Cancer and Autoimmune Flashcards
1
Q
t(9;22)
A
Philedelphia chromosome, CML OR Ph+ B-ALL
2
Q
Jak2 kinase
A
Chronic myeloproliferatie disorders other than CML
3
Q
BCR-ABL
A
Same as Philedelphia?
4
Q
t(11;14)
A
Mantle cell lymphoma, translocation of cyclin D1 and heavy chain Ig allowing proliferation of cell from G1 to S phase
5
Q
t(14;18)
A
Follicular lymphoma, translocates heavy-chain Ig and BCL-2 resulting in survival of somatic hyperexpansion cells which should not survive
6
Q
tdt+ cells?
A
DNA polymerase in Lymphoblasts (proliferation in ALL)
7
Q
Myeloperoxidase? (MPO)
A
Myeloblasts (proliferation in AML)
8
Q
Aur Rod?
A
MPO accumulation - AML
9
Q
Down syndrome cancer after age of 5?
A
ALL
10
Q
CD10, 19 and 20?
A
B-cells -> abnormal proliferation means B-ALL
11
Q
t(12;21)
A
B-ALL - think reflection across B and reflextion across ;, good prognosis, usually in kids
12
Q
Ph+ B-ALL marker?
A
t(9;22) - Philedelphia chromosome - poor prognosis
13
Q
t(15;17)
A
Acute promyelocytic leukemia - translocation of retinoic acid receptor which blocks maturation - treatment with ATRA which binds mutated receptor
14
Q
Band cells
A
Immature cells with fewer nuclear segments - means shortened maturation / infection
15
Q
CD5+ and CD 20+?
A
CLL
16
Q
Smudge cell?
A
CLL
17
Q
Tartrate resistant acid phosphatase?
A
Hairy cell leukemia - treated with 2-CDA - which blocks adenosine deaminase causing toxic adenosine levels in cell
18
Q
HTLV-1 -> Japan and Carribean
A
Adult T-Cell leukemia/lymphoma
19
Q
Cerebreform nuclei
A
Sezary cells in mycosis fungoides
20
Q
Neoplastic cells in epidermis
A
Pautrier microabscesses - Mycosis fungoides
21
Q
IL-6?
A
Multiple myeloma
22
Q
Peak age for multiple myeloma?
A
50-60
23
Q
Solitary plasmitic lesion?
A
Osseous - will be multiple myeloma, extraosseous - can be resected!
24
Q
Leukemia not caused by radiation?
A
CLL (according to kreisle)
25
Precursors
Lmyphoid
CFU-G/M
CFU-E
Lymphoid - CLL, Hairy cell, mutliple myeloma
CFU-G - CML, myelodysplastic syndrome, melofibrosis
CFU-E - PCV, Essential thrombocytosis
26
Chronic leukemia vs acute leukemia onset.
CLL
CML
AML
ALL
Chronic leukemia = disease of adults
Acute lekumia = disease of the young
CLL>50
CML40-50
AML 15-30
ALL 4
27
Progressions
CML
MDS
CML -> AL
| MDS ->AML
28
Marker for ALL?
Acid shiff no peroxidase, yes for terminal deoxyransferase (TdT)
29
Prominent thymic mass?
T-cell ALL
30
MPO on wright Giemsa stain?
AML
31
Leukemia with hypergranulation and RAR-Alpha-PML mutation
M3 AML, treat with retinoic acid
32
CD5+ with Cd19 and CD20 without CD10 or TdT
CLL
33
Trisomy 12
CLL associated
34
Tartrate resistant acid phosphatase
Hairy cell leukemia
35
t(8;21)
AML
36
Top 5 hematological cancers?
Non=hodkins, MM, AML, CLL,Hodgkins
37
Hodgkins or non-hodgkins older?
Non hodgkins - hodgkins
38
Bad differetnaiation for Non-hodgkin's?
Large, diffuse, high grade
39
Prominent white pulp in spleen?
Follicular lymphoma
40
Leukemic version of small cell lymphoma?
CLL
41
EBV infection past?
Burkitt's lymphoma, mandible and abdomen
42
Sezary Syndrome
Tumors of CD4+ T cells
43
CD38
MM
44
CD15, 30
Hodgkins
45
t(8;14), t(2;8), T(8;22)
Burkitt's, cmyc
46
t(14;19)
Bcl-3
47
Form of cancer more common in women?
Nodular Sclerosis Hodgkin's disease
48
ALL best to worst translocation with random order in between
Hyperploidy --> t)12;21,), (8;14) burkitt's ->t(9;22) worst
49
PIG-A gene
PNH, lack of CD55, CD59
50
Which AML cannot be cured by chemo?
MDS -> AML
51
AML best to worst
t(15;17), t(8;21), inv(16) best
| (9;22), MDS history, Monosomies worst
52
Two divisions of lung cancer
Small cell and non-small cell
53
Small cell S pneumnic
Small smokers central that causes syndromes (like SiADH, ACTH
54
Small cell histology and population
Poorly differentiated cells from neuroendocrine in male (usually) smokers
55
Why differentiate small cell?
Treat with chemotherapy not surgical resection
56
Squamous cell carcinoma histology and paraneoplastic syndrome
Intracellular bridges and keratin pearls - PTHrP
57
Most common tumor in male smokers
Squamous cell carcionma
58
Most common tumor in nonsmokers and female smokers
Adenocarcinoma
59
Difference histologically between adenocarcinoma and Large cell?
No glands, mucus, keratin pearls, bridges, etc. Located peripherally (pleural involvement)
60
What arises from Clara cells?
Bronchiolocarcinoma - looks like pneumonia - excellent prognosis
61
What is carcinoid made of and what does it stain positive?
Neuroendocrine with chromogranin positive
62
Difference between small cell and carcinoid
Poorly differentiated vs well differetiated
63
Classic appearance of carcinoid tumor
Nests of cells forming a polp-like mass in the bronchus
64
Most common metastasis of lung?
Breast and colon carcinoma
65
More common lung cancer - primary of secondary?
Secondary (metastasis)
66
Where does the lung like to metastasize cancer to?
Adrenal glands
67
Name of tumor in apex of lung? Most common cause
Pancoast tumor - horner syndrome, Squamous cell carcinoma
68
Central lung mass with paraneoplastic syndrome?
Small cell carcinoma
69
Central hilar mass/cavitation?
Squamous cell carcinoma
70
Peripheral neoplasm mimicking pneumoniae?
Bronchioalveolar adenocarcinoma
71
Genetic factors for small cell lung?
c-myc
72
Genetic factors for adenocarcinoma in lung?
K-ras
73
Another name for small cell?
Oat cell - resemble lymphocytes but twice the size
74
Symptoms of carcinoid syndrome
Diarrhea, flushing, cyanosis
75
DDX for bell's palsy
Damage to peripheral VII , HIV, sarcoidosis, Lyme, pancoast tumor
76
Where does each 1/3 of the esophagous metastasize?
Upper 1/3 - cervical nodes
Middle 1/3 - mediastinal or tracheobronchial nodes
Lower 1/3 - celiab and gastric nodes
77
DIfferentiating gastric ulcers and gastric carcinoma?
Heaped up borders, irregular margins
78
What is linitis plastica?
Thickening of stomach wall in response to diffuse type adenocarcinoma characterized by signet rings and desmoplasia - not associated with H. pylori
79
Sites of metastasis of gastric carcinoma
Supraclavicular nodes, liver, periumbilical region, bilateral ovaries
80
If a carcinoid tumor is secreting serotonin in the bowel, why do you not see carcinoid syndrome?
The liver uses MAO to metabolise serotonin to 5-HIAA
81
Why is left sided carcoinoid heart disease not seen?
MAO in the lung
82
What are carcinoid syndrome symptoms
Bronchospasm, diarhea, flushing skin
83
What makes senile cardiac amyloidosis different from familial amyloid cardiomyopathy?
FAC has mutated transthyretin and thus has more chance of being symptomatic, senile lower chancer with normal transthyretin
84
What protein accumulates in dialysis patients and what does it do?
B2 microglobulin in joints, support molecule for MHCI
85
Disorders of amyloidosis systemicand non-systemic
Systemic - primary (AL), secondary (AA) - Familial mediterranean fever - nephrotic syndrome, restrictive cardiomyopathy, tongue enlargement, malabsroption, hepatosplenomegaly - thickens everything
Localized - senile cardiac, familial amyloid, non-insulin-dependent DMII, Alzheimers, dialysis, medullary carcinoma ofthyroid
86
What is the path of leukocyte adhesion deficiency?
Defect in CD18, integrin malfunction, neutrophils can't attach - delayed umbillical detachment (due to lack of necrosis/inflammation), increased neutrophils circulating, reccurrent bacterial infections - non pus infections
87
Three basic phases of inflammation
Fluid -> neutrophils -> macrophages
88
Describe the process by which a neutrophil reaches a tissues
Margination due to vessel dilation, rolling due to P and E selectin binding to sialyl lewis X, adhesion between ICAM/VCAM and integrins, transmigration and chemotaxis via IL-8, C5a, LTB4, Phagocytosis
89
What is chediak higashi
"Chedi higa, chedi higa" - like a train - phagosome does not bind with lysosome
Protein trafficking defect, autosomal recessive, can't transport protein within cell - neutropenia, giant granules on golgi, defective hemostasis, albinism, peripheral neuropathy
90
What disease results and in inability to create O2*
NADPH oxidase deficiency - chronic grnulomatous disease - can be infected by catalase + organisms as cannot take H2O2 from bacteria - S. aureus, Psuedomonas cepacia ***, serratia marescens, norcardia, and aspergillus, test with nitroblue tetra -> no blue disease is present
91
What does MPO deficiency result in?
Lack of conversion of H2O2 -> HOCl* -> practically not much other than candida
92
What method do macrophages use for phagocytosis
Non-oxygen destruction pathway
93
What can macrophages do when they arrive at inflammation
Chronic inflammation - MHCII
Acute inflammation - IL-8 -> attracts neutrophils
Resolution -> IL-10, TGF-B
94
What is Hagemann Factor XII role in inflammation?
Similar to histamine and bradykinin, with addition of coagulation and fibrinolytic system activation
95
What role does TNF-a and IL-1 have in margination?
Upregulates E selectins and upregulate ICAM and VCAM
96
What upregulates integrins on neutrophils?
C5a and LTB4
97
Where are half of the neutrophils at a time of noninflammation state?
The lungs
98
CD3?
TCR transduction
99
Two forms of B cell activation
Bind to IgM -> produce more IgM
Phagocytose and present to Th cell -> class switching, hypermutation under influence of IL-4, IL-5
100
CD4+ cells second signal
B7 binding to CD28 on T cells
101
CD8+ cell second signal
IL-2 secreted by CD4+ T cells
102
Digeorge synrome microdeletion
22q11
103
Most common SCID
ADA deficiency - causes buildup of deoxyadenosine which is toxic to lymphocytes
104
What do you get when you don't have antibodies?
Bacterial, enterovirus, and giardia infections -don't give live polio vaccine! Can be caused by X- linked agammaglobulinemia or by common variable immunodeficiency - separated by age
105
What is the mutation cause of hyper-IgM syndrome?
CD40 L on T cells mutate so cannot induce isotype switching
106
What disease are you at increased risk for with C5-C9 deficiency?
Neisseria meningitidis
107
Anti-DNA or Anti-Sm
Lupus
108
Antiphospholipid antibody
Hypercoaguable lupus, or more frequently, Antiphospholipid antibody syndrome primary
109
Antihistone antibody
Drug induced lupus
110
Anti-SSA, SSB, RF, ANA
Sjogren's
111
What is anti-SSA/B directed gainst?
Anti-ribonucleoprotein
112
What does lip biopsy prove/exclude?
Lymphocytic sialadenitis proven, excludes amyloidosis, sarcoidosis
113
Anti DNA TopoI (Scl-70)
Schleroderma
114
Anti-U1 ribonucleoprotein
Mixed connective tissue disease
115
CD34?
Hematopoetic cells
116
What does collegenase do and what is its cofactor?
Removes type III collagen and needs zinc
117
What does Fibroblast growth factor do?
Angiogenesis, like VEGF
118
What does vit C do? Similar deficiencies?
Hydroxylates lysine to strengthen collagen for cross-linking. Copper, zinc (for collegenase)
119
Aflatoxins source and complication
Aspergillus in rice and grains -> hepatocellular carcinoma
120
Arsenic cancers?
SCC of skin, lung cancer, angiosarcoma, comes from cigarrettes
121
Naphthylamine
Urothelial carcinoma of the bladder, comes from smoke
122
PVC pipe maker exposure and cancer?
Vinyl chloride, angiosarcoma
123
EBV associated cnacers?
Nasopharyngeal carcinoma - Chinese and African male neck mass
Burkitt's lymphoma
CNS lymphoma in AIDS
124
PDGFB overexpression?
Astrocytoma
125
Examples of growth factor receptors?
ERBB2, RET
126
RET association
MEN2A, MEN2B
127
Ras gene oncogene type?
Signal tranducer - oint mutation
128
ABL assocation
CML and some AML (9;22)
129
C-myc, n-myc, and l-myc association? c-myc translocation?
Brukitts, neuroblastoma, lung small cell carcinoma. (8;14)
130
(11;14) translocation?
CCND1 (cyclin D1) with IgH translocation, mantle cell lymphoma
131
p53 and Rb cell cycle regulator
G1 -> S phase
132
Germline p53 syndrome
Li-Fraumeni syndrome
133
Mechanism for interference of Rb
Constant phosphorylation -> constituitvelly free E2F
134
Tumor with keratin
Epithelium
135
Tumor with vimentin
Mesenchyme
136
Tumor with desmin
Muscle
137
TUmor with GFAP
Neuroglia
138
Tumor with neurofilament
Neuron
139
S100 markers
Melanoma, schwannoma,langerhans cell histiocytosis
140
Lytic bone lesion, hypercalcemia, and rash?
Adult T- cell lymphoma
141
Aggregates of neoplastic T-cells in epidermis
Pautrier microabscesses - Mycosis fungoides, causes Sezary syndrome when spreading to blood
142
Mutation in HNPCC
Microsatellite instability affecting DNA repair enzymes - Colorectal, ovarian, and endometrial carcinoma
143
Chronic cholecystitis in an elderly woman?
Gallbladder cancer
144
AFP in adult
Hepatocellular carcinoma
