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Question 1

Breast Cancer : Principal site of metastasis

Answer 1

bone, lung, liver, brain

• mostly Bone

Question 2

Lung adenocarcinoma: Principal site of metastasis

Answer 2

brain, bone, adrenal gland, liver

Question 3

Skin Melanoma: Principal site of metastasis

Answer 3

Lung, Brain, Skin, Liver

Question 4

Colorectal Cancer:Principal site of metastasis

Answer 4

Liver and Lung

- metastasize to local lymph node then to liver

Question 5

Pancreatic Cancer: Principal site of metastasis

Answer 5

Liver and Lung

Question 6

Prostate Cancer Principal site of metastasis

Answer 6

Bone

Question 7

Sarcoma :Principal site of metastasis

Answer 7

Lung

Question 8

Vinyl Chloride can cause:

Answer 8

liver angiosarcoma

Question 9

Benzene can cause:

Answer 9

acute leukemia

Question 10

Arsenic can cause:

Answer 10

skin carcinoma, bladder cancer

Question 11

asbestos can cause:

Answer 11

mesothelioma

Question 12

Radium can cause:

Answer 12

osterosarcoma

Question 13

Tumor Initiator:

Answer 13

Can sow the seeds of cancer, 1 exposure does not cause cancer.

Question 14

Tumor promoter:

Answer 14

can cause cancer if tissue is previous exposed to tumor initiator

Question 15

BRAF mutation –> what common cancer? :

Answer 15

Melanoma

- intracellular signaling

Question 16

HER mutation –> what common cancer? :

Answer 16

Breast Cancer

Question 17

MYC mutation –> what common cancer? :

Answer 17

Many Cancers

- TF

Question 18

RAS mutation –> what common cancer? :

Answer 18

Colorectal

Question 19

VEGF mutation –> what common cancer? :

Answer 19

Mesastatic Colorectal

Question 20

WT1mutation –> what common cancer? :

Answer 20

Wilm’s tumor (nephroblastoma)

- TF

Question 21

NF1: mutation –> what common cancer? :

Answer 21

Schwannomas

• Schwann Cells tumor
• GTPas

Question 22

p16mutation –> what common cancer? :

Answer 22

mesothelioma/ melanoma

- CDKI

Question 23

Lifraumeni Syndrome:

• 45 yo female
• breast carcinoma twice
• sarcoma in calf muscle
• adrenal carcinoma

Answer 23

p53

Question 24

Cowden’s Syndrome:

• 30 yo women
• strong history of breast cancer
• exam skin

Answer 24

PTEN

Question 25

GIST : Gastrointestinal tumor - 60 yo - decrease appetite - tumor in mesentary

Answer 25

c-Kit

Question 26

Lung Cancer: - EGFR : active PI3K/AKT - more active in asian, mutation in 5% of smokers, 15% non-smokers, 50% never smoke

Answer 26

- used Erlotinib (Tarceva) (pill better than IV) - Chest xray shows pleural effusion and mass in right lung - adenocarcinoma tend to be small and peripheral - pills can produce better effects than drugs

Question 27

EML4-ALK mutation in lung cancer

Answer 27

``` 5% of lung cancer - usually adenocarcinoma - asian, female, nonsmokers Crizotinib (Xalkori) 57% response / 72% free in 6 mo. ```

Question 28

Head and Neck Cancer 58 yo male w/ R mass neck. tonsil mass - squamous cell carcinoma

Answer 28

- EGFR - use cetuximab (erbitux) 4 grades of gliomas

Question 29

Glioblastoma: 72 yo male - headache, left leg weakness - necrotic mass in right brain

Answer 29

- gliomas are most common brain neoplasm - Grade 1-2: benign - Grade 3-4: malignant Grade 4: glioblastoma - VEGF Inhibitors: Bevacizumab

Question 30

Renal cell Carcinoma: 66 yo AAM - iron deficiency anemia - gross hematuria, mass in kidney

Answer 30

VEGF TKI: Sunitinib

Question 31

Which cancer had its mortality cut in half with inhibition of its pathway?

Answer 31

CML

Question 32

``` Chronic Myeloid Leukemia: 54 yo CC: fatigue - enlarged spleen WBC: 56,000 t(9,22) ```

Answer 32

BCR-ABL inhibitor

Question 33

Breast Cancer: 67 yo female breast cancer to bone

Answer 33

EGFR with + estrogen - Tamoxifen - then can add mTOR

Question 34

Breast Cancer: Her2/NEU +

Answer 34

Herceptin

Question 35

Prostate Cancer 78 yo farmer bone pain PSA 223

Answer 35

Androgen Receptor Blockade: Enzalutamide (Zytiga)

Question 36

Melanoma: | 26 yo surfer

Answer 36

BRAF V600E/K | Vemurafenib (Zelboraf)

Question 37

Basal Cell carcinoma - 79 yo homeless man - large tumor anterior to left ear

Answer 37

Hedgehog system | - Vismodegib (Erivedge)

Question 38

t(14,18)

Answer 38

follicular lymphoma - BCL2 fusion to IgH locus of chromosome 14 - 60 yo: no tx

Question 39

4 stages of tumor invasion

Answer 39

1) detachment: E-cadherin 2) degradation of basement membrane: MMP9 3) attachment: laminin fibronectin receptors 4) migration : autocrine factors

Question 40

Tumor Embolus:

Answer 40

tumor cells invade veins, then to R heart and lungs

Question 41

Organ Tropism:

Answer 41

CXC4 / CCR7