Introduction to clinical medicine: CARCINOGENESIS AND NEOPLASIA

Question 1

What is basal cell carcinoma

Answer 1

cancer of the skin, only invades local areas and does not spread to other parts of the body

Question 2

how do you cure basal cell carcinomas

Answer 2

complete local excision

Question 3

why does basal cell carcinoma not spread

Answer 3

the cells do not circulate round the body

Question 4

what is leukaemia

Answer 4

cancer of lymphocytes

Question 5

what is the difference between basal cell carcinoma and leukaemia

Answer 5

white blood cells can circulate around the body and spread

unlike other cancers that cause tumours, leukaemia is the over production of abnormal white blood cells that circulate instead of mass to form a tumour

Question 6

why can leukaemia be referred to of cancer of the bone marrow and blood

Answer 6

because WBC are made in the bone marrow and circulate in the blood

Question 7

which lymph node are breast cancer cells found to spread to

Answer 7

axillary lymph nodes under the arm

Question 8

what is a carcinoma`

Answer 8

a type of cancer that arises from the epithelial cell of the skin of the lining of the eternal organ (affects surfaces)

Question 9

define metastases

Answer 9

development of secondary malignant growth (separate from the primary site of cancer)

Question 10

give an example of where micro metastases may occur

Answer 10

detection of cancerous cells in axillary node under the arm from breast cancer

Question 11

how is micro metastases dealt with

Answer 11

Adjuvant therapy - extra treatment given after surgical excision

Question 12

name 2 types of chemotherapy

Answer 12

Conventional and targeted

Question 13

define carcinogenesis

Answer 13

transformation of normal cells to neoplastic cells through permanent genetic alternation/mutation

Question 14

name the classes of carcinogen (what may initiate cancer)

Answer 14

chemical
viral
ionising and non-ionising
hormone, parasites, mycotoxins
miscellaneous

Question 15

define neoplasm

Answer 15

A lesion resulting from the AUTONOMOUS (or relatively autonomous) ABNORMAL growth which PERSISTS after initiating stimulus has been removed (how you know its autonomous … a neoplasm)

Question 16

factors of neoplasia

Answer 16

new growth
autonomous
persistent
abnormal

Question 17

true or false: neoplastic cells derive from nucleated cells

Answer 17

True. this is why RBC cells can not go through neoplasm but their precursors do.

Question 18

what are the 2 mains structures of neoplasm

Answer 18

• neoplastic cell

- stroma

Question 19

why does the risk of a neoplasm increase with age

Answer 19

the more divisions a cell has gone through, the more likely it will go through a neoplastic transformation

Question 20

what is a malignant tumour

Answer 20

a tumour that invades surrounding tissues

Question 21

what is a benign tumour

Answer 21

a tumour that does not invade surrounding tissue

Question 22

what are some of the main differences between a malignant and benign tumour

Answer 22

benign tumours are slower in division - due to a a slower mitotic rate
benign tumours are exophytic whilst malignant tumours are endophytic
necrosis is rare in benign tumours and metastases never occurs, with the cells of a benign tumour looking like the normal surrounding tissues

Question 23

what are the classifications of tumour

Answer 23

benign epithelial
Malignant epithelial
Benign connective tissue
Malignant connective tissue

Question 24

what type of tumour is a PAPILLOMA

Answer 24

Benign epithelial tumour - non-glandular or non-secretory

Question 25

what type of tumour is a ADENOMA

Answer 25

Benign epithelial tumour - glandular or secretory

Question 26

what type of tumour is a CARCINOMA

Answer 26

Malignant epithelial tumour - non-glandular

Question 27

what type of tumour is a ADENOCARCINOMA

Answer 27

Malignant epithelial tumour - glandular

Question 28

define invasion

Answer 28

direct extension and penetration by cancer cells into neighbouring tissues

Question 29

define metastasis

Answer 29

secondary tumour

Question 30

what is the main treatment does to remove micro-metastasis

Answer 30

adjuvant therapy

Question 31

what is adjuvant therapy

Answer 31

follow up surgery or chemotherapy done to remove secondary tumours

Question 32

what 2 qualities are important in order for tumours to invade

Answer 32

invading cells need to be able to 'move through' and 'chew through' a basement membrane move - cell motility chew - enzymatic activity - e.g. proteases

Question 33

what are the 5 stages of metastasis

Answer 33

``` Intravasation Evasion host immune defence Extravasation Growth at the metastatic site Angiogenesis ```

Question 34

what is involved in intravasation

Answer 34

leaving the site of primary tumour. involves invasion of the cell membrane and cell motility

Question 35

what are the 3 methods cells use during avoidance of host immune defence

Answer 35

- Aggregation with platelets - hide within platelets - shedding of surface antigens - lymphocytes detect and attack these instead as they may be non self antigens - adhesion to other tumour cells - lymphocytes unable to digest cells within the clump of cells. protection

Question 36

how do cells know where to exit into tissues or lymph nodes (for example) during extravasion

Answer 36

it is believed they they detect receptors at secondary tumour site and adhesion occurs

Question 37

how are these cells able to grow

Answer 37

cancer has growth factors that promote the growth of further neoplastic cells, acting as a positive feedback loop

Question 38

name 2 things a cell produces to promote angiogenisis

Answer 38

vascular endothelial growth factor | basic fibroblast growth factor

Question 39

name 3 treatments that inhibit angiogenesis | possible treatment

Answer 39

angiostatin endostatin vasculostatin statins reduce levels of cholesterol in blood - which may prevent the build of particular components

Question 40

why would cells die if they were more than 1mm in thickness

Answer 40

it would be too deep for oxygen to pass through and provide to deeper cells, causing them to die