2nd ASSESSMENT Flashcards
Benign pancreatic tissue in the gastrointestinal tract is one classic example of which type of tumor?
Choristoma
What are 2 main characteristics that will absolutely define malignancy?
Tumor Invasion and metastasis
What is TRUE of paraneoplastic syndromes in malignancy, EXCEPT:
• Small cell type of bronchogenic cancer secreting corticotropins
• Primarily defined as secretion of hormones from a non-endocrine tumor
• Hypercalcemia is from osteolytic bone metastasis of a primary malignancy
• May be the earliest manifestation of an occult tumor
• Largely associated with Bronchogenic carcinomas
Hypercalcemia is from osteolytic bone metastasis of a primary malignancy
Metastasis is TRUE of which of the following statement, EXCEPT:
• Liver and lung metastasis is more suggestive of a carcinoma
• Sarcomas favor hematogenous spread
• Carcinomas favor lymph node metastasis
• Axillary lymph node metastasis are primarily involved with Breast carcinomas
• Direct seeding most commonly involved peritoneal and pleural cavities
Axillary lymph node metastasis are primarily involved with Breast carcinomas
Which of the following is not a DNA oncogenic virus? • Hepatitis B virus • Epstein barr virus • Human T cell lymphoma virus (HTLV) • Herpes virus • Human papillomavirus
Herpes virus
MYC oncogene will upregulates the expression of Telomerase that makes the cell immortal.
True
Majority of malignancies (80%) are from an epithelial origin as opposed to mesenchymal elements.
True
A teratoma is characterized by all of the following, EXCEPT:
• none of the above
• It is usually a tumor of the testis and majority are malignant
• A common tumor of the ovary and majority are benign
• Unique tumor where structures found can arise in all three germ cell layers
• It is a benign tumor, the malignant counterpart of which is referred to as Immature teratoma
none of the above
APC gene mutation are associated with all of following, EXCEPT:
• Is a tumor suppressor gene
• Also known as the gatekeeper of colonic metaplasia
• Multiple colonic polyps
• Strong hereditary factor for early colon cancer
• Absence of colonic polyps
Absence of colonic polyps
Which of the following is a purely benign tumor of glandular nature?
Adenoma
Which statement is NOT true of tumor differentiation?
• Both benign and malignant tumors exhibit three grading system
• Grade 2 is synonymous to moderately-differentiated tumors
• Well-differentiated Squamous cell carcinoma will always secrete keratin
• Benign neoplasms are usually well-differentiated and resembles the native tissue
• Anaplasia is the hallmark of malignancy and will always be under histologic grading of 3
Both benign and malignant tumors exhibit three grading system
General characteristics of a tumor involved all of the following, EXCEPT: • Genetic mutations • Excessive growth • Disorganized growth • Autonomous growth • Polyclonal in origin
Polyclonal in origin
The following are TRUE of tumor markers, EXCEPT:
• Useful to gauge treatment effectivity or tumor recurrence
• Tumor markers are very sensitive and specific to a specific cancer
• Common tumor markers are PSA for prostate, CEA for colon and AFP for liver
• Not meant to give a definitive diagnosis
• Largely in the form of hormones
Tumor markers are very sensitive and specific to a specific cancer
Which of the following is NOT a mesenchymal tumor? • Leiomyoma • Urothelial cell carcinoma • Chondroma • Lymphoma • Osteosarcoma
Urothelial cell carcinoma
Which of the following microscopic finding is a 100% malignant feature, EXCEPT: • Bizarre quadripolar mitotic figures • Presence of giant cells • N:C ratio of tumor cells is 1:2 • Desmoplastic stroma • Anaplastic cells
Presence of giant cells
Which gene is known as the Governor of proliferation?
Rb gene
What is/are the hallmarks of Oncogenesis, EXCEPT:
• Sustained angiogenesis
• Proto-oncogene mutation produces cancer-inducing oncogenes
• Decrease uptake of Telomerase
• Activation and mutation of growth factors and growth factor receptors
• Inactivation of tumor suppressor gene
Decrease uptake of Telomerase
Lynch syndrome are compose of more than one primary cancer. Which statement would be FALSE?
• Increase incidence for Secondary tumors like uterine cancer
• Most likely genetic mutation is microsatellite instability
• Primary tumor usually involves Right sided colon carcinoma
• Also known HNPCC
• Associated with multiple polyps
Associated with multiple polyps
A well-differentiated squamous cell carcinoma will show microscopic evidence of the following?
Produce keratin, squamous “pearls” and intercellular bridges
Classification and biologic behavior of a tumor is based on what component?
Neoplastic cells
Which checkpoint in the cell cycle is most crucial to cause a malignant transformation?
G1/S
The growth and spread of tumor is more associated with connective tissue, blood vessels and variable inflammatory cells
True
What is the primary cause of cancer death in both sexes based on the of latest epidemiologic studies?
Lung
A 45 year old patient undergoes biopsy of a mole that appeared recently on his forehead. The tumor cells demonstrate a high activity of matrix metalloproteinases. The latter finding imposes the greatest risk for:
Invasion and metastasis
The following tumors are considered MALIGNANT, except? • Hepatoma • Seminoma • Leukemia • Teratoma • Glioma
Teratoma
RAS gene oncoprotein is active in the form of GDP (guanosine diphospate).
False
Hyperchromasia is TRUE of which of the following statement:
• Defines as increase in the cellular/nuclear size and shape
• Nuclear hyperchromasia will stain more of eosin than hematoxylin
• Benign tumors are also associated with prominent nuclear hyerchromasia & pleomorphism
• Increase uptake of the hematoxylin stain secondary clumping of nuclear chromatin
• Hyperchromasia is secondary to apoptotic bodies in a macrophage
Increase uptake of the hematoxylin stain secondary clumping of nuclear chromatin
The following are TRUE of suppressor tumor genes, EXCEPT:
• E-cadherin gene is a cell surface gene that maintains cell adhesiveness
• Knudson’s two hit hypothesis is to mainly emphasized that TSG is a recessive gene
• p53 gene is the most commonly mutated TSG and is responsible for >50% of cancers
• Rb is the first discovered tumor suppressor gene discovered
• BRCA1 gene is responsible for male breast cancers
BRCA1 gene is responsible for male breast cancers
All of these are benign tumors, EXCEPT: • Gastrointestinal Polyp • Hemangioma • Seminoma • Squamous cell Papilloma • Lymphangioma
Seminoma
All of these are EXCEPTIONS to the general classification of a tumor?
• Malignant epithelial cancers are either carcinomas and adenocarcinomas
• Sarcomas are malignant tumors that are derived from mesenchymal elements
• Both benign or malignant tumors that shows glandular components have “adeno….”
• Benign tumors of both epithelial and mesenchymal tumors is the suffix “..oma”
• Melanoma is 100% malignant tumor and is one of the 3 most common skin cancers
Malignant epithelial cancers are either carcinomas and adenocarcinomas
The following statements are TRUE to increased oncogenesis and uninterrupted cell cycle, EXCEPT:
• Disassociation of E2F from Rb gene
• Decrease P21 blocking CDK-cyclin complexes
• Decreased formation of p53mdm2 complexes
• Hyperphosphorylation of Rb gene
• Increase CDK-cyclin complexes
Decreased formation of p53mdm2 complexes
TRUE with regards to ERBB1, EXCEPT:
• Genetic damage is in the form of point mutation
• Primarily associated with Lung carcinomas
• Also known as Her1 protein
• Synonymous with Epidermal growth factor receptor
• It is one of the proteins responsible for DNA transcription
It is one of the proteins responsible for DNA transcription
Fine needle aspiration biopsy is TRUE of which of the following statements:
• Less invasive and are done with readily palpable lesions
• Biopsies are stained with hematoxylin and eosin
• Presents with definitive diagnosis
• Can be applied to all deep-seated tumors
• Considered under tissue sampling
Less invasive and are done with readily palpable lesions
Epithelial tumors will have a high incidence of anaplasia, bizarre giant tumor cells or bizarre mitotis.
• True
• False
TRUE
Cell cycle regulators are the following?
Cyclins and Cyclin-dependent kinases
What is the most common genetic mutation causing increase malignant transformation?
Point mutation
The N in the TNM staging classification represents which of the following?
Nodal involvement
FALSE of Apoptotic gene:
• Responsible for programmed cell death when there is DNA damage
• Oncogenesis involves decrease activity of BAX and inactivation of BCL
• Pro-Apoptotic genes include BAX and BAK
• The extrinsic pathway is the most common disabled in cancer
• Anti-apoptotic genes include BCL and BCL-XL
The extrinsic pathway is the most common disabled in cancer
True of cellular adaptation:
• Low grade Dysplasia is a precursor to malignant transformation
• High-grade dysplasia may oftentimes be pre-malignant or (non-invasive) carcinoma-in-situ
• Columnar metaplasia represents the most common types of metaplasia
• Squamous metaplasia is not reversible
• Anaplasia is a “primitive” cell but most times are benign tumors
High-grade dysplasia may oftentimes be pre-malignant or (non-invasive) carcinoma-in-situ
A 65 y.o. male is being evaluated for fatigue, anemia, anorexia and significant weight loss over the past 2 months. CXR reveals an irregular perihilar mass in the right lung field. This patient’s symptoms are attributed to which of the following?
TNFα
What is the Philadelphia chromosome?
t(9;22)
Which of the following statement is associated with a direct-acting carcinogen?
• Chemotherapy drugs with increase incidence of secondary skin cancers
• Common example would be cigarette smoking
• Exposure to household cleaning supplies and pesticides
• Directly causing DNA damage
• Must be metabolized to cause DNA damage
Directly causing DNA damage
A clinical study is done on oncogenesis in human neoplasms. It has been observed that some specific malignant neoplasms appear to develop from an oncogenic organism. Which of the following organisms follows a malignant transformation in a specific organ?
Helicobacter pylori for Gastric carcinoma
Anti-angiogenic factors include all of the following, EXCEPT: • Endostatin • Thrombospondin • Plasminogen • Angiostatin • Angiopoietin
Angiopoietin
Match each item to a choice. Cell cycle regulator Growth factor receptor Growth factor Signal Transduction protein Signal Transcription
Choices: • Cyclins • Most are Tyrosine kinase based • TGF⍺ and FGF • MYC oncogene • RAS oncogene
Cyclins - Cell cycle regulator
• Most are Tyrosine kinase based - Growth factor receptor
• TGF⍺ and FGF - Growth factor
• MYC oncogene - Signal Transcription
• RAS oncogene - Signal Transduction protein
The following are TRUE of carcinogens and the type of malignancy they caused, EXCEPT:
• Radioactive elements in mining for Lung cancers
• Chemotherapy drugs for Leukemias and Lymphomas
• UV rays for Breast cancers
• Aflatoxin B1 for Hepatocellular carcinoma
• EBV for Nasopharyngeal carcinoma
UV rays for Breast cancers
