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USMLE Step 1. > Intro Path > Flashcards

Intro Path Flashcards

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USMLE® Step 1 flashcards
1
Q

Acanthosis nigricans

A

Rare neoplastic indicator of visceral malignancy (more commonly associated with insulin resistance)

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2
Q

Barrett esophagus

A

Precursor to esophageal adenocarcinoma

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3
Q

Chronic atrophic gastritis, postsurgical gastric remnants

A

Predispose to gastric adenocarcinoma

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4
Q

Cirrhosis

A

Predisposes to hepatocellular carcinoma

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5
Q

Ulcerative colitis

A

Predisposes to colon adenocarcinoma

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6
Q

Actinic keratosis

A

Precursor to SCC of the skin

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7
Q

Dermato- and polymyositis

A

Predispose to visceral malignancies, particularly GU

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8
Q

Dysplastic nevus

A

Precursor to malignant melanoma

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9
Q

Multiple seborrheic keratoses

A

GI, breast, lung, and lymphoid malignancies

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10
Q

Paget disease of the bone

A

Predisposes to secondary osteosarcoma and fibrosarcoma

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11
Q

Plummer-Vinson Syndrome

A

Predisposes to SCC of the esophagus

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12
Q

Tuberous sclerosis

A

Often manifests with multiple hamartomatous (benign) tumors including giant cell astrocytomas, renal angiomyolipomas, cardiac rhabdomyomas; tumors may become malignant

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13
Q

Xeroderma pigmentosum, albinism

A

Predispose to SCC, basal cell carcinoma, melanoma

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14
Q

AIDS

A

Predisposes to aggressive lymphoma (non-Hodgkin) and Kaposi Sarcoma

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15
Q

Autoimmune diseases (like Hashimoto thyroiditis, SLE)

A

Predispose to lymphoma

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16
Q

Down Syndrome

A

Predisposes to acute lymphocytic leukemia

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17
Q

Immunodeficiency

A

Predisposes to lymphoma, melanoma, renal cell carcinoma

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18
Q

Li-Fraumeni syndrome

A

p53 mutation predisposes to various cancer types at a young age (sarcoma, breast, leukemia, adrenal gland)

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19
Q

Radiation exposure

A

High risk of developing leukemia, sarcoma, papillary thyroid cancer, breast cancer

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20
Q

Oncogenes

A

Gain of function leading to increased cancer risk. Need damage to only 1 allele.

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21
Q

Tumor suppressor gene

A

Loss of function leading to increased cancer risk. Both alleles must be lost for expression of disease

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22
Q

BCR-ABL

A

Oncogene

Gene product = tyrosine kinase

Tumor = CML, ALL

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23
Q

BCL-2

A

Oncogene

Gene product = Antiapoptotic molecule (inhibits apoptosis)

Tumor = Follicular and undifferentiated lymphomas

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24
Q

BRAF

A

Oncogene

Gene product = Serine/Threonine kinase

Tumor = Melanoma, non-Hodgkin lymphoma

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25
Q

c-kit

A

oncogene

Gene product = Cytokine receptor

Tumor = Gastrointestinal stromal tumor (GIST)

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26
Q

c-myc

A

Oncogene

Gene product = Transcription factor

Tumor = Burkitt lymphoma

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27
Q

HER2/neu (c-erbB2)

A

Oncogene

Gene product = Tyrosine kinase

Tumor = Breast, ovarian, and gastric carcinomas

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28
Q

L-myc

A

Oncogene

Gene product = Transcription factor

Tumor = Lung tumor

L = Lung

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29
Q

N-myc

A

Oncogene

Gene product = Transcription factor

Tumor = Neuroblastoma

N = Neuroblastoma

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30
Q

RAS

A

Oncogene

Gene product = GTPase

Tumor = Colon cancer, lung cancer, pancreatic cancer

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31
Q

RET

A

Oncogene

Gene product = Tyrosine kinase

Tumor = MEN2A and 2B, medullary thyroid cancer

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32
Q

APC

A

Tumor Supressor Gene

Gene product = -

Tumor = Colorectal cancer (associated with FAP)

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33
Q

BRCA1/BRCA2

A

Tumor Supressor Gene

Gene product = DNA repair protein

Tumor = Breast and ovarian cancer

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34
Q

DCC

A

Tumor Supressor Gene

Gene product = DCC (Deleted in Colon Cancer)

Tumor = Colon cancer

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35
Q

DPC4/SMAD4

A

Tumor Supressor Gene

Gene product = DPC (Deleted in Pancreatic Cancer)

Tumor = Pancreatic cancer

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36
Q

MEN1

A

Tumor Supressor Gene

Gene product = Menin

Tumor = MEN1

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37
Q

NF1

A

Tumor Supressor Gene

Gene product = Ras GTPase activating protein (neurofibromin)

Tumor = Neurofibromatosis type 1

38
Q

NF2

A

Tumor Supressor Gene

Gene product = Merlin (Schwannomin) protein

Tumor = Neurofibromatosis type 2

39
Q

p16

A

Tumor Supressor Gene

Gene product = Cyclin-dependent kinase inhibitor 2A

Tumor = Melanoma

40
Q

p53

A

Tumor Supressor Gene

Gene product = Transcription factor for p21, blocks G1 to S phase transition.

Tumor = Most human cancers, Li-Fraumeni syndrome

41
Q

PTEN

A

Tumor Supressor Gene

Tumor = Breast cancer, prostate cancer, endometrial cancer

42
Q

Rb

A

Tumor Supressor Gene

Gene product = Inhibits E2F; blocks G1 to S phase transition

Tumor = RetinoBlastoma, osteosarcoma

43
Q

TSC1

A

Tumor Supressor Gene

Gene product = Hamartin protein

Tumor = Tuberous sclerosis

44
Q

TSC2

A

Tumor Supressor Gene

Gene product = Tuberin protein

Tumor = Tuberous sclerosis

45
Q

VHL

A

Tumor Supressor Gene

Gene product = Inhibits hypoxia inducible factor 1a

Tumor = von Hippel-Lindau disease, renal cell carcinoma

46
Q

WT1/WT2

A

Tumor Supressor Gene

Tumor = Wilms Tumor (nephroblastoma)

47
Q

Tumor markers

A

should not be used as primary screening tool for cancer diagnosis or screening.

They may be used to monitor tumor recurrence and response to therapy, but definitive diagnosis is usually made via biopsy

48
Q

Alkaline phosphatase (ALP)

A

tumor marker

Metastases to bone or liver, Paget disease of bone, seminoma (placental ALP)

49
Q

Alpha fetoprotein (AFP)

A

tumor marker

Hepatocellular carcinoma, hepatoblastoma, yolk sac (endodermal sinus) tumor, mixed germ cell tumor

Normally made by fetus. Transiently elevated in pregnancy; high levels associated with neural tube and abdominal wall defects, lower levels associated with Down Syndrome

50
Q

B-hCG

A

Tumor marker

Hydatidiform moles and Choriocarcinomas (Gestational trophoblastic disease), testicular cancer, mixed germ cell tumor.

Produced by syncytiotrophoblasts of the placenta

51
Q

CA 15-3/CA 27-29

A

Tumor marker

Breast cancer

52
Q

CA 19-9

A

Tumor marker

Pancreatic adenocarcinoma

53
Q

CA 125

A

Tumor marker

Ovarian cancer

54
Q

Calcitonin

A

Tumor marker

Medullary thyroid carcinoma

55
Q

CEA

A

Tumor marker

CarcinoEmbryonic Antigen. Very nonspecific but produced by about 70% of colorectal and pancreatic cancers; also produced by gastric, breast, and medullary thyroid carcinomas

56
Q

Chromogranin

A

Tumor marker

Neuroendocrine tumors/carcinoid

57
Q

PSA

A

Tumor marker

Prostate-specific antigen. Prostate cancer.

Can also be elevated in BPH and prostatitis. Questionable risk/benefit for screening.

58
Q

EBV

A

Associated with:

Burkitt lymphoma
Hodgkin lymphoma
Nasopharyngeal carcinoma
Primary CNS lymphoma (in immunocompromised)

59
Q

HBV, HCV

A

Associated with:

Hepatocellular carcinoma

60
Q

HHV-8

A

Associated with:

Kaposi Sarcoma

61
Q

HPV

A

Associated with:

Cervical and penile/anal carcinoma (types 16, 18)
Head and neck cancer

62
Q

H. pylori

A

Associated with:

Gastric adenocarcinoma
MALT lymphoma

63
Q

HTLV-1

A

Associated with:

Adult T cell leukemia/lymphoma

64
Q

Liver fluke

A

Associated with:

Cholangeiocarcinoma

65
Q

Schistosoma haematobium

A

Associated with:

Bladder cancer (squamous cell)

66
Q

Aflatoxins (Aspergillus)

A

Carcinogen

Liver

Impact = Hepatocellular carcinoma

67
Q

Alkylating agents

A

Carcinogens

Blood

Impact = Leukemia/lymphoma

68
Q

Aromatic amines (benzidine, 2-naphthylamine)

A

Carcinogens

Bladder

Impact = Transitional cell carcinoma

69
Q

Arsenic

A

Carcinogen

Liver - Angiosarcoma
Lung - Lung cancer
Skin - SCC

70
Q

Asbestos

A

Carcinogen

Lung

Impact = Bronchogenic carcinoma > mesothelioma

71
Q

Carbon tetrachloride

A

Carcinogen

Liver

Impact = Centrilobular necrosis, fatty change

72
Q

Cigarette smoke

A

Carcinogen

Bladder - transitional cell carcinoma
Cervix - Cervical carcinoma 
Esophagus - SCC/adenocarcinoma 
Kidney - RCC
Larynx - SCC
Lung - Squamous cell and small cell carcinoma
Pancreas - Pancreatic adenocarcinoma
73
Q

Ethanol

A

Carcinogen

Esophagus - SCC
Liver - HCC

74
Q

Ionizing radiation

A

Carcinogen

Thyroid - Papillary thyroid carcinoma

75
Q

Nitrosamines (smoked foods)

A

Carcinogen

Stomach - gastric cancer

76
Q

Radon

A

Carcinogen

Lung - Lung cancer (2nd leading cause after cigarette smoke)

77
Q

Vinyl chloride

A

Carcinogen

Liver - Angiosarcoma

78
Q

Psammoma bodies

A

Laminated, concentric spherules with dystrophic calcifications. PSaMMoma bodies are seen in:

Papillary carcinoma of thryoid
Serous papillary cystadenocarcinoma of ovary
Meningioma
Malignant mesothelioma

79
Q

1,25-(OH)2D3 (Calcitriol)

A

Linked to paraneoplastic syndrome

Effect = hypercalcemia

Neoplasm = Hodgkin lymphoma, NH-Lymphoma

80
Q

ACTH

A

Linked to paraneoplastic syndrome

Effect = Cushing syndrome

Neoplasm = Small cell lung carcinoma, renal cell carcinoma

81
Q

ADH

A

Linked to paraneoplastic syndrome

Effect = SIADH

Neoplasm = Small cell lung carcinoma, intracranial neoplasms

82
Q

Antibodies against presynaptic Ca channels at NMJ

A

Linked to paraneoplastic syndrome

Effect = Lamber-Eaton myasthenic syndrome (muscle weakness)

Neoplasm = Small cell lung carcinoma

83
Q

Erythropoietin

A

Linked to paraneoplastic syndrome

Effect = Polycythemia

Neoplasm = Renal cell carcinoma, hemangioblastoma, hepatocellular carcinoma, leiomyoma, pheochromocytoma

84
Q

PTHrP

A

Linked to paraneoplastic syndrome

Effect = Hypercalcemia

Neoplasm = Squamous cell lung carcinoma, renal cell carcinoma, breast cancer

85
Q

Cancer incidence - Men

A

1) Prostate
2) Lung
3) Colon/rectum

Lung cancer incidence has dropped in men, but has not changed in women.

86
Q

Cancer incidence - Women

A

1) Breast
2) Lung
3) Colon/rectum

87
Q

Cancer mortality - Men

A

1) Lung
2) Prostate
3) Colon/rectum

Cancer is the second leading cause of death in the US (heart disease number 1)

88
Q

Cancer mortality - Women

A

1) Lung
2) Breast
3) Colon/rectum

89
Q

brain metastasis

A

Lung > breast > prostate > melanoma > GI

50% of brain tumors are from metastases. Commonly seen as multiple well-circumscribed tumors at gray/white matter junction

90
Q

Liver metastasis

A

Colon&raquo_space; stomach > pancreas

Liver and lung are the most common sites of metastasis after the regional lymph nodes

91
Q

Bone metastasis

A

Prostate, breast > lung, thyroid, kidney

Bone mets&raquo_space; primary bone tumors (multiple myeloma, lytic). Common mets to bone: breast (mixed), lung (mixed), thyroid (lytic), kidney (lytic), prostate (blastic).

Predilection for axial skeleton

USMLE Step 1. (19 decks)

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