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J Term 2 mix > Cancer > Flashcards

Cancer Flashcards

1
Q

The 6 Hallmarks of cancer

AIRSAM

A
  1. apoptosis-resistant
  2. Indefinite growing
  3. Resistant to anti-growth signals
  4. self-sufficient growth signals
  5. angiogenesis
  6. metastasis - altered e-cadherin expression
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2
Q

What is dysplasia

A

abnormal maturation of cells, premalignant

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3
Q

3 characteristics of benign and malignant tumour

A

Benign: differentiated, compressing on surrounding tissue, low mitotic count

malignant: undifferentiated, irregular outline as it’s broken through surrounding BM, low-high mitotic count

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4
Q

What is a benign epithelial transitional neoplasm called

A

transitional cell papilloma

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5
Q

What is a benign epithelial cell cancer called

A

papilloma

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6
Q

What is a malignant epithelial cell cancer called

A

carcinoma

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7
Q

What do carcinomas commonly invade into

A

lymphatics

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8
Q

What would you call a benign glandular epithelial neoplasm and give an example

A

adenoma, ex; polyp of the colon

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9
Q

Where would you find a basal cell carcinoma

A

the skin

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10
Q

How would you describe a malignant epithelial cancer of the stomach

A

adenocarcinoma

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11
Q

Give the cancerous word for a … neoplasm
Benign: fibrous tissue, nerve, glial cell
Malignant: bone, cartilage, fat, nerve sheath, glial cell

A

Benign: fibroma, neurofibroma, glioma
Malignant: osteosarcoma, chondrosarcoma, liposarcoma, neurilemmosarcoma, malignant glioma

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12
Q

Name two types of lymphoid neoplasms

A

Hodgkin’s and non hodgkin’s

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13
Q

Name two types of hematopoietic neoplasms

A

Acute and chronic leukemia

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14
Q

What is a myeloma and what’s a consequence?

A

A malignant neoplasm of the plasma cells in the bone marrow, destroys adjacent tissue

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15
Q

What is a cancer of all cell types called, where can it form and when is it malignant or benign?

A

Teratoma, testis - malignant, ovaries - benign

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16
Q

What is a seminoma

A

Malignant neoplasm of seminiferous tubules (sperm)

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17
Q

Name the 5 mechanisms that facilitate invasion and metastasis

A
  1. altered cell adhesion
  2. altered enzyme synthesis and interaction
  3. angiogenesis
  4. lymphatics
  5. vascular
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18
Q

What changes in altered cell adhesion?

A

Cadherins - link cell to cell, alteration allows cells to move apart from each other

Integrins - links cell to the stroma, alteration allows cell movement

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19
Q

How does the alteration of enzyme synthesis and interaction occur?

A

Metastatic cells release matrix metalloproteinases that destroy cartilage and the ECM, allowing them to move through and metastasize

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20
Q

When does a metastatic cell do angiogenesis, how and what 2 things does it allow?

A

When it has grown to 1-2mm cubed and run out of nutrients, in response to a hypoxic environment it secretes proangiogenesis factors such as angiopoietin and VEGF
This allows for; 1. continued growth, 2. opportunities for metastasis

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21
Q

What type of cancer commonly spreads to lymphatics

A

carcinoma

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22
Q

What are 4 common sites cancers can spread to vascularly

A

bone, brain, lung and liver

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23
Q

What two things can happen if cancer spreads to the bone

A
  1. pathological fractures

2. Osteosclerosis: production of dense bone when bone loses flexibility and becomes weaker

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24
Q

Local complications of benign and malignant neoplasms (3 shared ones!)

A

Benign:
partial or complete obstruction, ulceration, space occupying lesion, compression

Malignant: partial or complete obstruction, ulceration, space-occupying lesion, infiltration into surrounding nerves vessels and lymphatics, destroy surrounding tissue

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25
Name 3 components of Hematological systemic effects
1. anemia 2. low WC and platelet count 3. thrombosis
26
Two types of endocrine systemic effects
1. excessive hormone secretion - corticosteroids, parathyroid hormone 2. ectopic hormone secretion - ACTH by small cell carcinoma of bronchus
27
What could occur as a result of a neuromuscular systemic effect
balance problems, sensory and motorsensor neuropathies, myopathy that can progress to muscle weakness, progressive multifocal leucenopathy
28
How does Hep B induce a neoplasm, is it direct or indirect?
Infects the hepatocytes by injecting viral DNA into the host cell genome, causes chronic damage to hepatocytes leading to regeneration and risk of mutation Indirect.
29
How does Epstein Barr induce a neoplasm, what is associated with, is it direct or indirect?
Associated with the pathogenesis of Burkitt's lymphoma, some Hodgkin's lymphoma and Nasopharyngeal carcinoma Infects epithelial cells, oropharynx and B cells, makes them proliferate more increasing the chance of mutation Indirect.
30
How does Human papilloma induce a neoplasm, is it direct or indirect?
HPV produces E6 and E7, E6 inhibits P53 (tumour suppressor gene) - the guardian of the genome, scavenges mutated cells and marks them for apoptosis E7 inhibits PRB - the restriction point in the cell cycle, another tumour suppressor gene Direct.
31
What two things can asbestos result in and how? How is it related to cigarette smoke?
Asbestos has a long exposure time and is a complete carcinogen. It has thin fibres that can get into the lungs, causing inflammation that ciggy smoke can get stuck in Malignant mesothelioma, lung cancer
32
What are aflatoxins and what can they result in?
Aflatoxins are poisonous carcinogens produced in certain molds, hepatocelular carcinoma
33
What can result from a Schistosoma?
It's a parasite depositing in the bladder wall, leading to inflammation and mucosal squamous metaplasia - bladder cancer
34
What can cause helicobacter pylori cause
Gastric inflammation, it is an indirect carcinogen
35
What is ulcerative colitis? How can it predispose cancer?
A long term condition causing inflammation of the colon and rectum - leading to DNA damage and colorectal carcinoma
36
What is liver cirrhosis? How can it predispose cancer?
Fibrosis of the liver, caused by chronic Hep B, alcohol use or alpha1antitrypsin deficiency - leading to hepatocellular carcinoma
37
What kind of epithelial cancer can an adenoma (benign tumour of glands) cause ;)))))
adenocarcinoma
38
Hereditary non-polyposis colon cancer
Autosomal dominant, it's a germline mutation affecting one of several DNA mismatch repair genes - colon carcinoma associated
39
What can retinitis xeroderma pigmentosum cause?
Mutation in DNA repair genes, increases risk of skin cancers when exposed to UV
40
What can ataxia-telangiectasia cause?
Radiation damage can lead to profound susceptibility to lymphoid malignancies
41
What is Fanconi's anemia
Sensitivity to DNA cross-linking agents leads to BM hypofunction and multiple congenital abnormalities - predisposing cancer
42
How can a proto-oncogene become an oncogene? What do oncogenes do?
Needs one allele to be mutated, oncogenes create oncoproteins that allow the cell to escape normal growth control - providing self-sufficiency
43
How can a proto-oncogene become an oncogene? What do oncogenes do?
Needs one allele to be mutated, oncogenes create oncoproteins that allow the cell to escape normal growth control - providing self-sufficiency
44
What is the theory behind mutating tumour suppressor genes and what does this lead to?
Tumour suppressor genes encode proteins that suppress growth, need both alleles to be mutated. Knudson's 2 hit hypothesis states that you can have 2 sporadic mutations or 1 inherited and 1 sporadic to mutate a TSG
45
What is Ras and what is its role?
An oncogene. Encodes a small G protein that pushes cell pas the R point - leading to continuous stimulation of cells (colon and lung cancer)
46
What is c-myc and what is its role? What can it cause? | What is an example of Burkitt's lymphoma
stimulates proliferation and transcription factors in DNA, the defect becomes amplified. Causing neuroblastoma, breast cancer, and BL: translocation 8-14
47
What is Her-2 and its role? | What would you give?
Human epidermal GF receptor - an oncogene that encodes for GF receptor and is amplified - causing proliferation and gives 25% of breast cancers Give herceptin, a competitive antagonist against the receptor
48
How does PRB suppress tumour growth
When the cell is ready to divide, retinoblastoma (RB) phosphorylates into pRB, therefore inactivating itself so the cell can go through. Becomes permanently fucked in cancer
49
How does p53 work?
Encodes for a nuclear protein that binds to and modulates the expression of genes important for cell-cycle arrest, DNA repair and apoptosis
50
What's an initiator?
Mutagen, exposing the cell to a dose is irreversible but cannot induce a tumour on its own
51
What's a promoter
Causes overproliferation of cells - increasing the chances of mutation and that mutation being mitosed
52
What's a complete carcinogen and what does that mean?
It's an initiator and a promoter - cigarettes
53
List 2 agents that can result in the development of tumours
1. Radiation | 2. Chemicals
54
How does radiation cause a mutation, and what are the types?
A direct effect: causes single and double-strand breaks and base damage Indirect: free radical production If enough mutations occur in TSG and proto-oncogenes cancer can occur -ionizing radiation, e.g; hiroshima -UV radiation, skin cancers: squamous cell, basal cell carcinoma and malignant melanoma
55
Name the 5 types of chemicals that can interact with DNA and how they work
1. Polycyclic aromatic hydrocarbons: produced in the combustion of tobacco and fossil fuels - hydroxylated to active form 2. Aromatic amines: e.g 2-nap thylamine Hydroxylated in the liver and conjugated with glucuronic acid in the urinary tract by glucuronidase - active form sits in the bladder causing bladder cancer 3. alkylating agents: binds directly to DNA, causes alkylation which leads to DNA damage 4. N-nitroso compounds 5. Natural diverse products: aflatoxins and asbestos
56
What do pro-carcinogens require to be converted to carcinogens
P450 enzymes in the liver
57
How does TNM staging work?
``` T= primary tumour size 1-2 N = lymphatics - 3 M = metastasis - 4 ```
58
What is Dukes staging used for? How does it work?
Colorectal carcinoma A - still in the bowel wall B - through the bowel wall C - lymph node involvement (1-2) depending on the distance away
59
What staging is used for Hodgkin's disease
Ann Harbor Classification 1 - one node 2 - two nodes on the same side of diaphragm 3 - two nodes on both sides of diaphragm 4 - multiple foci
60
What does grading tell you?
Based on the degree of differentiation of tumour cells | G1-G4 well - undifferentiated (malignant)
61
What does anaplasia mean?
The most severe dysplasia, obviously undifferentiated
62
What grading system is used for Breast Carcinoma and what 3 things does it measure? What does the grading system tell you?
``` Scarff-Bloom-Richardson Grading System -Degree of Tubule formation -the extent of nuclear variation -number of mitoses Grade 1-3, decreases the % of 10-year survival rate ```
63
What grading system is used for prostate cancer
Gleason Grading System
64
How does radiotherapy help cancer?
Causes damage to DNA of rapidly dividing cells - if DNA damage becomes extensive this leads to apoptosis
65
How does chemotherapy help cancer? Name 3 drugs and what they do
Drugs have effects at particular stages of cell cycle and on rapidly diving cells - Cyclophosphamide: acts on cells in G1, S and mitosis - Plant-based drugs: Vincristine: blocks cells entering cell cycle - Methotrexate: acts on S phase
66
Name 2 types of hormone therapy and what they're used for
Tamoxifen - 50-80% of breast cancers express estrogen receptors, therefore tamoxifen competes for binding to estrogen receptors Herceptin: competes to bind to Her2 receptors which are overexposed in 20-30% of breast carcinomas -side effects: cardiac/pulmonary toxicity which can be fatal
67
What does treatment depend on for prostate cancer
The type of androgen
68
Name 3 tumour markers
Carcinoembryonic antigen Human Chorionic Gonadotrophin (HCG) Alpha-fetoprotein (AFP)
69
What does carcinoembryonic antigen do?
Normally only expressed in embryonic tissue but cancer cells express it again - useful to see if there's residual disease leftover after removal of tumours
70
When is HCG used?
1. evaluates testicular masses (germ cell) 2. indicates residual disease 3. monitors response to therapy and prediction of recurrence
71
When is AFP used?
normally synthesized early in fetal life by the yolk sac, fetal liver and fetal GIT Raised plasma levels indicate cancer of the liver and yolk sac tumour of the testis/nonseminatous testicular tumours
72
How is screening used? Name two examples
Aims to detect pre-malignant, non-invasive/early invasive cancers to improve prognosis Cervical Intraepithelial neoplasia - CIN Breast: identifying invasive cancers before they can be felt

J Term 2 mix (8 decks)

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