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MOD > Chapter 7 Part 4 > Flashcards

Chapter 7 Part 4 Flashcards

1
Q

Steps in chemical carcinogenesis

A
  1. Initiation resulting from exposure of a cell to a significant amount of carcinogen
  2. DNA damage that is unrepairable
  3. Promotion of tumor development
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2
Q

Direct acting carcinogen

A

require no metabolic conversion to become a carcinogen, CA treatments can be direct acting carcinogens and cause development of secondary cancers

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3
Q

Indirect-Acting carcinogen

A

carcinogens that require metabolic conversion to become active

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4
Q

Initiator

A

agent that causes DNA damage and eventually leads to rapid and irreversible damage

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5
Q

Promoter

A

agent that contributes to tumor growth only after the application of an initiator

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6
Q

Most common metabolizer of carcinogens

A

cytochrome P-450-dependent mono-oxygenases

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7
Q

Why does carcinogen metabolism vary among individuals?

A

polymorphisms of CYP450 cause differences in gene product and enzyme productivity

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8
Q

What breaks down polycyclic aromatic hydrocarbons?

A

CYP1A1

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9
Q

Main target of carcinogens

A

DNA

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10
Q

Are carcinogen caused DNA mutations entirely random?

A

No, carcinogens may be more attracted to DNA sequences or bases and produce “hotspots”

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11
Q

aflatoxin B1 preferentially binds what sequence/mutation?

A

T:A transversion in codon 249 that produces an Arg to Ser substitution

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12
Q

Types of carcinogenic radiant energy

A

UV rays, ionizing electromagnetic and particulate radiation

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13
Q

CA types associated with increased UV radiation

A

squamous cell carcinoma, basal cell carcinoma, melanoma of the skin

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14
Q

Wavelength range of UVA

A

320-400 nm

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15
Q

Wavelength range of UVB and CA associated

A

280-320 nm, cutaneous CAs

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16
Q

Wavelength range of UVC

A

200-280 nm

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17
Q

What causes the carcinogenicity of UVB light

A

formation of pyrimidine dimers in DNA

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18
Q

How does dimerization effect DNA?

A

crosslinking of DNA distorts the helix and prevents proper pairing, can be fixed by repair mechanisms

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19
Q

xeroderma pigmentosum

A

nucleotide excision repair process is damaged/defective

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20
Q

Ionizing radiation examples

A

x-rays, gamma-rays, a and b particles, protons and neutrons

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21
Q

CA risk associated with CT scans

A

3 fold higher risk of leukemia development in children who receive 2 or 3 CTs, 3 fold increase in brain tumors in children that have 5-10 CTs

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22
Q

Hierarchy of tissues vulnerable to radiation induced CA

A

myeloid leukemias (granulocytes), thyroid, breast, lungs, salivary glands

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23
Q

What tissues are typically not affected by radiation?

A

skin, bone, GI tract

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24
Q

CA associated with HTLV-1

A

adult T-cell leukemia/lymphoma

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25
Q

In what areas of the world is adult T-cell leukemia/lymphoma most commonly seen?

A

Japan, Caribbean basin, South America, and Africa

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26
Q

Major target of HTLV-1

A

CD4 T cells

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27
Q

Infection of HTLV-1 occurs via

A

blood exposure, sexual intercourse, breastfeeding

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28
Q

Genes in HTLV-1

A

gag, pol, env, tax

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29
Q

What is Tax responsible for

A

essential for viral replication, alters host genome to increased pro-growth signal via PI3/AKT, and increases genomic instability

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30
Q

CA associated with HPV

A

squamous cell carcinomas of cervix, anogenital region, head and neck

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31
Q

HPV genital warts are associated with which strains?

A

HPV-6 and -11

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32
Q

Where is HPV DNA inserted?

A

E1/E2 reading frame

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33
Q

What two viral genes are most responsible for HPV’s oncogenic potential?

A

E6 and E7

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34
Q

Actions of E6

A

stimulates TERT (catalytic portion of telomerase), degrades p53,

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35
Q

Actions of E7

A

speed cells through G1/S checkpoint, inactivates p21 and p27, activate cyclins A and E

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36
Q

tumors associated with EBV

A

Burkitt lymphoma, B-cell lymphomas in immunosuppressed individuals, subset of Hodgkin lymphoma, nasopharyngeal and gastric carcinomas, rare T and NK cell lymphomas

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37
Q

Most common EBV associated tumors

A

B-cells and nasopharyngeal carcinoma

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38
Q

EBV complement receptor

A

CD21

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39
Q

LMP-1 gene EBV

A

oncogene, acts like CD40 receptor, activates NF-kB and JAK/STATE to promote B-cell survival and proliferation, also prevents apoptosis by activating BCL-2

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40
Q

EBNA-2 gene EBV

A

transactivates cyclin D and SRC genes in host, encodes viralIL-10 which prevents macrophages and monocytes from attacking T cells

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41
Q

Burkitt Lymphoma

A

neoplasm of B lymphocytes, commonly in central Africa and New Guinea

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42
Q

How does EBV contribute to Burkitt lymphoma?

A

weakens the immune system to set the state for an 8;`14 translocation and other mutations

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43
Q

Populations in which nasopharyngeal carcinomas are endemic

A

southern China, parts of Africa, Inuit people of arctic, all due to EBV

44
Q

Estimated percent of hepatocellular carcinomas caused by hepatitis?

A

70-80%

45
Q

Dominant effect of HBV and HCV

A

chronic inflammation, hepatocyte death, genomic damage, hepatocyte proliferation

46
Q

Dominant mechanism of HPV associated cancer

A

activation of NF-kB pathway to prevent apoptosis

47
Q

CA associated with H. pylori

A

gastric adenocarcinoma, MALT lymphoma

48
Q

Pathogenesis of H. pylori induced gastric CA

A

multifactorial; involved chronic inflammation and reparative gastric cell proliferation

49
Q

H. pylori pathogenecity gene

A

CagA

50
Q

H.pylori in MALT lymphomas

A

B cell proliferation and inflammation promotors

51
Q

Cancer cachexia

A

equal loss of fat and lean muscle, elevated BMR, evidence of systemic inflammation

52
Q

Leading cytokine contributing to cachexia

A

TNFa

53
Q

Can a benign tumor be deadly?

A

Yes, it may cause compression of other surrounding structures that will eventually lead to the death of the patient

54
Q

Possible complications of GI tumors

A

obstruction, intussusception,

55
Q

Benign tumors in endocrine glands…

A

can become functional and cause a greater release of hormone

56
Q

Erosiveness of tumors may cause…

A

ulceration, infections, bleeding, hemoptysis, melena

57
Q

Paraneoplastic syndrome

A

signs and symptoms that can not readily be explained by the presence of a tumor, may be the earliest manifestation of cancer

58
Q

Hypercalcemia as a paraneoplastic syndrome

A

most common, occurs due to calcemic humoral substance production

59
Q

CA associated with hypercalcemia

A

squamous cell carcinoma of lung, breast and renal carcinoma, adult t-cell leukemia/lymphoma

60
Q

Molecules associated with hypercalcemia

A

PTHRP, TGF-a TNF, IL-1

61
Q

Most common endocrinopathy

A

Cushing syndrome

62
Q

CA associated with Cushing syndrome

A

small-cell carcinoma of the lung, pancreatic carcinoma, neural tumors

63
Q

Neuromyopahtic neoplastic syndromes

A

take diverse forms possibly caused by self reactive antibodies; mechanisms are not entirely known

64
Q

Acanthosis nigricans

A

disorder characterized by gray-black patches of thickened and hyperkeratotic skin with a velvety appearance

65
Q

CA associated with acanthosis nigricans

A

gastric, lung, uterine carcinomas

66
Q

Hypertrophic osteoarhthropathy

A

periosteal new bone formation at distal ends of long bones, arthritis of adjacent joints, clubbing of digits

67
Q

CA associated with hypertrophic osteoarthropathy

A

lung carcinoma

68
Q

Why grade tumors?

A

allows the ability to quantify the probable clinical aggressiveness of a given neoplasm and its extent and spread

69
Q

Grading cancers is based on…

A

degree of differentiation and number of mitoses/architectural features

70
Q

Staging of cancers is based on…

A

size of primary lesion, extent of spread to lymph nodes, presence or absence of blood borne metastases

71
Q

TNM staging

A

primary Tumor, Node involvement, Metastases

72
Q

Methods of tissue sampling

A

needle aspiration, excision or biopsy, cytologic smears

73
Q

Fine needle aspiration

A

aspirating cells from tumor, often rapid and reliable

74
Q

Cytologic smears

A

often used for bladder, lung, endometrium, cervix to identify tumor cells

75
Q

Cytologic features evaluated in a smear

A

anaplasia, dysplasia, cellular changes

76
Q

Immunohistochemistry

A

identifying cell products or markers using antibodies

77
Q

How can immunohistochem be used to categorize tumors?

A

Abs specific to cytoskeletal proteins in different cells, ags can be used to determine the location of origin, used to determine prognosis

78
Q

Flow cytometry

A

quantitatively measures cell characteristics, especially cellular antigens expressed by liquid tumors

79
Q

Circulating tumor cell assessment

A

permits detection, quantification and characterization of solid tumors circulating in the blood

80
Q

Diagnosis of malignant neoplasms

A

PCR-based evaluation, DNA microarrays

81
Q

Prognosis of malignant neoplasms

A

evaluation of genetic alterations; NMYC gene amplification and 1p deletions

82
Q

Detection of minimal residual disease

A

assessed by PCR amplification of sequences unique to the clone

83
Q

Diagnosis of hereditary predisposition to CA

A

detection of germline mutations to consider prophylactic surgery and counseling

84
Q

Guiding therapy with oncoprotein-directed drugs

A

identification of genetic lesions, treatments that can be directed against the effects of oncoproteins

85
Q

Difficulties of NextGen sequencing

A

expensive and lengthy process

86
Q

Major impacts of cancer genome sequencing

A

ID of new mutations that underlie cancers, description of genetic lesions, greater appreciation of genetic heterogeneity

87
Q

Diagnostic path that will most likely evolve…

A

morphologic and molecular techniques

88
Q

Genetic complexity of tumors

A

chromothripsis is a likely culprit of cancer cell development - single catastrophic event that lead to formation of multiple breaks, results in many gene rearrangements

89
Q

Tumor markers for diagnosis

A

can be used for detection of cancers and effectiveness of therapy

90
Q

Sensitivity/specificity of tumor markers

A

low; may come from nonneoplastic conditions

91
Q

Tumor associated with HCG

A

trophoblastic tumors, testicular tumors

92
Q

Tumor associated with calcitonin

A

medullary carcinoma of thyroid

93
Q

Tumor associated with catecholamines and metabolites

A

pheochromocytoma

94
Q

Tumor associated with alpha-fetoprotein

A

liver cell cancer

95
Q

Tumor associated with carcinoembryonic antigen

A

carcinoma of colon, pancreas, lung, stomach heart

96
Q

tumor associated with prostatic acid phosphatase

A

prostate CA

97
Q

Tumors associated with neuron-specific enolase

A

small-cell CA of lung, neuroblastoma

98
Q

Tumor associated with immunoglobulins

A

multiple myeloma

99
Q

Tumor associated with prostate-specific antigen

A

prostate CA

100
Q

Tumor associated with CA-125

A

Ovarian CA

101
Q

Tumor associated with CA-19-9

A

Colon cancer, pancreatic cancer

102
Q

Tumor associated with CA 15-3

A

Breast CA

103
Q

Tumor associated with TP53, APC, RAS mutants

A

colon CA

104
Q

Tumor associated with TP53 and RAS mutants in stool and serum

A

pancreatic CA

105
Q

Tumor associated with TP53, RAS mutants in sputum and serum

A

lung CA

106
Q

Tumor associated with TP53 mutants in urine

A

Bladder CA

MOD (34 decks)

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