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Gen Path > Exam 3: Section 5 Remaining Material > Flashcards

Exam 3: Section 5 Remaining Material Flashcards

1
Q

What is Mets

A

Metastasis

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2
Q

Which form of cancer is most likely to travel via lymphatics

A

Carcinoma

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3
Q

Tumors with anaplasia are most likely to be

A

Invasive malignant tumor

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4
Q

Tumors with fairly well differentiated cells are more likely to be

A

Slowly growing benign tumors

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5
Q

Most cancer related deaths occur between

A

55-70 years old

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6
Q

Most common cause of cancer related deaths in males

A

Prostate CA

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7
Q

____ correlation between rate of growth and differentiation in cancer cells

A

Inverse

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8
Q

____ tumors are less likely to be encapsulated

A

Malignant

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9
Q

MC breast cancer

A

Invasive ductal carcinoma

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10
Q

MC breast tumor

A

Fibroadenoma

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11
Q

Osteosarcomas travel ____ primarily

A

Lungs

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12
Q

Colorectal CA travels to ____ primarily

A

Liver

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13
Q

Most reliable indicator for malignancy

A

Metastasis

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14
Q

Most people from cancer die from ____ as a result of Mets

A

Organ failure

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15
Q

3 types of Mets

A
  1. Seeding
  2. Lymphatic
  3. Hematogenous
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16
Q

Seeding Mets

A

Invasion of natural body cavities

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17
Q

2 types of body cavities primary associated with seeding Mets

A

Ovaries

CNS

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18
Q

Lymphatic Mets are MC form of Mets for

A

Carcinomas

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19
Q

Lymphatic Mets are determined by

A

Site and tumor parenchyma

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20
Q

Lymphatic Mets usually involved a ___ node

A

Sentinel lymph node

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21
Q

Hematogenous Mets is MC Mets for

A

Sarcoma

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22
Q

Type of Mets that is very rapid

A

Hematogenous

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23
Q

Hematogenous Mets are most likely to spread to

A

First capillary bed

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24
Q

GI cancer using hematogenous Mets go to

A

Liver

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25
Q

Systemic circulation cancers using hematogenous Mets go to

A

Lungs

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26
Q

Ultimate cause of CA is

A

Genetic alterations

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27
Q

Common CA in US

A

Breast
Colorectal
Esophageal

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28
Q

Common CA in Africa

A

Liver

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29
Q

Common CA in Japan

A

Stomach

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30
Q

Cancer diagnosis is ___, but cancer related deaths are ___

A

Increasing

Decreasing

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31
Q

CA deaths in men is decreasing by

A

20%

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32
Q

CA deaths in women is decreasing by

A

10%

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33
Q

Cancer related deaths are decreasing due to

A
  1. Reduced tobacco
  2. Improved treatment
  3. Improved screening
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34
Q

Pediatric CA results in ___ of childhood deaths

A

10%

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35
Q

2 reasons CA affects older adults

A
  1. Acquired more somatic mutations

2. Less active immune system

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36
Q

Sporadic CA develops in the absence of

A

Family history

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37
Q

Sporadic CA is primary result of

A

Harmful environmental exposures and damage to genetic material

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38
Q

Examples of preneoplastic lesions

A

Metaplasia

Dysplasia

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39
Q

Proto-oncogene

A

Normal gene that promotes cellular growth by encoding for transcription factors

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40
Q

Oncogene

A

Altered proto-oncogene that now promotes excessive cellular growth

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41
Q

Only ___ allele is needed to be mutated to change a proto-oncogene to an oncogene

A

1

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42
Q

Tumor suppressor gene

A

Normal genes that slow down cellular growth

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43
Q

If TSGs are altered, they can contribute to

A

Uncontrolled/ dysregulated cell growth

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44
Q

___ alleles must be altered for a TSG to contribute to carcinogenesis

A

Both

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45
Q

Apoptosis Genes normally ___ cells that have genetic alterations

A

Kill

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46
Q

CA cells ____ pathways that enact apoptosis for altered cells

A

Deactivate

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47
Q

DNA repair genes

A

Gene abnormalities go uncorrected and may contribute to carcinogenesis

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48
Q

Karyotype

A

Number and appearance of chromosomes

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49
Q

Aneuploidy

A

Abnormal number of chromosomes

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50
Q

Balanced translocation

A

Large genetic change on chromosome level

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51
Q

Balanced translocations can result in

A

Overexpression of proto-oncogenes

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52
Q

Deletions can deactivate

A

TSGs by losing genes

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53
Q

Gene amplifications can overexpress

A

Proto-oncogenes

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54
Q

Structural abnormalities

A
  1. Balanced translocations
  2. Deletions
  3. Gene amplifications
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55
Q

Example of gene amplification

A

Breast CA over expressing HER2

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56
Q

Indications of gene amplification

A

Homogeneously stained region

Double minutes

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57
Q

Epigenetic modifications are ____ changes in gene expression

A

Heritable

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58
Q

Epigenetics impacts function, but not

A

Genotype

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59
Q

Epigenetic modifications are

A

Reversible

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60
Q

Epigenetic modifications silences genes via

A

DNA methylation

Histone modification

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61
Q

Epigenetics impacts carcinogenesis when ___ are silenced

A

TSGs or DNS repair genes

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62
Q

Sub clones ____ malignant potential

A

Increase

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63
Q

8 hallmarks of cancer

A
  1. Evade apoptosis
  2. Self sufficiency in growth signals
  3. Insensitivity to anti-growth signals
  4. Tissue invasion and metastasis
  5. Limitless replicative potential
  6. Sustained angiogenesis
  7. Evasion of immune system
  8. Altered cellular metabolism
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64
Q

Driver mutations

A

Directly contribute to development and progression of CA

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65
Q

Passenger mutations

A

Produce genetic variants that may give tumor selective advantage

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66
Q

Mutations inherited via the germline affect

A

Entire body

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67
Q

Mutation in RB gene

A

Retinoblastoma

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68
Q

TP53 gene mutation

A

LI-Fraumeni Syndrome

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69
Q

APC gene mutations

A

Colorectal CA

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70
Q

NF1 gene mutations

A

Neurofibromatosis

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71
Q

BRCA 1 and BRCA 2 gene mutations

A

Breast and ovarian CA

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72
Q

Philadelphia chromosome

A

Abnormality in chromosome 22 in which part of chromosome 9 is transferred to it

73
Q

Bone marrow cells that contain Philadelphia chromosome are often found in

A

Chronic myelogenous leukemia

74
Q

Burkitt Lymphoma involved balance translocation between chromosome __ and __

A

8

14

75
Q

Warburg Effect

A

Change in CA cell metabolism

Aerobic glycolysis

76
Q

Governor of cell cycle

A

RB gene

77
Q

RB plays role at ___ checkpoint

A

G1 to S

78
Q

This infection may inactivate Rb

A

HPV

79
Q

Guardian of genome

A

TP53 gene

80
Q

MC mutated gene in all CA

A

TP53 gene

>70%

81
Q

P53 monitors for cellular stressors such as

A

Anoxia
Activation of oncogenes
Genetic alterations

82
Q

3 controls mechanisms involving TP53 gene

A
  1. Quiescence
  2. Senescence
  3. Apoptosis
83
Q

Quiescence causes ___ cell cycle arrest in response to ___

A

Reversible

Minor DNA damage

84
Q

Senescence results in ___ cell cycle arrest in response to ___

A

Permanent

Major DNA damage

85
Q

Apoptosis results in ____ in response to irreversible genetic damage

A

Programmed cell death

86
Q

4 most common cancers associated with Li-Fraumeni Syndrome

A

SBLA

  1. Sarcomas
  2. Breast
  3. Leukemia / lymphomas
  4. Adrenal gland
87
Q

Hay flick limit

A

40-70 divisions

88
Q

Why is there a hay flick limit?

A

Telomeres shorten —activates TSGs—senescence

89
Q

Limitless replication in CA results from non-homologous end-joining between haphazard chromosomes, which can rarely cause

A

Telomerase re-activation

90
Q

Telomerase

A

Repairs and maintains telomeres

91
Q

The normal result from non-homologous end-joining

A

Mitotic catastrophe

92
Q

Reactivation of telomerase is observed in ___ of all cancers

A

90%

93
Q

Pro-angiogenic Factors can be from

A

Tumor cells
Macrophages
Stromal cells

94
Q

Angiogenesis is in response to

A

Tissue hypoxia

95
Q

The new vessels from angiogenesis are dilated, ___, and ____, and can be a route for

A

Tortuous, leaky

Metastasis

96
Q

Invasion occurs on a ___ level

A

Local

97
Q

Metastasis occurs on a __ level

A

Distant

98
Q

Invasion metastasis cascade

A
  1. Invasion of ECM
  2. Vascular spread
  3. Micrometastases grow and invade
99
Q

Intravasation

A

Process of tumor cells metastasizing and entering the blood vessels

100
Q

Sites of blood stasis

A

Lungs

Bone marrow

101
Q

Once in blood vessels, tumor cells can be vulnerable to attach from these lymphocytes

A

NK

CD8+ T cells

102
Q

___ can aggregate and provide some protection to CA cells from an immune attack

A

Platelets

103
Q

Genomic instability

A

High frequency of mutations within an individual’s genome

104
Q

Types of DNA repair

A
  1. Mismatch repair
  2. Nucleotide excision repair (NER)
  3. Homologous recombination
105
Q

Pathology caused by dysfunction in DNA mismatch repair

A

Hereditary Nonpolyposis Colorectal CA (HNPCC)

Aka lynch syndrome

106
Q

Pathology caused by dysfunction in NER

A

Xeroderma Pigmentosum

107
Q

Pathology caused by dysfunction in homologous recombination

A

Breast cancer

108
Q

Xeroderma pigmentosum is a ____ defect in NER

A

Congenital

109
Q

TP53 gene can by deactivated by __ or ___

A

HPV or Hep B

110
Q

CA cells loosen surrounding intercellular connections by deactivation

A

E-Cadherin genes

111
Q

CA degrade ECM via

A

Proteolytic enzymes

112
Q

Once a CA cells invades the basement membrane, it is no longer considered “____”, but rather ____

A

In situ

Stage 1 “invasive” CA

113
Q

3 features of inflammation that increase CA risk

A
  1. Release of growth factors
  2. Angiogenesis
  3. Local invasion
114
Q

Acute radiation syndrome can cause these cancers

A 
Leukemia 
Thyroid 
Breast 
Colon 
Lung
115
Q

Most common cancer, that exceeds breast, prostate, lung and colorectal ca combined

A

Skin

116
Q

MC skin cancer

A

Basal cell carcinoma

117
Q

Most lethal and rare skin cancer

A

Melanoma

118
Q

Melanoma is due to

A

Intense UV exposure

119
Q

3 types of skin cancer

A
  1. Basal cell carcinoma
  2. Squamous cell carcinoma
  3. Melanoma
120
Q

H. Pylori is associated with 90% of

A

Peptic ulcer disease

121
Q

H. Pylori can cause these 2 cancers

A

Gastric adenocarcinoma

MALT lymphoma

122
Q

Only ___ of H.pylori transitions to CA

A

3%

123
Q

Retroviruses are ___ viruses that use ____

A

RNA viruses

Reverse transcriptase

124
Q

Human T cell Lymphotropic virus-1 (HTLV-1) infects

A

CD4+ T cells

125
Q

HTLV-1 uses the ___ gene

A

TAX

126
Q

TAX gene activates ____ and suppresses ____

A

Cyclins (cyclin D)

TP53

127
Q

HTLV-1 is more common in

A

Japan
Africa
S. America

128
Q

How is HTLV-1 transmitted

A

Sexual contact
Infected blood
Breastfeeding

129
Q

Strains of HPV making genital warts

A

HPV-6

HPV-11

130
Q

Strains of HPV responsible for squamous cell carcinoma

A

HPV-16

HPV-18

131
Q

HPV promotes cellular growth by activating ____ and deactivating ____

A

Cyclins

TSGs

132
Q

HPV gene ___ deactivates p53

A

E6

133
Q

HPV gene ___ inactivates Rb

A

E7

134
Q

Epstein-Barr virus is responsible for __ and infects ___

A

Mono

B cells and epithelial cells

135
Q

EBV predisposes you for risk of

A

Burkitt lymphoma
Lymphomas
Hodgkin lymphoma
Nasopharyngeal CA

136
Q

Responsible for 80% liver CA

A

Hep b and c

137
Q

Hep B and C are MC in

A

Africa

SE Asia

138
Q

Cancer cachexia is associated with ___ cancer

A

Advanced

139
Q

Cachexia

A

Wasting away of body fat and lean muscles due to widespread CA causing hypermetabolic state on body

140
Q

Anorexia can be observed in cachexia due to

A

Cytokine TNF

141
Q

Not due to local destruction of tumor or tumor putting pressure on surrounding tissues

A

Paraneoplastic syndromes

142
Q

Paraneoplastic syndromes can be due to

A

Immune activation or hormone production

143
Q

Paraneoplastic syndromes occur in

A

15% of all CA

144
Q

Hypercalcemia is an example of

A

Paraneoplastic syndromes

145
Q

Hypercalcemia can be caused by

A

Breast CA stimulates PTH levels, increasing osteoclasts activity

146
Q

Cushing syndrome is an ____ disorder

A

Endocrine

147
Q

Cushing syndrome aka

A

Hypercorticoid

148
Q

Cushing syndrome can be due to

A
  1. Exogenous corticosteroid therapy
  2. Pituitary adenoma (Cushing disease)
  3. Adrenal adenoma
149
Q

Characteristics of Cushing syndrome

A
  1. Weight gain
  2. Hirsutism
  3. Purple striae
  4. Hypertension
  5. Muscle atrophy and weakness
  6. Menstrual abnormalities
150
Q

Suspected antigen Cushing syndrome

A

ACTH

151
Q

Suspected antigen hypercalcemia

A

PTH

152
Q

Suspected antigen polycythemia

A

EPO

153
Q

Suspected antigen anemia

A

Immune activation

154
Q

Suspected antigen thrombotic endocarditis

A

Inflammation

Hypercoagulability

155
Q

Suspected antigen acanthosis nigricans

A

Epidermal GFs

156
Q

Type of CA with Cushing syndrome

A

Lung
Pancreas
Neuronal

157
Q

Type of CA with hypercalcemia

A 
Lung
Breast
Kidney 
Leukemia 
Lymphoma
158
Q

Type of CA with polycythemia

A

Liver
Kidney
Cerebellar
Hemangioma

159
Q

Type of CA with anemia

A

Thymus gland

160
Q

Type of CA with hypertrophic osteoarthropathy

A

Lung

161
Q

Type of CA with thrombotic endocarditis

A

Any advanced CA

162
Q

Type of CA with acanthosis nigricans

A

Gastric
Lung
Uterine

163
Q

Grading

A

Degree of cellular differentiation

164
Q

Staging measures

A

Extent of spread

165
Q

Staging uses

A

Multiple sources

166
Q

Excision

A

Partial removal of organ or tissue from body

167
Q

Biopsy

A

Removal of smaller sample of cell

168
Q

Colposcopy

A

Imaging procedure to view magnified image of cervix

169
Q

Colposcopy is an example of a

A

Biopsy

170
Q

Fine needle aspiration

A

Removal of cells via aspiration with a needle

171
Q

Fine needle aspiration is used with

A

Superficial tumor that is easily palpated

172
Q

Examples of tissues that can have fine needle aspiration

A

Breast
Thyroid
Lymph nodes
Salivary glands

173
Q

Cytological smear aka

A

Papanicolaou smear

174
Q

Pap smear

A

Sampling sheet cells off the surface of an organ

175
Q

Organs that can have a Pap smear

A 
Cervix 
Endometrium 
Meninges 
Bronchi
Bladder
Prostate
Stomach
176
Q

___ may be sample for biochemical abnormalities or irregular enzyme levels

A

Body fluids

177
Q

Tumor makers are _____ for presence of cancer

A

Non-diagnostic

178
Q

Prostate specific antigen (PSA) elevated levels can be due to

A

Benign prostatic hyperplasia
Recent ejaculation
Prostate cancer

Gen Path (10 decks)

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