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Boards > Pathoma Ch. 3 - Neoplasia Basics > Flashcards

Pathoma Ch. 3 - Neoplasia Basics Flashcards

1
Q

Determining clonality in somatic cells vs. B cells

A

Somatic - G6PD isoform (normal = A:G 1:1)

B cells - Ig light chain (normal = kappa:lambda 3:1)

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2
Q

Leading causes of death in adults vs. children

A

Adults: Cardiovascular, cancer, cerebrovascular
Kids: Accidents, cancer, congenital defects

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3
Q

Why is lung cancer the most popular killer?

A

No good detection mechanism

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4
Q

Classes of oncogenes (w/ classic examples)

A

Growth factors (ex. PDGF-beta)
Growth factor receptors (ex. HER2, RET, KIT)
Signal transducers (ex. RAS, ABL)
Nuclear regulators (ex. Myc)
Cell cycle regulators (ex. cyclin D1, CDK4)

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5
Q

Classic tumor suppressor genes (w/ fxns of each)

A

P53 (slow G1 –> S cell cycle, upregulate DNA repair, and/or induce apoptosis via BAX if DNA damage can’t be repaired)

Rb (slow G1 –> S cell cycle by holding E2F inactive)

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6
Q

Rb phosphorylated vs. dephosphorylated

What inactivates it?

A 
Phosphorylated = release E2F
Dephosphorylated = hold E2F

Cyclin D/CDK4

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7
Q

What is true regarding the mutations for both p53 and Rb?

A
  1. Inactivating mutations

2. BOTH copies must be knocked out

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8
Q

Bcl overmutation

Result?

A

Follicular lymphoma

No apoptosis –> increased germinal centers, etc.

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9
Q

Overactive…

- PDGF-beta
- RET
- KIT
- ABL
- CKD4
A 
Astrocytoma
MEN2, Sporadic medullary thyroid cancer
GIST
CML, adult ALL
Melanoma
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10
Q

Contaminated stored grains

A

Aflatoxins – HCC

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11
Q

Alcohol - cancers (4)

A

Oropharynx SCC, Upper esophagus SCC, Pancreas, HCC

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12
Q

Arsenic - cancers (3)

A

SCC of skin, Lung cancer, Liver angiosarcoma

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13
Q

Cigarette smoke - cancers (5)

A

Oropharynx, Esophagus, Lung, Kidney, Bladder

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14
Q

Smoked foods in japan

A

Nitrosamines - intestinal stomach cancer

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15
Q

Naphthylamine

A

Urothelial carcinoma of bladder

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16
Q

Vinyl chloride

Common route of exposure here

A

Angiosarcoma of liver

PVC pipe

17
Q

Nickel, chromium, beryllium, or silica

A

Lung cancer

18
Q

EBV

A

Nasopharyngeal carcinoma (Asia, Africa), Burkitt lymphoma (endemic), primary CNS lymphoma (AIDS)

19
Q

HHV-8 in eastern european male

Treatment?

A

Kaposi sarcoma

Excise it

20
Q

High risk HPV

A

SCC of vulva, vagina, anus, cervix

Adenocarcinoma of cervix

21
Q

Ionizing radiation (Chernobyl, cancer)

A

AML, CML, papillary thyroid cancer (free radicals)

22
Q

UVB sunlight

A

BCC, SCC, Melanoma (pyrimidine dimers)

23
Q

Angiogenesis in cancers occurs via what?

A

FGF and VEGF

24
Q

Tumor cells dissociate via ____
Tumor cells attach to ___ on BM and destroy it via ____
Tumor cells attach to ___ in the ECM to spread locally

A

Down-regulation of E-cadherin
Laminin; Collagenase (type 4 collagen destruction)
Fibronectin

25
Q

IN GENERAL, carcinomas spread via ___

Exceptions? (4)

A

Lymphatics (regional LNs)

  1. RCC (renal vein)
  2. HCC (hepatic vein)
  3. Follicular thyroid carcinoma
  4. Choriocarcinoma (trophoblasts find BVs)
26
Q

Classic characteristics of malignant tumors (7)

A
  1. Poorly differentiated
  2. Disorganized growth
  3. Nuclear pleomorphism
  4. Hyperchromasia
  5. High nuclear:cytoplasm ratio
  6. High mitotic activity w/ atypical mitoses
  7. Invasion (metastatic potential)
27
Q

Cancer types…

  • Keratin
  • Vimentin
  • Desmin
  • GFAP
  • Neurofilament
A 
Epithelium
Mesenchyme
Muscle
Neuroglia
Neuron
28
Q

Cancers…

  • Thyroglobulin
  • Chromogranin
  • S-100
A

Thyroid FOLLICULAR cells
Neuroendocrine cells
Melanoma, LC Histiocytosis

29
Q

Elevated serum tumor marker (ex. PSA)…must do what?

A

Biopsy

30
Q

Low grade means ___

High grade means ___

A

Well-differentiated (looks like parent tissue)

Poorly-differentiated (does NOT look like parent tissue)

31
Q

Which is more important: stage or grade?

Single most important prognostic indicator?

A

STAGE

Metastasis (M)

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