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All the things > 3.1 - 3.4 Neoplasia > Flashcards

3.1 - 3.4 Neoplasia Flashcards

1
Q

What are the three basic features of a neoplasm?

A
  1. Unregulated
  2. Irreversible
  3. Monoclonal
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2
Q

What is the marker to determine if a growth is monoclonal? How does this work?

A

G6PD

If 1:1 ratio is disrupted, then monoclonal expansion, since one cell would have only one isotype

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3
Q

How is the clonality of B cell determined?

A

Via Kappa or lambda Ig light chain secretions– if 3:1, this is polyclonal if normal. If this ratio disrupted, then Monoclonal lymphoma.

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4
Q

Are benign tumor monoclonal? Malignant?

A

Both are monoclonal

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5
Q

What, generally, are papillomas?

A

Outpouching of epithelial tissue, with a central fibrovascular core

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6
Q

Are tumors that have the potential to metastasize called benign or malignant?

A

Malignant

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7
Q

Benign Tumors derived from glands = ?

A

Adenomas

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8
Q

Benign Tumors derived from epithelial tissues (not glands) = ?

A

Papilloma

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9
Q

Malignant Tumors derived from glands = ?

A

Adenocarcinoma

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10
Q

Malignant Tumors derived from epithelial tissues (not glands) = ?

A

Papillary carcinoma

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11
Q

Benign moles are called what? Malignant?

A

Nevus

Melanoma

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12
Q

What is the malignant form of lipomas?

A

Liposarcoma

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13
Q

When is the -sarcoma suffix added?

A

To describe malignant mesenchymal tissue

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14
Q

When is the -oma suffix added?

A

Benign epithelial tissue

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15
Q

What is the name for a benign growth of lymphocytes?

A

Does not exist–always lymphoma/leukemia, which are malignant

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16
Q

What is the second leading cause of death in both children and adults?

A

CA

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17
Q

What are the three most common forms of CA by incidence?

A
  1. Breast/prostate
  2. Lung
  3. Colorectal
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18
Q

What are the three most common forms of CA by mortality?

A
  1. Lung
  2. Breast/prostate
  3. Colorectal
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19
Q

Does lung CA have a screening test?

A

Not really

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20
Q

How many cell divisions occur before CA symptoms arise?

A

30 divisions

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21
Q

What happens to the number of mutation with each division of CA cells? What is the consequence of this?

A

Increased– more malignant

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22
Q

What is the difference between dysplasia and CA?

A

Dysplasia is reversible, whilst cancer is not.

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23
Q

Where in the prostate does CA grow?

A

Posterior, peripheral part

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24
Q

What is the PAP smear screening for?

A

HPV 16 and 18

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25
Q

What does PSA and DRE screen for?

A

Prostate CA

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26
Q

Where are aflatoxins found, and what CA are they associated with?

A

Aspergillus on grains

Hepatocellular CA

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27
Q

Where are alkylating agents used, and what is the CA associated with them?

A

Used for chemotherapy

Leukemia/lymphoma associated

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28
Q

What are the CAs associated with EtOH use? (3)

A
  • Squamous cell carcinoma of the oropharynx
  • Pancreatic carcinoma
  • Hepatocellular carcinoma
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29
Q

Where is arsenic found, and what CA is it associated with? (3)

A

-Present in cigarette smoke

  • Squamous cell carcinoma of the skin
  • Lung CA
  • Angiosarcoma of the liver
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30
Q

What CAs are associated with asbestos?

A

Squamous cell carcinoma and mesothelioma

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31
Q

What CAs are associated with cigarette smoke?

A

Carcinoma of oropharynx

  • esophagus
  • lung
  • kidney
  • bladder
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32
Q

What is the chemical found in cigarette smoke that is particularly carcinogenic?

A

Polycyclic hydrocarbons

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33
Q

Where are nitrosamines found, and what CA are they associated with?

A
  • Smoked foods

- Intestinal type of stomach carcinoma

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34
Q

Where is naphthylamine found, and what CA are they associated with?

A

Derived from cigarette smoke

Urothelial carcinoma of the bladder

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35
Q

Where is vinyl chloride found, and what CA is it associated with?

A
  • Making PVC

- Angiosarcoma of the liver

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36
Q

What are the two types of people who classically develop Nasopharyngeal carcinoma?

A
  • African male

- Young chinese male

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37
Q

What are the CAs caused by EBV? (3)

A
  • Nasopharyngeal carcinoma
  • Burkitt’s lymphoma
  • CNS lymphoma
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38
Q

What is the CA associated with HHV-8?

A

Kaposi sarcoma

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39
Q

What is the CA associated with HBV and HCV?

A

Hepatocellular carcinoma

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40
Q

What are the CAs associated with HTLV-1?

A

Adult T cell leukemia/lymphoma

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41
Q

What are the high risk HPV virus strains? What CAs do they cause?

A

16, 18, 31, 33

Squamous cell carcinoma of the vulva, vagina, anus, cervix

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42
Q

Ionizing radiation produces what carcinogenic agents? What CAs is this associated with (3)?

A

Hydroxyl free radical generation

  • AML
  • CML
  • papillary carcinoma of the thyroid
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43
Q

Non-ionizing radiation produces what? What is the most common source of this? What CAs is this associated with?

A

-Pyrimidine dimers
-UVB sunlight
-Basal cell carcinoma
Squamous cell carcinoma
Melanoma of the skin

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44
Q

What are the three systems (gene types) that can be disrupted by carcinogenic agents to cause a tumor?

A
  1. Protooncogenes
  2. Tumor suppressor genes
  3. Regulator of apoptosis
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45
Q

What are proto oncogenes?

A

genes that are essential for cell growth and differentiation, but can be mutated into oncogenes

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46
Q

What are the four categories of oncogenes?

A
  1. Growth factors
  2. Growth factor receptors
  3. Signal transducers
  4. Cell cycle regulators
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47
Q

What is the MOA of growth factors (i.e. what happens when it binds to a receptor)?

A

Binds to receptor, stimulates signal transducer, to start Cell cycle

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48
Q

What is the protein that drives the formation of an astrocytoma? How?

A

Overexpression of PDGFB by cell causes an (via an autocrine-like mechanism) increase in cell growth

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49
Q

ERBB2[HER2/Neu] is what? what happens to cause CA, and what specific CA does it cause?

A
  • Epidermal GF receptor

- Amplification causes breast CA by increasing the receptor density and thus the response to normal amounts of GF

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50
Q

RET is what? What happens to cause CA, and what specific CA does it cause?

A
  • Neural GF inhibitor
  • Point mutation causes MEN2A/B receptor upregulation

specifically medullary carcinoma of the thyroid

51
Q

KIT is what? what happens to cause CA, and what specific CA does it cause?

A
  • Stem cell GF receptor

- Point mutation causes GI stromal tumor

52
Q

Ras family gene is what? What happens to cause CA, and what specific CAs does it cause (3)?

A
  • GTP binding protein (cell signalling molecule)
  • Point mutation increases expression of nuclear proteins, to cause:
  • carcinoma
  • melanomas
  • lymphomas
53
Q

ABL is what? what happens to cause CA, and what specific CA does it cause?

A
  • Y kinase signal transducers

- t(9:22) with BCR causes CML (and some ALL)

54
Q

c-Myc is what? What translocation happens to cause CA, and what specific CA does it cause?

A
  • transcription factor (nuclear regulator)

- t(8,14) causes Burkitt’s lymphoma

55
Q

N-Myc is what? what happens to cause CA, and what specific CA does it cause?

A

Transcription factor

Amplification causes neuroblastoma

56
Q

L-Myc is what? what happens to cause CA, and what specific CA does it cause?

A

Transcription factor

Amplification causes lung carcinoma

57
Q

CCND1 (cyclin D1) is what? What translocation happens to cause CA, and what specific CA does it cause?

A
  • Cyclin D1

- t(11;14) involving IgH causes mantle cell lymphoma

58
Q

CDK4 is what? what happens to cause CA, and what specific CA does it cause?

A
  • Cyclin dependent kinase

- Amplification causes Melanoma

59
Q

What is the Philadelphia chromosome? What CA is it associated with?

A

t(9;22) with BCR.

CML and some types of ALL

60
Q

What is the MOA behind burkitt’s lymphoma?

A

t(8;14) causes change of IgH gene with Myc gene in B cells, causing the overproduction of c-Myc

61
Q

What is the MOA behind Mantle cell lymphoma?

A

Cyclin D1 (CCND1) gene on chr 8 is translated to chr 14 (IgH chain) in B cells, causing overexpression of CCND1

62
Q

What is the function of Cyclin D1?

A

Allows cells to go from G1 to S phase

63
Q

What are the two major tumor suppressor genes?

A

p53 and Rb

64
Q

What is the function of p53?

A

“traffic cop” for cell between G1 and S phase–checks to make sure DNA is in order

65
Q

What is the molecule that p53 calls in if there is DNA damage? What does this do?

A

BAX, which destroys BCL2 (this causes apoptosis)

66
Q

p53 follows what model of DNA damage?

A

Two hit model

67
Q

What is Li-Fraumeni syndrome

A

Germline mutation in one of the p53 genes, causing an increased propensity for developing carcinomas and sarcomas

68
Q

What is the function of E2F? What is this protein bound to usually?

A

Allows for progression from G1 to S phase

usually bound and inhibited by Rb

69
Q

What is the function of Rb?

A

Inhibits E2F protein, thereby inhibiting transition from G1 to S phase

70
Q

Bilateral Rb is more likely caused by what (germline mutation or sporadic)? Unilateral?

A 
Bilateral = Germline
Unilateral = Sporadic
71
Q

What is the function of Bcl2?

A

Stabilizes the mito membrane, so that cyt-c cannot be released

72
Q

Bcl2 is overexpressed in what cancer? What translocations allows for this?

A

Follicular lymphoma t(14;18) moves Bcl2 to Ig heavy chain (14), resulting in increased Bcl2

73
Q

What is the function of telomerase?

A

Preserves telomeres in CA cells

74
Q

What are the two angiogenic factors that are upregulated in tumors to promote angiogenesis?

A

FGF

VEGF

75
Q

Tumors create a lot of antigenic proteins. How do they avoid detection by the immune system?

A

Downregulate MHC I

76
Q

True or false: immunodeficiency has no effect on the probability of getting CA

A

False–increases the risk

77
Q

What is the function of E-cadherin? What is its role in CA?

A

Protein that attaches cells together.

Downregulation of this allows cell to metastasize

78
Q

What are the two major proteins that comprise the basement membrane?

A

Collagen IV and laminin

79
Q

What is the function of laminin in CA?

A

Allows tumors to attach to BM and destroy it via collagenases

80
Q

Once in the ECM, tumors attach to what protein to migrate locally?

A

Fibronectin

81
Q

What type of CA tends to spread via lymphatics?

A

Carcinomas

82
Q

Hematogenous spread is characteristic of what type of CA?

A

Sarcomas

83
Q

What are the four carcinomas that spread via hematogenous route?

A
  • RCC
  • Hepatocellular carcinoma
  • Follicular carcinoma
  • Choriocarcinoma
84
Q

Seeding of body cavities is characteristic of what particular CA?

A

Ovarian CA (omental caking)

85
Q

What is “omental caking”?

A

Local spread of ovarian CA into the omentum

86
Q

What are the top three causes of death in adults?

A
  1. CV disease
  2. CA
  3. Cerebrovascular disease
87
Q

What are the top three causes of death in children?

A
  1. Accidents
  2. Cancer
  3. Congenital defects
88
Q

Who is classically affected with HHV-8 Kaposi’s sarcoma?

A
  1. Older eastern european males (skin)
  2. AIDS pts
  3. Transplant patients
89
Q

What is the MOA and use of trastuzumab?

A

Antibody against the ERB2/Neu receptor on breast cancer

90
Q

How does Ras become activated? Deactivated?

A

Binds to GTP

GAP cleaves the phosphate off of GTP

91
Q

What is the treatment for CML?

A

Imatinib

92
Q

What is the classic histological characteristics of Burkitt’s lymphomas?

A

starry sky with tingible body macrophages

93
Q

What are the two regions that surround a follicle of a lymph node?

A

Mantle

Margin

94
Q

Rb mutations increase the risk for what cancers?

A

Retinoblastomas, and osteosarcomas

95
Q

Malignant or benign feature: slow growing

A

Benign

96
Q

Malignant or benign feature: rapid growth

A

Malignant

97
Q

Malignant or benign feature: poorly circumscribed

A

Malignant

98
Q

Malignant or benign feature: infiltrative

A

Malignant

99
Q

Malignant or benign feature: well circumscribed

A

Benign

100
Q

Malignant or benign feature: mobile

A

Benign

101
Q

Malignant or benign feature: fixed to surrounding tissues

A

Malignant

102
Q

What is the only way to determine if a mass is cancer?

A

Bx

103
Q

Malignant or benign feature: organized growth

A

Benign

104
Q

Malignant or benign feature: uniform nuclei

A

Benign

105
Q

Malignant or benign feature: minimal mitotic activity

A

Benign

106
Q

Malignant or benign feature: nuclear pleomorphism

A

Malignant

107
Q

How does the nuclear: cytoplasmic ratio compare between malignant and benign tumors?

A

Malignant has high nuclear: cytoplasmic ratio, whereas the reverse is true for benign

108
Q

What is the hyperchromasia that is characteristic of malignant cells?

A

Dark staining nuclei

109
Q

What is the absolute distinguishing feature between malignant and benign tumors?

A

Metastatic potential

110
Q

Keratin is found in what type of tissue?

A

Epithelium

111
Q

Vimentin is found in what type of tissue?

A

Mesenchyme

112
Q

Desmin is found in what type of tissue?

A

Muscle

113
Q

GFAP is found in what type of tissue?

A

Neuroglial cells

114
Q

Neurofilament is found in what type of tissue?

A

Neurons

115
Q

PSA is found in what type of tissue?

A

Prostate

116
Q

Estrogen receptors are found in what type of tissue?

A

Breasts

117
Q

Thyroglobulin is found in what type of tissue?

A

Thyroid follicular cells

118
Q

S100 is found in what type of tissue?

A

Melanoma

119
Q

Chromogranin is found in what type of tissue?

A

Neuroendocrine cells

120
Q

What are the three general uses of serum tumors markers?

A
  • screening
  • monitoring response to treatment
  • Monitoring recurrence
121
Q

What is involved in grading a tumor?

A

Looking at architectural and nuclear features to determine if well or poorly differentiated

122
Q

What, generally, is staging?

A

Size and spread of the cancer

123
Q

Which is more important: cancer grade, or stage

A

Stage

124
Q

What are the components of the TNM staging? Which of these is the most important?

A
  • Tumor size or depth of invasion
  • N = nodes
  • M = mets

All the things (36 decks)

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