and infarction:
a. Kidney
b. Liver
A
KIDNEY:
-Straight segment of the proximal tubule
-Thick ascending limb
(both are found in the medulla)
LIVER:
-Zone III…the area around the central vein
16
Q
In Hypoxic Ischemic Encephalophathy (HIE), which 2 areas are most susceptible?
A
- Pyramidal cells of the hippocampus
- Purkinje cells of the cerebellum
17
Q
What is the difference between a RED and a PALE infarct?
A
PALE:
- usually due to occlusion
- occurs in solid tissues with a single blood supply (heart, kidney, spleen)
RED:
- usually hemorrhagic
- occurs in loose tissue with multiple blood supply (liver, lungs, intestines, etc)
18
Q
What causes reperfusion injury?
A
Damage by free radicals…so enzymes that quench free radicals will minimize this damage.
- Superoxide Dismutase
- Glutathione Peroxidase
- Catalase
19
Q
How does the PCWP IN cardiogenic versus hypovolemic shock?
How is the PCWP (high or low) in a distributive shock e.e. one including septic, neurogenic, or anaphylactic
A
Increased in Cardiogenic
Decreased in Hypovolemic
Decreased in distributive
20
Q
How do the vessels differ in cardiogenic (or hypovolemic) as compared to distributive shock?
How do these differences contribute to the differences in the appearance of the patients?
A
CARDIOGENIC/HYPOVOLEMIA:
–The vessels are constricted and the patient is cool and clammy
DISTRIBUTIVE SHOCK:
—Vessels are vasodilated and therefore, the patient is warm and has dry skin (flushing too)
21
Q
Name 7 processes that could cause atrophy?
A
- Reduction of endogenous hormones eg post-menopausal ovaries
- Increase in exogenous hormones e.g. factitious thyrotoxicosis or steroid hormones
- Decreased innervation…e.g. muscle damage
- low blood flow or nutrients
- decreased metabolic demand e.g. inpatient
- increased pressure e.g. nephrolithiasis
- occlusion of secretory ducts e.g cystic fibrosis
22
Q
Name three enzymes that lower free radicals
A
- Superoxide Dismutase
- Glutathione Peroxidase
- Catalase
23
Q
In inflammation, which two agents cause pain and how do they accomplish this?
A
PGE2 and Bradykinin.
They sensitize nerve endings and that’s how they cause pain
24
Q
Which 3 cells types are the key players in acute inflammation?
Which 3 cells types are the key players in chronic inflammation?
A
ACUTE:
- neutrophils
- eosinophils
- antibodies
CHRONIC:
- Macrophages
- T-cells
- Fibroblasts
25
# Define chromatolysis.
Name 3 findings in chromatolysis?
DEF:
-Changes observed in a cell body of a nerve during axonal damage. The changes reflect increased protein synthesis to try and repair the damaged axon.
FINDINGS:
- nucleus to the periphery
- Round cellular swelling
- Nissl substance dispersed throughout the cytoplasm
26
What are the two types of calcification?
How do they differ from one another. Give a classic example of each.
DYSTROPHIC:
- calcium deposition in tissues secondary to necrosis
- tends to be localized
- Examples: psammona bodies, TB, infarcts, thrombi, schistosomiasis, Moceknberg arteriosclerosis, congenital CMV + toxoplasmosis, fact necrosis, liquefactive necrosis of chronic abscessses
METASTATIC:
- calcim deposition in tissues secondary to increased serum calcium
- tends to be diffuse in multiple organs
Examples: Sarcoidosis, primary hyperparathyroidism, hypervitamin D, high calcium-phosphate product (chronic renal failure + 2ndary hyperparathyroidism, long-ter dialysis, CALCIPHYLAXIS, warfarin)
Tissue that loses acid quickly (kidney, lungs, gastric mucosa)favor deposition since deposition likes alkaline pH
27
How do the calcium levels compare in the two types of calcification?
DYSTROPHIC:
-normal calcium levels
METASTATIC
-high calcium level
28
During the 5 stages of leukocyte extravasation, which elements on leukocytes and on endothelium facilitate:
- margination and rolling?
1. E-SELECTIN on endothelium binds to Sialyl-Lewis on Leukocyte
2. P-SELECTIN (from WP body!!)on endothelium binds to Sialyl-Lewis on Leukocyte
3. GlyCAM-1 and CD34 on endothelium bind to L-selectin on leukocyte
29
During the 5 stages of leukocyte extravasation, which elements on leukocytes and on endothelium facilitate:
- tight binding I.E. firm adhesion?
ICAM-1 (CD54) on endothelium binds to LFA1 (CD18)/Mac-1 on leukocyte
V-CAM1 (CD106) on endothelium binds to VLA-4 integrin on leukocyte
30
During the 5 stages of leukocyte extravasation, which elements on leukocytes and on endothelium facilitate:
- diapesdesis?
PECAM-1 (CD31) on endothelium binds to PECAM-1 (CD31) on leukocyte
****EASY TO REMEMBER—haha******
31
Name 3 major chemotactic factors for leukocyte (think=PMN) migration and 2 other less-high yiled ones?
MAJOR (esp for PMNs):
- C5a
- LTB4
- IL-8
MINOR:
- kallikrein
- platelet activating factor
32
Besides the three common enzymes, what 2 other non-enzymatic processes eliminate free radicals?
1. spontaneous decay
| 2. antioxidants
33
Of the following processes, which ones generate free radicals?
- Radiation (e.g. cancer therapy)
- metabolism of drugs e.g. acetaminophen
- redox reactions
- nitric oxide
- transition elements
- leukocyte oxidative burst
ALL OF THEM!!!
34
Name 3 pathologies that can result from free radical injury?
1. Reperfusion injury
2. aCETA
3.
***look this up***
35
1. What is the most common pulmonary complication after exposure to fire?
2. What are the 3 manifestations of this complication?
1. Inhalation Injury i.e. ingestion of carbon particles and toxic fumes from the combustion
2. MANIFESTATIONS:
- Chemical Tracheobronchitis
- Edema
- Pneumonia
36
What is the difference in the collagen types laid in
a) HYPERTROPHIC SCAR
b) KELOID SCAR
a) HYPERTROPHIC SCAR
- increased scar tissue localized to the wound
- Excess Collagen Type I (stronger type that is laid at the end of healing)
b) KELOID SCAR
- exuberant response to scar which extends beyond the borders of the original wound
- Excess collagen Type III (the temporary one that is usually laid in temporary scar)
37
In wound healing, which mediator stimulates all aspects of angiogenesis and skeletal development?
FGF
38
In wound healing, which mediator stmulates cell growth via tyrosine kinases such as EGFR, as expressed by ERBB2?
EGF
39
In wound healing, which mediator stimulates angionesis, FIBROSIS,cell-cycle arrest and INHIBITS INFLAMMATION?
TGF-B
40
In wound healing, which mediator stimulates Tissue Remodelling?
Metalloproteases
-requires Zinc as co-factor
41
1. In wound healing, which induces vascular remodeling and smooth muscle igration as well as stimulating fibroblast gworth for caollagen synthesis?
2. Where does this factor come from?
PDGF
--made by platelets!!
42
During the remodeling phase of wound healing (after inflammation and the proliferative), which factor is responsible for wound contraction?
Myofibrolasts!!
That’s why people get contractures?
43
What are the 3 major phases of wound healing and which mediators are the major players?
1. INFLAMMATORY:
- platelets
- PMNs
- Marophages
2. PROLIFERATIVE:
- fibroblasts
- myofibroblasts
- endothelial cells
- keratinocytes
- macrophages
3. REMODELLING:
- Fibroblasts
44
What is the key switch that happens in the 3rd phase of wound healing?
Collagen Type III is replaced with Type I
45
Which granulomatous disease forms stellate granulomas with central necrosis?
Cat Scratch Disease caused by Bartonella Henselae
46
Which granulomatous disease results in the formation of “gummas”
Tertiary Syphillis
47
Which granulomatous disease seeds inmultiple tissues in the body?
Sarcoidosis
48
Which granulomatpus disease results from a parasitic worm?
Schistosomiasis (a.k.a. bilharzia)
49
Which granulomatous disease results in the loss of sensation?
Leprosy..caused by Mycobacterium Leprae
50
Three major differences in the constituents of exudate vs. transudate?
EXUDATE:
- thick fluid
- lots of cells
- protein rich
TRANSUDATE:
- thin fluid
- hyPOcellular
- s.gravity <1.012
- protein poor
51
What are the causes of transudation vs. exudation
EXUDATION:
- lymphatic obstruction
- malignancy
- inflammatory/infection
TRANSUDATION:
- increase on hydrostatic pressure or
- decrease in oncotic pressure
- increase Na+ retention [remember that it’s Na+ that regulates volume]
52
What causes the ESR to increase?
Inflammatory products such as fibrinogen cause deposit on surfaces of RBCs and cause the cells to aggregate and hence fall faster:
Seen in diseases like multiple myeloma, most anemias, infections, inflammation, or pregnancy
53
Which disease processes lead to a reduction in the ESR?
| -Name 3
- CHF
- Sickle Cell Anemia due to altered shape
- Polycythemia (increase RBCs dilute aggregation factors)
54
How does Fe2+ poisoning lead to cell death?
How to treat Fe2+ poisoning?
Cell death due to peroxidation of membrane lipids
Treatment:
Chelation (IV deferoxamine, or oral deferasirox) and dalysis
55
Which amyloid protein is deposited in primary amyloidosis?
Name the disease(s) associated with this type.
Which organ(s) is/are involved?
AL type which is due to deposition of Ig Light chains
CONDITION:
-multiple myeloma usually
Affects multiple organs:
- Renal-nephrotic syndrome
- Cardiac-restrictive cardiomyopathy and arrhythmia
- Hematological (easy bruising)
- GI (hepatomegaly)
- Neurologic (neuropathy)
56
Which type of amyloid protein is deposited in secondary amyloidosis?
-Which diseases, conditions, and systems are affected?
Type AA is deposited
- Associated with chronic conditions such as IBD, Chrohn’s RA
- It s also multi-system like the other primary amyloidosis
57
Which kind of amyloidosis is associated with deposition of fibrils B2-Microglobulin.
What is the condition that they often present with?
Dialysis-related amyloidosis which is often seen in patients with ESRD who are on dialysis.
OFTEN PRESENT WITH:
-Carpal Tunnel…since this b2 microglobulin deposits in joints
58
In the heritable form of amyloidosis, which gene is involved and how does this form of amyloidosis compare to another related form?
HERITABLE:
Mutated serum transthyretin is deposited in various organs includes nerves (loss of sensation), myocardium, leptpmeninges..
In normal-AGE-RELATED (SENILE) SYSTEMIC type,
It’s the wild type of transthyretin that will be deposited in heart and other tissues in this form of amyloidosis.
--However, it’s usually asymptomatic and cardiac dysfunction lower relative to AL amyloidosis
59
Which amyloid protein is deposited in Alzheimer’s disease and from where is it derived?
--where does is deposit?
A-B amyloid which is derived from amyloid precursor protein (on chromosome #21)
-CNS
60
Which amyloid protein is deposited in Down’s Syndrome and from where is it derived?
--where does is deposit?
A-B amyloid which is derived from amyloid precursor protein (on chromosome #21)
-deposited in the CNS
61
Which amyloid protein is deposited in Type II diabetes and from where is it derived?
--where does is deposit?
Amylin (Islet amyloid polypeptide-IAPP) derived from insulin
| Deposited onto pancreatic islets
62
A Positive Congo Red stain which shows apple green birefringence under polarized light is a classic finding in _________?
AMYLOIDOSIS!!!!!
High High High High Yield!
63
Yellow-brown “wear and tear” pigment found in heart liver kidney eye, and most organs on autopsy in older patients indicate what?
Where does this substance come from?
What disease does it cause?
Lipofuscin
Formation:
Lipofuscin is a pigment formed by oxidation and polymerization of autophagocytosed organellar membranes
Harmless!!
64
What are the five steps in neoplastic progression from a normal cell to metastasis?
Normal Cell------Hyperplasia & Dysplasia------Carcinoma-in-situ-----invasive Carcinoma-----Metastatic Carcinoma
65
Name 2 enzymes used by an invasive carcinoma to destroy the basement membrane as it progressed closer and closer to metastasis?
Hydrolases and Collagenases
66
In cancer, hematogenous spread is typical of which kinds of cancers and lymphatic spread is typical of which?
--What are the exceptions?
HEMATOGENOUS SPREAD:
-sarcomas usually
LYMPHATIC SPREAD:
-carcinomas usually
A few carcinomas spread hematogenoously though:
- -Renal Cell Cracinoma (via Renal Vein)
- -Hepatocellular carcinoma (via Hepatic Vein)
- --Follicular Carcinoma of the thyroid
- --Choricarcinoma = malignancy of the placenta…sreads hematogenously
67
What is P-glycoprotein?
Where is it expressed? i.e. on which cells will you find it?
What is its relevance in the treatment o of cancer?
DEF:
this is also known as “multidrug resistance protein”
--a transmembrane ATP-dependent efflux transporter
LOCATION:
-found on some cancer cells esp colon and liver
RELEVANCE to Rx:
-It pumps out toxins, including chemotherapeutic agents and hence decreases responsiveness or increases resistance to Rx over time
68
# Define the following terms:
a. DESMOPLASIA
| b. ANAPLASIA
a. DESMOPLASIA
- fibrous tissue formation in response to neoplasm e.g. “Linitis Plastcica ” in diffuse stomach cancer
b. ANAPLASIA
- lack of structural differentiation and function of cells and they start to resemble primitive cells of the same tissue
69
What is the difference between tumor grade and tumor stage?
Which measure has more prognostic value?
GRADE (range 1 to 4):
-measures degree of differentiation
4=anaplastic/poor differentiation and 1=well-differentiated
STAGE (TNM system):
- measures
i. localization/spread based on site
ii. size of primary lesion
iii. spread to lymph nodes
iv. metastasis
Stage is more prognostic because it asseses metastasis (most important factor)
T= tumor size
N= spread to lymph nodes
M= metastasis
e.g. cT3N1M0
70
What is Hallmark difference between a benign tumor and a malignant tumor?
Malignant tumor has the ability to metastasize
71
In terms of cell origin, what is the difference between:
CARCINOMA and
SARCOMA?
Both are malignant cancers but they are distinguished by the origin of the cells:
1. CARCINOMA:
- --derived from epithelial origin
SARCOMA?
----derived from mesenchymal origin
72
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Epithelium
BENIGN:
- Adenoma
- Papiloma
MALIGNANT:
- Adenocarcinoma
- Papillary carcinoma
73
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----Blood Cells
BENIGN:
-do not exist!!
MALIGNANT:
- Leukemia
- Lymphoma
74
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----Smooth Muscle
BENIGN:
-leiomyoma
MALIGNANT:
leiomyosarcoma
75
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----bood vessel
BENIGN:
-hemangioma
MALIGNANT:
-angiosarcoma
76
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----striated muscle
BENIGN:
rhabdomyoma
MALIGNANT:
-rhabdomyosarcoma
77
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----connective tissue
BENIGN:
-fibroma
MALIGNANT:
-fibrosarcoma
78
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----bone
BENIGN:
osteoma
MALIGNANT:
Osteosarcoma
79
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----fat
BENIGN:
-lipoma
MALIGNANT:
-liposarcoma
80
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----Cartilage
BENIGN:
-chondroma
MALIGNANT:
-chondrosarcoma
81
For the tissue below, what do we call the benign tumor and what do we call the malignant one?
Mesenchyme:
----melanocytes?
BENIGN:
-nevus (mole)
MALIGNANT:
-melanoma
82
Name 4 features of cachexia?
What 3 inflammatory mediators promote cachexia?
FEATURES:
- weight loss
- muscle atrophy
- fatigue
- occurs in chronic diseases such as (cancer, AIDS, heart failure, TB)
MEDIATORS:
- TNF-alpha
- IFN-gamma
- IL-6
83
Which Neoplasms are associated with the following conditions:
ACANTHOSIS NIGRICANS:
ACTINIC KERATOSIS:
AIDS:
ACANTHOSIS NIGRICANS:
-visceral malignancy (esp stomach)
ACTINIC KERATOSIS:
-Squamoust Cell Carcinoma
AIDS:
- Kaposi Sarcoma
- Aggressive Malignant Lymphomas (non-Hodgkin)
84
Which Neoplasms are associated with the following conditions:
AUTOIMUNE DISEASES (e.g. SLE, Hashimoto Thyroiditis):
BARRERTT’S ESOPHAGUS:
CHRONIC ATROPHIC GASTRITIS:
PERNICIOUS ANEMIA/POST-SURGICAL GASTRIC REMNANTS:
```
AUTOIMUNE DISEASES (e.g. SLE, Hashimoto Thyroiditis):
-Lymphoma
```
BARRERTT’S ESOPHAGUS:
-Esophageal adenocarcinoma
CHRONIC ATROPHIC GASTRITIS:
-Gastric adenocarcinoma
PERNICIOUS ANEMIA/POST-SURGICAL GASTRIC REMNANTS:
--Gastric adenocarcinoma
85
Which Neoplasms are associated with the following conditions:
CIRRHOSIS:
CHUSHING SYNDROME:
DERMATOMYOSITIS:
DOWN’S SYNDROME:
CIRRHOSIS:
-hepatocellualr carcinoma
CUSHING SYNDROME:
-small cell cancer
DERMATOMYOSITIS:
-Lung Cancer
DOWN’S SYNDROME:
-ALL, AML
86
Which Neoplasms are associated with the following conditions:
DYSPLASTIC NEVUS:
HYPERCALCEMIA:
IMMUNODEFICIENCY:
LAMBERT-EATON MYASTHENIC SYN:
DYSPLASTIC NEVUS:
-malignant melanoma
HYPERCALCEMIA:
-squamous cell lung cancer
IMMUNODEFICIENCY:
-malignant lymphomas
LAMBERT-EATON MYASTHENIC SYN:
-small cell carcinoma
87
Which Neoplasms are associated with the following conditions:
MYASTHENIA GRAVIS or PURE RBC APLASIA:
PAGET’S DISEASE OF THE BONE:
PLUMMER VINSON SYNDROME:
POLYCYTHEMIA:
MYASTHENIA GRAVIS or PURE RBC APLASIA:
-thymoma
PAGET’S DISEASE OF THE BONE:
-2ndary osteosarcoma and fibrosarcoma
PLUMMER VINSON SYNDROME:
-squamous cell carcinoma of the esophagitis
POLYCYTHEMIA:
- renal cell carcinoma,
- hepatocellulalr carcinoma
88
Which Neoplasms are associated with the following conditions:
RADIATION EXPOSURE:
SIADH:
TUBEROUS SCLEROSIS:
```
RADIATION EXPOSURE:
-leukemia
-sarcoma
-papillary thyroid cancer
Breast cancer
```
SIADH:
-small cell lung cancer
TUBEROUS SCLEROSIS:
- giant cell astrocytoma
- renal angiomyolipoma
- cardiac rhabdomyoma
89
Which Neoplasms are associated with the following conditions:
ULCERATIVE COLITIS:
XERODERMA PIGMENTOSUM/ALBINISM:
ULCERATIVE COLITIS:
-colonic adenocarcinoma
XERODERMA PIGMENTOSUM/ALBINISM:
- melanoma
- basal cells carcinoma
- squamous cell carcinoma of the skin
90
What gene product results from the following oncogene?
BCR-ABL
What is the associated tumor?
GENE PRODUCT:
Tyrosine kinase
--Rx = gleevec (imatinib)
ASSOCIATED TUMOR:
- CML
- ALL
91
What gene product results from the following oncogene?
BCL-2
What is the associated tumor?
GENE PRODUCT:
-anti-apoptotic molecule
ASSOCIATED TUMOR:
-follicular and undifferentiated lymphomas
92
What gene product results from the following oncogene?
BRAF
What is the associated tumor?
GENE PRODUCT:
Serine/threonine kinase
--Rx = vemurafenib
ASSOCIATED TUMOR:
melanoma
93
What gene product results from the following oncogene?
C-KIT
What is the associated tumor?
GENE PRODUCT:
-cytokine receptor for stem cell factor
ASSOCIATED TUMOR:
-gastrointestinal stromal tumor [GIST]
94
What gene product results from the following oncogene?
C-MYC
What is the associated tumor?
GENE PRODUCT:
-transcription factor
ASSOCIATED TUMOR:
-Burkitt’s lymphoma
95
What gene product results from the following oncogene?
HER2/neu (c-erbB2)
What is the associated tumor?
GENE PRODUCT:
Tyrosine kinase
ASSOCIATED TUMOR:
Trastuzumab
96
What gene product results from the following oncogene?
L-MYC
What is the associated tumor?
GENE PRODUCT:
-transcription factor
ASSOCIATED TUMOR:
-lung tumor
97
What gene product results from the following oncogene?
N-MYC
What is the associated tumor?
GENE PRODUCT:
-transcripton factor
ASSOCIATED TUMOR:
-neuroblastoma
98
What gene product results from the following oncogene?
RAS
What is the associated tumor?
GENE PRODUCT:
-GTPase
ASSOCIATED TUMOR:
- colon cancer
- lung cancer
- pancreatic cancer
99
What gene product results from the following oncogene?
RET
What is the associated tumor?
GENE PRODUCT:
-tyrosine kinase
ASSOCIATED TUMOR:
MEN 2A and 2B
100
What gene product results from the following tumor suppressor genes?
APC
What is the associated tumor?
GENE PRODUCT:
-----
ASSOCIATED TUMOR:
-colorectal cancer (associated with FAP)
101
What gene product results from the following tumor suppressor genes?
BRCA1
BRACA2
What is the associated tumor?
GENE PRODUCT:
-dna repair protein
ASSOCIATED TUMOR:
-breast and ovarian cancer
102
What gene product results from the following tumor suppressor genes?
BRCA1
BRACA2
What is the associated tumor?
GENE PRODUCT:
-dna repair protein
ASSOCIATED TUMOR:
-breast and ovarian cancer
103
What gene product results from the following tumor suppressor genes?
CPD4/SMAD4
What is the associated tumor?
GENE PRODUCT:
-DPC (deleted in pancreatic cancer)
ASSOCIATED TUMOR:
-pancreatic cancer
104
What gene product results from the following tumor suppressor genes?
DCC
What is the associated tumor?
GENE PRODUCT:
DCC (deleted in colon cancer)
ASSOCIATED TUMOR:
-colon cancer
105
What gene product results from the following tumor suppressor genes?
MEN1
What is the associated tumor?
GENE PRODUCT:
------
ASSOCIATED TUMOR:
-MEN Type 1
106
What gene product results from the following tumor suppressor genes?
NF1
NF2
What is the associated tumor?
GENE PRODUCT:
-NF1=RAS GTPase activating protein (neurofibromin)
-NF2=Merlin (schwannomin) protein
ASSOCIATED TUMOR:
- neurofromatosis type 1
- neurofromatosis type 2
107
What gene product results from the following tumor suppressor genes?
p16
What is the associated tumor?
GENE PRODUCT:
-cyclin-dependent kinase inhibitor 2A
ASSOCIATED TUMOR:
-melanoma
108
What gene product results from the following tumor suppressor genes?
p53
What is the associated tumor?
GENE PRODUCT:
-TF for p1…block G1-S phase
ASSOCIATED TUMOR:
- most human cancers
- Li Fraumeni Syndrome
109
What gene product results from the following tumor suppressor genes?
-PTEN
What is the associated tumor?
```
GENE PRODUCT:
-----
ASSOCIATED TUMOR:
-breast cancer
-prostate cancer
-endometrial cancer
```
110
What gene product results from the following tumor suppressor genes?
Rb
What is the associated tumor?
GENE PRODUCT:
Inhibits E2F, blocks G1-S phase
ASSOCIATED TUMOR:
- retinoblastoma
- osteosarcoma
111
What gene product results from the following tumor suppressor genes?
- TSC1
- TSC2
What is the associated tumor?
GENE PRODUCT:
TSC1-Harmatin protein
TSC2-Tuberin protein
ASSOCIATED TUMOR:
-tuberous sclerosis
112
What gene product results from the following tumor suppressor genes?
-VHL
What is the associated tumor?
GENE PRODUCT:
-inhibits hypoxia inducible factor 1a
ASSOCIATED TUMOR:
-von Hippel-Lindau disease
113
What gene product results from the following tumor suppressor genes?
- WT1
- WT2
What is the associated tumor?
GENE PRODUCT:
------
ASSOCIATED TUMOR:
-Wilms Tumor
114
Which diseases/cancers are indicated by the following tumor markers?
**Alkaline Phosphatase
- Metastases to bone, liver
- Paget disease of bone
- seminoma (placental ALP)
115
Which diseases/cancers are indicated by the following tumor markers?
****Alpha-Fetoprotein
Normally made by fetus.
- hepatocellular carcinoma
- hepatoblastoma
- yolk sac (endodermal sinus) tumor
- testicular cancer
- mixed germ cell tumor (co-secreted with B-hCG)
116
Which diseases/cancers are indicated by the following tumor markers?
****B-hCG
- Hyatidiform moles
- Choriocarcinomas (gestational trophoblastic disease)
- testicular cancer
117
Which diseases/cancers are indicated by the following tumor markers?
* ***CA-15-3
* ***CA-27-29
Breast cancer
118
Which diseases/cancers are indicated by the following tumor markers?
*****CA-19-9
Pancreatic adenocarcinoma
119
Which diseases/cancers are indicated by the following tumor markers?
*****CA-125
Ovarian cancer
120
Which diseases/cancers are indicated by the following tumor markers?
****calcitonin
Medullary thyroid carcinoma
121
Which diseases/cancers are indicated by the following tumor markers?
* ***CEA
i. e. carcinoembryonic antigen
It’s very unspecific
~70% of colorectal and pancreatic cancers
-also produced by gastric breast and
Medullary thyroid carcinoma
122
Which diseases/cancers are indicated by the following tumor markers?
*****PSA
Used to follow prostate adenocarcinoma
***Can also be elevated in BPH and prostatitis
123
Which diseases/cancers are indicated by the following tumor markers?
*****S-100
Neural crest origin (e.g. melanoma, neural tumors, shchwannomas, Langerhans cell histiocytosis)
124
Which diseases/cancers are indicated by the following tumor markers?
****TRAP
Hairy Cell Leukemia (a B-cell neoplasm)
125
```
Which cancer(s) is/are associated with the following microbe:
-EBV
```
Burkitt lymphoma
- Hodgkin’s Lymphoma
- Nasopharyngeal Carcinoma
- CNC lymphoma (immunocomprised patients)
126
```
Which cancer(s) is/are associated with the following microbe:
-HBV, HCV
```
Hepatocellular carcinoma
127
```
Which cancer(s) is/are associated with the following microbe:
HHV-8
```
Kaposi sarcoma,
| Body cavity fluid B-cell
128
```
Which cancer(s) is/are associated with the following microbe:
-HPV
```
- cervical and penile/anal carcinoma (16,18)
| - head and neck or throat cancer
129
```
Which cancer(s) is/are associated with the following microbe:
-H.Pylori
```
Gastric adenocarcinoma
| MALT Lymphoma
130
```
Which cancer(s) is/are associated with the following microbe:
-HTLV-1
```
Adult- T-cell leukemia/lymphoma
131
```
Which cancer(s) is/are associated with the following microbe:
-Liver Fluke (Clonorchis Sinensis)
```
Cholangiocarcinoma
132
```
Which cancer(s) is/are associated with the following microbe:
Schistosoma Haematobium
```
Bladder cancer (squamous cell)
133
For the carcinogen listed below, which organ is affected and what type cancer results?
****Aflatoxin (Aspergillus)
ORGAN:
-Liver
IMPACT/CANCER:
-hepatocellular carcinoma
134
For the carcinogen listed below, which organ is affected and what type cancer results?
****Alkylating agents
ORGAN:
Blood
IMPACT/CANCER:
Leukemia/Lymphoma
135
For the carcinogen listed below, which organ is affected and what type cancer results?
*****Aromatic amines (eg benzidine or 2-napthylamine)
ORGAN:
-bladder
IMPACT/CANCER:
Transitional cell carcinoma
136
For the carcinogen listed below, which organ is affected and what type cancer results?
****Arsenic
ORGAN:
- liver
- lung
- skin
IMPACT/CANCER:
- angiosarcoma
- lung cancer
- squamous cell carcinoma
137
For the carcinogen listed below, which organ is affected and what type cancer results?
******Asbestos
ORGAN:
-lung
IMPACT/CANCER:
Bronchogenic carcinoma>>>mesothelioma
138
For the carcinogen listed below, which organ is affected and what type cancer results?
*****Carbon tetrachloride****
ORGAN:
-liver
IMPACT/CANCER:
- centrilobular necrosis
- fatty change
139
For the carcinogen listed below, which organ is affected and what type cancer results?
***cigarette smoke***
```
ORGAN:
Bladder
-esophagus
-kidney
-larynx
-lung
-pancreas
```
```
IMPACT/CANCER:
-Transitional cell carcinoma
-squamous cell carcinoma/adenocarcinoma
-renal cell carcinoma
-SCC
-SCC and small cell carcinoma
Pancreatic adenocarcinoma
```
140
For the carcinogen listed below, which organ is affected and what type cancer results?
****Ethanol (Alcohol)
ORGAN:
-liver
IMPACT/CANCER:
-hepatocellualr carcinoma
141
For the carcinogen listed below, which organ is affected and what type cancer results?
****ionizing radiation
ORGAN:
-thyroid
IMPACT/CANCER:
-papillary thyroid carcinoma
142
For the carcinogen listed below, which organ is affected and what type cancer results?
***nitrosamines (smoked foods)
ORGAN:
-stomach
IMPACT/CANCER:
-gastric cancer
143
For the carcinogen listed below, which organ is affected and what type cancer results?
***radon
ORGAN:
-lung
IMPACT/CANCER:
-LUNG CANCER (2nd leading cause after cigaretted smoke)
144
For the carcinogen listed below, which organ is affected and what type cancer results?
****Vinyl Chloride
ORGAN:
-liver
IMPACT/CANCER:
-angiosarcoma of the lover
145
For the carcinogen listed below, which organ is affected and what type cancer results?
****Nickel, Chromium, Beryllium, Silica
ORGAN:
-lung
IMPACT/CANCER:
-lung carcinoma
146
Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
1,25-(OH)2-D3
What is the effect of 1,25-(OH)2-D3?
EFFECT OF AGENT/HORMONE:
-hypercalcemia
NEOPLASM(S)
- hodgkin’s lymphoma
- some NHLs
147
Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
ACTH
What is the effect of ACTH?
EFFECT OF AGENT/HORMONE:
-cushing syndrome
NEOPLASM(S):
-small cell lung carcinoma
-
148
Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
-ADH
What is the effect of ADH?
EFFECT OF AGENT/HORMONE:
-SIADH
NEOPLASM(S):
- small cell carcinoma
- intracranial neoplasms
149
Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
-antibodies against pre-synaptic Ca2+ channels
What is the effect of this antibodies?
EFFECT OF AGENT/HORMONE:
-lambert eaton myasthenic syndrome
NEOPLASM(S):
Small cell lug carcinoma
150
Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
What is the effect of the hormone/agent?
EFFECT OF AGENT/HORMONE:
NEOPLASM(S)
151
Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
---erythropoietin (EPO)
What is the effect of the hormone/agent?
EFFECT OF AGENT/HORMONE:
--polycythemia
NEOPLASM(S):
- renal cell carcinoma
- thymoma
- hemangioblastoma
- hepatocellular carcinoma
- leiomyoma
- pheochromocytoma
152
Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
---PTHrP
What is the effect of the hormone/agent?
EFFECT OF AGENT/HORMONE:
--hypercalcemia
NEOPLASM(S):
- squamous cell lung carcinoma
- renal cell carcinoma
- breast cancer
153
Name the 5 conditons associated with Psammoma bodies?
- Papillary Carcinoma of the thyroid
- serous papillary cystadenocarcinoma of ovary
- meningioma
- malignant mesothelioma
154
Name, in order of prevalence, the top 3 cancers in men and women in the US?
MEN:
- Prostate cancer
- lung cancer
- colon/rectum cancer
WOMEN:
- breast cancer
- lung cancer
- colon/rectum cancer
155
Name, in order of mortality, the top 2 cancer killers in men and women in the US?
MEN:
- lung
- prostate
WOMEN:
- lung cancer
- breast cancer
156
Rank, in order from most common, the cancers that metastasize to the:
BRAIN
Lung>breast>genitourinary >osteosarcoma>melanoma>GI
157
Rank, in order from most common, the cancers that metastasize to the:
LIVER
Collon>>stomach>pancreas
158
Rank, in order from most common, the cancers that metastasize to the:
BONE
Prostate, Breast>Lung>thyroid
159
Which amyloid protein is deposited in medullary carcinoma of the thyroid and from where is it derived?
--where does is deposit?
A Cal
Deposits in the kidney and derived from “procalcitonin”
