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Evan's Step 1 Prep Material > Ch9 Neoplasia EC > Flashcards

Ch9 Neoplasia EC Flashcards

1
Q

“-oma”s are generally indicates a benign tumor. What are some exceptions?

A 
Seminoma (testicular)
Lymphoma (lymph nodes)
Glioma (glial cells in brain)
Mesothelioma (Pleural serosa)
Neuroblastoma (neuroblasts)
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2
Q

Skin cancer that invades but does not metastesize

A

Basal Cell Carcinoma (most common)

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3
Q

Tumor with two patterns both from the same germ cell layer

A

Mixed tumor

ie pleomorphic adenoma of parotid gland

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4
Q

Tumor containing tissue from all three germ layers. Most common sites?

A

Teratoma

Midline structures (Ovary, Testes, Mediastinum, Pineal gland

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5
Q

Malignant tumor derived from epithelial tissue

A

Carcinoma

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6
Q

Most common sites for squamous cell carcinoma

A

Mouth
Larynx
Cervix

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7
Q

Malignant tumor composed of glands. Most common locations?

A

Adenocarcinoma

Distal esophagus
Rectum
Pancreas
Breast
Kidneys
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8
Q

Malignant tumor derived from connective tissue. Most common locations?

A

Sarcoma
(therefore all mesodermal)

(40% in lower extremities)
Osteogenic sarcoma
~Codman’s triangle- b/c making bone

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9
Q

Malignant tumor of smooth muscle

A

Leiomyosarcoma

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10
Q

Malignant tumor of striated muscle

A

Rhabdomyosarcoma

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11
Q

Malignant tumor of fat

A

Liposarcoma

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12
Q

Biopsy from girl having necrotic mass coming out of vagina removed. Vimentin and Keratin -. Desmin +

A

Embryonal rhabdomyosarcoma

MC sarcoma of children (penis in boys)

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13
Q

Movable mass at angle of jaw

A

Mixed tumor in parotid (two types of tissue from SAME cell layer)

MC salivary tumor

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14
Q

Nonneoplastic overgrowth of tissue

A

Hamartoma

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15
Q

Normal tissue in foreign location (ie pancreatic tissue in stomach)

A

Choristoma

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16
Q

Neoplastic component of a tumor

A

Parenchyma

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17
Q

Nonneoplastic supporting tissue of a tumor

A

Stroma

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18
Q

Does cancer resemble parent tissue?

A

Grade

Low grade-keratin pearls, glands with lumen
High grade/anaplastic-no differentiating features

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19
Q

Changes in organelles in malignanct cells

A

Fewer mitochondria
Less prominent RER (don’t secrete hormones for others)
LOSS OF CADHERINS (allows metastasis)
Nucleus/Nucleoli enlarged and irregular

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20
Q

Metabolism in malignant cells

A

Use anaerobic glycolysis

Store glycogen in cytosol

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21
Q

PET scan

A

Measures glucose uptake

Diagnosis, staging, monitoring of therapy in cancer

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22
Q

Monoclonality

A

Cancers arise from single precursor

ie G6PD A or B found in leiomyoma of uterus, not both

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23
Q

Upregulation of DAF (decay accelerating factor)

A

Inhibits C3 and C5 convertase and thus MAC complex - cannot be killed

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24
Q

Important in stimulating synthesis of angiogenesis factors

A

TNF (released by macrophages)

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25
Q

Drug that inhibits binding of VEGF to endothelial cells in new capillary sprouts

A

Bevacizumab

Treats metastatic colon cancer and non-small cell carcinoma of the lung

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26
Q

1st step in tumor invasion

A

Lose cadherins (cell to cell adhesion)

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27
Q

2nd step of tumor invasion

A

Attach to basement membrane (laminin) and degrade it (collagenases)

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28
Q

3rd step of tumor invasion

A

Attach to ECM (fibronectin) and degrade it

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29
Q

4th step of tumor invasion

A

Stimulate cell motility

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30
Q

Tumor invasion of capillaries to enter circulation

A

Intravasation

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31
Q

Most important criterion of malignancy

A

Metastasis

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32
Q

Lymphatic spread through lymphatics to regional nodes before entering systemic circulation

A

Carcinomas

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33
Q

Initially have hematogenous spread. Avoid lymph nodes

A

Sarcomas

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34
Q

Metastasis in liver, from what vein did it come?

A

Portal vein

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35
Q

Metastasis in lungs. From what vein did it come?

A

Vena cava

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36
Q

Exfoliation from serosal surface and invade tissue in a body cavity. What are some examples?

A

Seeding

Malignant surface-derived ovarian cancer –> Omental implants

Peripheral adenocarcinomas of lung seed pleural cavity

Glioblastoma multiforme uses CSF to seed brainstem and spinal cord

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37
Q

Most common site of bone metastasis. Why?

A

Vertebrae

Batson paravertebral plexus has connections with vena cava and vertebral bodies

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38
Q

Most common cause of osteoblastic metastases

A

1 Prostate cancer

2 Breast cancer

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39
Q

Increased serum ALP and radiodensities on radiograph

A

Osteoblastic metastasis

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40
Q

Radiolucencies in bone. Hypercalcemia, pathologic fractures.

A

Osteolytic metastases

PGE2 and IL-1 produced by osteoclasts

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41
Q

Most common osteolytic cancers

A

1 lung
2 kidney
3 breast

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42
Q

Increased risk of prostate cancer and multiple myeloma

A

African Americans

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43
Q

Decreased incidence of prostate and breast cancer

A

Japanese

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44
Q

Most common cancers in children

A

Leukemia (ALL)
CNS (cerebellar)
Neuroblastoma

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45
Q

Most common cancers in men

A

Prostate
Lung
Colon

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46
Q

Most common cancers in women

A

Breast
Lung
Colon

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47
Q

Most common sites of gynecologic cancers

A

Endometrium
Ovary
Cervix

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48
Q

Common sites of cancer deaths in men

A

Lung
Prostate
Colon

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49
Q

Common sites of cancer deaths in women

A

Lung
Breast
Colon

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50
Q

Common sites of gynecologic cancer death

A

Ovary
Endometrium
Cervix

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51
Q

AD Cancer syndromes

A 
Retinoblastoma
Familial adenomatous polyposis
Li-Fraumeni syndrome
HNPCC
BRCA1/2
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52
Q

AR cancer syndromes of DNA repair

A 
Xeroderma pigmentosum
Ataxia telangiectasia (chromosomal instability)
Bloom syndrome (chromosomal instability)
Fanconi syndrome (chromosomal instability)
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53
Q

Nasopharyngeal carcinoma and SCC of the esophagus geographic location

A

China (EBV and alcohol)

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54
Q

Stomach adenocarcinoma geographic location

A

Japan (smoked foods)

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55
Q

Hepatocellular carcinoma geographic location

A

Southeast Asia (HBV)

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56
Q

Burkitt lymphoma and Kaposi sarcoma geographic location

A

Africa (EBV and HHV-8)

57
Q

What cancer does treatment of H. pylori prevent?

A

Gastric lymphoma

does NOT decrease adenocarcinoma of the stomach

58
Q

Neoplasms associated with Down syndrome

A

ALL, AML

“ALL fall DOWN”

59
Q

Neoplasms associated with Xeroderma pigmentosum and albinism

A

SCC
Melanoma
BCC

60
Q

Neoplasms associated with Chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnants

A

Gastric adenocarcinoma

61
Q

Neoplasms associated with tuberous sclerosis (facial angiofibroma, seizures, mental retardation)

A

Giant cell astrocytoma
Renal angiomyolipoma
Cardiac rhabdomyoma

62
Q

Neoplasms associated with Actinic keratosis

A

SCC of the skin

63
Q

Neoplasms associated with Barrett’s esophagus

A

Esophageal adenocarcinoma

64
Q

Neoplasms associated with Plummer-Vinson syndrome (decreased Fe)

A

SCC of the esophagus

65
Q

Neoplasms associated with Cirrhosis (alcoholic, Hep B or C)

A

Hepatocellular carcinoma

66
Q

Neoplasms associated with Ulcerative colitis

A

Colonic adenocarcinoma

67
Q

Neoplasms associated with Paget’s disease of bone

A

Secondary osteosarcoma and fibrosarcoma

68
Q

Neoplasms associated with Immunodeficiency states

A

Malignant lymphomas

69
Q

Neoplasms associated with AIDS

A

Aggressive malignant lymphomas (NHL)

Kaposi’s sarcoma

70
Q

Neoplasms associated with Autoimmune disease (Hashimoto’s, myasthenia gravis)

A

Lymphoma

71
Q

Neoplasms associated with acanthosis nigricans (hyperpigmentation and epidermal thickening)

A

Visceral malignancy (stomach, lung, uterus)

72
Q

Neoplasms associated with dysplastic nevus

A

Malignant melanoma

73
Q

Neoplasms associated with radiation exposure

A

Leukemia
Sarcoma
Papillary thyroid cancer
Breast cancer

74
Q

Neoplasms associated with chronic irritation at sinus orifice or third degree burn scars

A

SCC

75
Q

ABL proto oncogene (function, mutation, and cancers)

A

Nonreceptor Tyrosine Kinase

t(9;22) fusion forms BCR-ABL (Philadelphia chromosome)

CML (also ALL)

76
Q

ERBB2 (Her-2Neu) proto oncogene (function, mutation, and cancers)

A

Receptor synthesis

Amplification results in

Breast carcinoma

77
Q

C-MYC proto oncogene (function, mutation, and cancers)

A

Nuclear transcription

t(8;14) results in

Burkitt lymphoma

78
Q

N-MYC proto oncogene (function, mutation, and cancers)

A

Nuclear transcription

Amplification results in

Neuroblastoma “N-myc Neuroblastoma”
SCC of the lung

79
Q

RAS proto oncogene (function, mutation, and cancers)

A

GTP signal transduction

Point mutation results in

Colorectal carcinoma
Just about any cancer

80
Q

RET proto oncogene (function, mutation, and cancers)

A

Receptor synthesis

Point mutation results in

MEN IIa/IIIb
Leukemia

81
Q

SIS proto oncogene (function, mutation, and cancers)

A

Growth factor synthesis

Overexpression leads to

Osteogenic sarcoma
Astrocytoma

82
Q

L-MYC proto oncogene (function, mutation, and cancers)

A

Transcription factor

Results in Lung tumor

“L-myc Lung tumor”

83
Q

BCL-2 proto oncogene (function, mutation, and cancers)

A

Anti-apoptotic molecule

Associated with

Follicular lymphoma
Undifferentiated lymphoma

84
Q

APC tumor suppressor gene (function, associated cancers)

A

Prevents nuclear transcription (degrades catenin, an activator of nuclear transcription)

Familial polyposis (inherited)
Colona & stomach cancer (somatic)
85
Q

BRCA1/BRCA2 tumor suppressor gene (function, associated cancers)

A

Regulated DNA repair

Female breast and ovary cancer, male breast cancer (inherited)

86
Q

NF1 tumor suppressor gene (function, associated cancers)

A

Inhibits RAS signal transduction (cell cycle inhibitor)

NF1: Pheochromocytoma, Wilms tumor (kidney), Neurofibrosarcomas (inherited)

Neuroblastoma (somatic)

87
Q

NF2 tumor suppressor gene (function, associated cancers)

A

Cytoskeletal stability

NF2: Bilateral schwannomas, meningioma

88
Q

p53 tumor suppressor gene (function, associated cancers)

A

Inhibits G1/S phase
Repairs DNA
Inhibits BCL2 antiapoptotic gene

Li-Fraumeni: Breast, Brain, Leukemia, Sarcoma

89
Q

RB1 tumor suppressor gene (function, associated cancers)

A

Inhibits G1/S phase

Retinoblastoma, osteogenic sarcoma, breast, lung, colon

90
Q

TGF-beta tumor suppressor gene (function, associated cancers)

A

Inhibits G1/S phase

Familial stomach cancer
Pancreatic, Colorectal cancers

91
Q

VHL tumor suppressor gene (function, associated cancers)

A

Regulates nuclear transcription

von Hippel-Lindau: cerebellar hemangioma, retinal angioma, RCC (bilateral), pheochromocytoma (bilateral)

92
Q

WT1 tumor suppressor gene (function, associated cancers)

A

Regulates nuclear transcription

Wilms tumor (kidney)

93
Q

p16 tumor suppressor gene (function, associated cancers)

A

Melanoma

94
Q

DPC4 tumor suppressor gene (function, associated cancers)

A

Pancreatic cancer

“DPC=Deleted in Pancreatic Cancer”

95
Q

DCC tumor suppressor gene (function, associated cancers)

A

Colon cancer

“DCC=Deleted in Colon Cancer”

96
Q

Ingestion of maize and peanuts grown in hot/humid climates and later develop HCC associated with Hep B

A

Aflatoxin (Aspergillus)

97
Q

Oncology chemotherapy resulting in malignant lymphoma

A

Alkylating agents

98
Q

Herbicides (vineyard workers), fungicides, animal dips, metal smelting, incidental poisoning leading to SCC of the skin, lung cancer, or liver angiosarcoma

A

Arsenic

99
Q

Paints, printing inks, varnishes, leather, carpets, food products leading to hepatocellular carcinoma

A

Azo dyes

100
Q

Roofing material, insulation of pipes in shipyards, old homes, old cars with brake liners later develop Bronchogenic carcinoma or mesothelioma

A

Asbestos

101
Q

Component of light oil, used in print industry, dry cleaning, paint, adhesives and coatings leading to Acute leukemia and Hodgkin lymphoma

A

Benzene

102
Q

Used in space industry leading to bronchogenic carcinoma

A

Beryllium

103
Q

Industrial industries where ore is being smelted leading to prostate and lung cancer

A

Cadmium

104
Q

Chemotherapy agent leading to transitional cell carcinoma of urinary bladder

A

Cyclophosphamide

105
Q

Once used to treat women with threatened abortions daughters later develop clear cell carcinoma of the vagina/cervix

A

DES (diethylstilbestrol)

106
Q

Workers in the rubber, chemical, leather, textile, metal, and printing industries who develop transitional cell carcinoma of the urinary bladder

A

Beta-Naphthylamine and aromatic amines

107
Q

Nickel plating, byproduct of stainless steel welding, ceramics, batteries, spark plugs leads to bronchogenic carcinoma and nasal cavity cancer

A

Nickel

108
Q

Leading to breast and cervical cancer and hepatic adenoma

A

Oral contraceptives

109
Q

These are formed when coal, soot, wood, gasoline, oil, tobacco, or other organic material are burned leading to SCC of the skin, adenocarcinoma of esophagus, pancreas, or kidney, or transitional cell carcinoma

A

Polycyclic hydrocarbons

110
Q

Found in plastic piping material adhesive plastics, refrigerant leading to liver angiosarcoma

A

polyvinyl chloride

111
Q

By product of decay of uranium, hazard in quarries and underground mines leading to bronchogenic carcinoma

A

Radon

112
Q

Chemical silicon dioxide, rock quarries, sandblasting leading to bronchogenic carcinoma

A

Silica

113
Q

Substance released by cancer cells that causes degradation of skeletal muscle

A

PIF (proteolysis inducing factor)

114
Q

Substance released by cancer cells that decreases body fat, Increases TNF which suppresses appetite and initiates apoptosis of fat cells

A

LIF (lipolysis mobilizing factor)

115
Q

Marrow replacement by cancer/fibrotic tissue with immature normal cells in peripheral blood and teardrop RBCs

A

Myelophthisic anemia

116
Q

Acanthosis nigricans

A

Stomach cancer

117
Q

Myasthenia gravis-like symptoms with antibody directed against Ca channel (paraneoplastic syndrome)

A

Eaton-Lambert syndrome

associated with SCC of lung

118
Q

Periosteal reaction of distal phalanx (paraneoplastic syndrome)

A

Hypertrophic osteoarthropathy

associated with bronchogenic carcinoma

119
Q

Sterile vegetations on mitral valve (paraneoplastic syndrome)

A

Nonbacterial thrombotic endocarditis

Mucous secreting pancreatic and colorectal cancers

120
Q

Sudden appearance of numerous pigmented seborrheic keratoses (Leser-Trelat sign)

A

Seborrheic keratosis

Stomach carcinoma

121
Q

Release of procoagulants (Trousseau sign-Paraneoplastic)

A

Superficial migratory thrombophlebitis

Pancreatic carcinoma

122
Q

Diffuse membranous glomerulopathy (paraneoplastic syndrome)

A

Nephrotic syndrome

Lung, breast, and stomach carcinomas

123
Q

Cushings syndrome as a paraneoplastic syndrome (hormone and neoplasms)

A

ACTH or ACTH like peptide

SCC of lung

124
Q

SIADH paraneoplastic syndrome (hormone and neoplasms)

A

ADH

SCC of lung
Intracranial neoplasms

125
Q

Hypercalcemia paraneoplastic syndrome (hormone and neoplasms)

A

PTHrP (SCC of lung, RCC, breast cancer)

Calcitriol (vit D) - Lymphomas

126
Q

Polycythemia paraneoplastic syndrome (hormone and neoplasms)

A

Erythropoietin

RCC, hemangioblastoma, HCC, pheochromocytoma

127
Q

Used to follow up prostate carcinoma. Can also be elevated in BPH

A

PSA (prostate specific antigen)

128
Q

Produced by 70% colorectal and pancreatic cancers (can also be gastric, breast, or thyroid carcinomas)

A

CEA (Carcino Embryogenic Antigen)

129
Q

Normally made by fetus. Elevated in hepatocellular carcinomas and germ cell (yolk sac) tumors

A

AFP

130
Q

Elevated in Hydatidiform mole and Choriocarcinomas

A

beta-HCG

131
Q

Marker for ovarian cancer

A

CA-125

132
Q

Marker for melanoma, neuronal tumors, schwannomas

A

S-100

133
Q

Elevated in metastasis to bone, liver, Paget’s disease

A

Alkaline phosphatase

134
Q

Marker for Neuroblastoma, lung and gastric cancer

A

Bombesin

135
Q

Elevated in Hairy cell leukemia (B cell neoplasm)

A

TRAP (Tartrate Resistant Acid Phosphatase)

136
Q

Marker for pancreatic adenocarcinoma

A

CA-19-9

137
Q

Marker for medullary thyroid carcinoma

A

Calcitonin

138
Q

Laminated concentric, calcified pheres

A

Psammoma bodies

Papillary thyroid cancer
Serous cancer of ovary
Meningioma
Mesothelioma

“PSaMMoma”

Evan's Step 1 Prep Material (72 decks)

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