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STEP1 > Cancer > Flashcards

Cancer Flashcards

1
Q

What is the progression of cancer?

A 
Normal
Hyperplasia
Dysplasia
Carcinoma in situ
Invasive carcinoma (E-cadherin inactivated, no cell-cell adhesion)
Metastasis
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2
Q

What are the features of anaplasia?

A 
clumping nuclear chromatin
high N/C ratio
mitotic figures
prominent nucleoli
more primitive/less mature
may see giant cells
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3
Q

T/F Neoplasia means malignancy.

A

F. may be benign or malignant

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4
Q

What is desmoplasia?

A

fibrous tissue after a neoplasm

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5
Q

Describe grading and staging a tumor.

A

grade: 1-4. 1: well differentiated. 4: poorly differentiated.
stage: TNM
tumor size
nodal involvement
metastasis

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6
Q

Which cancers metastasize to the liver?

A 
Cancer Sometimes Penetrates Benign Liver
Colon
Stomach
Pancreas
Breast
Lung
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7
Q

What is the origin, stain, and spread of carcinoma and sarcoma?

A

carcinoma–epithelial, spread by lymph, cytokeratin stain

sarcoma-mesenchymal, spread by blood

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8
Q 
What are the benign and malignant forms of the following?
blood vessels
smooth muscle
striated muscle
CT
A

blood vessels:
benign: hemangioma; malignant: angiosarcoma

smooth muscle:
benign: leiomyoma; malignant: leiomyosarcoma

striated muscle:
benign: rhabdomyoma; malignant: rhabdomyosarcoma

CT
benign: fibroma; malignant: fibrosarcoma

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9
Q

What is cachexia?

A

weight loss and loss of fat and lean muscle

b/c of increased basal metabolic rate from release of TNFalpha, IFNgamma, IL-1, IL-6 from chronic disease

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10
Q

What are the paraneoplastic syndromes created by small cell lung cancer?

A

ACTH-Cushing’s
ADH-SIADH
Lambert Eaton–muscle weakness better w/ use, antibodies to presynaptic Ca++ channels at NMJ
PTHrP

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11
Q

What are the paraneoplastic syndromes created by renal cell carcinoma?

A

ACTH
PTHrP
EPO

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12
Q

Which cancers can cause increased EPO release and polycythemia?

A 
Potentially Really High HCT
Pheochromocytoma
Renal Cell Carcinoma
Hemangioblastoma
Hepatocellular carcinoma
leimyomas (fibroids that bleed may not cause anemia b/c also secrete EPO)
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13
Q

When do you see PSaMMOma bodies?

A

papillary carcinoma thyroid
serous papillary cystadenocarcinoma of ovary
meningioma
malignant mesothelioma

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14
Q

Which tumors give mets to the brain?

A 
Lots of Bad Stuff Kills Glia
Lung
Breast
Skin (melanoma)
Kidney (RCC)
GI (colon)
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15
Q

Which tumors give mets to the bone?

A

Permanently Relocated Tumors Like Bone

**genitourinary:
Prostate (blastic)
RCC (lytic)

Thyroid (lytic)
lung (mixed)
Breast (mixed)

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16
Q

What are the following associated w/?
BCR-ABL
BCL-2

A

BCR-ABL; oncogene
a part of the PHiladelphia chromosome t(9;22) CML, ALL
tyrosine kinase intracellular

BCL-2; oncogene
antiapoptotic
follicular lymphoma

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17
Q

What are the following associated w/?
c-myc
L-myc
N-myc

A

all oncogenes
c-myc: burkitt lymphoma, transcription factor
L-myc: lung tumor, transcription factor
N-myc: neuroblastoma, transcription factor

18
Q

What are the following related to?
DCC
DPC4/SMAD4

NF1
NF1

A

all tumor suppressor genes
DCC: colon cancer
DPC4: pancreatic cancer

NF1: chromosome 17; neurofibromatosis type 1
NF2; chromosome 22; NF2, related to acoustic schwannomas

19
Q

Describe what Rb does.

A

Rb regulates transition from G1–>S
binds E2F
released when it is phosphorylated by cyclin-dependent kinase4-cyclin D

when it is mutated, can’t regulate & can predispose to retinoblastoma and osteosarcoma

20
Q

How many mutant alleles does it take to produce cancer w/ oncogenes? tumor suppressor genes?

A

Oncogenes-1

tumor suppressor genes-2

21
Q

What does p53 do?

A

responsible for half of all cancers
w/ p21 can arrest cell cycle
at G1/S and G2/M checkpoints
if it chooses can upregulat BAX for apoptosis

22
Q

How does RAS work?

A

GPCR–>MAP kinase–>cell proliferation

oncogene

23
Q

Which cancers with these mutations:
K-RAS
H-RAS
N-RAS?

A

K-RAS: Kolon, lung, pankreatic tumors
H-RAS: hematuria: bladder and kidney tumors
N-RAS: melanoma, hematologic malignancies, follicular thyroid cancer

24
Q

What is the most common oncogene? Tumor suppressor gene?

A

oncogene-RAS

tumor suppressor gene–p53

25
Q

Which cancers are caused by ionizing radiation?

A

myeloid leukemias: AML, CML

thyroid cancer

26
Q

Which type of ultraviolet radiation causes skin cancer?

A

UVB–forms pyrimidine dimers

27
Q

What is used to treat actinic keratoses so that they don’t transition into squamous cell carcinoma?

A

5-FU

28
Q

What are the important features of tuberous sclerosis?

A 
ash leaf spots
SIA
seizures
ID
angiofibromas

3 cancers:

  1. cardiac rhabdomyoma
  2. renal angiomyolipoma
  3. astrocytoma
29
Q

What is a weird thing that HCV can cause?

A

papillary thyroid cancer

30
Q

What are the cancers w/ highest incidence and mortality in US among men and women?

A 
Men:
Incidence
1. Prostate
2. Lung
3. Colon
Mortality:
1. Lung
2. Prostate
3. Colon
Women:
Incidence
1. Breast
2. Lung
3. Colon/Uterine

Mortality:

  1. Lung
  2. Breast
  3. Colon
31
Q

What type of cancer do aromatic amines–such as benzidine and 2-naphthylamine cause?

A

transitional cell carcinoma

naphthalene found in moth balls

32
Q

What type of cancer does arsenic cause?

A

Angiosarcoma-liver
Lung cancer
Squamous cell carcinoma

33
Q

What type of cancer does carbon tetrachloride cause?

A

centrilobular necrosis, fatty change of the liver

34
Q

Nitrosamines (smoked foods) like hotdogs cause what types of cancer?

A

squamous cell carcinoma of esophagus

gastric cancer

35
Q

Vinyl chloride, found in refrigeration can cause what type of cancer?

A

angiosarcoma-liver

36
Q

Screening for breast cancer, cervical cancer?

A

Breast: mammogram 50-75 1/2 yrs
Cervical: pap smear 1/3yrs 21-65

37
Q

Screening for prostate, colon, lung cancer?

A

prostate: no recommendations
colon: colonscopy 1/10 yrs 50-75
flex sigmoidoscopy 1/5 yrs, fecal occult blood 1/1yr
Lung: annual CT lung 55-80 if 30 pack year hx of smoking and still smoking or quit

38
Q

Which cancers are patients who are obese at increased risk for?

A

esophageal adenocarcinoma
renal cell carcinoma
Women: gallbladder, endometrial
men: thyroid, colon

39
Q

When you have a high fat diet, what are you at increased risk for in terms of cancer?

A

Butter, Chips, Pringles, stEak

Breast, Colon, Prostate, Endometrial

40
Q

What are you at increased risk for w/ inactivity?

A

breast, colon

41
Q 
What do you the following tumor markers correspond to? 
Alk Phosph
AFT
CA15-3/CA27-29
CA19-9
CA125
CEA
S-100
TRAP
A 
Alk Phosph: bone or liver
AFT: hepatocellular carcinoma
CA15-3/CA27-29: breast
CA19-9: pancreatic
CA125: ovarian
CEA: pancreatic, colorectal
S-100: melanoma, schwannoma
TRAP: hairy cell leukemia (CLL)
42
Q

Which 2 tumor markers are elevated in pancreatic canceR?

A

CA19-9

CEA

STEP1 (54 decks)

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