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USMLE Step 1. > Intro Path > Flashcards

Intro Path 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
c-kit
oncogene Gene product = Cytokine receptor Tumor = Gastrointestinal stromal tumor (GIST)
26
c-myc
Oncogene Gene product = Transcription factor Tumor = Burkitt lymphoma
27
HER2/neu (c-erbB2)
Oncogene Gene product = Tyrosine kinase Tumor = Breast, ovarian, and gastric carcinomas
28
L-myc
Oncogene Gene product = Transcription factor Tumor = Lung tumor L = Lung
29
N-myc
Oncogene Gene product = Transcription factor Tumor = Neuroblastoma N = Neuroblastoma
30
RAS
Oncogene Gene product = GTPase Tumor = Colon cancer, lung cancer, pancreatic cancer
31
RET
Oncogene Gene product = Tyrosine kinase Tumor = MEN2A and 2B, medullary thyroid cancer
32
APC
Tumor Supressor Gene Gene product = - Tumor = Colorectal cancer (associated with FAP)
33
BRCA1/BRCA2
Tumor Supressor Gene Gene product = DNA repair protein Tumor = Breast and ovarian cancer
34
DCC
Tumor Supressor Gene Gene product = DCC (Deleted in Colon Cancer) Tumor = Colon cancer
35
DPC4/SMAD4
Tumor Supressor Gene Gene product = DPC (Deleted in Pancreatic Cancer) Tumor = Pancreatic cancer
36
MEN1
Tumor Supressor Gene Gene product = Menin Tumor = MEN1
37
NF1
Tumor Supressor Gene Gene product = Ras GTPase activating protein (neurofibromin) Tumor = Neurofibromatosis type 1
38
NF2
Tumor Supressor Gene Gene product = Merlin (Schwannomin) protein Tumor = Neurofibromatosis type 2
39
p16
Tumor Supressor Gene Gene product = Cyclin-dependent kinase inhibitor 2A Tumor = Melanoma
40
p53
Tumor Supressor Gene Gene product = Transcription factor for p21, blocks G1 to S phase transition. Tumor = Most human cancers, Li-Fraumeni syndrome
41
PTEN
Tumor Supressor Gene Tumor = Breast cancer, prostate cancer, endometrial cancer
42
Rb
Tumor Supressor Gene Gene product = Inhibits E2F; blocks G1 to S phase transition Tumor = RetinoBlastoma, osteosarcoma
43
TSC1
Tumor Supressor Gene Gene product = Hamartin protein Tumor = Tuberous sclerosis
44
TSC2
Tumor Supressor Gene Gene product = Tuberin protein Tumor = Tuberous sclerosis
45
VHL
Tumor Supressor Gene Gene product = Inhibits hypoxia inducible factor 1a Tumor = von Hippel-Lindau disease, renal cell carcinoma
46
WT1/WT2
Tumor Supressor Gene Tumor = Wilms Tumor (nephroblastoma)
47
Tumor markers
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
Alkaline phosphatase (ALP)
tumor marker Metastases to bone or liver, Paget disease of bone, seminoma (placental ALP)
49
Alpha fetoprotein (AFP)
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
B-hCG
Tumor marker Hydatidiform moles and Choriocarcinomas (Gestational trophoblastic disease), testicular cancer, mixed germ cell tumor. Produced by syncytiotrophoblasts of the placenta
51
CA 15-3/CA 27-29
Tumor marker Breast cancer
52
CA 19-9
Tumor marker Pancreatic adenocarcinoma
53
CA 125
Tumor marker Ovarian cancer
54
Calcitonin
Tumor marker Medullary thyroid carcinoma
55
CEA
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
Chromogranin
Tumor marker Neuroendocrine tumors/carcinoid
57
PSA
Tumor marker Prostate-specific antigen. Prostate cancer. Can also be elevated in BPH and prostatitis. Questionable risk/benefit for screening.
58
EBV
Associated with: Burkitt lymphoma Hodgkin lymphoma Nasopharyngeal carcinoma Primary CNS lymphoma (in immunocompromised)
59
HBV, HCV
Associated with: Hepatocellular carcinoma
60
HHV-8
Associated with: Kaposi Sarcoma
61
HPV
Associated with: Cervical and penile/anal carcinoma (types 16, 18) Head and neck cancer
62
H. pylori
Associated with: Gastric adenocarcinoma MALT lymphoma
63
HTLV-1
Associated with: Adult T cell leukemia/lymphoma
64
Liver fluke
Associated with: Cholangeiocarcinoma
65
Schistosoma haematobium
Associated with: Bladder cancer (squamous cell)
66
Aflatoxins (Aspergillus)
Carcinogen Liver Impact = Hepatocellular carcinoma
67
Alkylating agents
Carcinogens Blood Impact = Leukemia/lymphoma
68
Aromatic amines (benzidine, 2-naphthylamine)
Carcinogens Bladder Impact = Transitional cell carcinoma
69
Arsenic
Carcinogen Liver - Angiosarcoma Lung - Lung cancer Skin - SCC
70
Asbestos
Carcinogen Lung Impact = Bronchogenic carcinoma > mesothelioma
71
Carbon tetrachloride
Carcinogen Liver Impact = Centrilobular necrosis, fatty change
72
Cigarette smoke
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
Ethanol
Carcinogen Esophagus - SCC Liver - HCC
74
Ionizing radiation
Carcinogen Thyroid - Papillary thyroid carcinoma
75
Nitrosamines (smoked foods)
Carcinogen Stomach - gastric cancer
76
Radon
Carcinogen Lung - Lung cancer (2nd leading cause after cigarette smoke)
77
Vinyl chloride
Carcinogen Liver - Angiosarcoma
78
Psammoma bodies
Laminated, concentric spherules with dystrophic calcifications. PSaMMoma bodies are seen in: Papillary carcinoma of thryoid Serous papillary cystadenocarcinoma of ovary Meningioma Malignant mesothelioma
79
1,25-(OH)2D3 (Calcitriol)
Linked to paraneoplastic syndrome Effect = hypercalcemia Neoplasm = Hodgkin lymphoma, NH-Lymphoma
80
ACTH
Linked to paraneoplastic syndrome Effect = Cushing syndrome Neoplasm = Small cell lung carcinoma, renal cell carcinoma
81
ADH
Linked to paraneoplastic syndrome Effect = SIADH Neoplasm = Small cell lung carcinoma, intracranial neoplasms
82
Antibodies against presynaptic Ca channels at NMJ
Linked to paraneoplastic syndrome Effect = Lamber-Eaton myasthenic syndrome (muscle weakness) Neoplasm = Small cell lung carcinoma
83
Erythropoietin
Linked to paraneoplastic syndrome Effect = Polycythemia Neoplasm = Renal cell carcinoma, hemangioblastoma, hepatocellular carcinoma, leiomyoma, pheochromocytoma
84
PTHrP
Linked to paraneoplastic syndrome Effect = Hypercalcemia Neoplasm = Squamous cell lung carcinoma, renal cell carcinoma, breast cancer
85
Cancer incidence - Men
1) Prostate 2) Lung 3) Colon/rectum Lung cancer incidence has dropped in men, but has not changed in women.
86
Cancer incidence - Women
1) Breast 2) Lung 3) Colon/rectum
87
Cancer mortality - Men
1) Lung 2) Prostate 3) Colon/rectum Cancer is the second leading cause of death in the US (heart disease number 1)
88
Cancer mortality - Women
1) Lung 2) Breast 3) Colon/rectum
89
brain metastasis
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
Liver metastasis
Colon >> stomach > pancreas Liver and lung are the most common sites of metastasis after the regional lymph nodes
91
Bone metastasis
Prostate, breast > lung, thyroid, kidney Bone mets >> 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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