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JL Principles > Disorders of Growth > Flashcards

Disorders of Growth Flashcards

0
Q

In terms of increases in size of tissue - what does auxetic mean?

A

Increased size of individual cells

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1
Q

In terms of increase in the size of tissue - what does muliplicative mean?

A

Increased number of cells

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2
Q

In terms of increase in size of a tissue - what does Accretionary mean?

A

Increased connective tissue

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3
Q

What does the term atrophy mean?

A

Decreased number/size of cells

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4
Q

What does the term hypoplasia mean?

A

Failure of organ development

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5
Q

What are the three hormonally sensitive organs to hyperplasia?

A

Endometrium
Breast
Thyroid

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6
Q

What is the term for an increase in cell size?

A

Hypertrophy

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7
Q

Out of hyperplasia, hypertrophy, atrophy, hypoplasia and metaplasia - which one is irreversible?

A

Hypoplasia

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8
Q

What is the term for an aquired form of altered differentiation?

A

Metaplasia

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9
Q

What type of neoplasia occurs in Barrett’s oesophagus, cervix, bronchus and salivary ducts?

A

Metaplasia

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10
Q

What are the Hayflick numver, Telomere erosion and Telomerase all related to?

A

Senescence

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11
Q

What type of cells are continuosuly dividing and are present as surface epithelia and haematopoetic cells?

A

Labile cells

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12
Q

What type of cells have a low level of replicative activity, may divide rapidly if stimulated, hepatocytes, fibroblasts and endothelium?

A

Stable cells

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13
Q

What type of cells are non-dividing, not able to re-enter the cell cycle and are neurones, skeletal and cardiac muscle?

A

Permananet cells

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14
Q

What is the key to regeneration of a cell population?

A

Control of the cell cycle

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15
Q

In relation to the control of the cell cycle - what can growth result from?

A

Shortening cell cycle time

Recruiting cells from resting or quiescent population

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16
Q

What four phases does the cell cycle consist of?

A

G1, S, G2, and M

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17
Q

In what stage of the cell cycle are cells quiescent?

A

G0

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18
Q

What is the term for an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues, and persists in the same excessive manner after cessation of stimuli that evoked the change?

A

Neoplasm

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19
Q

What are the two major classifications of neoplasia?

A

Behavioural - benign or maligant

Histogenic

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20
Q

What type of neoplasm has expansile growth and no invasion?

A

Benign neoplasm

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21
Q

What type of neoplasm is encapsulated?

A

Bengin

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22
Q

What is the N:C ration like in benign neoplasms?

A

Normal

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23
Q

How much pleomorphims is present in benign neoplasms?

A

Minimal

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24
Q

What can be said about the mitotic figures in a benign neoplasm?

A

Few mitotic figures

Normal mitotic figures

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25
Q

In a benign neoplasm, what are the nuclei not?

A

Hyperchromatic

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26
Q

Do benign neoplasms metastasise?

A

No

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27
Q

What type of neoplasm has an invasive growth pattern and is not encapsulated?

A

Malignant neoplasm

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28
Q

What type of neoplasm is necrosis common in?

A

Maliganant

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29
Q

What can be said about the N:C ratio in maligant neoplasms?

A

Increased

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30
Q

Are maligant neoplasms pleomorphic?

A

Yes

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31
Q

What can be said about the mitotic figures in a malignant neoplasm?

A

More frequent mitotic figures

Abnormal mitotic figures

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32
Q

What can be said about the nuclei of a malignant neoplasm?

A

Hyperchromatic

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33
Q

Which neoplasm is diploid and which is aneuploid?

A

Diploid - benign

Aneuploid - Malignant

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34
Q

What two classes of neoplasm can epithelial be divided into?

A

Squamous

Glandular

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35
Q

What is a benign, squamous neoplasm called?

A

Squamous papilloma

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36
Q

What is a benign glandular neoplasm called?

A

Adenoma

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37
Q

What is a malignant squamous neoplasm called?

A

Squamous carcinoma

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38
Q

What is a malignant, glandular neoplasm called?

A

Adenocarcinoma

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39
Q

What 6 classes can mesenchymal neoplasms be split into?

A 
Fat
Endothelium
Chondrocyte
Osteoblast
Smooth muscle
Skeletal muscle
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40
Q

What is a fat, benign neoplasm called?

A

Lipoma

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41
Q

What is a fat, maligant neoplasm called?

A

Liposarcoma

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42
Q

What is an endothelium, benign neoplasm called?

A

Ahgioma

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43
Q

What is an endothelium, malignant neoplasm called?

A

Angiosarcoma

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44
Q

What is a chondrocyte, benign neoplasm called?

A

Chondroma

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45
Q

What is a chondrocyte, malignant neoplasm called?

A

Chondrosarcoma

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46
Q

What is an osteoblast, benign neoplasm called?

A

Osteoma

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47
Q

What is a malignant, osteoblast neoplasm called?

A

Osteosarcoma

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48
Q

What is a smooth muscle, benign neoplasm called?

A

Leiomyoma

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49
Q

What is a smooth muscle, malignant neoplasm called?

A

Leiomyosarcoma

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50
Q

What is a skeletal muscle, benign neoplasm called?

A

Rhabdomyoma

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51
Q

What is a skeletal muscle, maligant neoplasm called?

A

Rhabdomyosarcoma

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52
Q

What type of neoplasm are glioma, lymphoma, melanoma, seminoma, mesothelioma all?

A

Malignant tumours

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53
Q

What are the three key elements in cancer development?

A
  1. Tumour growth
  2. Angiogenesis
  3. Invasion and metastasis
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54
Q

What are the 4 cancerous factors of tumour growth?

A
  1. Replication
  2. Escape from senescence
  3. Evasion of apoptosis
  4. Limitless replicative potential
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55
Q

What are the 5 components of neoplasms?

A 
Neoplastic cells
Blood vessels
Inflamamtory cells
Fibroblasts
Stroma
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56
Q

What three inflammatory cells are found in a neoplasm?

A

Macrophages, lymphocytes and polymorphs

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57
Q

In relation to tumour growth - what types of cells are monoclonal?

A

Neoplastic cells

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58
Q

What are all neoplastic cells in a lesion derived from?

A

A single common ancestor

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59
Q

What is a pre-maligant process?

A

Dysplasia

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60
Q

What is invasive growth?

A

The migration of cells that have detached from the primary tumour mass.

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61
Q

What are the two types of movement for invasive growth in single cells?

A

Mesenchymal migration - proteolysis/traction

Amoeboid movement - propulsion/utilise defects

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62
Q

During groups of cells moving in invasive growth what are there high levels of?

A

Autocrine promigratory factors and of proteolytic enzymes

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63
Q

What is a tumour stroma?

A

Desmoplasia

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64
Q

What does angiogenesis involve the formation of?

A

New blood vessels

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65
Q

What are 4 key modulators for angiogenesis?

A

Hypoxia
VEGF
FGF
TNFalpha

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66
Q

Name an endogenous inhibitor for angiogenesis?

A

Thrombospondin-1

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67
Q

Do tumours require less oxygen and metabolites than normal cells?

A

Yes

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68
Q

What are tumour implants that are discontinuous with the primary lesion?

A

Metastasis

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69
Q

What are the 4 routes of metastasis?

A
  1. Lymphatic
  2. Haematogenous
  3. Across body cavities
  4. Direct implantation
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70
Q

If the route of metastasis has been lymphatic what will the tumours be called?

A

Carcinomas

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71
Q

If the route of metastasis is haematogenous what with the tumours be called?

A

Sarcomas

72
Q

What type of patterns account for common metastatic profiles?

A

Circular patterns

73
Q

How far can a primary CNS malignancy spread?

A

Not beyond the CNS

74
Q

What two neoplasms are at risk of direct implantation?

A

Mesothelioma

Chondrosarcoma

75
Q

What two immunological cells are involved inthe regression of cancer i.e. melanoma?

A

Cytotoxic T lymphocytes and NK cells

76
Q

What part of the immune system are NK cells a part of?

A

Innate

77
Q

What part of genomic instability is key in cancer development?

A

Defective DNA repair mechanisms

78
Q

What type of change - that is a key element in cancer development - is reversible, heritable altered gene expression without mutation?

A

Epigenetic changes

79
Q

In relation to epigenetic changes what do cancer cells show?

A

Global hypomethylation

80
Q

What can some tumour suppressors be silenced by?

A

Hypermethylation

81
Q

What two metabolic alterations are key elements in cancer development?

A
  1. Aerobic glycolysis

2. Switch from mitochondrial oxidative phosphorylation to glycolytic pathways

82
Q

What cancer can be caused by hydrocarbons?

A

Scrotal cancer

83
Q

What cancer can be caused by aniline dyes?

A

Bladder cancer

84
Q

What cancer can be caused by smoking?

A

Lung cancer

85
Q

What cancer can be caused by Ni, wood dust?

A

Cancer of nasal sinuses

86
Q

What cancer can be caused by sunlight?

A

Melanoma

87
Q

What cancer can be caused by ionising radiation?

A

Leukaemia

88
Q

What type of cancer can be caused by hepatitis B?

A

Hepatoma

89
Q

What type of cancer can be caused by EBV?

A

NPC, Hodgkin’s

90
Q

What type of cancer can be caused by HPV?

A

Cervical cancer, head and neck cancer

91
Q

What type of cancer can be caused by H.pylori?

A

Gastric lymphoma

92
Q

What type of cancer can be caused by dietary factors?

A

GI cancers

93
Q

What two steps does development of a tumour require?

A
  1. Initiation - electrophilic molecules, DNA damage

2. Promotion - stimulate proliferation

94
Q

Name 3 chromosome breakage syndromes?

A
  1. Fanconi’s anaemia
  2. Bloom’s syndrome
  3. Ataxia telangiectasia
95
Q

Name 3 specific gene defects that can cause cancer?

A

APC
BRCA-1
p53

96
Q

Name an RNA viral carcinoma?

A

Rous sarcoma virus

97
Q

Name a DNA viral carcinoma?

A

SV40, HBV, HPV

98
Q

Name 6 classical oncogenes?

A 
PDGF
EGFR
ras
src
myc
Bcl2, Pim kinases
99
Q

What are the 4 ways proto-oncogenes can be activated?

A

Amplification
Translocation
Point mutation
Insertional mutagenesis

100
Q

What cancer is N-myc associated with?

A

Neuroblastoma

101
Q

What cancer is erb-B2 associated with?

A

Breast cancer

102
Q

What type of proto-oncogene activation are N-myc and erb-B2 involved in?

A

Amplification

103
Q

What type of proto-oncogene activation do these have:
t(14;18) - IgH/Bcl-2 (follicular lymphoma)
t(8;14) - c-myc/IgH (Burkitt’s lymphoma)
t(9;22) - c-abl-bcr fusion (CGL)

A

Translocation

104
Q

What type of proto-oncogene activation does Ras have?

A

Point mutation

105
Q

What type of activation of proto-oncogenes do slow transforming RNA viruses have?

A

Insertional mutagenesis

106
Q

Say 4 things about K-ras-activating point mutation?

A

Activating point mutations
GTP binding pocket
GTP hydrolysis
Locked in GTP bound (active form)

107
Q

Name a gene affected by inactivation of tumour suppressors?

A

p53

108
Q

Name a gene that is involved in point mutation during inactivation of tumour suppressors?

A

p53

109
Q

To inactivate tumour suppressor genes how many alleles must be lost?

A

Both

110
Q

What two ways can tumour suppressors lose both alleles?

A

Deletion and point mutation

111
Q

what is another way - other than losing alleles by mutation - to inactivate a tumour suppressor?

A

Degrade protein

112
Q

What is HPV degraded to?

A

E6 protein (p53) and E7 protein (pRb)

113
Q

What is mdm2 degraded to?

A

Cellular protein

114
Q

Name the “guardian of the genome”

A

p53

115
Q

What occurs when p53 is activated?

A

Regulation of transcription of down-stream target genes

116
Q

What two things does regulation of transcription of down stream target genes - from activation of p53 lead to?

A
  1. Cell cycle arrest

2. Cell death apoptosis

117
Q

What is p53?

A

A tumour suppressor protein

118
Q

What tumour suppressor protein is activated by cell stress?

A

p53

119
Q

What tumour suppressor protein is a transcription factor?

A

p53

120
Q

Which tumour suppressor protein binds DNA and regulates expression of many genes?

A

p53

121
Q

What 4 things can inactivate p53?

A
  1. Point mutation
  2. Deletion
  3. Degrredation
  4. Structural changes
122
Q

Name 6 tumour suppressor genes

A
  1. p53
  2. pRB
  3. APC
  4. BRCA-1
  5. NF-1
  6. WT-1
123
Q

What type of oncogenes: stimulate cell proliferation, inhibit cell death and are dominant?

A

Classical oncogenes

124
Q

What type of cancer genes inhibit cell proliferation, stimulate cell death and are recessive?

A

Tumour suppressors

125
Q

What does molecular carcinogenesis involve?

A

Both classical oncogenes and tumour suppressors

126
Q

What occurs in the conversion of normal mucosa to hyperplastic mucosa?

A

Abnormal methylation

127
Q

What is the risk of breast cancer if a patients mother got it at 70?

A

Low risk

128
Q

What is the patients risk of cancer if their mother and sister had breast cancer at 45?

A

Medium risk

129
Q

What is the patients risk of breast cancer if they have a BRCA1 mutation?

A

High risk

130
Q

What clinical finding can chronic blood loss as a result of cancer lead to?

A

Anaemia

131
Q

What can acute blood loss as a result of cancer lead to in a clinical presentation of a patient?

A

Haematemesis and haemoptysis

132
Q

What can stridor and dyspnoea, dysphagia, abdominal pain, renal failure, jaundice and infection behind obstructing lesion all be a result of?

A

Narrow lumen due to primary tumour

133
Q

What can metastasis in bone cause a patient to prevent with?

A

Pain and pathological fracture

134
Q

What can metastasis in the brain cause a patient to present with?

A

Raised intracranial pressure, epilepsy and CVA

135
Q

What can a meatastasis in the liver cause a patient to present with?

A

Jaundice

136
Q

What can a metastasis in the adrenal glands cause a patient to present with?

A

Addison’s disease

137
Q

What are paraneoplastic syndromes?

A

Symptoms/syndromes in cancer patients that cannot be explained by the effects of local or distant spread of tumours

138
Q

What are the 6 clinical syndromes of paraneoplastic syndromes?

A 
Endocrinopathy
Neuromuscular
Dermatologic
Osteoarticular
Vascular
Nephrotic syndrome
139
Q

What are the 4 clinical syndromes that come under endocrinopathy?

A

Cushings syndrome
Innappropriate ADH
Hypercalcaemia
Polycytheamia

140
Q

What is the underlying cancer if a patinet has cushings syndrome?

A

Small cell lung cancer (causal mechanism - secrete ACTH)

141
Q

What is the underlying cancer present if a patient has innappropriate ADH?

A

Small cell lung cancer (causal mechanism - Secrete ADH or atrial natriuretic)

142
Q

What is the underlying cancer present if a patient has hypercalcaemia?

A

Squamous carcinoma of lung, T-cell keukaemia/lymphoma, renal carcinoma (causal mechanism - erythropoitein)

143
Q

What is a clinical syndromes under the heading of neuromuscular?

A

Myasthenia

144
Q

What is the underlying cancer if a patient has myasthenia?

A

Bronchogenic carcinoma (causal mechanism - immunologic Eaton-lambart syndrome)

145
Q

Name a clinical syndrome under the heading Dermatologic

A

Acanthosis nigricans

146
Q

What is the underlying cancer if a patient has acanthosis nigricans?

A

Gastric carcinoma (causal mechanism - immunologic, secrete ECF)

147
Q

What is a clinical syndrome under the heading of osteoarticular?

A

Hypertrophic osteoarthropathy

148
Q

What is the underlying cancer if a patient has hypertrophic osteoarthropathy?

A

Bronchogenic carcinoma

149
Q

What are two clinical syndromes that come under the heading Vascular?

A 
Venous thrombosis (Trousseau)
Nonbacterial thrombotic endocarditis
150
Q

What is the underlying cancer if a patient has Venous thrombosis?

A

Pancreatic cancer (causal mechanism - activate clotting by mucin)

151
Q

What is the underlying cancer if a patient has Nonbacterial thrombotic endocarditis?

A

Advanced cancer (causal mechanism - hypercoaguability)

152
Q

What two underlying cancers could a patinet with nephrotic syndrome have?

A

Colo-rectal carcinoma

Hodgkin’s disease

153
Q

What is the causal mechanisms for colo-rectal carcinoma and Hodgkin’s disease causing nephrotic syndrome?

A

Immune complexes, tumoiur antigens

154
Q

What are the two tumour types of breast cancer?

A

Tubular vs. NST

155
Q

What are the two tumour types of lymphoma?

A

B-NHL vs. T-NHL

156
Q

What are the two tumour types of non-melanoma skin cancer?

A

Basal cell carcinoma

Squamous carcinoms

157
Q

What does Duke’s stage A say about colo-rectal cancer?

A

Confined to wall, no lymph node metastasis

158
Q

What does Duke’s stage B say about colo-rectal cancer?

A

Penetrates wall, no lymph node metastasis

159
Q

What does Duke’s stage C say about colo-rectal cancer?

A

Lymph node metastasis

160
Q

What does Duke’s stage D say about colo-rectal cancer/

A

Metastatic disease

161
Q

What is the T1 stage of cancer?

A

Invasion of submucosa

162
Q

What is the T2 stage of cancer?

A

Invasion of muscularis propria

163
Q

What is the T3 stage of cancer?

A

Invasion to subserosa and non-peritonealised pericolic and pararecal tissues

164
Q

What is T4 stage of cancer?

A

Invasion of adjacent organs or perforation of visceral peritoneum

165
Q

What does the N0 stage say about colorectal cancer?

A

No regional lymph node metastasis

166
Q

What does N1 stage say about colorectal cancer?

A

1-3 regional nodes contain metastatic tumour

167
Q

What does N2 stage say about colo-rectal cancer?

A

4 or more nodes contain metastatic tumour

168
Q

What does M0 stage say about colo-rectal cancer?

A

No distant metastasis

169
Q

What does M1 stage say about colorectal cancer?

A

Distant metastasis

170
Q

What does clinical staging I mean?

A

T1/T2, NO, MO

171
Q

What does clinical staging IIA mean?

A

T3, NO, MO

172
Q

What does clinical staging IIB mean?

A

T4, NO, MO

173
Q

What does clinical staging IIIA mean?

A

T1/T2, N1, MO

174
Q

What does clinical staging IIIB mean?

A

T3/T4, N1, MO

175
Q

What does clinical staging IIIC mean?

A

Any T, N2, M0

176
Q

What does clinical staging IV mean?

A

Any T, any N, M1

177
Q

Where can a prostatic carcinoma metatasise to?

A

Vetebrae

JL Principles (12 decks)

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