Clinical Aspects Of Neoplasia

Question 1

What are the host factors that affect the tumour cell growth

Answer 1

1.Blood supply ( fibroblast growth factor,vascular endothelial growth factor)
2.Hormones( prostate,endometrium)
3.Immunological

Question 2

Characteristics of tumour host interactions

Answer 2

Local effects
Cancer cachexia
Paraneoplastic syndromes

Question 3

What are the local effects of tumours

Answer 3

1.Tumour impingement
2.ulceration/bleeding
3.Infection
Rupture or infarction

Question 4

What is cancer cachexia

Answer 4

Weight loss,appetite loss (anorexia)and weakness(asthenia)

Question 5

What is the cause of cancer cachexia

Answer 5

Macrophage producing TNF alpha
Macrophage inhibitory cytokine 1

Question 6

What is the importance of paraneoplastic syndromes

Answer 6

Earliest manifestation of an occult neoplasm
Significant clinical problems that maybe lethal
May mimic metastatic disease thereby confounding treatment

Question 7

What is the importance of paraneoplastic syndrome

Answer 7

Mat represents the earliest manifestation of an occult neoplasm
May represent significant clinical problems and maybe lethal
May mimic metastatic disease and thereby confounding treatment

Question 8

What does small cell lung cancer produce

Answer 8

ACTH or ACTH like substance

Question 9

What does small cell lung cancer cause

Answer 9

Cushing syndrome

Question 10

Where else does Cushing syndrome cause tumors in

Answer 10

Adrenal
Pituitary

Question 11

What does bronchial carcinoid and pancreatic carcinoma produce

Answer 11

Serotonin
Bradykinin

Question 12

What does bronchial carcinoid and pancreatic carcinoma cause

Answer 12

Carcinoid syndrome

Question 13

What does a person who has bronchial carcinoid or pancreatic carcinoma have

Answer 13

Flushing
Diarrhoea

Question 14

What do renal cell carcinoma and hepato cellular carcinoma produce

Answer 14

Erythropoietin

Question 15

What does renal carcinoma and hepato cellular carcinoma cause

Answer 15

Polycythaemia

Question 16

What are the presentations of polycythaemia

Answer 16

An increase in RBC mass
Increase in haemoglobin concentration

Question 17

Squamous cell carcinoma of lung,and breast carcinoma produces

Answer 17

PTHRP
TGF alpha
TNF
IL-1

Question 18

Squamous cell carcinoma of lung and breast carcinoma causes

Answer 18

Hypercalcemia

Question 19

Cushing syndrome
What are the major forms of underlying cancer
What is the casual mechanism (what does it produce)

Answer 19

Small cell lung carcinoma
Pancreatic carcinoma
Neural tumors

ACTH or ACTH like substance

Question 20

SIADH

What are the major forms of underlying cancer
What is the casual mechanism (what does it produce)

Answer 20

Small cell lung carcinoma
Intracranial neoplasms

ADH or atrial natriuretic hormone

Question 21

Hypercalcemia

What are the major forms of underlying cancer
What is the casual mechanism (what does it produce)

Answer 21

Squamous cell lung carcinoma
Breast carcinoma
Renal carcinoma
Adult T Cell lymphoma

PTHRP,TGF-alpha,TNF,IL-1

Question 22

Hypoglycaemia

What are the major forms of underlying cancer
What is the casual mechanism (what does it produce)

Answer 22

Ovarian carcinoma
Fibrosarcoma
Mesenchymal sarcomas

Insulin or insulin like substance

Question 23

Carcinoid syndrome

What are the major forms of underlying cancer
What is the casual mechanism (what does it produce)

Answer 23

Hepatocellular carcinoma
Bronchial adenoma
Pancreatic carcinoma

Serotonin,bradykinin

Question 24

Polycythemia

What are the major forms of underlying cancer
What is the casual mechanism (what does it produce)

Answer 24

Gastric carcinoma
Renal carcinoma
Cerebella hemangioma
Hepato cellular carcinoma

Erythropoietin

Question 25

Clinical procedures for diagnosis of tumours

Answer 25

History and clinical examination

Question 26

Radiological procedures for tumour diagnosis

Answer 26

Procedures like endoscopy and laparoscopy
Imaging procedures like X-rays ,ultrasound scan,CT,MRI

Question 27

Morphological methods for tumour diagnosis

Answer 27

Cytology- Pap smear,FNAC
Biopsy-Histopathology,molecular markers

Question 28

What is grading?

Answer 28

Cellular differentiation (microscopic)

Question 29

What is staging?

Answer 29

Progression or spread(clinical)

Question 30

How do they grade tumours?

Answer 30

Grade one
Grade 2
Grade 3
Grade 4

Question 31

What is TNM staging system?

Answer 31

T = tumour size
N = lymph node involvement
M = presence or absence of metastasis

Question 32

What are the diagnostic methods in tumour pathology?

Answer 32

Morphology – microscope, H&E slides
Immuno Histo chemistry – tumour differentiation

Question 33

Alpha fetoprotein tumour marker

Answer 33

Hepato cellular carcinoma
Embryonal carcinoma of testes and ovary

Question 34

CEA tumour marker

Answer 34

Colorectal carcinoma
Pancreatic carcinoma

Question 35

HCG tumour marker

Answer 35

Choriocarcinoma

Question 36

CA 15-3 or CA 27.29 tumour marker

Answer 36

Breast carcinoma

Question 37

CALCITONIN tumour marker

Answer 37

Thyroid medullary carcinoma

Question 38

Prolactin tumour marker

Answer 38

Pituitary adenoma

Question 39

CA 125 tumour marker

Answer 39

Ovarian carcinoma

Question 40

Chromogranin A tumour marker

Answer 40

Endocrine neoplasia

Question 41

CA 19–9 tumour marker

Answer 41

Pancreatic
Sometimes bile ducts, gallbladder, stomach,colon

Question 42

CD20

Answer 42

Non Hodgkin lymphoma

Question 43

C-kit/CD 117

Answer 43

Gastrointestinal stromal tumour