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USMLE > Cancers > Flashcards

Cancers Flashcards

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USMLE® Step 1 flashcards
1
Q

Which cancer do Aflatoxins cause and where are they derived?

A

Hepatocellular carcinoma; Aspergillus (contaminated stored rice and grains)

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2
Q

Which cancer can chemotherapy cause?

A

Leukemia/lymphoma

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3
Q

Alcohol causes

A

Squamous cell carcinoma of oropharynx and upper esophagus and hepatocellular carcinoma

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4
Q

Cancer from arsenic (cigarette smoke)

A

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

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5
Q

Nitrosamines (smoked foods)

A

Stomach cancer

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6
Q

Napthylamine (cigarette smoke)

A

Urothelial carcinoma of bladder

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7
Q

Vinyl chloride (PVC pipes)

A

Angiosarcoma of liver

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8
Q

Asbestos

A

Lung carcinoma and mesothelioma

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9
Q

Nickel, chromium, beryllium or silica

A

Lung carcinoma

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10
Q

3 cancers that EBV causes

A

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

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11
Q

HHV-8 cancer

A

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

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12
Q

HTLV-1 cancer

A

Adult T cell leukema/lymphoma

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13
Q

ABL is a gene in which family?

A

Tyrosine Kinase signal transducer

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14
Q

Which cancer is associated with ABL mutations

A

CML and some types of ALL

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15
Q

RET mutations are associated with which 3 cancers

A

MEN2A, MEN2B, and sporadic medullary carcinoma of thyroid

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16
Q

What is the Knudson two-hit hypothesis?

A

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

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17
Q

How does p53 regulate the cell cycle?

A

Upregulates DNA repair enzymes after slowing cycle

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

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18
Q

How does Rb regulate progression from G1 to S phase

A

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

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19
Q

How is Bcl2 pro-cancerous?

A

Inhibits apoptosis of cells by stabilizing mitochondrial membrane

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20
Q

How do tumor cells evade immune surveillance

A

Downregulate expression of MHC I on their cell surface

21
Q

List 3 steps of tumor spread

A
  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
22
Q

Which four carcinomas spread hematogenously?

A

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

23
Q

Carcinomas spread by which route?

A

Lymphatically

24
Q

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

A

hematogenously

25
Q

List 5 characteristics of malignant tumors

A
  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
26
Q

S-100 stains for which 3 cancers

A

Melanoma, Schwannoma and Langerhans cell histiocytosis

27
Q

Chromogranin stains for which cancers

A

small cell carcinoma of lung and carcinoid tumor

28
Q

Describe the TNM of staging cancers

A

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

29
Q

Two common locations of cavernous hemangiomas

A

Liver and brain

30
Q

Appearance of cavernous hemagniomas

A

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

31
Q

Where are ependymomas found in children and adults, respectively

A

Intracranially, spinal cord

32
Q

Histologic appearance of ependymomas

A

Pseudorosettes arranged around blood vessels

33
Q

Pseudopalisading necrosis in the brain describes which tumor?

A

Glioblastoma

34
Q

What agent causes Kaposi sarcoma?

A

HHV8

35
Q

Histologic appearance of Kaposi sarcoma

A

highly vascular tissue with elongated spindle cells

36
Q

Where do you find manifestations of Kaposi sarcoma

A

Skin nodules, GI tract and respiratory tract

37
Q

Which marker is useful for diagnosing sarcomas?

A

Vimentin

38
Q

Blasts in peripheral blood smear are suggestive of which malignancy?

A

leukemia

39
Q

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

A

T-cell ALL

40
Q

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

A

B-cell ALL

41
Q

Keratin is a marker for

A

Epithelial cells

42
Q

CD3 is a marker for

A

T lymphocytes

43
Q

Actin, caldesmon, desmin are markers for

A

Muscle tissue

44
Q

CD34 and vWF are markers for

A

Endothelium

45
Q

GFAP is marker for

A

Glial cells

46
Q

Vimentin is a marker for

A

Mesenchymal tissue/sarcoma

47
Q

Chromogranin A and synaptophysin are markers for

A

Neuroendocrine tumors

48
Q

cancers arising in distal rectum metastasize to lungs first because of

A

Systemic venous drainage via internal iliac vein

49
Q

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

A

Inferior mesenteric vein to Portal venous system

USMLE (36 decks)

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