Carcinogenesis

Question 1

What is the definition of carcinogenesis

Answer 1

neoplastic cell transformation and proliferation by permanent mutation

Question 2

What is a neoplasm

Answer 2

Autonomous, Abnormal and persistent new growth

-Arise from nucleated cells (No erythrocytes)

Question 3

What cells can’t neoplasms arise some

Answer 3

Erythrocytes as no nucleus

Question 4

What is a tumour

Answer 4

An abnormal swelling

-Neoplasm w/ inflammation, hypertrophy and hyperplasia

Question 5

How are tumours classified by

Answer 5

Behaviour

Histogenesis

Question 6

Describe Benign behaviour of tumours

Answer 6

Local (No bone marrow involved)
Slow
Well circumscribed
Exophytic (Outward growth)
No Ulcer/necrosis

Question 7

Describe malignant behaviour of tumours

Answer 7

Bone marrow invading
Fast mitotic growth w/Hyper-dense nuclei
Poor Circumscribed
Endophytic (Inward growth)
Necrosis and Ulcers form
Poor differentiation (No resemblance to origin cell)

Question 8

What does it mean for a cell to be well differentiated

Answer 8

Close resemblance to origin cell

Question 9

How can benign tumours pose problems

Answer 9

Hormone secreting
-Prolactinoma
Local structure pressure
-Bilateral hemianopia

Question 10

Why doe malignant tumours cause problem

Answer 10

Pressure on structures
Secondary tumour formation
Obstruction
Painful
Blood loss
Paraneoplastic (SIADH/Cushings)

Question 11

What is the difference between endophytic and exophytic tumours

Answer 11

Exophytic = Outward benign growth
Endophytic = Inward Bening growth

Question 12

Paippiloma, Carcinoma, Adenoma and Aden carcinoma all belong to which tumour cell origin

Answer 12

Epithelium (Carcinoma)

Question 13

What is a Papilloma

Answer 13

Non Glandular benign

Question 14

What is a Carcinoma

Answer 14

Non glandular malignant

Question 15

What is an Adenoma

Answer 15

Gandular benign

Question 16

What is an Adenocarcinoma

Answer 16

Glandular malignant

Question 17

Sarcomas arise from what cell origin

Answer 17

Connective tissue

Question 18

Lipoma and Liposarcoma are tumours of what cells

Answer 18

Adipocytes

Question 19

Skeletal muscle sarcomas are called what

Answer 19

Rhabdomyoma and Rhabdomyosarcoma

Question 20

Smooth muscle sarcomas are called what

Answer 20

Leiomyoma and Leiomyosarcoma

Question 21

Chondroma and chondrosarcoma belong to what tissue

Answer 21

Cartilage

Question 22

Bone tumours are known as what

Answer 22

Osteoma and Osteosarcoma

Question 23

What are the two types of Malignant lymphoid tumours

Answer 23

Leukaemia

Lymphoma

Question 24

How are tumours graded in relation to the parent cell

Answer 24

Well differentiated = >75% resemblance
Moderate Differentiation = 10-75%
Poor Differentiation = <10% resemblance

Question 25

What are the characteristics of a neoplastic cell

Answer 25

``` Autocrine growth (Increase GF/Mutated Tumour suppressor and Inhibited Growth inhibitors) Apoptosis Evasion Telomerase Activation (Increase mitosis as Telomeres can't shorten with replication) Angiogenesis continued and BM Invaded ```

Question 26

What three things occur in autocrine stimulation of neoplastic cells

Answer 26

Increased GF Undersupressed Growth Inhibitor Mutated Tumour Suppressor genes

Question 27

What doe telomerase do to neoplastic cells undergoing mitosis

Answer 27

Prevents telomere shortening so cycle lasts longer for each cell

Question 28

What are the main classes of carcinogens

Answer 28

``` Chemical (Paint, dye and soot) Virus (EBV and HPV) Radiation Hormones Occupational ```

Question 29

What are the stages of metastasis

Answer 29

``` Detachment Invading tissue Invading Bone marrow Host defence evasion Blood vessel wall adhesion Extravastation to distant site ```

Question 30

What are the modes of metastatic spread

Answer 30

Haemategenous(Blood in KP BLT Sites) Lymphatic (formation in lymph nodes) Transcolemic (Exudative fluid in pleural/pericardial and peritoneal effusion)

Question 31

What are the main Metastasis sites of haematogenous spread tumours

Answer 31

``` Kidney Prostate Breast Lung Thyroid ```

Question 32

What is transcolemic metastatic spread

Answer 32

By exudative fluid accumulation | @Pleural/ Pericardial and Peritoneal effusions

Question 33

How are tumours staged

Answer 33

TNM Staging | Ann Arbour ab1-4 (Lymphomas)

Question 34

What are the two mutations prevalent in colorectal cancer

Answer 34

FAP -Familial Adenomatous Polyposis HNPCC -Lynch syndrome

Question 35

What is FAP mutation

Answer 35

Aut Dom mutation of APC gene = Many colorectal adenomas = adenocarcinoma (Over expression of c-MYC)

Question 36

What is Lynch syndrome/HNPCC Mutation

Answer 36

Aut Dom Mutated MSH gene (Cant repair DNA Mismatch)

Question 37

What type of prevention is screening

Answer 37

Secondary

Question 38

Which cancers are screened for in the UK

Answer 38

Cervical (Swab) Breast (Mammogram) Colorectal (FITT Test/Foecal occult)

Question 39

What is the heel prick test used for in neonates

Answer 39

Sickle cell Cystic Fibrosis Hypothyroid

Question 40

What is the difference between germ line and somatic mutations

Answer 40

Germ Line = Mutated germ cell passes down the line to next generation Somatic = Mutated mitotic copy of germ cell DOES NOT pass to the next generation