Exam 1; Neoplasia III

Question 1

This is the prototypic anti-apoptosis gene, found in low-grade lymphomas, these tumors grow relatively slowly because the cells do not die quickly - not because they are being stimulated to proliferate

Answer 1

BCL2

Question 2

Even with multiple genetic abnormalities, tumors cannot exceed what measurements in diameter unless they are vascularized; sustained angiogenesis

Answer 2

1-2mm

Question 3

Overexertion of BCL2 proteins cells from what

Answer 3

apoptosis, allowing them to survive for prolonged period

Question 4

Angiogenesis facilities what

Answer 4

metastases; provides access to the vasculature

Question 5

What are the two 2 major phases of invasion

Answer 5

invasion of the extracellular matrix

vascular dissemination and adhesion/homing of tumor cells

Question 6

What are the four steps involving the invasion of the ECM

Answer 6

detachment of tumor cells from one another
attachment of tumor cells to matrix components
degradation of ECM
migration of tumor cells

Question 7

Once in circulation, the tumor cells are vulnerable to what

Answer 7

destruction by the host immune cells

Question 8

The distribution of tumor metastases can generally be predicted by what

Answer 8

the location of the primary tumor and its vascular or lymphatic drainage

Question 9

Organ tropism is sometimes seen; for example, lung cancer often spreads to adrenal glands, but almost never involves the skeletal muscle, why?

Answer 9

organ-specific endothelial adhesion molecules bind tumor cell ligands
chemokine receptors on tumor cells home to sites where specific ligands are readily produced

Question 10

This is critical to the integrity of genome and control of cellular growth; patients with inherited defects in this have an increased cancer risk

Answer 10

DNA repair

Question 11

This is a familial concert of the color resulting from defective genes involved in DNA mismatch repair and evidence of micro satellite instability (MSI)

Answer 11

hereditary nonpolyposis colon cancer syndrome

Question 12

This is a defective nucleotide excision repair system; UV light causes pyrimidine cross-linking, halting replication; this puts patients at risk for skin cancer

Answer 12

xeroderma pigmentosum

Question 13

Bloom syndrome, ataxia telangiectasia and fanconi anemia are characterized by what

Answer 13

hypersensitivty to DNA damage; increasing cancer and other health problems

Question 14

These genes are involved with the repair of sDNA breaks and may also have tumor suppressor roles; involved in familial breast cancer

Answer 14

BRCA 1 and 2

Question 15

Every human cancer has shown what

Answer 15

multiple genetic alterations and the loss of two or more cancer suppressor genes

Question 16

What is meant by tumor progression and heterogeneity

Answer 16

tumors begin as a monoclonal proliferation of one transformed cell, as the daughter cells divide, they tend to develop more and more mutations; by the time the tumor mass has formed, they cells are quite heterogenous and more selected for survival

Question 17

What is an example of a balanced translocation karyotypic change in the tumor

Answer 17

a translocation between chromosome 22 and 9, resulting in 22 looking shorter

Question 18

This is the second most prevalent form of karyotypic abnormality in tumors - Rb, colon and oral cancers

Answer 18

deletions

Question 19

This is form of karyotypic abnormality in tumors such as neuroblastoma and some breast cancers

Answer 19

gene amplifications

Question 20

What are the three major classes of carcinogenic agents

Answer 20

chemicals
radiant energy
oncogenic virusis

Question 21

How do some carcinogens react with DNA

Answer 21

directly, but most are indirect and require some metabolic conversion (pro carcinogens) active end products are termed ultimate carcinogens

Question 22

All chemical carcinogens are what

Answer 22

highly reactive electrophiles, interacting with the electron rich DNA molecule and inducing genetic damage

Question 23

Some carcinogens can be augmented by what

Answer 23

promoters (agents that have little inherent transforming ability)

Question 24

The carcinogen is thought to serve as what

Answer 24

the initiator of a mutagenic event, while the promoter drives replication of the damaged cell

Question 25

Latent periods for radiation exposure to the time of cancer development are what

Answer 25

7-12 years, relatively long

Question 26

This is an RNA oncogeneic virus found in certain parts of Japan and the Caribbean

Answer 26

human T-cell leukemia virus type 1; causes leukemia

Question 27

What are three examples of DNA oncogenic viruses

Answer 27

HPV
epstein-barr virus
hepatitis B virus

Question 28

The concept of this refers to the recognition and destruction of non-self tumor cells when they appear

Answer 28

tumor immunity

Question 29

These are antigens only associated with tumor cells

Answer 29

tumor-specific antigens

Question 30

These are antigens that may be found on normal cells but may be overexposed or represent a specialized function of cells

Answer 30

tumor associated antigens

Question 31

What are some examples of a tumor specific antigen

Answer 31

cancer testis antigen

MAGE-1 (melanoma)

Question 32

What is an example of a tumor associated antigen

Answer 32

prostate specific antigen

Question 33

What are the four methods in which the body kills tumor cells

Answer 33

cytotoxic T lymphocytes
NK cells
macrophages
humoral mechanisms

Question 34

The strongest argument for this is the increased frequency of cancer observed in the immunocompromised

Answer 34

immunosurveillence

Question 35

Most cancers develop in immune competent individuals. How?

Answer 35

selective outgrowth of the most antigen negative clones
loss or reduced expression of histocompatibility antigens
lack of co-stimulation
immunosuppression

Question 36

Why is location a critical feature of neoplasia

Answer 36

benign tumors that are located in critical areas can be very serious

Question 37

This seems to be more frequent with well-differentiated benign tumors

Answer 37

hormone production

Question 38

This is when a tumor expands to the point of breaking through an epithelial surface, problems with bleeding and secondary infection arise

Answer 38

ulceration

Question 39

This is seen in cancer patients and is characterized by progressive loss of body fat and lean body mass, accompanied by profound weakness, anorexia, and anemia; usually terminal, may involved TNF and IL-1

Answer 39

cachexia

Question 40

What are paraneoplastic syndromes, which occur in 10-15% of cancer patients; examples include hypercalcemia, Cushing’s, etc.

Answer 40

may represent an early manifestation of occult disease
may pose significant clinical problems for affected patients
may mimic metastatic disease and thereby confound treatment

Question 41

This refers to an estimate of the aggressiveness of a cancer based on the microscopic appearance

Answer 41

grading

Question 42

This describes the extent of the cancer; the size of the primary lesion, lymph node involvement, and metastatic spread

Answer 42

staging

Question 43

This method is commonly used for SCC

Answer 43

TNM

tumor, node, metastases

Question 44

Which is more valuable, grading or staging, when making a prognosis

Answer 44

staging

Question 45

What are some examples of how to diagnose cancer

Answer 45

biopsy
electron microscopy
frozen section biopsy
fine needle aspiration biopsy
cytologic smears
immunocytochemistry
flow cytometry
biochemical assays
molecular diagnosis