Cancers

Question 1

Which cancer do Aflatoxins cause and where are they derived?

Answer 1

Hepatocellular carcinoma; Aspergillus (contaminated stored rice and grains)

Question 2

Which cancer can chemotherapy cause?

Answer 2

Leukemia/lymphoma

Question 3

Alcohol causes

Answer 3

Squamous cell carcinoma of oropharynx and upper esophagus and hepatocellular carcinoma

Question 4

Cancer from arsenic (cigarette smoke)

Answer 4

Squamous cell carcinoma of skin, lung cancer, agniosarcoma of liver

Question 5

Nitrosamines (smoked foods)

Answer 5

Stomach cancer

Question 6

Napthylamine (cigarette smoke)

Answer 6

Urothelial carcinoma of bladder

Question 7

Vinyl chloride (PVC pipes)

Answer 7

Angiosarcoma of liver

Question 8

Asbestos

Answer 8

Lung carcinoma and mesothelioma

Question 9

Nickel, chromium, beryllium or silica

Answer 9

Lung carcinoma

Question 10

3 cancers that EBV causes

Answer 10

Nasopharyngeal carcinoma (Chinese male), Burkitt lymphoma (African child), CNS lymphoma in AIDS

Question 11

HHV-8 cancer

Answer 11

Kaposi sarcoma (purplish raised lesions on skin; Eastern European, AIDS pts, Transplant pts)

Question 12

HTLV-1 cancer

Answer 12

Adult T cell leukema/lymphoma

Question 13

ABL is a gene in which family?

Answer 13

Tyrosine Kinase signal transducer

Question 14

Which cancer is associated with ABL mutations

Answer 14

CML and some types of ALL

Question 15

RET mutations are associated with which 3 cancers

Answer 15

MEN2A, MEN2B, and sporadic medullary carcinoma of thyroid

Question 16

What is the Knudson two-hit hypothesis?

Answer 16

Both copies of p53 tumor suppressor gene must be knocked out to form cancer

Question 17

How does p53 regulate the cell cycle?

Answer 17

Upregulates DNA repair enzymes after slowing cycle

if DNA cannot be repaired, upregulates BAX to inhibit Bcl2 and activates cyt c apoptosis

Question 18

How does Rb regulate progression from G1 to S phase

Answer 18

Unphosphorylated (active) Rb binds E2F and inhibits cell cycle progress

Question 19

How is Bcl2 pro-cancerous?

Answer 19

Inhibits apoptosis of cells by stabilizing mitochondrial membrane

Question 20

How do tumor cells evade immune surveillance

Answer 20

Downregulate expression of MHC I on their cell surface

Question 21

List 3 steps of tumor spread

Answer 21

1. Downregulate E-cadherin to dissociate
2. Attach to laminin and destroy BM (type IV collagen) with collagenase (a metallopreotease)
3. Attach to fibronectin in ECM and spread

Question 22

Which four carcinomas spread hematogenously?

Answer 22

Renal cell carcinoma, hepatocellular carcinoma, follicular carcinoma of thyroid, choriocarcinoma

Question 23

Carcinomas spread by which route?

Answer 23

Lymphatically

Question 24

Sarcomas (cancers of mesenchymal tissue like bone, CT) spread by which route?

Answer 24

hematogenously

Question 25

List 5 characteristics of malignant tumors

Answer 25

1. Disorganized growth (loss of polarity) 2. Nuclear pleomoprhism and hyperchromasia (dark, odd-shaped nuclei) 3. High nuclear to cytoplasmic ratio 4. high mitotic activity with atypical mitosis 5. Invasion

Question 26

S-100 stains for which 3 cancers

Answer 26

Melanoma, Schwannoma and Langerhans cell histiocytosis

Question 27

Chromogranin stains for which cancers

Answer 27

small cell carcinoma of lung and carcinoid tumor

Question 28

Describe the TNM of staging cancers

Answer 28

T: tumor size and depth of invasion N: spread to local lymph nodes M: metastasis (most important prognostic factor)

Question 29

Two common locations of cavernous hemangiomas

Answer 29

Liver and brain

Question 30

Appearance of cavernous hemagniomas

Answer 30

Masses with engorged purplish clusters ("mullberry"). Dilated capillaries with lakes of blood.

Question 31

Where are ependymomas found in children and adults, respectively

Answer 31

Intracranially, spinal cord

Question 32

Histologic appearance of ependymomas

Answer 32

Pseudorosettes arranged around blood vessels

Question 33

Pseudopalisading necrosis in the brain describes which tumor?

Answer 33

Glioblastoma

Question 34

What agent causes Kaposi sarcoma?

Answer 34

HHV8

Question 35

Histologic appearance of Kaposi sarcoma

Answer 35

highly vascular tissue with elongated spindle cells

Question 36

Where do you find manifestations of Kaposi sarcoma

Answer 36

Skin nodules, GI tract and respiratory tract

Question 37

Which marker is useful for diagnosing sarcomas?

Answer 37

Vimentin

Question 38

Blasts in peripheral blood smear are suggestive of which malignancy?

Answer 38

leukemia

Question 39

Which ALL is more likely to present with large anterior mediastinal mass that can cause dyspnea and stridor?

Answer 39

T-cell ALL

Question 40

Which ALL is more likely to present with fever, malaise, bleeding, bone pain and hepatosplenomegaly

Answer 40

B-cell ALL

Question 41

Keratin is a marker for

Answer 41

Epithelial cells

Question 42

CD3 is a marker for

Answer 42

T lymphocytes

Question 43

Actin, caldesmon, desmin are markers for

Answer 43

Muscle tissue

Question 44

CD34 and vWF are markers for

Answer 44

Endothelium

Question 45

GFAP is marker for

Answer 45

Glial cells

Question 46

Vimentin is a marker for

Answer 46

Mesenchymal tissue/sarcoma

Question 47

Chromogranin A and synaptophysin are markers for

Answer 47

Neuroendocrine tumors

Question 48

cancers arising in distal rectum metastasize to lungs first because of

Answer 48

Systemic venous drainage via internal iliac vein

Question 49

Cancers in proximal rectum metastasize to liver first because of venous drainage via

Answer 49

Inferior mesenteric vein to Portal venous system