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Pass Program > Chapter 10: Cancers: Cells out of control > Flashcards

Chapter 10: Cancers: Cells out of control Flashcards

1
Q

What is an abnormal mass of cells caused by uncontrolled growth?

A

Neoplasm

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2
Q

What is a malignant neoplasm with the ability to spread?

A

Cancer

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3
Q

When cells of malignant neoplasm spread to another location that is called

A

metastasis

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4
Q

When cell shrinks in size it is called

A

atrophy

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5
Q

When cell enlargens in size it is called

A

hypertrophy

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6
Q

When cells multiply it is called

A

hyperplasia

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7
Q

Normal cell growth in wrong location

A

metaplasia

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8
Q

Loss of cell to cell contact inhibition; cells crawling on top of each other

A

dysplasia

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9
Q

Difference between benign and malignant

A

benign is usually well circumscribed, does not outgrow its capsule, does not outgrow its blood supply; does not metastasize; obeys physiology
Malignant is the opposite of the above.

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10
Q

What do malignant cells secrete to increase blood supply to “feed the tumor”

A

angiostatin

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11
Q

MC tumor of any organ (be careful, it doesn’t say “primary”)

A

metastasis

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12
Q

Usually -oma on end means benign tumor. What are some exceptions?

A

seminoma, lymphoma, mesothelioma, retinoblastoma

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13
Q

What ending do you give tumor if it has epithelial tissue origin?

A

carcinoma

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14
Q

What ending do you give tumor if it has connective tissue origin?

A

sarcoma

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15
Q

malignant gland tumor of epithelial origin

A

adenocarcinoma

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16
Q

a tumor that has tissue from ectoderm, mesoderm and endoderm (hair, teeth, bone)

A

teratoma

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17
Q

MC primary cancer overall in US?

A

basal cell carcinoma #2 squamous cell carcinoma of skin (but because of slow growth and early detection, usually not listed in MC cancers that cause death)

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18
Q

MC primary cancer of liver

A

hepatocellular adenocarcinoma

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19
Q

MC primary breast cancer

A

invasive ductal carcinoma

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20
Q

MC primary lung cancer

A

adenocarcinoma

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21
Q

MC intracranial tumor (brain)

A

meningioma

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22
Q

MC primary brain tumor

A

astrocytoma

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23
Q

MC astrocytoma in child

A

pilocytic astrocytoma (posterior fossa, “Rosenthal fibers”(worm-like, corkscrew fibers)

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24
Q

4 neoplasms with Psammoma bodies

A

PSAMM
Papillary thyroid carcinoma
Serous-
Adenocarcinoma of ovary
Meningioma
Mesothelioma

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25
Q

brain tumor associated with NF1

A

optic glioma and neural crest derived tumors

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26
Q

brain tumor of oligodendrocytes that cause personality changes and movement disorders

A

oligodendroglioma

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27
Q

brain tumor of ependymal cells that line ventricles

A

ependymomas

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28
Q

What happens if an ependymoma obstructs CSF flow?

A

non-communicating hydroencephalus

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29
Q

What are signs and symptoms of non-communicating hydroencephalus?

A

papillary edema, blurring of disc, headache, seizures

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30
Q

Peripheral neuromas, axillary freckling, Lisch nodules, pheochromocytoma, and optic gliomas associate with

A

NF1

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31
Q

Which chromosome is affected in NF1?

A

Ch 17

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32
Q

Which chromosome is affected in NF2?

A

Ch22

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33
Q

Which tumor suppressor gene is inactivated in NF2?

A

MERLIN

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34
Q

What brain tumors are seen in NF2?

A

meningiomas, bilateral schwannomas (Ch22, 2 ears)

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35
Q

What skin anamoly is seen in NF2?

A

cafe au lait spots

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36
Q

What other disease can you see cafe au lait spots with precocious puberty?

A

McCune–Albright Syndrome

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37
Q

Which syndrome has noted port wine stain on forehead with angiomas of brain and retina accompanied by learning disabilities.

A

Sturge-Weber Syndrome

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38
Q

Which disease can you see ash leaf spots (hypopigmentation) and sebaceous adenomas?

A

tuberous sclerosis

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39
Q

What three organs are affected in Tuberous Sclerosis?

A

brain (tubors); heart (rhabdomyoma/rhabdomyosarcoma); kidney (renal cell carcinoma)

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40
Q

Which two tumor suppressor genes are responsible for TS and which chromosome are they found on?

A

TS1 (Ch 9– hamartin); TS2 (Ch16–tuberin)

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41
Q

MC primary brain cancer

A

grade IV astrocytoma a.k.a. Gliobastoma Multiforme

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42
Q

What does GM look like histologically?

A

pseudopallisading pleiomorphic cells around central hemorrhage/necrosis; “garland-like”

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43
Q

most common brain cancer (“didn’t say primary!!)

A

metastasis (usually at grey-white junction) and usually from lung, breast & skin

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44
Q

MC pituitary tumor?

A

pituitary adenoma

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45
Q

pituitary adenoma (acidophilic)

A

produce prolactin and growth hormone

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46
Q

pituitary adenoma of (basophilic)

A

produce ACTH, TSH, FSH, LH

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47
Q

most common functional tumor of pituitary

A

prolactinoma

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48
Q

Which medicine can shrink prolactinoma?

A

bromocriptine/cabergoline (dopa agonist)

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49
Q

What tumor could cause precocious puberty?

A

pinealloma

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50
Q

Englargement of pineal gland could cause..

A

noncommunicating hydroencephalus and Parinaud’s syndrome (eyes fixed down ward, cannot look up)

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51
Q

Which eye problem is seen in Marfan’s syndrome?

A

can’t look down

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52
Q

Which eye problem is seen in homocystinuria?

A

can’t look up

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53
Q

Which brain tumor develops from Rathke’s pouch, may damage pituitary, is quite cystic and liquid inside has “motor-oil” appearance?

A

craniopharyngioma

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54
Q

MC childhood malignant primary brain tumor

A

medulloblastoma (cerebellar, papilledema, headaches, ataxia)

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55
Q

What “neuro” origin tumor grows medially in abdomen and is known to exhibit “dancing eyes, dancing feet”?

A

neuroblastoma

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56
Q

Rule of 10 for pheochromocytomas

A

10%in children; 10%bilateral; 10%metastatic; 10% familial; 10%malignant (don’t forget to turn it around 90% in adults; 90% unilateral; 90% not metastatic; 90% idiopathic; 90% benign

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57
Q

Neural crest locations MOTEL PASS

A

melanoma
odentoblasts
tracheal cartilage
enterochromaffin (make serotonin)
laryngeal cartilage
pseudo unipolar cells (cover neurons)
adrenal medulla
schwann cells
spiral membrane (aorto-pulmonary membrane)

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58
Q

Which tests can detect neural crest cancers?

A

urinary or serum VMA, metanephrines, or HVA (dopamine)

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59
Q

Medicine for neural crest tumors (to control)

A

phenoxybenzamine

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60
Q

Definite treatment for neural crest tumors

A

surgical removal

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61
Q

The four T tumors of anterior mediastinum

A

thymus, thyroid, T-cell leukemia(hairy cell)/lymphoma, teratomas

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62
Q

What is the main T cell leukemia?

A

hairy cell leukemia

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63
Q

What test is positive in hairy cell leukemia?

A

TRAP (tartrate resistant acid phosphatase)

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64
Q

Two kinds of T cell lymphomas:

A

mycosis fungoides (cutaneous), and sezary syndrome (systemic)

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65
Q

What autoimmune disease is thymoma associated with?

A

Myasthenia gravis

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66
Q

Which organs are immunoprivileged (have barriers)

A

thymus, brain, eyes, testes, (remember if one eye loses immunoprivilege, the other loses it too)

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67
Q

What is the first thing to do if a thyroid mass is discovered?

A

ultrasound (to determine if cystic or solid)

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68
Q

If a thyroid mass is cystic, what is the next step in management?

A

FNA (fine needle aspiration)–diagnostic and therapeutic

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69
Q

If thyroid mass is solid, what is the next step in management?

A

If less than 1 cm, do thyroid scan: hot nodule, treat for hyperthyroidism; cold nodule and previous irradiation of the neck, lobectomy; no previous irradiation, fine needle biopsy.
If greater than 1 cm, fine needle biopsy.

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70
Q

PTH up, Ca up, PO4 down What is the meaning?

A

primary hyperpituitarism (moans, groans, stones and psychiatric overtones)

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71
Q

Tx for primary hyperparathyroidism

A

bisphosphanates (remember to sit up at least 30 minutes after taking them!); parathyroidectomy if severe

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72
Q

Most common cancer of parafollicular gland?

A

medullary carcinoma of thyroid (produces calcitonin)

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73
Q

3 Ps of MEN1 (Werner’s syndrome)

A

pituitary, pancreatic, parathyroid tumors

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74
Q

MENII (Sipple Syndrome)

A

medullary carcinoma of thyroid (parafollicular secretes Calcitonin), pheochromocytoma, +/- parathyroid adenomas
mutation in RET

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75
Q

MEN IIb

A

Marfanoid habitus,pheochromocytoma, mucosal neuroma (like bumps on tongue) mutation in RET

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76
Q

MC tumor of heart?

A

myxoma (more common in females: pass out and recover a few seconds later–estrogen connection)

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77
Q

What are the two central primary lung cancers?

A

squamous cell carcinoma and small celll carcinoma

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78
Q

What hormone does squamous cell carcinoma often produce?

A

PTHrp

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79
Q

What hormones are small cell carcinomas able to produce?

A

ACTH, ADH, PTH, TSH

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80
Q

Which primary lung cancer is not related to smoking?

A

bronchoalveolar adenocarcinoma

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81
Q

Which syndrome of SCLC is when antibodies to presynaptic Ca channels produce muscle weakness that gets better with repetitive movement?

A

Lambert–Eaton

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82
Q

Which complication of SCLC present with low serum osmolarity and high urine osmolarity?

A

SIADH

83
Q

If after high dose dexamethasone, the cortisol level is suppressed, where was the problem?

A

pituitary

84
Q

If after high dose dexamethasone, the cortisol level is NOT suppressed, which two possible origins did problem originate? How can we distinguish one from the other?

A

could be a problem from adrenal gland or Lung cancer (SCLC) if ACTH is down from adrenal; if ACTH is up from lung cancer (or we can CT chest to find lesion)

85
Q

What kind of pneumocosis comes from coal dust?

A

anthracosis

86
Q

What kind of pneumocosis comes from shipyard work, construction, or plumbing?

A

asbestosis

87
Q

What kind of pneumocosis comes from sandblasting?

A

silicosis

88
Q

What kind of pneumocosis can you see eggshell calcifications in the hilum?

A

silicosis

89
Q

What kind of pneumocosis could come from working in electronics or space industry?

A

berryliosis

90
Q

All pneumocosis show restrictive lung pattern: what would lab values pAO2, RR, pCO2, pH look like?

A

pAO2 down, RR up, pCO2 down, pH up respiratory alkalosis

91
Q

What three differentials for hilar calcifications?

A

silicosis, sarcoidosis, lymphoma

92
Q

What is cancer of pleura?

A

mesothelioma

93
Q

What is the histological finding of mesotheliomas?

A

psammoma bodies

94
Q

most common primary cancer of nasopharynx

A

nasopharyngeal carcinoma MCC seen in Chinese men

95
Q

Most common primary cancer of oral cavity

A

squamous cell carcinoma from smoking, chewing tobacco

96
Q

Most common primary cancer of esophagus

A

squamous cell carcinoma

97
Q

risk factors for esophageal SCC

A

Barrett’s esophagus

98
Q

How does Barrett’s esophagus often present

A

odonyphagia (first cannot eat solids, then cannot drink liquids)

99
Q

If a person has Barrett’s, how often should they have an endoscopy?

A

If they have low dysplasia, give endoscopy once every 6-12 mo.

100
Q

cancer associated with Virchow’s nodes

A

stomach adenocarcinoma

101
Q

What kind of cells can be seen in stomach adenocarcinoma biopsy?

A

signet ring (M cells making mucin)

102
Q

What if stomach adenocarcinoma spreads to ovaries? What is it called?

A

Kruckenberg tumor

103
Q

1 risk factor for stomach MALToma (kind of B cell lymphoma)

A

H. pylori

104
Q

Tx for H. Pylori

A

triple therapy: clarythromycin, amoxicillin, PPI; if resistant to amoxicillin: metronidazole; if no response chemotherapy

105
Q

top risk factors for UGI cancers

A

1 smoking, alcohol, nitrates, Japanese race

106
Q

most common cancer of ileum

A

lymphoma

107
Q

most common cancer of the appendix

A

carcinoid: usually originates from 1)pancreas 2) ileum; puts out large amount of serotonin; check urinary serotonin levels;

108
Q

What other condition could develop with carcinoid syndrome?

A

Pellagra: dermatitis, diarrhea, dementia (death) because using up niacin to make serotonin

109
Q

Tx for carcinoid syndrome

A

octreatide

110
Q

top colon cancer risk factors

A

low fiber diet, high fat diet, polyps, UC

111
Q

In familial polyposis, which gene is inactivated? Which gene is activated?

A

APC inactivated, KRAS activated

112
Q

When should children in families with FAP get colonoscopy and how often?

A

yearly colonoscopy by age 12

113
Q

Which disease presents with osteomas and sebaceous adenomas (bone tumors)

A

Gardner’s

114
Q

Which present with osteomas, sebaceous adenomas (polyps) and brain tumors?

A

Turcot’s

115
Q

Lynch syndrome (HNPCC) is associated with which gene mutations?

A

MSH1,2; MCH1

116
Q

Which liver tumor is associated with estrogen use or injected steroids and could rupture and lead to life-threatening hemorrhage if ruptured?

A

hepatic adenoma

117
Q

Which disease is associated with arteriovenous malformations in brain, GI and pulmonary?

A

Osler-Weber-Rendu

118
Q

Which gene mutation is associated with Osler-Weber-Rendu?

A

ALK1, ALK2 on Ch12

119
Q

Which disease leads to AVM or cysts in brain and abdomen?

A

VHL, from VHL gene on Ch3 (increase susceptibility to renal cell carcinoma)

120
Q

Name 2 cancers where smoking is protective:

A

UC and endometriosis, all other cancers #1 risk factor

121
Q

name risk factors for hepatocellular carcinoma

A

smoking, alcohol, Hep B, Hep C, schistosomiases, aniline dyes, aflatoxin, vinyl chloride (angiosarcoma); benzene

122
Q

Most common primary cancer of biliary tract

A

cholangiosarcoma

123
Q

Which autoimmune biliary disease is associated with anti-mitochondrial antibodies?

A

Primary Biliary cholangitis (PBC)

124
Q

Which biliary disease is seen in men with UC and is associated with pANCA.

A

primary sclerosing cholangitis (PSC)

125
Q

Adenocarcinoma of which organ is associated with Trousseau syndrome (migratory thrombophlebitis) and why?

A

pancreatic adenocarcinoma because mucin interacts with PLTs and makes them “sticky”, so pts. develop clots in various veins

126
Q

What is Libman Sachs endocarditis

A

a noninfectious endocarditis due to antigen-antibody (IgG-C3-IgM) immune complex deposition in heart valves

127
Q

Which pancreatic adenoma can cause elevated glucose, lipids and ketones

A

glucagnoma (maybe treated as diabetes, but does not respond to insulin)

128
Q

Which pancreatic adenoma can cause very low blood glucose?

A

insulinoma

129
Q

Which pancreatic adenoma could cause severe constipation?

A

somatostatinoma

130
Q

Which pancreatic adenoma could cause watery diarrhea?

A

VIPoma

131
Q

Most common primary ovarian tumor?

A

serous adenocarcinoma (highly malignant and most mucinous cancer in women)

132
Q

ovarian cancer with elevated estrogen

A

granulosa cell tumor

133
Q

ovarian cancer with high AFP

A

yolk sac tumor

134
Q

ovarian cancer with high hCG

A

choriocarcinoma

135
Q

ovarian cancer with masculinization

A

Sertoli-Leydig (elevated testosterone)

136
Q

ovarian cancer that could cause pseudomyxoma peritonei

A

mucinous cystadenocarcinoma

137
Q

fibroma associated with pleural effusion or ascites

A

Meig’s syndrome

138
Q

germ cell tumor with elevated LDH

A

dysgerminoma/seminoma or embryonal cell carcinoma

139
Q

most common tumor in uterus

A

leiomyoma

140
Q

most common cancer

A

endometrial adenocarcinoma

141
Q

irregularly enlarged uterus (nonsymmetrical)

A

fibroids

142
Q

Tx for fibroids:

A

OCPs, leuprolide (GnRH analogue); surgery (uterine artery embolization)

143
Q

bleeding between periods or after menoupause:

A

endometrial adenocarcinoma

144
Q

risk factors for endometrial adenocarcinoma

A

early menarche, late menopause, PCOS, obesity

145
Q

most common cancer of cervix

A

squamous cell carcinoma

146
Q

most common cause of cervical cancer (preventable)

A

HPV

147
Q

most common mass of vagina

A

warts, Bartholin cysts

148
Q

tx of Bartholin cysts

A

1st time: antibiotics; reoccurrence: marsupialization (open gland); after age 50 BIOPSY

149
Q

most common cancer of vagina (upper half)

A

squamous cell from cervix

150
Q

most common cancer lower vagina

A

children–rhabdomyoma; adults rhabdomyosarcoma (sarcoma botryoides “bunch of grapes”

151
Q

treatment for warts

A

trichloroacetic acid, podophyllum drops, cryosurgery

152
Q

Most common primary kidney cancer

A

children–Wilm’s tumor (WAGR Wilm’s, Aniridia, GU abnormalities, retarded mentation)
Adults- renal cell carcinoma

153
Q

What hormones could renal cell carcinoma produce and their effects?

A

If JG cell hyperplasia: up renin, up ALDO=HTN
If peritubular interstitial hyperplasia, up EPO, polycythemia vera

154
Q

What is Conn’s syndrome

A

hyperplasia of glomerula of adrenals, ALDO up=HTN

155
Q

What is Cushing syndrome

A

adrenal adenoma of fasciculata makes more cortisol

156
Q

What will an adenoma in adrenal medulla lead to?

A

pheochromocytoma; up in metanephrines

157
Q

Most common primary cancer of bladder

A

transitional cell adenocarcinoma

158
Q

risk factors for transitional cell adenocarcinoma of bladder

A

aniline dyes, benzene, aflatoxin, cyclophosphamide

159
Q

What is the rescue drug for doxirubicin causing cardiomyopathy?

A

dextrazoxane

160
Q

What is the rescue drug for methotrexate causing Bone marrow depletion?

A

leukovorin (folinic acid)

161
Q

What is the rescue drug for cyclophosphamide causing bladder cancer?

A

Mesna (a scavenger drug)

162
Q

What is the rescue drug for cysplatin causing nephrotoxicity?

A

Amifostine

163
Q

Which parasite can cause squamous cell carcinoma of bladder?

A

schistosoma haematobium

164
Q

What is the difference between prostatitis, prostatic hyperplasia, and prostate adenocarcinoma on digital rectal exam?

A

prostatitis the prostate will feel soft and boggy; prostatic hyperplasia prostate is big with no nodules, prostate adenocarcinoma prostate is hard and nodular

165
Q

Rx for benign prostate hyperplasia:

A

terazosin/doxazocin (alpha 1 antagonists relax sphincter); finasteride/dutasteride 5 alpha reductase inhibitor (shrink prostate); TURP transurethral resection of prostate

166
Q

Most common cancer of testes in first year of life

A

yolk sac cancer

167
Q

most common cancer of testes in teens to adults

A

seminoma

168
Q

most common skin cancer

A

basal cell

169
Q

most common malignant skin cancer

A

squamous cell carcinoma

170
Q

most malignant skin cancer

A

melanoma

171
Q

What determines the prognosis of melanoma?

A

depth of invasion

172
Q

most common bone cancer of epiphysis

A

chondrosarcoma

173
Q

most common bone cancer of metaphysis

A

osteosarcoma: starburst effect on cortex; “Codman’s triangle”

174
Q

most common bone cancer of diaphysis (middle) for children

A

Ewing’s osteosarcoma t(11,22); onion skinning

175
Q

most common tumor of breast under 25 y/o

A

fibroadenoma (estrogen dependent)

176
Q

most common tumor of breast above 25 y/o

A

fibrocystic disease (progesterone dependent)

177
Q

most common cancer of breast

A

intraductal adenocarcinoma

178
Q

presenting sign of intraductal adenocarcinoma

A

dimpling of breast

179
Q

breast cancer with nipple bleeding

A

intraductal papilloma

180
Q

breast cancer with cells lined up in single file

A

lobular adenocarcinoma

181
Q

breast cancer with focal areas of necrosis

A

comedocarcinoma

182
Q

breast cancer with peau d’orange

A

inflammatory adenocarcinoma (most malignant)

183
Q

a sarcoma that explodes out of breast then stops growing; wide excision is curative

A

cystosarcoma phyllodes

184
Q

ulcerative rash around nipple associated with intraductal adenocarcinoma

A

Paget’s Disease

185
Q

tx for cystic breast mass

A

FNA

186
Q

tx for firm breast mass

A

lumpectomy and biopsy

187
Q

benign firm breast mass

A

removal only

188
Q

malignant firm breast mass

A

after lumpectomy, perform modified radical mastectomy, nodal dissection, check for estrogen/ progesterone +, Raloxifene for estrogen +, chemo for premenopausal and radiation for postmenopausal; HER2NEU Tran2zumab (SE cardiomyopathy rescue drug Dextrazoxane–same for doxirubicin)

189
Q

PSA marker for

A

prostate cancer

190
Q

CEA marker for

A

colon, pancreas, biliary cancers

191
Q

S-100 marker for

A

melanoma (neural crest)

192
Q

AFP

A

yolk sac tumor, choriocarcinoma

193
Q

hCG

A

choriocarcinoma,

194
Q

C-myc

A

Burkitt’s lymphoma

195
Q

L-myc

A

small cell lung cancer

196
Q

N-myc and bombesin

A

neuroblastoma

197
Q

desmin

A

rhabdosarcoma

198
Q

vimentin

A

sarcoma

199
Q

Ca-125

A

serous adenocarcinoma of ovaries

200
Q

Ca-19

A

pancreatic cancer

201
Q

BCL2

A

follicular lymphoma

202
Q

RET

A

MEN II

203
Q

RB

A

retinoblastoma, osteosarcoma

204
Q

p53

A

everything!

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