Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MBD/MI (Wothaya) > Introduction To Hormone Dependant Cancers: Breast And Prostate Cancers > Flashcards

Introduction To Hormone Dependant Cancers: Breast And Prostate Cancers Flashcards

1
Q

What is a hormone?

A

Chemical messenger made by specialist cells and is released into the bloodstream to have an effect in another part of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where are hormones produced?

A 
Pineal gland
Hypothalamus
Pituitary
Thyroid
Thymus
Pancreas
Adrenal cortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the three groups of hormones?

A

Steroids
Peptide/proteins
Modified amino acids/amine hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are steroids synthesised from?

A

Cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where are the main corticosteroids and mineralocorticoids synthesised?

A

In the adrenal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are sex hormones responsible for?

A

Sexual dimorphism between males and females and development of secondary sexual characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the effects of female sex steroid hormones?

A

Oestrogen controls the menstrual cycle and breast tissue development, fertility and reproductive organ development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the effects of male sex steroid hormones?

A

Testosterone controls reproductive and supportive organs (prostate) and development of secondary characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why are breast/prostate cancer the most commonly diagnosed?

A

Tissues are hormone dependant

Steroids control several aspects of cellular proliferation, tissue function, gene expression and morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the steroid mechanism of action?

A

Enters cell and binds to cytoplasmic receptor

  • > Conformational change in the receptor -> dissociated from the cytoplasmic proteins and translocates into the nucleus
  • > receptor binds to DNA promoter regions and act as transcription factors and induces gene expression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the key characteristics of a nuclear receptor?

A

Ligand binding domain
DNA binding domain
Activation function domain
Ligand activated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the ligand binding domain of a nuclear receptor do?

A

Binds specific steroids with a high affinity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the DNA binding domain of a nuclear receptor do?

A

Binds specific DNA sequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the activation function domain of a nuclear receptor do?

A

Recruits gene activation machinery, some receptors have a secondary af2 domain towards the c-terminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does ligand binding to the ligand binding site cause?

A

A shift in the alpha helix, which activates the receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are hormone responsive genes controlled?

A

Up or down regulated by steroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are hormone response elements?

A

Specific DNA segments found in the promoters of hormone response genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are hormone response elements made up of?

A

6 bases, 3 spacer DNA bases, 6 bases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How many genes are contained in the nuclear receptor superfamily?

A

48

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do the nuclear receptor superfamily share?

A

Common domain receptor structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does the main steroid receptor depend on?

A

The thing they bind

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the mammary gland tissue composed of?

A

Glands and ducts that produce fatty breast milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the type of the gland that produces milk?

A

Apocrine gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the milk producing part of the breast organised into (and what are they called)?

A

15-20 sections called lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does milk travel through in the breast?

A

Networks of tiny tubules called ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does an exocrine gland do?

A

Secretes substances out onto a surface or cavity via a ductal structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does an endocrine gland do?

A

Secrete substances directly into the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is an apocrine gland?

A

Specialised exocrine gland in which a part of the cell’s cytoplasm breaks off, releasing the contents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the luminal structure of the mammary gland?

A

Form a single layer of polarised epithelium and the ductal lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do luminal cells produce (And when?)

A

Milk during lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the basal mammary gland tissue structure?

A

Comprise the cells that do not touch the lumen and basally orient the epithelial cells in contact with the basement membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the two major phases in mammary gland development and when do they happen?

A 
Hormone independant (embryonic -> puberty)
Hormone dependant (after puberty)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does hormone dependant mammary gland development cause?

A

Ductal elongation and side branching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In an adult what does estrogen allow for in the breast?

A

Maintenance of mammary gland tissue and primes it for the effects of progesterone during pregnancy for milk production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the etiology of breast cancer?

A 
Age (normally >50) 
Genetic mutations (BRCA1 and 2)
Reproductive history
Previous radiotherapy to the chest or breasts
Not physically active
Overweight
HRT for >5 yrs
Pregnancy after 30, not breastfeeding and never having a full term pregnancy
Drinking alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What facets of the reproductive history increase the chance of breast cancer?

A

Early menstrual cycle onset (<12)

Menopause >55

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What causes a ductal breast carcinoma in situ (DCIS)?

A

Cancer developing in ducts and staying there

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Why do the cancer cells not spread more in DCIS?

A

Not yet developed the ability to spread

39
Q

What is lobular breast carcinoma in situ?

A

Abnormal cells form in the milk glands

40
Q

Is lobular breast carcinoma in situ cancer?

A

No but indicates there could be an increased risk of its development

41
Q

What is the prognosis for estrogen and progesterone receptor positive cancers?

A

Good

42
Q

What is the prognosis for estrogen and progesterone receptor negative cancers?

A

Poor

43
Q

How are estrogen and progesterone receptor negative cancers treated?

A

Hormonally

44
Q

What happens when the estrogen receptor pathway is subverted?

A

ER’s ability to bind DNA and open chromatin is hijacked and used to transcribe many genes and RNAs

It then governs cancer cell proliferation

45
Q

What is fulvestrant?

A

Analogue of estradiol

46
Q

How does fulvestrant work?

A

Competitively inhibits binding of estradiol to the ER, with a binding affinity that is 89% that of estradiol

47
Q

What does the fulvestrant- ER complex do?

A

Impairs receptor dimerisation and energy dependant nucleo-cytoplasmic shuttling. This blocks nuclear localisation of the receptor

48
Q

How does tamoxifen work?

A

Binds to the ER at the ligand binding site

49
Q

Is tamoxifen an agonist or an antagonist?

A

Agonist in uterus but antagonist in breast tissue

50
Q

What happens to tamoxifen bound ER?

A

Doesnt fold properly and AF2 domains do not function,

51
Q

Where does estradiol normally bind to the ER?

A

Deep within a pocket in the receptor

52
Q

What happens when estradiol binds to ER?

A

Covered by a loop of protein chain, which is its active configuration

53
Q

How does tamoxifen affect the binding of estradiol to the ER?

A

Binds to the chain that covers bound estradiol cauing it to be too bulky to cover it, so it cant adopt its active conformation

54
Q

Where does estrogen come from in post-menopausal women?

A

Peripheral conversion of androgens by blood vessels

55
Q

Where is the aromatase enzyme present?

A

Adipose tissue, brain, blood vessels, skin, bone, endometrium and breast tissue

56
Q

What is a type 1 aromatase inhibitor?

A

Exemestane

Androgen analogue that binds nearby to aromatase

57
Q

What is an example of a type 1 aromatase inhibitor?

A

Exemestone

58
Q

What is the duration of type 1 aromatase inhibitor effect dependant on?

A

Rate of de novo aromatase synthesis

59
Q

What is an example of a type 2 aromatase inhibitor?

A

Mastozole

60
Q

What do type 2 aromatase inhibitors contain?

A

Functional group within the ring structure that binds to the haem iron of cytochrome P450

61
Q

What is the main function of normal prostate gland tissue?

A

Produce prostatic fluid that creates semen when mixed with the sperm produced by the testes

62
Q

What type of gland is a prostate gland?

A

Exocrine

63
Q

What are the steps in prostate development?

A

Hormone independant (embryo->puberty)
Englargement during puberty
Hormone dependant maintenance in adulthood
Reactivation of prostate growth in old age

64
Q

What is prostatitis?

A

Prostate inflammation due to infection

65
Q

What are the two types of dysregulated prostate growth?

A

Benign - benign prostatic hyperplasia

Malignant - prostate cancer

66
Q

What are the symptoms of prostate cancer?

A 
Frequent urination
Poor urinary stream
Urgent need to urinate
Hesitancy while urinating
Lower back pain
Blood in urine
67
Q

Where does prostate cancer start?

A

Luminal epithelium tissues

68
Q

What does hyperproliferation of the luminal epithelium cause?

A

Prostate intraepithelial neoplasia

69
Q

How can prostate cancer be detected?

A

Digital rectal examination
PSA test (prostate antigen blood test)
Ultrasound

70
Q

What are the classes of prostate cancer?

A

T1-4,
N0-3,
M1a-c

71
Q

What is a T1 tumour?

A

Small localised tumour

72
Q

What is a T2 tumour?

A

Palpable tumour

73
Q

What is a T3 tumour?

A

Escape from prostate gland

74
Q

What is a T4 tumour?

A

Local spread to pelvic region

75
Q

What is a N0 tumour?

A

No cancer in any lymph nodes

76
Q

What is a N1 tumour?

A

One positive lymph node <2cm big

77
Q

What is a N2 tumour?

A

> 1 positive lymph node or one 2-5 cm big

78
Q

What is a N3 tumour?

A

Any positive lymph node >5cm across

79
Q

What is a M1a tumour?

A

Non-regional lymph nodes

80
Q

What is a M1b tumour?

A

Bone

81
Q

What is a M1c tumour?

A

Other sites

82
Q

What is the gleason grading system used for?

A

To help evaluate the prognosis of men using prostate biopsy samples

83
Q

What are the stages in the gleason grading system?

A 
1- small, uniform glands
2- more stroma between glands
3- distinctly infiltrative margins
4- irregular masses of neoplastic glands
5- only occasional gland formation
84
Q

What are the treatments for prostate cancer?

A

Watchful waiting
Radical prostatectomy
Radical radiotherapy
Hormone therapy

85
Q

What are the risk factors for prostate cancer?

A 
Age
Ethnicity
Family history
Inherited BRCA1/2 gene
Men with lynch syndrome
Diet
Obesity
Chemical exposures
Inflammation of the prostate
STIs
86
Q

What is pten?

A

Phosphatase that antagonises the phosphatidylinositol 3-kinase signalling pathway

87
Q

What does loss of pten result in?

A

Increased growth function signalling

88
Q

How does TMP-RSS2 ERG fusion cause prostate cancers?

A

Androgen receptor drives proto-oncogene ERG which leads to inappropriate gene activation

89
Q

What does abiratrone acetate do?

A

Inhibits testosterone synthesis in the adrenal gland

90
Q

What are finasteride and dutasteride?

A

5 alpha reductase inhibitors

91
Q

What are some examples of anti-androgen drugs?

A

Bicalutamide
Enzalutamide
Flutamide
Nilutamide

92
Q

What are 5 alpha reductase inhibitors commonly used for?

A

Benign prostate hyperplasia

93
Q

What happens to hormone therapies over time?

A

Become less and less effective because cells develop mechanisms to overcome hormonal starvation

94
Q

What kind of mechanisms can tumours develop to overcome hormonal starvation?

A

Tumours start to synthesise their own steroid hormones
Mutations making ligand binding sites less specific
Receptor bypass
Receptor cofactor amplification
Antagonists become agonists via ligand binding domain mutations

MBD/MI (Wothaya) (57 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions