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MRCS A: Pathology II > Cancer > Flashcards

Cancer Flashcards

1
Q

Phases of cell cycle (5)

A 
G1-Presynthetic
S-DNa synthesis
G2-Pre-mitotic
M-Mitotic
G0-Quiescent
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2
Q

Phases of Mitosis

A

Interphase-G1, S, G2 (Chromosomes double to 92)

Prophase: Centrioles
Prometaphase: Nuclear membrane dissolves and chromosomes migrate out

Metaphase: Spindle fibres align centrally

Anaphase: Paired chromosomes separate and dragged to opposite sides of the cells

Telophase: Chromatids arrive at opposite poles

Cytokinesis: Actin fibre creates two new cells

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3
Q

Cell cycle control: Intracellular enzymes

A

Upregulation by Cyclin dependent kinases:

  • PDGF
  • EDGF
  • IGF-1

Downregulation by: TGF-b

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4
Q

Protein p53

A

Blocks G1

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5
Q

Proto-oncogenes

A

Ras (p21)
ERB1 and ERB2
Telomerase

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6
Q

Tumour Suppressors

A

APC
E-Cadherin
P53

Anti-apoptosis bcl2

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7
Q

Angiogenesis promotors

A

Fibroblast growth factors
Vascular endothelial growth factors
Angioproteins 1 and 2

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8
Q

Inhibitors of angiogenesis

A

Angiostatin
Endostatin
Thrombostatin

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9
Q

PSA

A

PSA velocity (>0/75ng/dl/yr malignant)

PSA density PSA value with volume (>0/15)

Free-total PSA ratio (<25%)

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10
Q

Tumour markers

A

CEA-Colorectal cancer

AFP-Liver, NSGT (testes)

bHCG-Choriocarcinoma, NSGCT

Thyroglobulin-Thyroid cancer

Calcitonin-MTC

ACTH/ADH-Small cell lung cancers

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11
Q

Chemotherapeutic Agents

A 
Classical Alkylating agents
Non-classical alkylating agents
Anti-metabolites
Anthracycline agents
Non-anthracycline agents
Vinca alkaloids
Taxanes
Topoisomerase inhibitors
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12
Q

Classical Alkylating agents

Form covalent bonds with nucleic acids, amino acids, proteins etc

A

Mustargen

  • CML
  • CLL
  • Hodgkins
  • Non-hodgkins

Cyclophosphamide

  • Lymphoma
  • Breast
  • Lung
  • Ovary

Chlorambucil
-CLL
NHL
Ovary

Melphalan
-Multiple myeloma

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13
Q

Non-Classical Alkylating agents

Cross link DNA strands

A

Cisplatin

  • Testis, ovart
  • Head and neck cancer
  • Lung cancer
  • Oesophageal and stomach
  • Bladder

Carboplatin

  • Lung
  • Ovary
  • Seminoma
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14
Q

Antimetabolistes

Interfere with purine, pyramiding synthesis

A

Methotrexate (s-phase)
-ALL
Breast
Lung

F-FU
Colon
Breast
stomach
oesophagus
Pancreas
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15
Q

Anthracycline

Multiple actions)

A

Doxorubicin

  • Leukaemia
  • Lymphoma
  • breast cancer
  • small cell lung
  • sarcoma
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16
Q

Non-anthracycline

Alkylation

A

Bleomycin
-Lymphoma

Mitomycin

  • Breast
  • Bladder
17
Q

Vinca alkaloids

Inhibit mitosis-M phase specific

A

Vincristine
acute leukaemia
lymphoma
neuroblastoma

Vinblastine
Testis
Hodgkins and non
choriocarcinoma

18
Q

Taxanes

Stabilise microtubules

A

Docetaxel
Breast
Ovarian

Paclitaxel
Ovary
Breast
Lung

19
Q

Topoisomerase inhibitors

A

Irinotecan

-Colorectal cancer

20
Q

Hormonal Therapy

A

Prostate

  • Bilateral orchidectomy
  • Antiandrogens
  • LHRH analogues
  • Stilboestrol (oestrogen)

Breast

  • Tamoxifen (ER - and PR -)
  • Aromatase inhibitors
  • Progestogens
  • LHRH analogues
21
Q

Thyroid tumours

A

Thyroxine suppresses TSH

22
Q

Monoclonal abs

A

Rituximab
-Monoclonal ab against B cells
For low grade lymphoma

Trastuzumab (Herceptin)
-HER-2

Bevacizumab
-VEGF angiogenic activity

23
Q

Oncological Emergencies

A

Neutropenia and sepsis
Hypercalcaemia
SVC obstruction
Spinal cord compression

24
Q

Neutropenia and sepsis

A

Bone marrow depression due to malignancy cell infiltration

Treatment causing suppression of bone marrow

25
Q

Hypercalcaemia

A 
Bones, moans, stones, psychic groans
May resolve with treatment of primary cancer
Fluids replacement
Stop thiazide diuretics
Oral phosphatesm calcitonin and NSAIDs
26
Q

SVC

A 
Plethoric facies
Obstructed dilated neck veins
Dizziness on bending
Dyspnoea and pulmonary oedema
Headache
Venous thrombosis

Management: Local radiotherapy
Dexamethasone 4mg/6hrs

27
Q

Spinal Cord Compression

A

70% Thoracic 20% lumbosacral 10% cervical

Back pain
Leg weakness
Urinary retention
Upper motor neurone signs, sensory signs

MRCS A: Pathology II (15 decks)

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