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Sbmmid4 Flashcards

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1
Q

Hallmarks of cancer

A

1.sustaining proliferative signaling
رشد مداوم با فعال‌سازی خودکار مسیرهای سیگنالینگ مثل Ras/MAPK، HER2

2.evading growth suppressor
مهار RB و p53 برای فرار از کنترل چرخه سلولی
3.resisting sell death
مهار آپوپتوز با افزایش Bcl-2 یا جهش در p53
4. Enabling replicative immortality
فعال‌سازی تلومراز (hTERT)

  1. Inducing angiogenesis
    – افزایش VEGF برای ایجاد رگ‌های جدید
  2. Activating invasion and metastasis –
    از بین رفتن E-cadherin، فعال شدن MMPs، EMT
  3. Reprogramming energy metabolism
    – اثر واربرگ: گلیکولیز هوازی حتی در حضور اکسیژن
  4. Evading immune destruction
    – کاهش MHC I، ترشح PD-L1، جذب Treg

New Proposed Hallmarks (2022):

  1. Unlocking phenotypic plasticity –
    تغییر تمایز سلولی، EMT، stem-like behavior
  2. Nonmutational epigenetic reprogramming – تغییر بیان ژن بدون جهش، با متیلاسیون و هیستون
  3. Senescence avoidance –
    مهار مسیر پیری سلول‌ها (p16INK4A، p53)
  4. Influence of polymorphic microbiomes –
    اثر میکروبیوم بر پاسخ ایمنی، متابولیسم، مقاومت دارویی
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2
Q

For Hallmarks of Cancer
E. Quick Recall (Mnemonic):

“G-RIME-PIES + NEWS”

A

G → Growth signals sustained

R → Resist death

I → Immortality

M → Metastasis

E → Evade suppressors

P → Promote angiogenesis

I → Immune evasion

E → Energy metabolism reprogramming

S → Stability loss (genome)

+ N → Nonmutational epigenetics

E → Escape senescence

W → Microbiome

S → Stemness/plasticity

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3
Q

Key Molecular Tools & Pathways:

A

Ras/MAPK → proliferative signaling

Bcl-2, Bax, Caspases → apoptosis

hTERT → telomere maintenance

VEGF → angiogenesis

E-cadherin, MMPs → metastasis

PD-L1/PD-1, CTLA-4 → immune escape

HIF-1α → hypoxia & angiogenesis

DNA methyltransferase → epigenetic silencing

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4
Q

Lipoma

A

Benign Adipose لیپوم – چربی شایع‌ترین تومور خوش‌خیم نرم

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5
Q

Leiomyoma

A

Benign Smooth muscle لومیوم – عضله صاف (رحم) شایع‌ترین تومور خوش‌خیم رحمی

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6
Q

Leiomyosarcoma

A

Malignant Smooth muscle لومیوسارکوما – عضله صاف بدخیم مهاجم، متاستاز به ریه و کبد

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7
Q

Fibrosarcoma

A

Malignant Fibrous tissue فیبروسارکوما
سلول‌های دوکی شکل، میتوز بالا

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8
Q

Rhabdomyoma

A

Benign Skeletal muscle
رابدومیوم – عضله مخطط نادر، قلب کودکان

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9
Q
A
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10
Q

Fibroma

A

Benign Fibrous tissue فیبروما –
بافت همبند بسیار خوش‌خیم، اغلب پوست

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11
Q

Osteoma

A

Benign Bone
استئوما – استخوان سر/صورت، با Gardner syndrome همراه است

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12
Q

Chondroma

A

Benign Cartilage کندروما – غضروف اغلب دست و پا

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13
Q

Chondrosarcoma

A

Malignant Cartilage
کندروسارکوما لگن، دنده‌ها، استخوان‌ها

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14
Q

Neurofibroma

A

Benign Nerve sheath نوروفیبروم همراه با NF1، توده نرم

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15
Q

Squamous papilloma

A

Benign Squamous epithelium
پاپیلوم سنگفرشی پوست، دهان، HPV

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16
Q

Angiosarcoma

A

Malignant Blood vessels
آنگیوسارکوما عروق – پوست سر و صورت، سریعاً پخش می‌شود

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17
Q

Squamous cell carcinoma

A

Malignant Squamous epithelium SCC
– سرطان پوست، دهان کراتین‌پرل، اینواسو

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18
Q

Colon Polyp

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A

Pre-malignant Epithelial
پولیپ کولون آدنوم → خطر پیش‌سرطان دارد

19
Q

Adenocarcinoma

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A

Malignant Glandular epithelium
آدنوکارسینوم روده، معده، پستان، پانکراس

20
Q

Lymphoma

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A

Malignant Lymphoid
لنفوم لنفوسیت‌ها – هوچکین/غیرهوچکین

21
Q

Seminoma

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A

Malignant Germ cell
سمینوم – سلول زایا بیضه، پاسخ خوب به درمان

22
Q

Retinoblastoma

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A

Malignant Retinal cells
رتینوبلاستوما کودکان، سفید شدن چشم، RB1 mutation

23
Q

Fibroadenoma

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A

Benign Breast fibrous & glandular
فیبروآدنوم پستان شایع‌ترین تومور خوش‌خیم پستان جوان

24
Q

Mature Cystic Teratoma

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A

Benign (mostly) Germ cells
کیست درموئید شامل مو، دندان، پوست – تخمدان

25
نکات امتحانی کلیدی (بولد شده)
"Sarcoma" → بدخیم، از mesenchymal origin "Carcinoma" → بدخیم، از epithelial origin "Papilloma / -oma" → اغلب خوش‌خیم، ولی استثنا دارد (مثلاً melanoma) Retinoblastoma → RB1 gene mutation (Two-hit hypothesis) Melanoma → ABCDE: Asymmetry, Border, Color, Diameter, Evolution Fibroadenoma → breast, mobile, painless, well-circumscribed Teratoma → 3 germ layers; risk of malignancy in males > females
26
مراحل کامل Invasion-Metastasis Cascade
1. Detachment جدا شدن سلول از تومور اولیه Tumor cell detaches from primary tumor 2. Invasion نفوذ به ماتریکس خارج سلولی و استروما Invasion through ECM and stromal tissue 3. Intravasation ورود به عروق خونی/لنفی Entry into circulation 4. Survival زنده ماندن در گردش خون Survival in bloodstream 5. Arrest & Extravasation توقف در اندام هدف و خروج از عروق Arrest and extravasation in distant organ 6. Micrometastasis ماندگاری در بافت و رشد به میکرومتاستاز Survival and growth in foreign site 7. Colonization ایجاد متاستاز ماکروسکوپی بالینی Formation of detectable metastasis
27
Colonization = step limiting
محدودکننده‌ترین مرحله: رشد متاستاز در مقصد
28
اجزای اصلی Invasion
1. EMT – Epithelial to Mesenchymal Transition 📙 تغییر فنوتیپ سلول‌های اپی‌تلیال به نوع مزانشیمی 📘 Loss of E-cadherin, gain of vimentin, ↑ mobility فاکتورهای تنظیمی Snail, Twist, Slug, Zeb1/2 2. Cell Adhesion Molecules (CAMs) نوع نقش Integrins چسبندگی به ECM، تنظیم بقای سلول E-cadherin اتصال سلول-به-سلول؛ کاهش آن باعث تهاجم می‌شود Catenins تثبیت اتصال E-cadherin 3. Matrix Degradation – تخریب ECM آنزیم‌ها نقش MMP-2, MMP-9 تخریب کلاژن، لامینین، فیبرونکتین Plasminogen Activators (uPA, tPA) فعال‌سازی plasmin → فعال‌سازی MMPها Serine Proteases مشارکت در تجزیه ECM و فعال‌سازی سایر پروتئینازها 4. Motility Factors 📘 Rho GTPases (Rac, Rho, Cdc42) → کنترل حرکت، تغییر اسکلت سلولی 📙 سلول‌ها برای مهاجرت نیاز به تغییر در actin cytoskeleton دارند که توسط Rho GTPase تنظیم می‌شود.
29
Organotropism – متاستاز ترجیحی
تئوری بذر و خاک (Seed and Soil – Paget): سلول سرطانی (seed) فقط در بافت مناسب (soil) رشد می‌کند. ✅ Examples: Breast → Bone, brain Prostate → Bone Lung → Brain, liver Melanoma → Liver, GI, brain
30
Which of the following is a T cell mediated systemic autoimmune disease?
Sjogren’s Syndrome Autoimmune heamolytic anemia, autoimmune thrombocytopenia, autoimmune atropic gastritis of pernicious anemia, myasthenia gravis, graves disease (thyroid) and goodpasture Syndrome (Renal and pulmonary) are among organ specific antibody mediated autoimmune disease. Type 1 diabetes mellitus and multiple sclerosis are among organ specific but t cell mediated autoimmune diseases. Systemic antibody mediated autoimmune diseases include systemic lupus erythematosus and T cell mediated diseases include rheumatoid arthritis, systemic sclerosis and sjogren’s sydrome.
31
If the expression levels of EGF and EGFR increase in a cell, which of the following cellular events may probably increase as well? (Choose as many as required) اگر سطح بیان EGF و EGFR در یک سلول افزایش یابد، کدام یک از رویدادهای سلولی زیر نیز احتمالاً افزایش می‌یابد؟ (هر تعداد که لازم است انتخاب کنید)
Growth factor signaling can lead to cell proliferation cell adhesion invasion motility
32
Which of the following statements are characteristic metabolic features of cancer cells?
Glucose consumption is increased in cancer cells. Cancer cells act as if they were in hypoxia even in normoxic conditions. Cancer cells utilize glycolysis and Krebs cycle for synthesis of different metabolites.
33
In malaria transmission, which of the following is the life form of Plasmodium spp. transmitted to humans from the Anopheles mosquitoes?
Sporozoite Sporozoite is the life form of Plasmodium sp. transmitted to humans.
34
Which of the following statements regarding Helicobacter pylori are correct? (Choose as many as required)
H.pylori causes gastritis and peptic ulcers. The bacteria produce urease. Chronic stimulation inflammation stimulates B cell proliferation and causes B cell lymphoma No bacteremia
35
Which of the following hepatitis viruses are transmitted by fecal-oral route? (Choose as many as required)
Hepatitis A Virus Hepatitis E Virus
36
Which of the following virulence factor of Staphylococcus aureus prevents the activation of complement and thereby reduces opsonization by C3b?
Protein A is an antiphagocytic molecule
37
Which of the following inflammatory mediator is associated with membrane attack complex (MAC) formation?
Complements Complements are among plasma derived mediators of inflammation. C3a and C5a are named as anaphylatoxins. C5b-C9 takes part in the formation of membrane attack complex (MAC).
38
Which of the following are mixed tumors? (Choose as many as required)
Teratoma Pleomorphic adenoma Fibroadenoma Tumor cells are often monoclonal and similar with each other, when they differentiate in different directions, take the name of mixed tumor. Pleomorphic adenoma, fibroadenoma and teratoma are among the mixed tumors. Osteosarcoma, leiomyoma are mesenchymal tumors; adenocarcinoma is epithelial tumor. سلول‌های تومور اغلب مونوکلونال و مشابه یکدیگر هستند، وقتی در جهات مختلف تمایز می‌یابند، نام تومور مختلط را به خود می‌گیرند. آدنوم پلئومورفیک، فیبروآدنوم و تراتوم از جمله تومورهای مختلط هستند. استئوسارکوم، لیومیوما تومورهای مزانشیمی هستند؛ آدنوکارسینوما تومور اپیتلیال است.
39
Which of the following is considered among the enabling characteristics of cancer?
Nonmutaional epigenetic reprogramming Resisting cell death, deregulating cellular metabolism and activation invasion&metastasis are among the hallmarks of cancer while nonmutaional epigenetic reprogramming is considered among the enabling characteristics.
40
Which of the following is a property of cancer stem cells? (Choose as many as required)
Self-renewal SurvivalModulation of intracellular signaling Immunosuppression Drug resistance Activation of angiogenesis Quiescence
41
Which of the following statements is correct regarding oncogenes and tumor suppressor genes? (Choose as many as required)
Ras is very well-known example for oncogenes p53 is very well-known example for tumor suppressors Tumor suppressors control the mechanisms that regulate the cell numbers Proto-oncogenes stimulate the cell to divide Tumor suppressor genes arrest cell cycle in response to DNA break X Oncogenes trigger apoptosis in response to DNA break (Tumor suppressor genes trigger apoptosis) X Oncogenes act as stop signs (Tumor suppressor genes act as stop signs) X Tumor suppressor genes act in a dominant manner (Oncogenes act in a dominant manner) X BRCA1 is very well-known example for oncogenes (BRCA1 is very well-known example for tumor suppressors)
42
In cancer, oncogenes act in a [a] manner while tumor suppressor genes act in a [b] manner.
In cancer, oncogenes act in a dominant manner while tumor suppressor Genes act in a recessive manner.
43
Which of the following polarized immune cell types is associated with tumor supression?
ایمنی به‌صورت پولاریزه (قطبی‌شده) به دو گروه اصلی تقسیم می‌شن: برخی سرکوبگر تومور (Tumor-suppressive) و برخی ترویج‌کننده تومور (Tumor-promoting) هستن. Tumor-Suppressive: M1 macrophages Th1 CD4⁺ Activated CD8⁺ T cells NK cells Mature DCs N1 neutrophils Activated B cells Tumor-Promoting: M2 macrophages Th2, Treg Bregs N2 neutrophils Immature DCs Exhausted CD8⁺ Suppressed NK cells
44
Dysentery, اسهال خونی
Schistosoma masoni : the trematode causes dysentery through tissue invasive eggs in the intestinal wall. Balantidium coli,B.coli : causes dysentery & chronic ulcers resembling entamoeba histolytica Entamoeba histolytica , E.histolytica :is the classic cause of ameobic dysentery Trichuris trichiura : heavy infection with trichuris trichiura may cause dysentery & rectal prolapse

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