Cap. 8 Oncología en cirugía Flashcards
Tumores carcinoides y GIST son los tópicos mas preguntados.
1
Q
En que fase de la mitosis desaparece el núcleo?
A
Profase
2
Q
En que fase de la mitosis ocurre la alineación de los cromosomas?
A
Metafase
3
Q
En que fase de la mitosis se separan los cromosomas?
A
Anafase
4
Q
En que fase de la mitosis se forman nucreos alrededor del ADN?
A
Telofase
5
Q
Nombre de las purinas?
A
Guanina y adenina
6
Q
Nombre de las pirimidinas?
A
Citosina, tiamina y uracilo
7
Q
Que es la traducción en lo que se refiere al ciclo celular?
A
Sintesis de proteinas usando un RNAm como plantilla por los ribosomas
8
Q
Que es la transcripción en lo que se refiere al ciclo celular?
A
Sintesis de RNAm del ADN plantilla por el RNA polimerasa
9
Q
En que fase del ciclo celular se hace la sintesis de proteinas y la duplicación de cormosomas?
A
Fase S
10
Q
En que fase del ciclo ocurre la mitosis
A
Fase M
11
Q
What tumor marker is associated with choriocarcinoma/testicular cancer?
A
β-Human chorionic gonadotropin (HCG)
12
Q
What tumor marker is associated with colon cancer?
A
Carcinoembryonic antigen
13
Q
What tumor marker is associated with liver cancer?
A
α-Fetoprotein
14
Q
What tumor marker is associated with ovarian cancer?
A
CA-125
15
Q
What tumor marker is associated with pancreatic cancer?
A
CA 19-9
16
Q
What tumor marker is associated with melanoma?
A
S-100
17
Q
Chromogranin A is elevated in what adrenal tumor?
A
Carcinoid tumor
18
Q
What tumor marker is associated with prostate cancer?
A
Prostate-specific antigen (PSA)
19
Q
What tumor marker is associated with neuroblastoma/small cell lung CA?
A
Neuron-specific enolase
20
Q
What tumor marker is associated with nonseminomatous testicular cancer?
A
α-Fetoprotein
21
Q
What is the term for an increased number of cells?
A
Hyperplasia
22
Q
What is the term for replacement of one tissue with another?
A
Metaplasia
23
Q
What is the term for altered shape, size, or organization of cells?
A
Dysplasia
24
Q
What is the most sensitive stage of the cell cycle for radiation?
A
M phase
25
What is the term for human genes with malignant potential?
Proto-oncogenes
26
What cancer are aflatoxins associated with?
Hepatocellular carcinoma
27
What organism produces aflatoxins?
Aspergillus flavus
28
What cancer is associated with Schistosoma haematobium?
Urinary bladder cancer
29
What cancer is associated with Opisthorchis viverrini?
Cholangiocarcinoma
30
What cancer was associated with chimney sweeps (due to soot)?
Scrotal cancer
31
What cancer is associated with benzene?
Leukemia
32
What is the primary cause of skin cancer in humans?
Ultraviolet radiation
33
How do viruses cause cancer?
Insertion of foreign DNA into the human genome
34
What is the first phase of chemical carcinogenesis?
Initiation. A carcinogen reacts with DNA irreversibly without enzymatic activity or specificity
35
What is the second phase in chemical carcinogenesis?
Promotion. Cells that were initiated are then stimulated to develop into cancer cells. This process is slow and reversible
36
What is the last phase of chemical carcinogenesis?
Progression. This involves the maturation of cancer cells
37
What cancers are associated with the Epstein-Barr virus?
Nasopharyngeal carcinoma and Burkitt lymphoma
38
What viruses are associated with adult T-cell leukemia?
Human immunodeficiency virus and human T-lymphotropic virus type 1
39
What is the major fuel source for tumor cells?
Glutamine
40
What are small circular rings of DNA capable of autonomous replication?
Plasmids
41
What hormone receptors are commonly tested for in breast cancer?
Estrogen receptor and progesterone receptor
42
What hormonal therapy is used for estrogen- and progesterone receptor–positive breast tumors?
Hormone receptor–positive tumors are targeted by tamoxifen and aromatase inhibitors. Tamoxifen has shown survival benefit as adjuvant treatment and for metastatic disease in both premenopausal and postmenopausal women. Aromatase inhibitors (anastrozole, letrozole, and exemestane) have shown a survival benefit as adjuvant therapy and for metastatic disease in postmenopausal women.
43
What cancers are associated with estrogen replacement therapy?
Endometrial and breast
44
What is the mechanism of action of Tamoxifen?
Selective estrogen receptor modulator, which binds to and inhibits estrogen receptors
45
What tumor markers are associated with breast cancer?
BRCA I and II
46
What is the lifetime risk of cancer in a woman with BRCA I mutation?
Ninety percent lifetime risk of breast cancer and 40% lifetime risk of ovarian cancer
47
What is the lifetime risk of cancer in a woman with BRCA II mutation?
Eighty percent lifetime risk of breast cancer and 35% lifetime risk of ovarian cancer; 60% lifetime risk of breast cancer in men.
48
What tumor characteristics are associated with BRCA I and II mutations?
BRCA I tumors are poorly differentiated invasive ductal carcinoma and usually hormone receptor– negative, whereas RCA II tumors are well-differentiated invasive ductal carcinoma and more likely to be hormone receptor–positive.
49
What other tumors are associated with the BRCA II mutation?
Prostate, colon, stomach, pancreatic, gall bladder, and bile duct tumors
50
What type of receptor is the human epidermal growth factor receptor 2 (HER-2)/neu receptor?
HER-2/neu is an epidermal growth factor receptor
51
What does overexpression of HER-2/neu in breast cancer portend?
Overexpression of HER-2/neu is associated with increased tumor invasiveness and metastatic potential.
52
Overexpression of HER-2/neu is used to identify patients who would benefit from this drug:
Trastuzumab (Herceptin)
53
What is the mechanism of action of Herceptin (trastuzumab)?
Herceptin (trastuzumab) is a murine monoclonal antibody, which targets the HER-2/neu receptor. Its use as adjuvant therapy was associated with a 50% reduction in recurrence after 1 year.
54
What is the second leading cause of cancer death in the United States?
Colon cancer
55
What is the sequence of tumorigenesis of colon cancer?
Mutation/loss in APC (chromosome 5q) → K-ras mutation (chromosome 12p) → loss of DCC (chromosome 18q) → loss of p53 (chromosome 17p)
56
What is the recommended screening for colon cancer in the average risk population?
Starting at age 50, fecal occult blood test (FOBT) annually with flexible sigmoidoscopy every 5 years or flexible colonoscopy every 10 years or air/contrast barium enema every 5 to 10 years as recommended by the American Cancer Society. Annual FOBT alone has been given as an option for colon and rectal cancer screening; however, small tumors may be missed.
57
What are the Amsterdam criteria?
At least 3 relatives with colorectal cancer, 1 of whom is a first-degree relative of the other, at least 2 successive generations involved, and 1 or more relative diagnosed before the age of 50 years
58
What percentage of patients who develop colon cancer has no identifiable risk factors?
75%
59
What 3 carcinomas account for 95% of all skin cancers?
Basal cell and squamous cell carcinoma and melanoma
60
What is the most common form of skin cancer?
Basal cell carcinoma
61
Where are melanocytes located?
Dermoepidermal junction
62
What is the most carcinogenic portion of the UV spectrum?
UVB
63
How are melanomas described on physical examination?
ABCDE: Asymmetric, irregular/blurred Border, more than a single Color, Diameter >6 mm, Elevated
64
What are the subtypes of melanoma?
Superficial spreading, nodular, lentigo maligna, acral lentiginous
65
What is the most common type of melanoma?
The most common form of melanoma is the superficial spreading variant (70%).
66
What type of melanoma has the worst prognosis?
The variant with the worst prognosis is nodular melanoma.
67
What is the eponym for squamous cell carcinoma?
Bowen disease
68
What is the eponym for squamous cell carcinoma in situ of the glans penis?
Erythroplasia of Queyrat
69
What is the mechanism of action of taxanes?
Disruption of microtubule function (mitotic inhibitor)
70
Doxorubicin and daunorubicin fall under which class of chemotherapeutic agent?
Anthracycline
71
Screen for virilization in suspected adrenal carcinoma:
Androstenedione, dehydroepiandrosterone, serum testosterone, and 24-hour urinary 17 ketosteroids
72
What chemotherapeutic agent is used for the management of adrenocortical carcinoma?
Mitotane
73
Etoposide is what type of chemotherapeutic agent?
Topoisomerase II inhibitor
74
Cyclophosphamide is what type of chemotherapeutic agent?
Alkylating agent
75
What is the mechanism of action for 6-mercaptopurine?
Inhibition of purine nucleotide synthesis.
76
What medication inhibits xanthine oxidase, the enzyme that breaks down 6-MP?
Allopurinol
77
Vinblastine and Vincristine are examples of what class of chemotherapeutic agents?
Vinca alkaloids
78
What chemotherapeutic agents are antimetabolites?
5-Fluorouracil (5-FU), 6-mercaptopurine
79
What common chemotherapeutic agent is a pyrimidine analog?
5-FU through noncompetitive inhibition of thymidylate.
80
Pulmonary fibrosis is a serious side effect of what chemotherapeutic?
Bleomycin
81
What chemotherapeutic agent is used in the treatment of carcinoid syndrome?
Streptozocin
82
What is CHOP regimen?
Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone
83
CHOP regimen is used in treatment of:
Non-Hodgkin lymphoma
84
What are the recommendations for prostate cancer screening?
PSA and digital rectal examination annually beginning at age 50.
85
HCG is present in about 20% of this tumor?
Seminoma
86
What is the primary test to detect the overproduction of serotonin in carcinoid tumors?
Urinary 5-hydroxyindoleacetic acid
87
What are the 3 most common sarcomas?
Liposarcoma, malignant fibrous histiocytoma, and leiomyosarcoma
88
What are the most common sarcomas of the extremity?
Liposarcoma and malignant fibrous histiocytoma
89
What are the most common sarcomas of the retroperitoneum?
Liposarcoma and leiomyosarcoma
90
What is the most common sarcoma in childhood?
Rhabdomyosarcoma
91
MOPP, for a long time, was the standard treatment for Hodgkin disease. What is MOPP?
Mustargen, Oncovin, Procarbazine, Prednisone
92
MOPP has been replaced by ABVD as the treatment of Hodgkin disease. What is ABVD?
Adriamycin, Bleomycin, Vinblastine, Dacarbazine
93
What are the cells with bilobed nuclei seen in Hodgkin lymphoma referred to as?
Reed-Sternberg cells
94
What mesenchymal neoplasm is derived from the interstitial cells of Cajal?
Gastrointestinal stromal tumor (GIST)
95
What is the gene mutation associated with gastrointestinal stromal tumors?
c-kit gene
96
What is the mechanism of Gleevec, the pharmacologic therapy for GIST?
Inhibition of tyrosine kinase
97
What syndrome is caused by p53 mutations and is associated with multiple cancers?
Li-Fraumeni syndrome
98
What rare genetic syndrome caused by PTEN mutations is associated with intestinal hamartomas, cutaneous lesions, and thyroid cancer?
Cowden disease
