Case 7 Flashcards

1
Q

what are the 6 hallmarks of cancer?

A
indefinite replication
angiogenesis
apoptosis evasion
independent growth
intolerance to growth signals
metastasis
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2
Q

what is clonal evolution?

A

when sporadic mutations are passed on to daughter cells meaning each point mutation can occur independently

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3
Q

what are the types of mutation that cause cancer?

A

Leads to cell proliferation

Leads to genome destability

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4
Q

how are oncogenes activated?

A

Point mutations
Chromosomal translocations- different promoter control
Chimeric genes

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5
Q

what is the ligand for the Her2 receptor?

A

EGF

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6
Q

Describe the cascade following Her2 receptor activation

A

homodimer transphosphorylation
Grb-SOS
Ras GTPase
eventual phosphorylation of ETS

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7
Q

What are the consequences of Her2 activation?

A

cyclin D1 gene expression

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8
Q

what genes come under the control of the estrogen response element?

A

Cyclin D and E

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9
Q

the progesterone response element controls expression of what gene?

A

cyclin D

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10
Q

What protein does BRCA1 associate with?

A

BRCA associated ring domain BARD

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11
Q

What are the functions of BRCA1? (4 main functions)

A

E3 ubiquitin ligase
double stranded DNA repair
Apoptosis
Controls cell cycle

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12
Q

How does BRCA1 control the cell cycle?

A

activates p21
p21 inhibits CDK’s
cell cycle arrest

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13
Q

What are the functions of BRCA2?

A

single stranded DNA repair

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14
Q

Why is Rb known as a tumour suppressor protein?

A

Binds E2F

E2F is a TF for cyclin genes

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15
Q

How is the Rb protein inactivated?

A

hyperphosphorylation by cyclins

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16
Q

What are the functions of p53?

A

apoptosis initation
DNA repair
Cell cycle control

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17
Q

What protein regulates p53?

A

mdm2- E3 ubiquitin ligase

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18
Q

How does p53 carry out its DNA repair function?

A

mdm2 senses DNA damage
Disocciates from p53
p53 increases expression of p21
cell cycle arrest

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19
Q

What cyclins and CDKs are associated with the G1:S phase?

A

Cyclin D:CDK4

Cyclin E:CDK2

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20
Q

What cyclins are associated with the S:G2 phase?

A

Cyclin A:CDK2

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21
Q

What cyclins are associated with the G2:M phase?

A

Cyclin B:CDK1

Cyclin A:CDK1

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22
Q

What is the treatment for Her2 receptor positive cancer?

A

Herceptin/trastuzumab

monoclonal antibody

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23
Q

what is the treatment for estrogen receptor positive breast cancer?

A

Tamoxifen

estrogen receptor inhibitor

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24
Q

What is the mechanism of action of Anastrazole?

A

aromatase inhibitor

used to treat estrogen receptor positive breat cancer in peri/post menopausal women

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25
Q

What are the ligands that initiate extrinsic apoptosis?

A

Fas and TNFa

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26
Q

What is the mechanism of extrinsic apoptosis?

A

Fas ligand binding
DISC formation @ membrane
caspase activation

27
Q

What are the functions of the two types of caspase?

A

Initiator- mitochondrial stress

Executioner- degrade cellular components

28
Q

What are the main steps in intrinsic apoptosis pathway?

A

Bax recognises intracellular signals
Bax binds mitochondrial membrane
Cytochrome C released
Caspases activated

29
Q

What is atrophy?

A

Cell shrinking in size

30
Q

What is hypertrophy?

A

Cells increasing in size and functional capacity

31
Q

What is hyperplasia?

A

increased number of cells caused by increased cell division

32
Q

What is metaplasia?

A

the transformation of one cell type to another

33
Q

What is dysplasia?

A

The enlargement of a tissue as a result of proliferation of abnormal cells

34
Q

What is anaplasia?

A

The loss of structural differentiation within a cell

35
Q

Neoplasia is…

A

abnormal growth of tissue that continues to grow in the absence of growth signals

36
Q

If there is expansion of cells confined to a local area, it is a….

A

benign tumour

37
Q

Invasion of neighbouring tissue is a characteristic of what type of tumour?

A

Malignant

38
Q

What are the clinical effects of a benign tumour?

A

Mechanical pressure
Obstruction
Infection
Increased hormone production (in some cases)

39
Q

In addition to those of a benign tumour, what are the clinical effects of malignancy?

A

tissue destruction
haemorrhage
Secondary infection

40
Q

What is a paraneoplastic syndrome?

A

An event due to tumour secretions, not at the location of the tumour

41
Q

Finger clubbing, non-bacterial endocarditis and ancanthosis nigricans are all examples of what type of syndrome?

A

Paraneoplastic

42
Q

What is an adenoma?

A

benign
gland forming
epithelia

43
Q

What is a papilloma?

A

benign
protrusion from a surface
epithelia

44
Q

From which tissue does a carcinoma arise?

A

epithelial tissue

45
Q

From which tissue does a sarcoma arise?

A

Stromal tissue

46
Q

From which tissue does leukemia arise?

A

Bone marrow

Blood

47
Q

From which tissue does a lymphoma arise?

A

lymph tissue

48
Q

From which tissue does a teratoma arise?

A

Germ line cells

49
Q

What are the most common routes of malignancy? (4)

A

Blood
Lymph
Transcoelomic
Along epithelia

50
Q

what is cachexia?

A

unintentional weight loss as a result of increased metabolic rate

51
Q

What is a ductal carcinoma in situ?

A

malignancy inside duct

not spread to surrounding stroma

52
Q

How do you treat a DCIS?

A
lumpectomy
radiation therapy (in some cases)
53
Q

How do you treat an invasive ductal carcinoma?

A

Mastectomy
Radical mastectomy- associated lymph node removal
Chemotherapy

54
Q

How do you manage a BRCA positive test result?

A

annual mammography
MRI screening
oophrectomy
mastectomy

55
Q

Olaprib and Niraprib are examples of what class of drug?

A

PARP inhibitor

induces apoptosis

56
Q

What drug is used as a chemopreventative agent in response to BRCA mutation?

A

Tamoxifen- 5 year course

reduces risk by 40%

57
Q

What is an effective treatment for estrogen receptor positive breast cancer in pre-menopausal women?

A

bilateral oophrectomy

58
Q

What is the structure of the over 50 breast cancer screening program?

A

one mammogram every 3 years

59
Q

beliefs about illness appear to follow a pattern. They are made up of what categories?

A
Identity
Cause
Controllability
Timeline
Cure
60
Q

illness belief identity…

A

diagnosis and symptoms

61
Q

illness belief consequence…

A

severity

62
Q

illness belief timeline

A

how long it will last

63
Q

illness belief cause

A

how the illness was brought on

64
Q

illness belief cure

A

prognosis