INTRO to neoplasia - EXAM 1

Question 1

What does neoplasm mean

Answer 1

new growth thats either benign or malignant

Question 1

what is hyperplasia

Answer 1

an increase size of an organ due to an increased number of cells

Question 2

what is metaplasia

Answer 2

substitution of one type of adult tissue to another type of adult tissue

Question 3

what is dysplasia

Answer 3

an abnormal proliferation that results in loss of normal architecture

Question 4

What is carcinoma

Answer 4

malignant neoplasm of squamous epithelial cell origin

Question 5

what is anaplasia

Answer 5

a loss of structural differentiation. Cells dedifferentiate

Question 6

what is adenocarcinoma

Answer 6

adeno= from glands
malignant neoplasm that started in glandular tissue

Question 7

what is sarcoma

Answer 7

malignant neoplasm that started in mesenchymal tissue (bone, fat, muscle)

Question 8

lymphoma and leukemia

Answer 8

malignant neoplasms of hematopoietic tissues

Question 9

Melanoma

Answer 9

type of cancer of pigment production cells in the skin or the eye

Question 10

blastoma

Answer 10

malignancy in precursor cells - commonly seen in children

Question 11

teratoma

Answer 11

a germ cell neoplasm made of several different differentiated cells and tissue types
(can look real wonky)

Question 12

Question
A 6 month old boy is determined to have a systemic malignancy originating from precursor cells of the nervous system. the pathology report would state?
A. Adenocarcinoma
B. Neuroblastoma
C. leukemia
D. Metastatic sarcoma

Answer 12

B. Neuroblastoma

Question 13

Numerical staging system:

Answer 13

0: in situ carcinoma, no signs of local invasion (hasn’t left the tissue it was first diagnosed in)

I: microscopic invasion of surrounding tissue (not in lymph node but has traveled to surrounding tissues)

II: 4-9 surrounding lymph nodes are involved

III: 10 or more surrounding lymph nodes are involved

IV: distant metastases are detected

Question 14

TNM staging
Primary Tumor (T)

Answer 14

TX: Primary tumor cannot be evaluated
T0: no evidence of primary tumor
Tis: carcinoma in situ
T1,T2,T3,T4: size and or extend of invasion of the primary tumor

Question 15

TNM staging system
Regional lymph nodes

Answer 15

N1,N2,N3 - degree of regional lymph node involvement

Question 16

TNM staging system
Distant metastasis (M)

Answer 16

MX: distant metastasis cannot be evaluated
M0: no distant metastasis
M1: distant metastasis is present

Question 17

TNM staging system example
A breast cancer is found to be a large tumor that has spread outside the breast to nearby lymphy nodes but not to other parts of the body

Answer 17

T3 N2 MO

Question 18

Question 2
A 48 year old woman has a routine physical examination. A 4cm diameter non-tender mass is palpated in her right breast. the mass appears fixed to the chest wall. Another 2cm non-tender mass is palpable in the left axillary node. A chest radiograph receals multiple 0.5 to 2cm nodules in both lungs. Which of the following TNM classifications best indicates the stage of her disease?
A. T1 N1 M0
B. T1 N0 M1
C. T2 N1 M0
D. T3 N0 M0
E. T4 N1 M1

Answer 18

E. T4 N1 M1

Question 19

SEER staging
Summary staging

Answer 19

In situ: abnormal cells are present only in the layer of cells in which they developed

Localized: cancer is limited to the organ in which it began, without evidence of spread (primary site)

Regional: cancer has spread beyond the primary site to the lymph nodes or tissues and organs

distant: cancer has spread from primary site to distant tissues or organs or to distant lymph nodes

Unknown: There is not enough information to determine the stage

Question 20

Tumor Grading

Answer 20

Gx: grade cannot be assessed
G1: well differentiated
G2: moderately differentiated
G3: poorly differentiated
G4: undifferentiated

Question 21

Oncogene

Answer 21

Oncogenes are what initiate cancer and the first example was v-Src

Question 22

Proto-oncogene

Answer 22

Gene that has the capacity to cause cancer but hasn’t yet

Question 23

Tumor suppressor

Answer 23

Some cancers form from the deletion or mutation of a single proton which is known as tumor suppressor and these tend to fun in families

Question 24

RB1

Answer 24

this is a tumor suppressor

Question 25

BRCA1 and BRCA2

Answer 25

These are tumor suppressor genes that encode for proteins invovled in the DNA repair

Question 26

How will genome sequencing change personalized cancer treatment

Answer 26

oncogenes show a better response to targeted therapies whereas tumor suppressors respond better to chemotherapies

Question 27

Importance of cell cycle in cancer chemotherapy

Answer 27

G1: Mitogentic signaling
- G1 is trageted by kinase inhibitors and hormone inhibitors
S: DNA replication
- Targeted by anti-metabolites, anti-folates, and topol inhibitores
G2: Sister chromatid seperation
- targeted by topo2 inhibitors
M: Chromosome segregation
- targeted by microtubule inhibitors

Question 28

Understand how chemotherapies target cancer growth and cancer survival

Answer 28

in cancer cells they have lost the checkpoints inbetween each cycle so when chemotherapy causes damage to the DNA in a normal cell it will stop and repair the damage, but in cancer cells they will continue on with the cycle even with the damage which eventually triggers apoptosis

Question 29

Kinetics of cancer cell proliferation (rate of tumor growth, growth fraction, doubling time) and kinetics of cancer cell killing by chemotherapy

Answer 29

Tumor cells have lost cell cycle control mechanisms and leads to increased cell proliferation and checkpoints in-between the stages of the cell cycle are often lost

Question 30

Major mechanisms of drug resistance in cancer chemotherapy

Answer 30

1. the cells increase efflux pumps which pushes the drug outside of the cell leaving the drug ineffective
2. reduce transport into the cell
3. decreased activation of prodrug
4. increased detoxification of drug molecule
5. can also increase amount of cell receptors so that the drug is unable to block all receptors and thus becomes less effective
6. can change the type of receptor which means the drug can no longer bind to the receptor

Question 31

Most common dose-limiting toxicities resulting from cancer chemotherapy

Answer 31

Hematopoietic - WBC - infections, platelets- hemostasis, RBC- anemia
nausea, vomiting, diarrhea, loss of appetite

Question 32

Principles of combination chemotherapy

Answer 32

it is impossible to kill all tumor cells with a single dose of drug
Giving dose dense and combination of drugs with distinct mechanisms has shown to improvement in treatment according to norton- simon hypothesis

Question 33

PARP inhibitors

Answer 33

Examples: Olaparib, rucaparib, niraparib, talazoparib, veliparib

These are used for cancers with BRCA1/2 mutations (tumor suppressor genes)

they work by trapping PARP to DNA which makes it unable to move to other damaged DNA and repair it which leads to buildup of damaged DNA and usually cell death in the cancer cell

Question 34

Chemotherapy that interferes with DNA synthesis is
A S-phase specific
B G1-phase specific
C cell cycle non-specific D M-phase specific

Answer 34

A. S-phase specific

Question 35

Which phase of the cell cycle do you think is targeted by Palbociclib (the CDK4/6 inhibitor)?
A. G1
B. S
C. G2
D. M

Answer 35

A. G1

Question 36

What is the most common reason for resistance to multiple chemotherapies at once?
A. Decreased activation of prodrugs
B. Drug transport out of cells
C. Cell cycle changes
D.Mutations in drug targets

Answer 36

B. Drug transport out of cells