Cancer Flashcards
1
Q
Trusseau sign
- what is it
- location
- associated w
- LE
- UE
A
- superficial migratory thromboflibitis -> inflammation of blood vessel secondary to clot
- superficial v
- pancreatic CA
- long (mid shin) and short saphenous v (on top calf)
- Cephalic v and basilic v
2
Q
Cachexia
- what is it
- sxs
- caused by
- how
- when else can this occur, sxs
A
- failure to thrive in adult
- anorexia, muscle wasting, fatigue, malaise
- TNF alpha -> from macrophages and neoplastic cells
- stimulates hypothal to decrease appetite
- septic shock -> tachycardia, hypotensive, fever
3
Q
Resistance to chemo
- caused by
- codes for
- presentation
A
- human mutli-drug resistance gene
- p -glycoprotein which is transmembrane ATP efflux pump protein to flush away chemo
- tumor won’t shrink
4
Q
Tumor lysis syndrome
- what is it
- when
- labs
- sxs
- tx and MOA
A
- lots of cancer cells killed at exact same time and lysing realing all intracellular ions at once
- high grade lymphoma or high sensitvity to chemo
- hyperkalemia, hyperphasphatemia, hypo Ca bc binding to phophorus, uric acid from DNA and RNA causing acidic env
- cardiac arrythmia, muscle weakness, phophate crystals, calcium stones, tetany, seizure, myopathy
- racburicase -> washes out excess uric acid
5
Q
Most Common CA
- men
- men causing death
- women
- women causing death
A
- prostes, lung, colon
- lung, prostate, colon
- lung, breast, colon
- lung, breast, colon
6
Q
Most Common CA overall
- 1
- 2
- 3
- 4
A
- breast
- lung
- prostate
- skin
7
Q
Types of Cell changes
- metaplasia: what is it, ex
- dysplasia: what is it
A
- one cell type replaced by different cell type -> barrets (strat squamous -> columnar -> adenocarcinoma)
- abnormal cell growth that is conficed to epi -> does not violate basement membrane
8
Q
Grade
- low
- high
- invasive
A
- not entire epithelium
- entire epithelium but not into BM (carcinoma in situ)
- invades into BM
9
Q
Histo of Dysplasia
- pleomorphic
- staining
- mitoses
A
- cells and nuclei differ in shape and size
- stain intensely because all nuc and little cytoplasm
- increase significantly
10
Q
how dysplastic cells violate BM to become invasive carcinoma
- step 1
- step 2
- step 3
A
- decrease in e-cadherin -> no longer attached to neighboring cells
- increase in laminin -> so it can attach to BM
- secretion proteolytic enzyme by tumor (metalloproteinase and cathepsin D protease) in order to break down BM and ECM
11
Q
Why does CA met? Most common mets
- breast
- colon
- lung
- melanoma
- prostate
A
- bc it outgrows local blood supply
- bone, brain, liver, lungs
- liver, lung, bone, brain
- bone, brain, liver, adrenal
- bone, brain, liver lung
- bone
12
Q
Mech of CA
- pre initiation
- initiation
- promotion
- progression
- malignancy
A
- no CA
- exposed to carcinogen which interacts with DNA
- carcinogen causes mutation in DNA -> usually a transcription regulator -> will start replicating faster than cells around it
- continue to have exposure to carcinogens -> mutations in DNA accumulate -> dysplasia is occurring so benign tumor is growing
- cancer begins to violate BM
13
Q
Tumor suppressor genes
- what are they
- mutations
- ways
- two hit hypothesis
- kinds of mutations
A
- anti-oncogene protecting cell from CA
- loss or reduction of function allowing cell to progress to CA
- gene repression, apoptosis, cell adhesion, block loss of contact inhibition, inhibit mets, DNA repair, stop cell cycle
- both alleles have to be mutated in order to have increased susceptibility to CA
- point mutation -> causing truncated protein OR large deletion -> loss of protein function
14
Q
Oncogenes
- what are they
- proto; code for
- activation
A
- genes that can cause CA
- normal gene that can become oncogene if mutated; cell growth and differentiation
- mutation in proto oncogene or its regulatory region
15
Q
Classifying Oncogenes
- Growth Factors
- Receptor Tyr Kinase
- Reg GTPase
- Transcription factors
- cytoplasmic kinase
- cytoplasmic tyrosine kinase
A
- induce cell proliferation
- transduce signal for cell growth and differentiation
- signal pathway that leads to cell proliferation
- reg transcription of genes that induce proliferation
- cell cycle regulation, proliferation, differetiation, survival
- mediates response to and activation of receptors for cell proliferation
16
Q
Oncogenes Altered in CA
- AKT1 *
- BRAF *
- FOS *
- ERB2 *
- C-MYC *
- N- MYC *
- HRAS
- KRAS
- NRAS *
- RET *
- WNT1 *
A
- hepatoblastoma, wilms, lung, ovarian, colon, beckwidth weeman syndrome
- breast CA, lung, colon, rectum, ovary, thyroid, Gastro-intestinal stromal tumors
- osteosarcoma, endometrial, cervical
- breast, lung, gastric, ovarian, glioma **
- murkitts, ovarian, breast, colorectal, pancreas, uterus
- neuroblastoma
- neuroblastoma
- MEN2a, 2b, medullary CA of thyroid
- basal, colorectal, breast
17
Q
Important translocation
- 9:22
- 8:14
- 14:18
- 11:22
- 15:17
A
- phil chromosome -> CML
- burkitts
- follicular
- ewings osteosarcoma
- AML -> promyeloblastic
18
Q
Viruses and CA
- how
- HPV
- EBV
- Hep B, C
- Retrovirus
A
- activate growth promoting pathways or inhibit tumor suppressor
- E6 -> p53, E7 -> RB; throat cancer, vulvar CA, penile CA, rectal CA
- HCC
- T cell leukemia
19
Q
Staging
- what is it
- T
- N
- M
A
- extent or severity of CA
- extent of tumor; 0= only marker, TIS = in situ, 1-3: size or extenet of tumor
- Lymph nodes; regional LN, n=0 none, N1-3: # LN or extenet of spread
- Mets; 0= no mets, 1: distant mets
20
Q
Grading
- what is it
- in situ
- localized
- regional
- distant
- unknown
- 1
- 2
- 3
- 4
A
- classifies CA cells in terms of how abnormal the cells look microscopically and how quickly they are to grow and spread
- abnrml cells present only in layer of cells in which they devleop
- cancer limited to organ where it began
- CA spread beyond primary sight to nearby LN or organs
- CA spread from primary sight to distant organ of LN
- not enough info to determine stage
- well differentiated (low) -> similar to histo of tissue of origin
- moderately diff (intermediate)
- poorly diff (high) -> lack majority of characteristi features of normal cells
- undiff (high) -> do not look anything like a normal cell