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Pathology > 9. Fundamentals of Neoplasia > Flashcards

9. Fundamentals of Neoplasia Flashcards

1
Q

Where does most of the neoplasias arise from?

A

From epithelium (90%). The remainder arise from mesenchymal cells.

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2
Q

What is carcinogenesis?

A

A multistep process involving a sequence of initiation (mutation) followed by promotion (proliferation).

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3
Q

What are initiators?

A

They are direct-acting chemical carcinogens. These are mutagens that cause cancer directly by modifying DNA.

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4
Q

What are promotors?

A

They cause cellular proliferation of mutated (initiated) cells. Proliferation of a mutated cell may lead to accumulation of additional mutations.

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5
Q

What do nitrosamines cause?

A

Gastric Cancer.

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6
Q

What do polycylic aromatic hydrocarbons cause?

A

Bronchogenic carcinoma.

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7
Q

What does asbestos cause?

A

Bronchogenic carcinoma, mesothelioma.

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8
Q

What does chromium and nickel cause?

A

Bronchogenic carcinoma.

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9
Q

What does arsenic cause?

A

Squamous cell carcinomas of skin and lung, angiosarcoma of liver.

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10
Q

What does vinyl chloride cause?

A

Angiosarcoma of liver.

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11
Q

What does aromatic amines and azo dyes cause?

A

Hepatocellular carcinoma.

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12
Q

What does alkalating agents cause?

A

Leukemia, lymphoma, other cancers.

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13
Q

What does benzene cause?

A

Leukemia.

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14
Q

What does napthylamine cause?

A

Bladder cancer.

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15
Q

What method employs bacteria to test potential carcinogens?

A

Ames test.

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16
Q

What is the effect of ultraviolet radiation on cells?

A

Produces pyrimidine dimers in DNA leading to transcriptional errors and mutations of onogenes and tumor suppressor geners.

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17
Q

What is Xeroderma Pimentosum?

A

Autosomal recessive inherited defect in DNA repair; they can’t repair the pyrimidine dimers caused by UV light.

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18
Q

What is the effect of ionizing radiation on cells?

A

They cause cross-linking and chain breaks in nucleic acids.

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19
Q

What stage of cell cycle is most vulnerable to ionizing radiation?

A

Cells in mitosis or G2 of the cell cycle.

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20
Q

What are the sources of ionizing radiation?

A

X-rays, gamma rays, alpha and beta particles, protons and neutrons, atomic bombs and uranium miners.

21
Q

Give an example of RNA oncogenic virus.

A

The human T-cell leukemia virus (HTLV-1) causes adult T-cell leukemia/lymphoma.

22
Q

What are four DNA oncogenic virus?

A

I. Hepatitis B virus. II. Epstein-Barr virus (EBV). III. Human papilloma virus (HPV). IV. Kaposi-sarcoma-associated herpesvirus (HHV8).

23
Q

What type of cancer does Hepatitis B virus cause?

A

Hepatocellular carcinoma.

24
Q

What type of cancer does Epstein-Barr virus (EBV)?

A

I. Burkitt lymphoma. II. B-cell lymphomas in immunsuppressed patients. III. Nasopharyngeal carcinoma.

25
Q

What type of cancer deos Human papilloma virus (HPV)?

A

I. Benign squamous papillomas (warts). II. Cervical cancer.

26
Q

What does p53 tumor suppresor gene do?

A

Prevents a cell with damaged DNA from entering S-phase by promoting apoptosis in said cells by stimulating bax synthesis.

27
Q

What does Rb tumor suppresor gene do?

A

Prevents the cell from entering S-phase unti the appropriate growth signals are present.

28
Q

What is Knudson’s “two hit hypothesis”?

A

Both tumor suppresor genes must be inactivated for oncogenesis.

29
Q

What would be an example of a first hit in Knudson’s hypothesis?

A

An inherited germ-line mutation.

30
Q

What would be an example of a second hit in Knudson’s hypothesis?

A

An acquired somatic mutation.

31
Q

What are two examples of inherited germ-line mutation?

A

Familial retinoblastoma and Li-Fraumini syndrome.

32
Q

What is Familial retinoblastoma?

A

Caused by Germ-line muation of Rb on chromosome 13, it causes high rate of retinoblastoma and osteosarcoma.

33
Q

What is Li-Fraumini syndrome?

A

Caused by Germ-line muation of p53 on chromosome 17, it causes high rate of many types of tumors.

34
Q

What does bcl-2 do?

A

Prevents apoptosis. It is overexpressed in follicular lymphomas t(14:18) = Chrom14 - immunoglobulin heavy chain gene and Chrom18 - bcl-2 gene.

35
Q

Which four genes promote apoptosis?

A

bax, bad, bcl-xS, bid

36
Q

What does c-myc do?

A

Promotes cellular proliferation.

37
Q

What diseases are associated with alpha-fetoprotein (AFP)?

A

Hepatoma, nonseminomatous testicular germ-cell tumors.

38
Q

What diseases are associated with beta human chorionic gonadotropin (hCG)?

A

Trophoblastic tumors, choriocarcinoma.

39
Q

What diseases are associated with cacitonin?

A

Medullary carcinoma of the thyroid.

40
Q

What diseases are associated with carcinoembryonic antigen (CEA)?

A

Carcinomas of the lung, pancreas, stomach, breast and colon.

41
Q

What diseases are associated with alpha-fetoprotein CA-125?

A

Ovarian cancer.

42
Q

What diseases are associated with CA19-9?

A

Pancreatic cancer.

43
Q

What diseases are associated with placental alkaline phosphatase?

A

Seminoma.

44
Q

What diseases are associated with PSA?

A

Prostate cancer.

45
Q

What diseases are associated with prostatic acid phosphatase?

A

Prostate cancer.

46
Q

What does TNM staging system criteria stand for?

A

T: Size of the primary tumor. N: Extent of regional lymph node spread. M: Presence of metastatic disease.

47
Q

What is the most common rout of spread for epithelieal carcinomas?

A

Lymphatic spread.

48
Q

Which carcinomas spread through the blood?

A

Most sarcomas, renal cell carcinoma, hepatocellular carcinomas, follicular carcinoma of the thyroid, choriocarcinoma.

49
Q

Which serological marker is associated with melanomas and neural tumors?

A

S100.

Pathology (16 decks)

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