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Pathology: Neoplasia Flashcards

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1
Q

What neoplasms are associated with Down Syndrome?

A

ALL (think we ALL fall DOWN), AML

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2
Q

Melanoma, basal cell carcinoma, and especially squamous cell carcinoma of the skin are all associated with what conditions?

A

Xeroderma Pigmentosum, Albinism

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3
Q

What conditions are associated with Gastric adenocarcinoma?

A
  1. Chronic atrophic gastritis;
  2. Post-surgical gastric remnants;
  3. Pernicious Anemia;
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4
Q

What neoplasms are typically found in this condition that is characterized by a facial angiofibroma, seizures and mental retardation?

A

Tuberous Sclerosis
1. Giant cell astrocytoma;
2. Renal angiomyolipoma
3. Cardiac rhabdomyoma;

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5
Q

Actinic Keratosis is associated with what neoplasm?

A

Squamous cell carcinoma of the skin;

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6
Q

Esophageal adenocarcinoma most commonly arises from what condition?

A

Barrett’s Esophagus due to chronic GI reflux

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7
Q

Squamous cell carcinoma of the esophagus in associated with what condition?

A

Plummer-Vinson syndrome - presents as a triad of dysphagia , esophageal webs, and iron deficiency anemia.

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8
Q

Hepatocellular carcinoma is often associated with Cirrhosis. What types of patients are at risk?

A
  1. Alcoholics;
  2. Hepatitis B;
  3. Hepatitis C;
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9
Q

Colonic adenocarcinoma is associated with what subtype of inflammatory bowel disease?

A

Ulcerative Colitis

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10
Q

Paget’s disease of the bone is associated with what neoplasms?

A

Secondary osteosarcoma and fibrosarcoma

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11
Q

Immunodeficiency states are associated with what neoplasms?

A

Lymphomas

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12
Q

AIDS is associated with what neoplasms?

A
  1. Aggressive malignant lymphomas (non-Hodgkin’s);
  2. Kaposi’s sarcoma;
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13
Q

In addition to immunodeficiency states, lymphomas are also associated with…

A

Autoimmune diseases (e.g. Hashimoto’s thyroiditis, myasthenia gravis);

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14
Q

Hyperpigmentation and epidermal thickening that can be associated with visceral malignancy (e.g. stomach, lung, uterus):

A

Acanthosis Nigricans

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15
Q

What condition is associated with a malignant melanoma?

A

Dysplastic Nevus

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16
Q

Radiation exposure is associated with what neoplasms?

A
  1. Leukemia;
  2. Sarcoma;
  3. Papillary thyroid cancer;
  4. Breast cancer;
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17
Q

_________ is weight loss, muscle atrophy, and fatigue that occur in chronic disease such as cancer, AIDS, heart failure and TB. What mediates this process?

A

Cachexia
1. TNF-alpha
2. IFN-gamma
3. IL-6

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18
Q

Oncogene associated with CML:

A

ABL-BCR t(9,22)

(ABL codes for a tyrosine kinase & its translocation next to BCR makes it constitutively active, stimulating the proliferation of granulocytes)

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19
Q

Oncogene associated with Burkitt’s Lymphoma:

A

c-myc t(8,14)

(c-myc = nuclear phosphoprotein that functions as a transcription activator. It is translocated to the Ig heavy chain region on chromosome 14)

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20
Q

Oncogene associated with follicular and undifferentiated lymphomas:

A

BCL-2 (anti-apoptotic molecule)

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21
Q

Oncogene associated with breast, ovarian, and gastric carcinomas:

A

HER2/neu (c-erbB2) – (tyrosine kinase)

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22
Q

Oncogene associated with colon carcinoma:

A

ras (GTPase)

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23
Q

Oncogene associated with lung tumors:

A

L-myc (transcription factor)

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24
Q

Oncogene associated with neuroblastoma:

A

N-myc (transcription factor)

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25
Oncogene associated with multiple endocrine neoplasia (MEN) types 2A and 2B:
RET (tyrosine kinase)
26
Oncogene associated with GI stromal tumor:
c-kit (cytokine receptor)
27
TSG associated with retinoblastoma and osteosarcoma:
Rb (inhibits E2F thereby blocking G1 to S phase transition)
28
TSG associated with most human cancers and particularly with *Li-Fraumeni syndrome*:
p53 (transcription factor for p21 that blocks G1 to S phase)
29
TSG associated with breast and ovarian cancer:
BRCA1/BRCA2 (DNA repair proteins)
30
TSGs associated with melanoma:
p16, BRAF
31
TSG associated with colorectal cancer (specifically familial adenomatous polyposis):
APC
32
TSG associated with Wilm's Tumor (nephroblastoma):
WT1
33
TSG associated with neurofibromatosis type 1:
NF-1 (RAS GTPase activating protein or RAS-GAP)
34
TSG associated with neurofibromatosis type 2:
NF-2 (Merlin protein) -- aka schwannomin
35
TSG associated with Pancreatic cancer:
DPC4 THINK deleted in pancreatic cancer
36
TSG associated with colon cancer:
DCC THINK -- deleted in colon cancer;
37
What microbe is associated with adult t cell leukemia/lymphoma?
HTLV-1
38
What microbes are associated with hepatocellular carcinoma?
Hepatitis B and Hepatitis C virus
39
What cancers are associated with EBV?
1. Burkitt's Lymphoma; 2. Hodgkin's Lymphoma 3. Nasopharyngeal carcinoma; 4. CNS lymphoma (in immunocompromised)
40
What cancers are associated with HPV infection?
1. Cervical carcinoma (HPV 16, 18); 2. Penile/anal carcinoma; 3. Upper respiratory SCC
41
HHV-8 is associated with what cancers?
1. Kaposi's Sarcoma; 2. Body cavity fluid B-cell lymphoma;
42
H. pylori is associated with what cancers?
Gastric adenocarcinoma and lymphoma
43
Bladder cancer (squamous cell) is associated with what microbe?
Schistosoma haematobium
44
Cholangiocarcinoma is associated with what microbe?
Liver fluke (Clonorchis Sinensis)
45
_____ is used to follow prostate carcinoma. What other conditions can it be elevated?
PSH BPH, prostatitis
46
Marker specific for prostate carcinoma:
Prostatic acid phosphatase
47
*Carcino-Embryonic Antigen* or CEA is a nonspecific marker seen in what cancers?
70% of colorectal and pancreatic cancers; Gastric, breast, and medullary thyroid carcinomas;
48
alpha-fetoprotein is normally made by a fetus. It is associated with what cancers?
1. Hepatocellular carcinoma 2. Non-seminomatous germ cell tumors (e.g. testis, ovary)
49
This tumor marker is commonly associated with pregnancy. What types of cancer is it associated with?
B-hCG Hydatidiform moles and Choriocarcinoma (Gestational Trophoblastic Disease)
50
Tumor marker associated with ovarian cancer:
CA-125
51
Marker associated with neuroendocrine cell tumors (e.g. melanoma, neural tumors, schwannomas):
S-100
52
Tumor marker associated with neuroblastoma, lung and gastric cancer:
Bombesin
53
Tumor marker associated with Hairy cell leukemia (B cell neoplasm):
Tartrate-Resistant Acid Phosphatase (TRAP) -- think TRAP the hairy animal !
54
Tumor marker associated with pancreatic adenocarcinoma:
CA-19-9
55
Tumor marker associated with medullary thyroid carcinoma:
Calcitonin
56
What chemical carcinogen causes hepatocellular carcinoma of the liver?
Aflatoxin (Aspergillus)
57
What chemical carcinogen causes angiosarcoma of the liver?
Vinyl chloride
58
What chemical carcinogen causes centrilobular necrosis and fatty change of the liver?
Carbon Tetrachloride
59
What chemical carcinogen causes gastric cancer in the stomach? (HINT -- high incidence in Japan)
Nitrosamines (smoked foods)
60
List the organs that cigarette smoke affects and the associated cancer:
1. Larynx (squamous cell carcinoma) 2. Lung (squamous cell carcinoma + small cell carcinoma) 3. Kidney (renal cell carcinoma) 4. Bladder (transitional cell carcinoma) 5. Pancreas (pancreatic adenocarcinoma)
61
This chemical carcinogen causes bronchogenic carcinoma > mesothelioma:
Asbestos
62
What chemical carcinogen causes squamous cell carcinoma of the skin along with angiosarcoma in the liver?
Arsenic
63
What chemical carcinogen causes transitional cell carcinoma in the bladder?
Naphthalene (aniline) dyes
64
Alkylating agents are chemical carcinogens that can cause....
Leukemia
65
*Psammoma bodies* are laminated, concentric, calcific spherules that are seen in what conditions?
1. Papillary adenocarcinoma of thyroid 2. Serous papillary cystadenocarcinoma of the ovary 3. Meningioma 4. Malignant mesothelioma
66
Cushing's syndrome can be associated with what neoplasm?
Small cell lung carcinoma (produces ACTH or ACTH-like peptide)
67
SIADH can be associated with what neoplasms?
1. Small cell lung carcinoma | 2. Intracranial neoplasms
68
Hypercalcemia can be associated with what neoplasms that produce PTH-RP?
1. Squamous cell lung carcinoma 2. Renal cell carcinoma 3. Breast cancer;
69
Hypercalcemia can be associated with what neoplasms that produce calcitriol?
1. Hodgkin's Lymphoma | 2. Some non-Hodgkin's Lymphoma
70
Polycythemia due to elevated erythropoietin production is associated with what neoplasms?
1. Renal cell carcinoma 2. Hemangioblastoma 3. Hepatocellular carcinoma 4. Pheochromocytoma
71
Lambert-Eaton syndrome is associated with what neoplasm?
Small cell lung carcinoma (antibodies against pre-synaptic Ca2+ channels at NMJ)
72
List the order of incidence of cancer in males and females:
Male: Prostate > Lung > Colon/Rectum Female: Breast > Lung > Colon Rectum
73
List the order of mortality from cancer in males and females:
Male: Lung > Prostate Female: Lung > Breast
74
50% of brain tumors are from metastases and are typically multiple well-circumscribed tumors at gray/white matter junction. List the order of primary tumors that metastasize to the brain:
Lung > Breast > Genitourinary > Osteosarcoma > Melanoma > GI
75
Liver and lung are the most common sites of metastasis after regional lymph nodes. List in order of frequency the primary tumor sites:
Colon >> Stomach > Pancrease
76
Bone metastasis >> Primary bone tumors. Whole body bone scans shows tumor predilection for the axial skeleton. List in order of frequency the primary tumor sites:
Prostate, breast > lung > thyroid, testes
77
How can you tell the difference between a lung, prostate or breast cancer metastasis to the bone?
``` Lung = lytic lesion Prostate = blastic lesion Breast = lytic and blastic lesion ```
78
Overexpressed in astrocytoma:
Platelet Derived Growth Factor (PDGF)
79
Cell cycle regulator turned oncogene associated with mantle cell lymphoma:
Cyclin D1 -- involves t(11,14) involving IgH (heavy chain) | cyclin D1 = promoter of G1 - S phase transition
80
Cell cycle regulator turned oncogene that is amplified in melanoma:
CDK4
81
Explain how RAS works:
*Mutated RAS* -- inhibits the activity of GTPase activating protein. This prolongs the activated state of RAS, resulting in increased growth signals.
82
Necessary for cell immortality:
*Telomerase* -- normally telomeres shorten with serial cell divisions, eventually resulting in cellular senescence. Cancer cells have upregulated telomerase, which preserves telomeres
83
Necessary for tumor survival and growth:
Angiogenesis -- production of new blood vessels -- *FGF* and *VEGF* are commonly produced by tumor cells.
84
Mutations often result in the production of abnormal proteins, which are expressed on MHC class I. CD8+ T cells detect and destroy such mutated cells. How do tumor cells avoid immune surveillance?
Via the downregulation of MHC Class I -- note that states of immunodeficiency increases the risk for cancer
85
Seeding of body cavities is characteristic of this cancer that often involves the peritoneum -- "omental caking":
Ovarian Carcinoma
86
The first stop in metastasis:
Initial spread is to regional draining lymph nodes
87
What is the function of the gene that is mutated in Retinoblastomas?
Rb "holds" the E2F transcription factor, which is necessary for transition to the S phase. By doing so Rb exerts control over cell cycle progression. E2F is only released when Rb is phosphorylated by CyclinD/CDK-4 complex. Rb mutation results in constitutively free E2F, allowing progression through the cell cycle and uncontrolled growth of cells.
88
Hematogenous spread is typically characteristic of sarcomas but some carcinomas can also spread via circulation. What are they?
1. Renal cell carcinoma (invades renal vein) 2. Hepatocellular carcinoma (invades hepatic vein) 3. Follicular carcinoma of the thyroid;4. Choriocarcinoma
89
Intermediate filament found in epithelium:
Keratin
90
Intermediate filament found in mesenchyme:
Vimentin
91
Intermediate filament found in muscle:
Desmin
92
Intermediate filament found in neuroglia cells:
GFAP
93
Intermediate filament found in neurons:
Neurofilament
94
Gene mutation ass'd w/ Renal Cell Carcinoma?
Gene deletion on Chromosome 3
95
Gene mutation ass'd w/ Wilm's Tumor (Nephroblastoma)?
Deletion of tumor suppressor gene WT1 on chromosome 11 | most common renal malignancy of early childhood, 2-4 yrs.
96
Transitional Cell Carcinoma is ass'd w/ what 4 things?
Phenacetin, Smoking, Aniline dyes, Cyclophosphamide | problems w/ your "Pee SAC"

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