9.12 Neoplasia 2

Question 1

what does the presence of carcinoembryonic antigen (CEA) tell you?

Answer 1

elevated in a variety of cancers

Question 2

what does ionizing radiation do to DNA?

Answer 2

chromosomal breakage (deletions), point mutations, translocations

Question 3

a lung carcinoma produces parathyroid hormone. what is this an example of?

Answer 3

paraneoplastic syndrome

Question 4

the process of going from a normal cell to a cancer cell

Answer 4

carcinogenesis

Question 5

what can molecular studies tell you about cancer cells? what types are there?

Answer 5

are there translocations or other genetic changes associated with malignancy?
karyotypic analysis, PCR, FISH

Question 6

what histologic features are used in grading?

Answer 6

degree of differentiation
pleomorphism
number of mitotic figures
necrosis?

Question 7

RB and p53 are examples of

Answer 7

tumor repressor genes

Question 8

how does human papillomavirus work?

Answer 8

viral proteins E6/E7 inhibit Rb and p53

Question 9

histology is used for tumor _______

Answer 9

grading

Question 10

Aflatoxin B1 is an ________ _______, which _______ itself in DNA. In which gene?

Answer 10

intercalating agent
inserts
p53

Question 11

what are 3 examples of tumor markers?

Answer 11

prostate specific antigen
alpha-fetoprotein
carcinoembryonic antigen (CEA)

Question 12

___________ ___ is a type of chemical carcinogen that is found naturally in a fungus (mold).

Answer 12

Aflatoxin B1

Question 13

________ ________ chemical carcinogens do not need metabolic activation

Answer 13

direct

Question 14

grade 2 means:

Answer 14

moderately differentiated

Question 15

what could cachexia be due to?

Answer 15

tumor products, cytokines from inflammatory cells

Question 16

UVB light is ______ energy and causes DNA damage by forming _______ ________

Answer 16

radiant
pyrimidine dimers (tyrosine)

Question 17

grade 3 means:

Answer 17

poorly differentiated - disorganized, high N:C ratio, many mitoses, often necrotic

Question 18

staging of a tumor is based on what system?

Answer 18

TNM system
extent of tumor (size)
extent of spread to regional lymph nodes (node involvement)
metastases (presence of metastases)

Question 19

what does TNM stand for? what is it used for?

Answer 19

used for tumor staging
T - tumor (size, depth)
N - nodes?
M - metastases?

Question 20

what are the steps in chemical carcinogenesis?

Answer 20

1. tumor initiation (chemical –> mutation)
2. tumor promotion (cell proliferation from promoter)
3. tumor progression (becomes autonomous due to sufficient mutations)
4. malignancy (cancer - can invade and metastasize)

Question 21

Aflatoxin B1 is a chemical carcinogen that causes what type of cancer?

Answer 21

liver

Question 22

how does Helicobacter pylori (H. pylori) increase risk for cancer?

Answer 22

cause of chronic infection (gastritis and ulcers) and can increase risk of gastric carcinoma and pancreatic cancer

Question 23

what does the presence of alpha-fetoprotein tell you?

Answer 23

most likely cancer of liver/gonads

could also be elevated in pregnancy

Question 24

what are two hormonal effects a tumor can have?

Answer 24

1. endocrine gland neoplasms secrete hormone normally produced by that organ
2. tumors from non-endocrine tissues may elaborate hormones (paraneoplastic syndromes)

Question 25

mutated porto-oncogenes =

Answer 25

oncogenes

Question 26

alkylating agents are a type of ______ carcinogen. What do they do, why are they bad?

Answer 26

chemical

they alkylate DNA, altering base pairing

Question 27

oncoproteins are ________ ________ (NOT dependent on growth signals or responsive to inhibitory signals)

Answer 27

constitutively active

Question 28

an example of indirect acting chemical carcinogen

Answer 28

tobacco (needs combustion)

Question 29

grade 1 means:

Answer 29

well-differentiated, resembles normal tissue

Question 30

_____ ______ virus is associated with types of B-cell lymphoma (Burkitt lymphoma). Viral proteins promote B-cell survival and proliferation.

Answer 30

Epstein Barr virus (EBV)

Question 31

what does the presence of prostate specific antigen tell you?

Answer 31

most likely prostate carcinoma

Question 32

human papillomavirus (HPV) is THE major cause of what?

Answer 32

cervical cancer (SCC)

Question 33

this effect of tumor on host is a wasting syndrome, it causes loss of body fat and muscle mass. There is profound weakness, anemia, and anorexia.

Answer 33

cachexia

Question 34

the 4 regulatory genes that could be targets of mutations related to cancer:

Answer 34

1. proto-oncogenes
2. tumor-supressor genes
3. regulators of apoptosis
4. DNA repair genes

Question 35

____________ _______ is a bacteria that is a cause of chronic infection (gastritis and ulcers) and can increase risk of gastric carcinoma and pancreatic cancer

Answer 35

Helicobacter pylori (H pylori)

Question 36

hormone production by a neoplasm derived from cells that do not normally produce this hormone (not of endocrine origin - ectopic hormone production)

Answer 36

paraneoplastic syndrome

Question 37

growth factors, ras, myc, cyclins and CDKs are all examples of:

Answer 37

protooncogenes

Question 38

mutations in what genes allow for accumulation of mutations in photo-oncogenes, tumor repressor genes, and apoptotic regulatory genes?

Answer 38

DNA repair genes

Question 39

what is the most common example of paraneoplastic syndrome? what is it due to?

Answer 39

Cushing syndrome

small cell carcinoma of lung that produces corticotropin

Question 40

in diagnosis is cancer, if histologic methods are not clear, we may need:

Answer 40

immunohistochemistry
flow cytometry
molecular studies

Question 41

indirect acting chemical carcinogens need _________ to become active

Answer 41

metabolism

Question 42

malignancy is seen after an ________ of mutations

Answer 42

accumulation

Question 43

hepatitis viruses (B and C) are commonly implicated in what type of cancer?

Answer 43

hepatocellular carcinoma