Endocrinology of Cancer Flashcards
Carcinoma
Cancers arising from epithelial cells (line surfaces of organs, skin, and glands)
Sarcoma
Cancers arising from CT (bones, muscle, cartilage, fat)
Adenoma
Benign tumor originating from glandular tissue (adrenal gland or thyroid)
Hyperplasia
Increase in the number of cells within a tissue or organ (can lead to enlargement)
Dysplasia
Abnormal development or growth of cells
Anaplasia
Lack of differentiation in cells
Angiogenesis
Formation of new blood vessels
Explain the causes and mechanisms of hypercalcemia of neoplasia.
- Humoral hypercalcemia of malignancy: tumor cells secrete PTHrp (mimics PTH)
- Osteolytic Hypercalcemia: tumor invasion of bone stimulates osteoclast activity -> localized bone resorption and calcium release
- Vitamin D-Mediated Hypercalcemia: tumor cells produce excess vitamin D3
- Ectopic PTH secretion (rate) tumors produce PTH
- Diagnosis
Which term describes a tumor that has not yet invaded surrounding tissues?
A. Dysplasia
B. In situ
C. Metastasis
D. Anaplasia
In situ
What does carcinoma specifically refer to?
A. Cancers arising from CT
B. Benign tumor of glandular tissue
C. Cancers arising from epithelial cells
D. Tumor capable of metastasis
Cancers arising from epithelial cells
Which of the following processes allows tumors to obtain nutrients for growth by forming new blood vessels?
A. Anaplasia
B. Dysplasia
C. Hyperplasia
D. Angiogenesis
Angiogenesis
A tumor described as poorly differentiated on histology would most likely be classified as:
A. well-differentiated
B. low-grade
C. high-grade
D. non-invasive
High-grade
What is the main difference between a benign tumor and a malignant tumor?
A. Benign tumors arise only from epithelial cells
B. Malignant tumors invade and metastasize
C. Benign tumors always regress without treatment
D. Malignant tumors are always hormone-dependent
Malignant tumors invade and metastasize
What is the most common mechanism of hypercalcemia in cancer patients?
A. Tumor production of PTH
B. Tumor secretion of PTH-related peptide (PTHrP)
C. Excess dietary calcium
D. Tumor suppression of calcitonin
Tumor secretion of PTHrP
In humoral hypercalcemia of malignancy, PTH levels are typically:
A. Increased
B. Decreased
C. Normal
D. Unaffected
Decreased (because tumor cells secrete PTHrP -> negative feedback)
Which hormone can be used for rapid but short-term reduction of hypercalcemia?
A. PTHrP
B. Calcitonin
C. Vitamin D
D. Cortisol
Calcitonin
What should be measured in neoplasia?
- Serum calcium: elevated total calcium (bound to protein) or ionized calcium levels
- PTH: suppressed in msot cancer-associated hypercalcemia (when elevated PTHrP)
- PTHrP: elevated in humoral hypercalcemia of malignancy
- VitD3: elevated in vitamin D-mediated hypercalcemia
How is neoplasia managed?
- Focuses on lowering calcium levels and addressing underlying cancer
- Calcitonin provides rapid but short-term reduction in calcium by inhibiting bone resorption
Pituitary Adenoma
- Benign growth in the pituitary gland, some can change H production/secretion
- Dx/Rx: increase hormone -> result (-treatment)
- Increase ACTH -> excess adrenal cortisol (- inhibit POMC breakdown)
- Increase GH -> giantism (birth) acromegaly (adult onset) (-somatostatin)
- Increase prolactin -> infertility, galactorrhea, amenorrhea (dopamine agonists)
Adrenal Adenoma
- Benign (Adrenal carcinoma: neoplastic) growth in the adrenal cortex or medulla, some can result in altered secretion of HPA hormones
- Increased cortisol (decreased CRH, ACTH)
- Increased aldosterone
- Catecholamines (medulla)
A pituitary adenoma producing excess ACTH would lead to which condition?
A. Increased cortisol from adrenal cortex
B. Increased catecholamines from adrenal medulla
C. Increased aldosterone from adrenal cortex
D. Increased cortisol from adrenal medulla
Increased cortisol from adrenal cortex
Which hormone is likely elevated in an adrenal adenoma producing cortisol?
A. CRH
B. ACTH
C. Aldosterone
D. Cortisol
Cortisol (or aldosterone)
What would CRH levels likely be in a patient with an adrenal cortisol-producing tumor?
A. Increased
B. Decreased
C. Normal
D. Fluctuating
Decreased
What would the clinical sign of a benign adenoma from lactotroph cells?
A. Hypertension
B. Galactorrhea
C. Water retention
D. Giantism
Galactorrhea
Benign prostatic hyperplasia
- Benign enlargement of prostate gland due to hyperplasia of stromal and epithelial cells
- Age associated (>50 years), increased DHT, and chronic inflammation
Prostatic Cancer
- Malignant growth of prostate cells, tumor capable of invasion and metastasis
- Genetic mutations, family history, aging, and androgen signaling abnormalities
- Radiation, chemo, decrease androgens
Which feature distinguishes benign prostatic hyperplasia (BHP) from prostate cancer?
A. BHP is invasive and metastatic
B. Prostate cancer is associated with increased DHT
C. BPH affects stromal and epithelial cells but does not invade
D. Prostate cancer results from decreased androgen signaling
BPH affects stromal and epithelial cells, but does not invade
What is a common treatment for BPH?
A. Estrogen therapy
B. 5-alpha reductase inhibitors
C. Aromatase inhibitors
D. Androgen receptor blockers
5- alpha reductase inhibitors (to decrease DHT synthesis)
Estrogen receptor-positive (ER+) breast cancer is typically treated with:
A. Aromatase inhibitors and selective estrogen receptor modulators (SERMs)
B. Testosterone supplements and SERMs
C. Calcitonin and PTH analogs
D. Alpha adrenergic receptor blockers and calcitonin
Aromatase inhibitors and selective estrogen receptor modulators (SERMs)?
Why does ER+ breast cancer have a better prognosis than ER- breast cancer?
A. ER+ tumors grow more rapidly, allowing for early detection
B. ER+ tumors respond well to therapy directed against ERs
C. ER+ tumors are not invasive or metastatic
D. ER+ tumors are more common in younger women
ER+ tumors respond well to therapy directed against ERs
