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Y1-3 CLASP > Cancer > Flashcards

Cancer Flashcards

1
Q

what is hyperplasia?

A

increase in the number of cells

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2
Q

when does hyperplasia occur?

A

in response to a stimulus

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3
Q

when does hyperplasia regress?

A

when the stimulus is removed

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4
Q

what is hypertrophy?

A

increase in cell size

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5
Q

what is atrophy?

A

loss of cell size or number

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6
Q

when does atrophy occur?

A

with the withdrawal of a stimulus

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7
Q

what two things can atrophy be?

A

hormonal or mechanical

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8
Q

what is metaplasia?

A

reversible change from one mature cell type to another

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9
Q

what does metaplasia occur in response to?

A

injury

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10
Q

what is neoplasia?

A

new growth without a stimulus

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11
Q

what are the three types of neoplastic growth?

A

benign
premalignant
malignant

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12
Q

what do benign growths not have?

A

any malignant potential

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13
Q

describe a premalignant growth

A

dysplastic but still benign as there is no invasion

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14
Q

what is the closest a growth can be to malignancy whilst still being benign?

A

carcinoma in-situ

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15
Q

what is malignancy?

A

growth that has invaded and has metastatic potential

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16
Q

who gets screened for colonic cancer?

A

patients with positive FOB tests

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17
Q

what is the gold standard for colonic cancer screening?

A

optical colonoscopy

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18
Q

what does radical treatment mean?

A

treatment with curative intent

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19
Q

what is the aim of radical treatment?

A

to eradicate a tumour, often at the expense of side effects

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20
Q

what does palliative treatment mean?

A

non-curative

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21
Q

what is the aim of palliative treatment?

A

to improve symptoms or prolong life

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22
Q

what is adjuvant treatment?

A

treatment done after surgery

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23
Q

what is the aim of adjuvant surgery?

A

reducing risk of recurrence

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24
Q

what is neo-adjuvant treatment?

A

treatment done before surgery

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25
Q

what is the aim of neoadjuvant treatment?

A

to shrink a tumour before surgical removal

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26
Q

name four descriptors of treatment endpoint

A

overall survival
disease free survival
progression free survival
local control

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27
Q

what is overall survival?

A

the patients time alive

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28
Q

what is disease free survival?

A

time without any symptoms or signs of cancer

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29
Q

what is progression free survival?

A

the time living with cancer that is not getting worse

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30
Q

what is local control?

A

time without recurrence or progression at a specific tumour site

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31
Q

name four non surgical treatment modalities

A

external beam radiotherapy
brachytherapy
radionuclide therapy
systemic anti cancer therapy

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32
Q

how does radiotherapy cause cancer cell death?

A

radiation causes a double strand break in DNA that prevents cell division, resulting in cell death

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33
Q

what is brachytherapy?

A

chips with radiation inserted into a patient

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34
Q

name three things included in systemic anti cancer therapy (SCAT)

A

cytotoxic chemotherapy
targeted therapy
immunotherapy

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35
Q

name three chemotherapy agents

A

alkylating agents
taxanes
anthracyclines

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36
Q

how do alkylating agents work?

A

attach an alkyl group to DNA

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37
Q

how do platinum salts work?

A

DNA cross linking

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38
Q

how do anti metabolites work?

A

interfere with RNA/DNA growth

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39
Q

how do taxanes work?

A

mitotic inhibitors

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40
Q

how do anthracyclines work?

A

interfere with enzymes for DNA copying

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41
Q

how does topoisomerase work?

A

prevents DNA strands from unwinding

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42
Q

what unit is a radiotherapy prescription given in?

A

grays (Gy)

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43
Q

what is Gy the unit of?

A

absorbed dose

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44
Q

what are targeted agents?

A

monoclonal antibodies

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45
Q

what monoclonal agent can be used to treat some breast cancers?

A

Herceptin/Trastuzumab

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46
Q

what does Herceptin target?

A

HER2

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47
Q

what are the three broad groups that most cancers fall under?

A

epithelial
mesenchymal
haematological

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48
Q

what is the term for epithelial malignancy?

A

carcinoma

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49
Q

who is more likely to get carcinoma, children or the elderly?

A

the elderly

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50
Q

what is carcinoma progression characterised by?

A

local growth

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51
Q

what two ways does a carcinoma spread?

A

haematogenous and lymphatic orutes

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52
Q

where is lymphatic spread to in colorectal cancer?

A

local lymph nodes in the mesentery

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53
Q

where is lymphatic spread to in testicular cancer?

A

para-aortic lymph nodes

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54
Q

where do lung cancers metastasise to via the blood?

A

bone
brain
adrenal glands
the liver

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55
Q

where do GI malignancies commonly spread to in the blood?

A

the liver

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56
Q

where does prostate cancer spread in the blood?

A

anywhere

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57
Q

what are mesenchymal tumours called?

A

sarcomas

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58
Q

what is a benign tumour of smooth muscle called?

A

leiomyoma

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59
Q

what is a benign tumour of skeletal muscle called?

A

rhabdomyoma

60
Q

what is a benign tumour of fat called?

A

lipoma

61
Q

what is a benign tumour of bone called?

A

osteoma

62
Q

what is a benign tumour of cartilage called?

A

chondroma

63
Q

what is a benign tumour of blood vessels called?

A

haemangioma

64
Q

what is a benign tumour of nerves called?

A

neuroma

65
Q

what is a malignant tumour of smooth muscle called?

A

leiomyosarcoma

66
Q

what is a malignant tumour of skeletal muscle called?

A

rhabdomyosarcoma

67
Q

what is a malignant tumour of fat called?

A

liposarcoma

68
Q

what is a malignant tumour of bone called?

A

osteosarcoma

69
Q

what is a malignant tumour of cartilage called?

A

chondrosarcoma

70
Q

what is a malignant tumour of blood vessels called?

A

angiosarcoma

71
Q

what is a malignant tumour of nerves called?

A

malignant peripheral nerve sheath called (MPNST)

72
Q

are sarcomas common or rare?

A

rare

73
Q

what is the defining feature of sarcoma progression?

A

local growth

74
Q

what type of spread is very rare in a sarcoma?

A

lymphatic spread

75
Q

describe the morphology of a sarcoma cell

A

spindle cell

very long tapered shape

76
Q

can haematological tumours metastaised?

A

no

77
Q

what is a lymphoma?

A

tumour like masses in lymph nodes

78
Q

what is crucial in haematological tumours?

A

FBC

79
Q

what is a brain tumour often called?

A

glioma

80
Q

what are lesions in the brain considered to be until proven otherwise?

A

metastases

81
Q

where do primary brain tumours metastasise to?

A

nowhere, they can’t cross the blood brain barrier

82
Q

what does TNM stand for?

A

tumour size
lymph node involvement
metastasis

83
Q

what does Tis stand for?

A

tumour in situ

84
Q

what does tumour in situ mean?

A

the tumour is contained within the lamina propria

85
Q

what does T1 mean?

A

the tumour has invaded the submucosa only

86
Q

what does T2 mean?

A

the tumour has invaded the muscularis propria and has not extended beyond it

87
Q

what does T3 mean?

A

the tumour has invaded into the subserosa but not into the serosa or any adjacent tissues

88
Q

what does T4 mean?

A

the tumour has directly invaded other organs or structures

89
Q

what does NX mean?

A

lymph nodes cannot be assessed

90
Q

what does N0 mean?

A

no regional lymph node metastasis

91
Q

what does N1 mean?

A

metastasis to 1-3 nearby lymph nodes

92
Q

what does N2 mean?

A

metastasis to four or more regional nodes

93
Q

what does M0 mean?

A

no metastasis

94
Q

what does M1 mean?

A

metastasis to distant tissues, including lymph nodes

95
Q

what stage is a tumour with T1N1M0?

A

III A

96
Q

what stage is a tumour with T2N2M0?

A

III C

97
Q

what stage is a tumour with T2N0M1?

A

IV

98
Q

describe the TNM score for a stage I cancer?

A

T1/2
N0
M0

99
Q

describe the TNM score for a stage II A cancer?

A

T3
N0
M0

100
Q

describe the TNM score for a stage II B cancer?

A

T4
N0
M0

101
Q

describe the TNM score for a stage III A cancer?

A

T1/2
N1
M0

102
Q

describe the TNM score for a stage III B cancer?

A

T3/4
N1
M0

103
Q

describe the TNM score for a stage III C cancer?

A

T ANY
N2
M0

104
Q

describe the TNM score for a stage IV cancer?

A

T ANY
N ANY
M1

105
Q

what staging system can be used for bowel cancer?

A

duke’s staging

106
Q

describe duke’s stage A bowel cancer

A

confined to the bowel wall with no lymph node metastases

107
Q

describe duke’s stage B bowel cancer

A

local spread out of the bowel wall with no lymph node metastasis

108
Q

describe duke’s stage C bowel cancer

A

lymph node metastasis

109
Q

describe duke’s stage D bowel cancer

A

metastatic disease

110
Q

what is the prognosis for stage A bowel cancer?

A

95%

111
Q

what is the prognosis for stage B bowel cancer?

A

85%

112
Q

what is the prognosis for stage C bowel cancer?

A

60%

113
Q

what is the prognosis for stage D bowel cancer?

A

8%

114
Q

what does PSA stand for?

A

prostate specific antigen

115
Q

what is PSA?

A

a protein produced only by the prostate

116
Q

what is prostatism?

A

a collection of symptoms including urinary hesitation and difficulty in emptying the bladder

117
Q

what causes the symptoms of prostatism?

A

enlargement of the prostate which narrows or completely closes the urethra

118
Q

what are two possible causes of prostatism?

A

prostate cancer

benign prostate hyperplasia (BPH)

119
Q

what should be measured in people with prostatism?

A

PSA

120
Q

what is a normal range for PSA?

A

0-4

121
Q

what are differentials of high PSA?

A

prostate cancer

benign prostate hyperplasia

122
Q

what examination can be done to differentiate between BPH and prostate cancer?

A

PR exam, BPH feels smooth while prostate cancer feels rough

123
Q

besides PSA and PR exam, what other test needs to be done to diagnose prostate cancer?

A

biopsy

124
Q

name two enzymes that are raised in muscle damage

A

CK

AST

125
Q

name four enzymes that are raised in liver damage

A

ALT
AST
ALP
GGT

126
Q

name four enzymes that are raised in heart damage

A

troponin
CK
AST
LDH

127
Q

name two enzymes that are raised in pancreas damage

A

amylase

lipase

128
Q

name an enzyme that is raised in bone damage

A

ALP

129
Q

what is the normal range for alkaline phosphatase?

A

30-130

130
Q

name two types of cells that contain ALP?

A

hepatocytes

osteoblasts

131
Q

what does high alkaline phosphatase in a cancer patient suggest?

A

metastasis to either the liver or bone

132
Q

what test can be done to determine whether raised ALP is due to liver or bone pathology?

A

GGT, if elevated it is liver pathology

133
Q

which type of pleural effusion is more likely to be caused by malignancy?

A

exudate

134
Q

what is the reference interval for calcium?

A

2.10-2.55

135
Q

what is the most important thing to measure in someone with raised calcium?

A

PTH

136
Q

what does it mean if someone has high calcium and high PTH?

A

the high PTH is what is causing the high calcium, as PTH stimulates calcium production when levels are low

137
Q

what is PTHrP?

A

PTH related protein

138
Q

is PTHrP seen upon measuring PTH?

A

np

139
Q

what may be causing high calcium in a patient whose PTH levels are normal?

A

PTHrP

140
Q

what do oncogenes do?

A

promote cell division

141
Q

what do tumour supressors do?

A

stop cell division

142
Q

what do DNA repair genes do?

A

repair DNA damage

143
Q

what do drug metabolism genes do?

A

metabolise carcinogens

144
Q

name four types of genes that are involved in cancer

A

oncogenes
tumour suppressor genes
DNA repair genes
drug metabolism genes

145
Q

what is a driver mutation?

A

a mutation that drives carcinogenesis

146
Q

what is a passenger mutation?

A

an incidental mutation that develops because the tumour is unstable

Y1-3 CLASP (4 decks)

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